Criminalization of the Mentally Ill
Virginia Aldige Hiday
Handbook for the Study of Mental Health: Social Contexts,
Theories, and Systems Edited by ALLAN V. HORWITZ and TERESA L.
SCHEID copyright Cambridge University Press 1999
may resort to arrest even when treatment is clearly needed.
Teplin (1984a,b) found that Chicago police arrested mentally
ill persons when treatment was preferable in cases of deviant
behavior that were so public and visible as to exceed the
limits of tolerance, and when deviant behavior was likely to
continue, proliferate, and require later police intervention
if the person were not removed from the site. Police also
resorted to arrest when treatment facilities refused to accept
a mentally disordered individual. Psychiatric staff, in
attempting to control their work environment, commonly refuse
persons with criminal charges or criminal records and persons
with substance abuse comorbidity. Substance abuse facility
staff likewise refuse substance abusers with comorbid mental
illness, leaving police with little choice but arrest (Teplin
1984b, 1985). Ironically, police sometimes resort to arrest
when psychiatric emergency staff turn down mentally disordered
persons who are neither sick enough nor dangerous enough to
meet civil commitment criteria for involuntary hospitalization
(Steadman et al.1986).
Ill Persons Arrested
than criminalization of the mentally ill, higher arrest rates
of former mental patients may result from another trend, the
medicalization of deviance, in particular the trend to
hospitalize substance abusers and persons with antisocial
personality (ASP) (Kittrie 1971; Steadman et al.1978; Stone
group of mentally ill persons that appears to have a high rate
of arrests is the homeless mentally ill (Belcher 1988;
Crystal, Ladner, & Towber 1986; Fischer 1988; Martell,
Rosner, & Harmon 1995; Morse & Calsyn 1986). Although
the public has been greatly concerned with the criminal
behavior of homeless mentally ill persons, little empirical
research has been directed to the criminalization of the
mentally ill via homelessness. Two studies of temporary
housing and shelter residents in New York and St. Louis
reported that almost half of mentally disordered persons
(broadly defined) had been arrested (Morse & Calsyn 1986)
or jailed (Crystal et al. 1986); however, because a broad
definition of mental illness can encompass substance abuse and
situational depression and anxiety, one must be careful in
generalizing these results to persons with severe mental
illness. One in-depth study of persons with major mental
disorders who became homeless shortly after hospital discharge
to a Midwestern city found that 64% were arrested (Belcher
1988). Those arrested who self-medicated with alcohol and
street drugs (rather than taking their prescribed medication)
became increasingly impaired in cognitive and social
functioning, wandered aimlessly, appeared psychotic much of
the time, and manifested bizarre and often threatening
behaviors in public places (Belcher 1988).
of the Mentally Ill
second belief linking mental illness and the criminal justice
system is that mentally ill persons are dangerous and likely
to commit crimes, especially violent crimes. Going back at
least to the Greco-Roman period, the public has believed that
a disproportionate number of the mentally ill were
unpredictable and dangerous (Monahan 1992; Rosen 1968). This
belief is reinforced today in fiction and human interest news
stories (Gerbner et al.1981; Steadman & Cocozza 1978). The
frenzied madman, the "psycho" who is driven to harm
others, and the delusional paranoid who unexpectedly and
randomly kills are regular grist for television and motion
picture studios as well as features for the news media (Wahl
criminalization (which holds society responsible for
processing the mentally ill through the criminal justice
system instead of treating them more humanely with mental
health and social services), the criminality thesis blames
mental illness for behavior that the criminal justice system
must control. Indeed, the legal verdict of NGRI is premised on
the understanding that mental illness can make an individual
insane -- that is, it can override an individual's ability to
control criminal behavior. To evaluate the criminality of the
mentally ill, researchers have looked to arrest rates and
incarceration surveys and have examined data on dangerous
behavior that is not punished or treated by the criminal
observers have cited the previously discussed higher arrest
and incarceration rates of mentally disordered persons as
evidence supporting the criminality (instead of
criminalization) of the mentally ill (Hodgins 1995; Rabkin
1979; Sosowsky 1980). If the criminality concept is correct --
that is, if mentally ill persons are more dangerous -- then
they should be arrested predominantly for violent behavior
that threatens or brings physical harm to others. However,
most studies find the distribution of offenses for mental
patients to be similar to that of the general population: most
arrests are for misdemeanors (83% for mental patients, 75% for
the general population) rather than felonies (Schuerman &
Kobrin 1984); most are for less serious offenses (75% for
mental patients, 84% for general population) rather than for
