By Mai P. Tran
The American Bar Association (ABA) and American Psychological Association (APA) recently co-hosted the ABA-APA National Conference, “Confronting Family and Community Violence,” bringing together experts and professionals in the fields of psychology, law, and public policy, to discuss issues related to the exposure of violence to children, youth, and their families. At the May conference, attendees shared information, research, and strategies to promote how law and psychology can address the effects of violence.
David D’Amora from the Council of State Governments Justice Center (CSG) and Dr. Eric B. Elbogen from the University of North Carolina (UNC) School of Medicine co-presented in the session, Addressing the Role of Factors that May Contribute to Violence: Mental Illness and Substance Abuse. They discussed current research and practices related to the interplay of mental illness, substance use and violence, as well as research that supports effective reentry programs and practices for individuals with behavioral health disorders.
Dr. Elbogen, a forensic psychologist and UNC associate professor, discussed the relationship between mental illness, substance abuse, and violent offending, and whether the former two are known to cause violence. In his presentation, Dr. Elbogen challenged the common perception that mental illness is a leading cause of violence. “While virtually every study has shown that substance abuse leads to the increased risk of violence,” he said, “the real debate is: Is there a link between mental illness and violence?”
Citing data from the National Epidemiologic Survey on Alcohol and Related Conditions, Dr. Elbogen notes that while there is some evidence that shows a relationship, the answer is not simple: while severe mental illness (SMI) is a predictor of violence, it is the weakest predictor among other risk factors such as age, gender, substance abuse, education level, employment status, and more. “Mental illness may just be a proxy for other risk factors,” Dr. Elbogen said. “It is too bad is that in the media this kind of information does not get portrayed. Instead, between fifty and sixty percent of news articles in American and European countries portray mentally ill individuals as violent.”
In addition, findings from the survey also revealed a high prevalence of substance use and dependence among individuals with SMI. Data also show that individuals in this group have a higher risk for violence than individuals who have substance use disorder/dependence without SMI. “The results point to the need for integrated treatment for mental health and substance use disorders,” Dr. Elbogen said.
Following Dr. Elbogen’s presentation, David D’Amora, Director of the National Initiatives Division of the CSG Justice Center, presented on principles of the Risk-Need-Responsivity (RNR) model, and how these principles can be applied to create effective reentry programs and practices.
Research shows that delivering services that incorporate RNR principles—which target each individual’s risk for future criminal behavior, criminogenic needs (changeable factors related to recidivism), and responsivity factors (maximizing the individual’s ability to learn new thinking and behaviors)—maximizes the benefits of effective treatment and services. “Individuals with mental disorders are more likely to remain mired in the criminal justice system because we don’t do a good job focusing our resources on high-risk individuals,” said Mr. D’Amora. When all individuals get the same type and level of treatment, he says, these “low-risk folks often get more treatment than they need, while the high-risk folks don’t get what they need.”
In addition, research shows that targeting criminogenic need is critical to successful treatment. Mr. D’Amora listed examples of antisocial behavior, antisocial thinking, association with criminogenic peers, and substance use. “Interventions should also be workable for folks with mental illness,” he said. “Many fail under supervision because they were put into programs that weren’t designed to work for people with mental illness, or they were put into the right programs, but not at the right time. ”
Mr. D’Amora also presented the Criminogenic Risk and Behavioral Health Needs Framework, introduced in the Justice Center’s 2012 report, Adults with Behavioral Health Needs Under Correctional Supervision: A Shared Framework for Reducing Recidivism and Promoting Recovery. The evidence-based framework is a structure for state and local agencies to build collaborative responses that integrate an individual’s risk of criminal activity, substance abuse treatment needs, and and mental health treatment needs, while also prioritizing the use of scarce resources.
Keynote addresses were delivered by Robert L. Listenbee, Administrator of the Department of Justice’s Office of Juvenile Justice and Delinquency Prevention, and Dr. Robert D. Macy, Founder and President of the International Trauma Center.
To view more information about the conference, click here.
To learn more about the principles of RNR, and to view the report, Adults with Behavioral Health Needs Under Correctional Supervision, click here.