Op-Ed

Mental illness, substance abuse a toxic mix

Programs at Whatcom County Jail, in downtown Bellingham, were discussed at the March 19 League of Women Voters of Bellingham & Whatcom County’s “Mental Health & the Whatcom County Jail: Where are We Going?” program.
Programs at Whatcom County Jail, in downtown Bellingham, were discussed at the March 19 League of Women Voters of Bellingham & Whatcom County’s “Mental Health & the Whatcom County Jail: Where are We Going?” program. eabell@bhamherald.com

Last of a series adapted from presentations given March 19 at the League of Women Voters of Bellingham & Whatcom County’s “Mental Health & the Whatcom County Jail: Where are We Going?” program.

When we talk about mental illness and the criminal justice system, things start to get complicated. We hear that our jails and prisons have a higher percentage of people with mental illness than our general population. We know that people with mental illness tend to stay in jail for longer periods of time. We know that inmates suffering from acute symptoms of mental illness may be placed in special housing areas of the jail for their safety and the safety of others. And we know that special housing is typically segregated from the general population and may be detrimental to one’s mental wellness. To state the obvious, these are clearly significant concerns.

Behavioral health disorders are not the main cause of criminal behavior.

But what caused the arrest and booking into jail in the first place? Did the mental illness drive the criminal behavior? Research tells us that mental illness rarely drives criminal behavior. Only a small fraction of those booked into jail committed their alleged crimes solely as a direct result of their mental illness. Studies bear this out time and again. However, when substance use disorders co-exist with mental illness, individuals are three times more likely to engage in behaviors that land them in jail.

Mental illness and addiction, known collectively as behavioral health disorders, are equal opportunists — they can affect anyone regardless of wealth or poverty, race, age or country of origin. They share some common characteristics. Both impact a person’s brain, thereby negatively affecting thinking and judgment, decision-making, learning, mood, social interactions and even daily functioning.

These negative effects may make a person more vulnerable to the risk factors that cause criminal behavior. To be clear, behavioral health disorders are not the main cause of criminal behavior. Then what does drive criminal behavior? As you can envision, much research has been conducted in this field as well.

Risk factors

Eight “criminogenic” risk factors have been identified through this research. The “big four” have been shown to be predictive of future criminal behavior. The first factor is “criminal history.” The earlier one begins to engage in anti-social acts and the longer one engages in them, the more likely that person is to continue. Their risk of criminal thinking and behavior increases.

The second criminogenic risk factor is “anti-social patterns of behavior.” These behaviors take the form of impulsivity and low self-control, irritability, risk-taking, pleasure-seeking and restless aggression, to name a few. We all may exhibit these at some point, but the difference in risk for further criminal behavior lies in the ongoing pattern of these behaviors.

The third risk factor is “anti-social thinking and attitudes.” These are detected in features like a sense of entitlement, rationalizing criminal acts, minimizing the impact of the criminal acts, denial of responsibility, and a lack of empathy toward other humans.

The fourth risk factor predictive of future criminal behavior is “criminal associates.” Isolation from pro-social peers and reinforcement of a criminal lifestyle from “friends” supports the continuation of crime.

While these four factors are predictive of criminal behavior, four more are associated with it. They include “substance abuse,” “dysfunctional family/marital relationships,” “poor work or school performance” and a “lack of pro-social recreational activities.” Imagine how intoxication clouds thinking and judgment. Low satisfaction in one’s work or school challenges a person’s ability to feel his/her worth. Never experiencing a healthy family life deprives a person of positive role models who display respect and love for another. And spending one’s leisure time engaged in non-productive activity robs a person of opportunities to socialize in beneficial ways.

How do these eight criminogenic risk factors relate to our understanding of mental illness and the criminal justice system? Simply put, this research has dramatically changed our way of thinking. The salient point is this: the factors that lead to criminal behavior are the same for people with behavioral health disorders as for those without!

Crime reduction

This revealing truth affirms that treatment alone is not effective in reducing crime or recidivism.

A person may have a mental illness, but if s/he is firmly rooted in criminal thinking and behavior, we can’t assume that treatment will have a positive impact on the criminogenic risk factors. Indeed, it doesn’t. Effective interventions must include the focus on changing criminogenic thinking and behavior.

The criminal justice diversion programs that we have implemented address these risk factors. We have developed these programs along a continuum that allow us to intervene before arrest, while incarcerated, as well as upon re-entry to the community. Wherever we first “meet” someone involved in the criminal justice system, we want to provide an effective intervention to change their trajectory toward a crime-free life.

For those individuals in the criminal justice system who are living with mental illness, we also provide treatment. Behavioral health disorders can be debilitating. Treatment works. When mental illness is well-managed, people are afforded the ability to benefit from programs that reduce their criminogenic risk. Once criminogenic risk is effectively addressed, perhaps then we will see a decrease in the number of people with mental illness in our criminal justice system.

Anne Deacon is human services manager for the Whatcom County Health Department.

Related stories from Bellingham Herald

  Comments