the more serious FBI "index" crimes (Hiday 1992b). A
minority of offenses of mentally ill persons are violent; few
(either absolutely or proportionately) are arrested for the
violent crimes the public most fears: murder, rape, aggravated
assault, and arson (Bloom, Williams, & Bigelow 1992; Feder
1991; Harry & Steadman 1988; Hiday 1991, 1992b; Holcomb
& Ahr 1988; Teplin 1994). A Milwaukee study of persons
artested for deadly and dangerous crimes against others found
no support for the stereotypical madman violently out of
control (Steury & Choinski 1995). Even homeless, severely
mentally ill persons, whose homelessness puts them most at
risk of arrest, are arrested predominantly for nonviolent
crimes (Belcher 1988; Fischer 1988). Remember, with the same
distribution of offenses as the general population, mentally
ill persons will have higher arrest rates for violent crime
because of their higher overall arrest rates. Thus, several
studies report that mental patients are more likely to be
arrested for violent offenses than nonpatients in the same
community (Hodgins 1992, 1993; Link, Andrews, & Cullen
order to address the question of the criminality of the
mentally ill, we must be able to ascertain whether mental
illness causes the violent crime or whether coincidental
factors are causal. Robins (1993) reported that the
association between crime and major mental illness in the ECA
data completely disappeared when controls were placed for age,
gender, ASP adult symptoms, childhood conduct disorder
symptoms (generally considered integral to ASP diagnosis), and
substance abuse. She concluded that the association of major
mental illness with crime is not direct but occurs when severe
mental illness is secondary to ASP and substance abuse.
Recidivism studies that compare disordered to nondisordered
offenders' arrests after imprisonment also fail to find severe
mental illness to be the causal factor in crime and violence.
Among Teplin's (1990a) jail detainees, severe mental illness
did not predict the probability of arrest or the number of
arrests for violent crime over a three-year or a six-year
postrelease period:(Teplin, Abram, & McClelland 1994;
Teplin, McClelland, & Abram 1993). Among a sample of
offenders admitted to a maximum security forensic institution
for competency assessment, four fifths of whom had at least
one violent offense, schizophrenia was negatively associated
with violent recidivism over an eight-year mean risk period
(Rice & Harris 1995). Psychopathy and alcohol abuse were
the factors that placed this sample of offenders at high risk
for violent recidivism. In a study.examining only
schizophrenic defendants who were evaluated in.a forensic
psychiatric hospital, Rice and Harris (1992) found the
predictors of both general and violent recidivism to be the
same as those that predict recidivism for nondisordered
offenders: prior offenses and aggressive behavior, age,
alcohol abuse, and psychopathy (Harris, Rice, & Cormier
of legal records for involuntary hospitalization and of
medical records of both voluntary and involuntary hospital
admissions indicate that mental patients often are
hospitalized because of dangerous behavior. Depending on the
definition used, rates of violence toward others vary.
Definitions restricted to threats of physical harm and
physical assaults yield lower rates than definitions including
loss of impulse control, hostile verbalizations, and thoughts
of harming others physically (Hiday 1988). By the more
restrictive definition of physical assault, studies report
between 10% and 40% of persons admitted to mental hospitals
are violent in the community in the weeks immediately prior to
hospitalization (Monahan 1992). However, one must use caution
in measuring violence mentioned in admission records, because
physicians and families may use allegations of dangerousness
to obtain admission for a person they think is in need of
hospital treatment, given that mental hospitalization is now
often limited to those who are dangerous (Hiday 1988; Miller
1987). As a result, court hearings often find that allegations
of violence in commitment petitions and medical records cannot
be substantiated (Hiday & Markell 1981; Warren 1977,
epidemiological studies, which avoid the aforementioned
problems, have shown that most mentally ill are not violent,
that only a small minority with severe mental illness commit
any violent act in a year's time, but that their low rate is
higher than what is found among those with no mental illness
(Link et al.1992; Link & Stueve 1994; Swanson 1994;
Swanson et al. 1990). These findings held with controls for
age, gender, and socioeconomic status. Further analysis in one
sample showed that substance abuse or dependence comorbidity
greatly raised the violence rate above that for severe mental
illness alone (Swanson 1994; Swanson et al.1990). In the other
sample, psychotic symptoms -- especially those that produce
feelings of personal threat or involve intrusion of thoughts
that can override self-control -- accounted for all violence
differences with the nondisordered (Link et al.1992; Link
& Stueve 1994). Three other studies also support the
finding that active symptoms of psychosis are predictive of
violent behavior (McNiel & Binder 1994; Mulvey et al.
