Mental Health Practice in Criminal Justice Systems

Forensic Occupational Therapy

The application of mental health specialty practice within the criminal justice
system

Commonly Reported Disorders in Criminal Justice System

Depression

Bipolar Disorder

Anxiety Disorder

Post Traumatic stress disorder (PTSD)

Personality disorder

Schizophrenia

Criminal Justice System Environment

Legislators

Courts

• Problem solving courts

• Mental Health courts

• Veteran treatment courts

Diversion

Correctional Institution Knowledge

Need to have a working knowledge of the basic
sequence of events from arrest through conviction, sentencing, and release. If the adjudication process results in a conviction, a judge imposes a sentence that may include incarceration, or it can be a non-custodial sentence (i.e., a penalty other than incarceration)

Incarceration

Maintains secure control of a person and deprives the person of certain liberties and occupations

Noncustodial Sentence

Restitution - compensation for their criminal behavior

Probation - court-defined directives that impact participation in occupations or environments

Prisons

Secure institutions that confine offenders who, in general, have been convicted of a felony and have been sentenced to at least 1 year of incarceration.
• Larger, more stable environments
• Classified by level of security
• Security as high, medium, low, and minimum security. Security features include armed external patrols, security towers, fences and other security barriers, electronic detection devices, and staff-to-prisoner ratios.
• Prisons are mandated to provide a basic level of psychiatric service, including screening, assessment, referral, evaluation, intervention, and community reentry planning

Jails

Smaller than prisons
• Sentences usually 1 year or less
• This creates an environment where there is a steady stream of family members, visitors, and legal, social, and faith-based human service personnel moving in and out of jails, all of whom must adhere to visitation protocols and are subjected to security

Secure Psychiatric Hospitals

Facilities that evaluate, treat, and rehabilitate individuals with
mental illnesses who have entered the criminal justice system or
those who, because of their conditions, are considered unfit for
trial or are deemed not criminally responsible (NGRI)

• Dual responsibility to treat mental illness and address individual’s offense

Community Based Justice Settings

Residential or nonresidential community-based programs
• May be an alternative to incarceration or occur directly before or upon release
• Community-based correction settings can be a heterogeneous mix of programs developed to serve the needs of varied populations

Residential Reentry Centers

Assist residents with reintegration planning, job placement, and financial management; help them to locate permanent housing; and connect residents with an array of community services that can support their recovery and return to the community

• Not specifically designed to address unique needs of a person with mental illness

Community Based Programs: Criminal Justice

This includes programs addressing the needs of those who are at-risk of entering or re-entering criminal justice settings. Funding for these programs may come from a variety of public and private sources.

Eval and Assessments: Justice Systems

UK practitioners overwhelmingly use assessments based in MOHO
• MOHO screening tool
• Assessment of motor and process skills (AMPS) (RIP?)
• Assessment of communication and interaction skills (ACIS)
• Occupational therapy task observation scale
• Allen cognitive level screen (ACLS)

Interviews: Occupational Justice

Occupational Circumstances Assessment Interview and Rating Scale
(OCAIRS)
• Based on MOHO
• Modified for forensic setting
• Kawa model interview process
• Offender Reintegration Scale (ORS)
• Self-report tool

OT Interventions: Justice Systems

Skill development

Relapse prevention

Community reintegration

Primary vocational skills - employment

Time management

Self awareness

Leisure and life skills

Role functioning