Probation Officers' Perceptions of Supervising Probationers with Mental Illness in Rural and Urban Settings

As part of a larger study of probation workload and workforce challenges in one southeastern state, this study reports the results from a statewide survey of probation officers’ experiences supervising probationers with mental illness. A total of 615 officers responded to closed- and open-ended questions about the challenges and barriers to supervising offenders with mental illness, and the responses of officers from rural versus urban settings were compared. Officers reported that probationers with mental illness are difficult to supervise and supervision challenges are exacerbated by a scarcity of mental health and substance abuse treatment resources, limited social support, and a lack of employment opportunities for this population of probationers. Officers report unique and similar challenges across rural and urban settings. This study contributes to our understanding of the challenges of supervising probationers with mental illness and informs practice, policy and research at the interface of the criminal justice and mental health systems

Intimate Partner Violence and Women with Severe Mental Illnesses: Needs and Challenges from the Perspectives of Behavioral Health and Domestic Violence Service Providers

Women with severe mental illnesses face high rates of violence victimization, yet little is understood about the unique needs and challenges these women present to the domestic violence and behavioral health agencies that serve them. To help address this knowledge gap, focus groups were conducted with 28 staff members from local behavioral health and domestic violence service agencies. Results from this exploratory study suggest that women with severe mental illnesses who experience intimate partner violence face additional challenges that exacerbate behavioral health and domestic violence issues and put these women at greater risk for continued victimization. DV and behavioral health agency staff experience individual-, provider-, and system-level barriers to serving this high-risk, high-need population. Recommendations and implications for domestic violence and behavioral health providers are discussed

Using statewide administrative data and brief mental health screening to estimate the prevalence of mental illness among probationers

There is little published information about the measures that probation agencies in the United States use to identify individuals with mental illnesses who are under community supervision. This study used statewide administrative data to estimate and compare the prevalence of mental illnesses among probationers using officer report and offender self-report data. Prevalence estimates of mental illnesses ranged from 15 percent to 19 percent, which is consistent with prior studies that used formal diagnostic assessments. In the absence of costly and time-consuming diagnostic assessments, probation agency-developed mental health scales can aid in identifying those who might be in need of additional mental health assessment

Using the Consolidated Framework for Implementation Research to examine implementation determinants of specialty mental health probation

Background Specialty mental health probation (SMHP) is designed to improve outcomes for the large number of people with serious mental illnesses who are on probation and/or parole. The evidence for specialty mental health probation is promising; however, little is known about the implementation challenges and facilitators associated with SMHP. To address this gap, we used the consolidated framework for implementation research (CFIR) to analyze 26 interviews with stakeholders representing multiple agencies involved in the implementation of SMHP. Results Results indicate a number of challenges and facilitators related to the inner setting, outer setting, implementation process, and characteristics of individuals. Conclusions Findings suggest that complex and cross-sectoral interventions are context-dependent and introduce a number of challenges and facilitators related to multiple CFIR domains. Consequently, agency administrators implementing these types of interventions should consider small pilot studies and develop implementation strategies tailored to the local implementation context

Intimate partner violence and sexual assault among women with serious mental illness: A review of prevalence and risk factors

As compared with the general population, women with serious mental illness experience higher rates of intimate partner violence, sexual assault, and are at a greater risk of future victimization, post-traumatic stress disorder, exacerbated symptoms of mental illness, and other negative health outcomes. Despite substantial research, the field lacks clear, consistent guidance for intervention development. To this end, this review aims to move the field beyond its focus on prevalence by providing a comprehensive and concise summary that compares and assesses the findings, quality, and scope of 10 systematic reviews (reviewing 168 studies) pertaining to prevalence and risk factors of intimate partner violence and/or sexual assault among women with serious mental illness

Statewide mental health training for probation officers: improving knowledge and decreasing stigma

Abstract Background The large and growing number of probationers with mental illnesses pose significant challenges to the probationer officers who supervise them. Stigma towards mental illnesses among probation officers is largely unstudied and the effectiveness of training initiatives designed to educate probation officers about mental illness is unknown. To address these gaps in the literature, we report findings from a statewide mental health training initiative designed to improve probation officers’ knowledge of mental illnesses. A single-group pretest posttest design was used and data about stigma towards mental illnesses and knowledge of mental illnesses were collected from 316 probation officers. Data were collected prior to and shortly after officers viewed a series of educational training modules about mental illnesses. Results Officers’ knowledge of mental illnesses increased and officers demonstrated lower levels of stigma towards persons with mental illnesses as evidenced by scores on a standardized scale. Conclusion Mental health education can help decrease stigma and increase knowledge of mental illnesses among probation officers. More research is needed to assess the impact of these trainings on probationers’ mental health and criminal justice outcomes

The application of implementation science methods in correctional health intervention research: a systematic review

Abstract Background Improving access to high-quality healthcare for individuals in correctional settings is critical to advancing health equity in the United States. Compared to the general population, criminal-legal involved individuals experience higher rates of chronic health conditions and poorer health outcomes. Implementation science frameworks and strategies offer useful tools to integrate health interventions into criminal-legal settings and to improve care. A review of implementation science in criminal-legal settings to date is necessary to advance future applications. This systematic review summarizes research that has harnessed implementation science to promote the uptake of effective health interventions in adult criminal-legal settings. Methods A systematic review of seven databases (Academic Search Premier, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Social Work Abstracts, ProQuest Criminal Justice Database, ProQuest Sociological Abstracts, MEDLINE/PubMed) was conducted. Eligible studies used an implementation science framework to assess implementation outcomes, determinants, and/or implementation strategies in adult criminal-legal settings. Qualitative synthesis was used to extract and summarize settings, study designs, sample characteristics, methods, and application of implementation science methods. Implementation strategies were further analyzed using the Pragmatic Implementation Reporting Tool. Results Twenty-four studies met inclusion criteria. Studies implemented interventions to address infectious diseases (n=9), substance use (n=6), mental health (n=5), co-occurring substance use and mental health (n=2), or other health conditions (n=2). Studies varied in their operationalization and description of guiding implementation frameworks/taxonomies. Sixteen studies reported implementation determinants and 12 studies measured implementation outcomes, with acceptability (n=5), feasibility (n=3), and reach (n=2) commonly assessed. Six studies tested implementation strategies. Systematic review results were used to generate recommendations for improving implementation success in criminal-legal contexts. Conclusions The focus on implementation determinants in correctional health studies reflects the need to tailor implementation efforts to complex organizational and inter-agency contexts. Future studies should investigate policy factors that influence implementation success, design, and test implementation strategies tailored to determinants, and investigate a wider array of implementation outcomes relevant to criminal-legal settings, health interventions relevant to adult and juvenile populations, and health equity outcomes. Trial registration A study protocol (CRD42020114111) was registered with Prospero

Intimate Partner Violence and Women with Severe Mental Illnesses: Needs and Challenges from the Perspectives of Behavioral Health and Domestic Violence Service Providers

Women with severe mental illnesses face high rates of violence victimization, yet little is understood about the unique needs and challenges these women present to the domestic violence and behavioral health agencies that serve them. To help address this knowledge gap, focus groups were conducted with 28 staff members from local behavioral health and domestic violence service agencies. Results from this exploratory study suggest that women with severe mental illnesses who experience intimate partner violence face additional challenges that exacerbate behavioral health and domestic violence issues and put these women at greater risk for continued victimization. DV and behavioral health agency staff experience individual-, provider-, and system-level barriers to serving this high-risk, high-need population. Recommendations and implications for domestic violence and behavioral health providers are discussed