1996; Swanson et al. 1996). But it must be emphasized that,
although these findings are significant, only a small
proportion of persons with severe mental illness and active
psychotic symptoms become violent. Traits that are far more
predictive of violence than mental illness include being
single, a young adult, male, of low socioeconomic status, and
a substance abuser (Hiday 1995; Link et al.1992; Monahan
Mentally Ill in the Criminal Justice System
have seen that the mentally ill are more likely to be detected
when they commit an offense and more likely to be arrested
during encounters with police than are persons without mental
disorders. Are they also differentially handled once they
enter the criminal justice system?
on our society's moral values, legal advocacy system, and
presumptions about voluntary behavior, the law provides for
different processing when a defendant's mental status impairs
his or her capacity to meet the assumptions underlying legal
procedures. The law holds that, to be found guilty of a crime
and punished for it, a person must be blameworthy - that is,
able to choose rationally to commit the offense.
public's concern about "coddling" and subsequent
release of NGRI offenders into the community seems to be
unwarranted. ... Although results are mixed across
jurisdictions and time as to whether NGRI acquittees serve
longer confinements than comparable offenders (Sales &
Hafemeister 1984; Silver 1995), unsuccessful NGRI defendants
have been found to have longer detention times than convicted
felons who did not raise the insanity defense (Braff,
Arvinites, & Steadman 1983).
the public and the law give much attention to incompetent and
insanity defendants, only a small proportion of offenders with
major mental illness are evaluated for IST and an even smaller
proportion raise the insanity defense. Most mentally ill
offenders go undetected during pretrial and adjudication
stages and proceed through conviction to imprisonment (Freeman
& Roesch 1989; Marques et al.1993; Teplin l990b; Wack
1993). These legally "fit and sane" mentally ill
detainees and prison inmates constitute a minority who serve
longer incarceration times than nonmentally ill offenders,
require significant management attention by correctional
authorities (Kropp et al. 1989), and need mental health
services (Dvoskin & Steadman 1989). They are more likely
to be held in custody awaiting trial because of denial of
bail, and this "dead time" commonly exceeds the
length of sentence ordered for the substantive offense
(Freeman & Roesch 1989). Once imprisoned, they are more
likely to be denied parole and to serve a greater proportion
of their maximum sentences, in large part because parole
boards find few community programs willing to service and
supervise offenders with mental illness (Feder 1994; Porporino
& Motiuk 1995). Community agencies frequently refuse to
take mental patients with criminal records into their
programs, causing mentally ill offenders to be detained longer
(once imprisoned) than nondisordered offenders (Feder 1994;
Porporino & Motiuk 1995).
mentally ill offenders are never incarcerated or are held only
a short time before diversion out of the legal system.
Pretrial diversion programs began during the 1960s when minor
cases increasingly clogged courts, and popular rehabilitative
and therapeutic philosophies encouraged their use (Kittrie
1971; LaFond & Durham 1992; Roesch & Corrado 1983;
Roesch et al.1995). Initially, courts relied on informal
arrangements with other community agencies, but they soon
established many formal diversion programs to turn minor
offenders into law-abiding citizens (Roesch et al. 1995).
programs are also used for mentally ill offenders to prevent
disruption in the antitherapeutic, crowded, noisy cell blocks
of jails (Kropp et al.1989; Steadman et al.1989,1995). Often,
the diversion is ad hoc and passive rather than programmatic;
that is, court officers merely drop charges and dismiss a case
when they learn that the mental health system is treating the
defendant's mental illness (Hiday 1991; McFarland et al.1989;
Steadman et al.1989). Formal diversion programs, run mostly by
the larger jails, consist of: initial screening of all
detainees; evaluation of possible cases by mental health
professionals; negotiation with court officers and community
mental health providers to agree on a treatment or service
instead of prosecution, or as a condition of reduction in
charges; and, finally, referral to the treatment or service
itself for residential placement, outpatient treatment, and
case management (Steadman et al. 1995). Unfortunately, few of
the formal programs have specific follow-up procedures once
initial placements are made.
Tenure and Management
mentally ill inmates are released from imprisonment or from
forensic commitment to a psychiatric facility, mental health
treatment is often a condition of probation or parole. But
mental health services seldom exist for severely disordered
persons with antisocial and substance abusing behaviors, and
too often mental health practitioners do not want to engage
such persons with criminal records (Draine & Solomon 1992;
Freeman & Roesch 1989; McFarland et al.1989; McMain et
al.1989). The lack of services for mentally ill offenders in
the community and their depressing and unstable living
situations -- along with their comorbidities -- lead to a
strong likelihood of re-arrest, ranging from 24% to 56% (Bieber
et al. 1988; Corrado, Doherty, & Glackman 1989; Draine et
al. 1994). However, they are neither more criminal nor more
violent than released nondisordered offenders (Feder 1991;
Teplin et al. 1993, 1994). Mentally ill persons are also
likely to be rehospitalized in psychiatric institutions
following criminal justice release. The extensive follow-up
study of the Metropolitan Toronto Forensic Service reported
that the overwhelming majority of patients have repetitive
cycles of institutionalization in both hospitals and prisons (McMain
et al.1989; Menzies et al.1994).
break the cycles of institutionalization and to protect
society from both feared and actual violent behavior, some
observers have called for an assertive case management model
for this population (Draine & Soloman 1994; Dvoskin &
Steadman 1994). Assertive case management, which has
successfully aided community adjustment of chronically
mentally ill patients discharged from mental hospitals, uses
case management teams to work intensively with individual
clients in obtaining services, resources, and social support
such as medication, therapy, housing, and financial assistance
(Stein & Test 1985). For mentally ill offenders,
establishment of a therapeutic relationship along with
assessment and planning begin with the inmate in the prison or
forensic unit during the month before discharge. Thereafter,
most case management occurs out of the office on the streets
and is available after normal work hours, when these clients
are likely to get in trouble. Careful monitoring is employed;
probation and parole officers become treatment allies, and
case management continues into the criminal justice system
when a client is jailed (Dvoskin & Steadman 1994; Steadman
et al. 1989, 1995). Only two studies have evaluated assertive
case management programs with mentally disordered offenders.
Both offer preliminary support for its usefulness. The
Vancouver program reported that clients had more community
time before reconviction (271 vs. 120 days) and fewer days in
correctional facilities (80 vs. 214 days) than a comparison
group of released mentally disordered offenders (Wilson, Tien,
& Eaves 1995). Dvoskin and Steadman (1994) reported that
75% of mentally ill offenders in a Texas program had no
arrests after one year of program entry, 92% did not return to
state prison, and 80% of those on parole had no parole
is no doubt that the criminal justice system deals with a
significant number of mentally ill persons on the street, and
that it processes and holds a significant number in its
correctional and forensic facilities. But whether there has
been a criminalization of the mentally ill since
deinstitutionalization became public policy cannot be answered
definitively because necessary longitudinal data do not exist.
Whether mentally ill persons are dangerous and likely to
commit crimes -- that is, whether mental illness causes
criminality -- remains uncertain.
reading of the literature leads me to hypothesize that there
are three subgroups of persons with severe mental illness who
come into contact with the criminal justice system for
violating laws. One group commits only misdemeanor offenses,
some of which (e.g., disturbing the peace or loitering) would
not lead to arrests of nondisordered offenders. Others in this
group commit survival behaviors such as shoplifting and
failure to pay for restaurant meals (Steadman et al. 1995;
Teplin 1984b; Torrey 1995). This group violates the law and
becomes criminal not because their mental illness forces them
to do so but rather because their social background and their
mental illness leave them poor and marginal, and because they
do not get the necessary care and services they need in order
to survive in the community without getting into trouble. For
this group, the American Bar Association (1989) recommends
diversion to mental health, not arrest. Prior to
deinstitutionalization, this group would have been
hospitalized for much of their adult lives and not at risk for
criminal offending and arrest.
second group with severe mental illness who come into contact
with the criminal justice system have accompanying character
disorders and abuse alcohol and drugs. They are aggressive,
often threatening or intimidating, and are likely to have a
history of violent acts (Belcher 1988; Corrado et al. 1989;
Draine et al. 1994; Lamb et al. 1995). As with the first
group, they have few resources and are extremely needy of
food, clothing, shelter, direction, and protection. Many of
them become homeless. Some fall between the cracks of mental
health and substance abuse systems, but others are frequent
and demanding users of multiple community agencies such as
hospitals, "detox" facilities, emergency shelters,
welfare, and community mental health centers. Often their
abusive and uncooperative behavior (plus lack of agency
coordination and concerted action) deprive them of service
benefits. They have high rates of criminal offenses, arrests,
and incarceration, which are often for violent behavior (Corrado
et al. 1989; Martell et al. 1995). This group is most visible
and disturbing to the public. However, their criminal and
violent behavior seems to be driven by their character
disorders, substance abuse, and desperate situations, and not
by mental illness.
there seems to be a much smaller subgroup consisting of
severely mentally ill persons who fit the stereotypical image
of the madman out of control. Delusions and hallucinations
drive them to criminally violent behaviors. This very small
group is the one that receives the most media and fictional
attention. These three groups are different -- both from each
other and from the larger population of mentally ill persons
who are not arrested and incarcerated. It is thus incorrect to
generalize from their behavior to all persons with major
mental illness, because they are not representative of that
three of these groups tend to live in impoverished communities
and within social environments that have substantially
deteriorated in the late twentieth century, making it more
difficult for persons with major mental illness to survive
outside of institutions. Many individuals in these groups come
from broken families and disorganized communities that are
unable to give desperately needed support and care. In
addition, the high prevalence of drugs, alcohol, and violence
entrap these very vulnerable persons in greater pathology.
Mental health and social welfare systems try to ameliorate the
effects of such deleterious social conditions, but the
criminal justice system is often left to pick up the pieces
when these other systems fail.
K. M. (1989). The effect of co-occurring disorders on criminal
careers: Interaction of antisocial personality, alcohol and
drug disorders. Internat. J. Law & Psychiatry 12: 133-48.
The problem of co -occurring disorders among jail detainees:
Antisocial disorder, alcoholism, drug abuse, and depression.
Law & Human Behavior 14: 333-45.
& Teplin 1991
K. M., & L. A, Teplin (1991). Co-occurring disorders among
mentally ill jail detainees. Amer. Psychologist 46:1036-45.
M. L. (1972). The criminalization of mentally disordered
behavior: Possible side effects of a new mental health law.
Hospital & Community Psychiatry 23: 101-5.
Bar Association 1989)
Bar Association Criminal Justice Standards Committee (1989).
American Bar Association Criminal Justice and Mental Health
Standards. Washington, DC: ABA.
T. M. (1988). The impact of state mental hospital
deinstitutionalization on commitments for incompetency to
stand trial. Criminology 26: 307-20.
J. R. (1988). Are jails replacing the mental health system for
the homeless mentally ill? Community Mental Health J. 24:
E. (1967). Police discretion in apprehension of mentally ill
persons. Social Problems 14: 278-92.
et al. 1988
S. L., R. A. Pasewark, K. Bosten, & H. J. Steadman (1988).
Predicting criminal recidivism of insanity acquittees.
Internat. J. Law & Psychiatry 11: 105-12.
et al. 1986
J. D., J. L. Rogers, S. M. Manson, & M. H. Williams
(1986). Lifetime police contacts of discharged psychiatric
security review board clients. Internat. J. Law &
Psychiatry 8: 189-202.
& Bloom 1981
J. L., & J. D. Bloom (1981), Disposition of insanity
defense cases in Oregon. Bun Amer. Acad Psychiatry & Law
Williams, & Bigelow 1992
J. D., M. H. Williams, & D. A. Bigelow (1992). The
involvement of schizophrenic insanity acquittees in the mental
health and criminal justice systems. Clinical Forensic
Psychiatry 15: 591-604.
Shore, & Arvidson 1981
J. D., J. H. Shore, & B. Arvidson (1981), Local variations
in arrests of psychiatric patients. Bun Amer. Acad. Psychiatry
& Law 9: 203-10.
& Bonovitz 1981
J. C., & J. S. Bonovitz (1981). Diversion of the mentally
ill into the criminal justice system: The police intervention
perspective. Amer. J. Psychiatry 138: 973-6.
& Guy 1979
J. C., & E. B. Guy (1979). Impact of restrictive civil
commitment procedures on a prison psychiatric service. Amer.
J. Psychiatry 136: 1045-8.
Arvinites, & Steadman 1983
J., T. Arvinites, & H. J. Steadman (1983). Detention
patterns of successful and unsuccessful insanity defendants.
Criminology 21: 439-48.
& Steadman 1978
N. M., & H. J. Steadman (1978). Legal professionals'
perceptions of the insanity defense. J. Psychiatry & Law
Mayer, & Steadman 1987
L. A., C. Mayer, & H. J. Steadman (1987). Insanity defense
reform in the United States post Hinckley. Mental &
Physical Disability Law Reporter 11: 54-9.
et al. 1992
L. A., M. A. McGreevy, C. Cirincione, & H. J. Steadman
(1992). Measuring the effects of the guilty but mentally ill (GMBI)
verdict: Georgia's 1982 GBMI reform. Law & Human Behavior
et al. 1994
C., H. J. Steadman, P. C. Robbins, & J. Monahan (1994).
Mental illness as a factor in criminality: A study of
prisoners and mental patients. Criminal Behavior & Mental
Health 4: 33-47.
& Marcos 1990
N. L., & L. R. Marcos (1990). Law, policy and involuntary
emergency room visits. Psychiatric Q. 63: 197-204.
& Schlenger 1983
J. J., & W. E. Schlenger (1983). The prevalence of
psychiatric disorder among admissions to prisons. Paper
presented at the annual meeting of the American Society of
Criminology (November 9-13), Denver, CO.
Doherty, & Glackman 1989
R. R., D. Doherty, & W, Glackman (1989). A demonstration
program for chronic recidivists of criminal justice, health
and social service agencies. Internat. J. Law & Psychiatry
and Hodgins 1990,1992
G., & S. Hodgins (1990). Co-occurring mental disorders
among criminal offenders. Bull. Amer. Acad Psychiatry &
Law 18: 271-81.
The prevalence of major mental disorders among homicide
offenders. Internat. J. Law & Psychiatry 15: 89-99.
Ladner, & Towber 1986
S., S. Ladner, & R. Towber (1986). Multiple impairment
patterns in the mentally ill homeless. Internat. J. Mental
Health 14: 61-73.
Edell, & Cumming 1965
E., & C. Harrington (1963). Clergyman as counselor. Amer.
J. Sociology 69: 234-43.
W. (1980). Incompetency and the nondangerous mentally ill
client. Criminal Law Buff 16: 22-40.
& Solomon 1992
J., & P. Solomon (1992). Comparison of seriously mentally
ill case management clients with and without arrest histories.
J. Psychiatry & Law 20: 335-49.
& Soloman 1994
J., & P. Solomon (1994). Jail recidivism and the intensity
of case management services among homeless persons with mental
illness leaving jail. J. Psychiatry & Law 22: 245-61.
Solomon, and Meyerson 1994
J., P. Solomon, and A. T. Meyerson (1994). Predictors of
reincarceration among patients who received psychiatric
services in jail. Hospital & Community Psychiatry 45:
Carr, & Pierce 1984
M. L., H. D. Carr, & G. L. Pierce (1984). Police
involvement in involuntary civil commitment. Hospital &
Community Psychiatry 35: 580-4.
& Steadman 1989
J. A., & H. J. Steadman (1989). Chronically mentally ill
inmates: The wrong concept for the right services. Internat.
J. Law & Psychiatry 12: 203-11.
& Steadman 1994
J. A., & H. J. Steadman (1994). Using intensive case
management to reduce violence by mentally ill persons in the
community. Hospital & Community Psychiatry 45: 679-84.
L. (1991). A comparison of the community adjustment of
mentally ill offenders with those from the general population:
An 18 month followup. Law & Human Behavior 15: 477-94.
L. (1994). Psychiatric hospitalization history and parole
decisions. Law & Human Behavior 18: 395410.
& Sullivan 1988
P. E., & M. Sullivan (1988). Police respond to special
populations. NIJ Reports 209: 2-8
P. J. (1988). Criminal activity among the homeless: A study of
arrests in Baltimore. Hospital & Community Psychiatry 39:
& Roesch 1989
R. J., & R. Roesch (1989). Mental disorder and the
criminal justice system: A review. Internat. J. Law &
Psychiatry 12: 105-16.
& Lister 1978
J. L., & E. D. Lister (1978). The process of criminal
commitment for pretrial psychiatric examination: An
evaluation. Amer. J. Psychiatry 135: 53-60.
G., L. Gross, M. Morgan, & N. Signorielli (1981). Health
and medicine on television. New England J. Medicine 305:
Eaves, & Kowaz 1989
S. L., D. Eaves, & A. M. Kowaz (1989). The assessment,
treatment and community outcome of insanity acquittees:
Forensic history and response to treatment. Internat. J. Law
& Psychiatry 12: 149-79.
M. R (1983). From mental hospitals to jails: The pendulum
swings. J. Amer. Medical Assoc. 250: 3017-18.
Gabrielsen, & Kramp 1987
P., G. Gabrielsen, & P. Kramp (1987). Psychotic homicides
in Copenhagen from 1959-1988. Acta Psychiatrica Scandinavica
and Boker (1982)
H., & W. Boker (1982). Crimes of Violence by Mentally
Abnormal Offenders. Trans. by H. Marshall. Cambridge
V. P. (1986). An analysis of public attitudes toward the
insanity defense. Criminology 4: 393-415.
Rice, & Cormier 1991
G. T., M. E. Rice, & C. A. Cormier (1991). Psychopathy and
violent recidivism. Law & Human Behavior 15: 625-38.
& Steadman 1988
B., & H. J. Steadman (1988). Arrest rates of patients
treated at a community mental health center. Hospital &
Community Psychiatry 39: 862-6.
& Griffin 1993
K., & P. A. Griffin (1993). Community based forensic
treatment of insanity acquittees. Internat. J. Law &
1988 (Hiday 1990) (Hiday 1991 Hiday 1992b Hiday 1995 Hiday
& Markell 1981 Hiday & Smith 1987
V. A. (1988). Civil commitment: A review of empirical
research. Behavioral Sciences & the Law 6: 15-43.
Dangerousness of civil commitment candidates: A six months
followup. Law & Human Behavior 14: 551-67.
Hospitals to jails: Arrests and incarceration of civil
commitment candidates. Hospital & Community Psychiatry 42:
Coercion in civil commitment: Process, preferences and
outcome. Internat. J. Law & Psychiatry 15: 359-77.
Civil commitment and arrests: An investigation of the
criminalization thesis. J. Nervous & Mental Disease 180:
The social context of mental illness and violence. J. Health
& Social Behavior 36: 122-37.
V. A., & S. J. Markell (1981). Components of
dangerousness: Legal standards in civil commitment. Internat.
J. Law & Psychiatry 3: 405-19.
V. A., & L. N. Smith (1987). Effects of the dangerousness
standard in civil commitment. J. Psychiatry & Law 15:
1992, 1993 Hodgins 1995
S. (1992). Mental disorder, intellectual deficiency and crime:
Evidence from a birth cohort. Arch. General Psychiatry 49:
S. (1993). Mental Disorder and Crime. London: Sage.
Assessing mental disorder in the criminal justice system:
Feasibility versus clinical accuracy. Internat. J. Law &
Psychiatry 18: 15-28.
& Ahr 1988;
W. R., & P. R. Ahr (1988). Arrest rates among young adult
psychiatric patients treated in inpatient and outpatient
settings. Hospital & Community Psychiatry 39: 52-7.
Gregory, & Jones 1980;
E, D. Gregory, & R. K. Jones (1980). Psychiatric morbidity
in prisons. Hospital and Community Psychiatry 140: 674-7.
et al. 1996
B. K., W. E. Schlenger, J. A. Fairbank, & J. M. Caddell
(1996). Prevalence of psychiatric disorders among incarcerated
women II. Convicted women felons entering prison. Arch.
General Psychiatry 53: 513-19.
I. (1987). Researching and reforming the insanity defense.
Rutgers Law Rev. 39: 289-322.
N. N. (1971). The Right to Be Different. Baltimore: Johns
Hopkins University Press.
Rogers, & Hafner 1995
R, J. Rogers, & R. J. Hafner (1995). Characteristics of
police referrals to a psychiatric emergency unit in Australia.
Psychiatric Services 46: 620-2.
et al. 1989
P. R., D. N. Cox, R. Roesch, & D. Eaves (1989). The
perceptions of correctional officers toward mentally
disordered offenders. Internat. J. Law & Psychiatry 12:
& Durham 1992
J. Q., & M. L. Durham (1992). Back to the Asylum. New
York: Oxford University Press.
Perlmutter, & Huefinger 1977 Lagos, J. M.. K. Perlmutter,
& H. Huefinger (1977). Fear of the mentally ill: Empirical
support for the common man's response. Amer. J. Psychiatry
& Grant 1982 Lamb & Grant 1983 Lamb et al. 1995 Lamb,
Weinberger, & Gross 1988 Lamb et al. 1995
H. R., & R. W. Grant (1982). The mentally ill in a urban
county jail. Arch. General Psychiatry 39: 17-22.
Mentally ill women in a county jail. Arch. General Psychiatry
H. R., R. Shaner, D. M. Elliott, W. J. De Cuir, & J. T.
Foltz (1995). Outcome for psychiatric emergency patients seen
by an outreach police-mental health team. Psychiatric Services
H. R., L. E. Weinberger, & B. H. Gross (1988). Court
mandated outpatient treatment for persons found NGRI: A 5 year
follow-up. Amer. J. Psychiatry 145: 450-6.
Mulvey, & Gardner 1993 Lidz et al.1996
C. W., E. P. Mulvey, & W. P. Gardner (1993). The accuracy
of predictions of violence to others. J. Amer Medical Assoc.
C. W., E. P. Mulvey, W P. Gardner, & E. C. Shaw (1996).
Conditional clinical predictions of violence: The condition of
alcohol use. Law & Human Behavior 20: 35-48.
et al. 1987 Link, Andrews, & Cullen 1992 Link & Stueve
B. G. (1982). Mental patient status, work, and income: An
examination of the effects of a psychiatric label. Amer.
Sociological Rev. 47: 202-15.
The reward system of psychotherapy: Implications for
inequities in service delivery. J. Health & Social
Behavior 24: 61-9.
Understanding labeling effects in the area of mental
disorders: An assessment of the effects of expectations of
rejection. Amer. Sociological Rev. 52: 96-112.
B. G., H. Andrews, & E T. Cullen (1992). The violent and
illegal behavior of mental patients reconsidered. Amer.
Sociological Rev. 57: 275-92.
B. G., & E T. Cullen (1983). Reconsidering the social
rejection of ex-mental patients: Levels of attitudinal
response. Amer. J. Community Psychology 11: 261-73.
The labeling theory of mental disorder: A review of the
evidence. Res. in Community & Mental Health 6: 75-105.
B. G., E T. Cullen, J. Frank, & J. E Wozniak (1987). The
social rejection of former mental patients: Understanding why
labels matter. Amer. J. Sociology 92: 1461-1500.
B. G., E T. Cullen, E. Struening, P. Shrout, & B. P.
Dohrenwend (1989). A modified labeling theory approach in the
area of the mental disorders: An empirical assessment. Amer.
Sociological Rev. 54: 400-23.
B. G., & B. P. Dohrenwend (1980a). Formulation of
hypotheses about the true relevance of demoralization in the
United States. In Dohrenwend et al. (1980: 114-32).
Hypotheses concerning the relationship of treated to true
rates of psychological disorder. In Dohrenwend et al. (1980:
B. G., B. P. Dohrenwend, & A. E. Skodol (1986).
Socio-economic status and schizophrenia: Noisome occupational
characteristics as a risk factor. Amer. Sociological Rev. 51:
B. G., M. C. Lennon, & B. P. Dohrenwend (1993).
Socioeconomic status and depression: The role of occupations
involving direction, control and planning. Amer. J. Sociology
B. G., & B. Milcarek (1980). Selection factors in the
dispensation of therapy: The Matthew effect in the allocation
of mental health resources. J. Health & Social Behavior
B. G., J. Mirotznik, & E T. Cullen (1991). The
effectiveness of stigma coping orientations: Can negative
consequences of mental illness labeling be avoided. J. Health
& Social Behavior 32: 302-20.
B. G., & J. Phelan (1995). Social conditions as
fundamental causes of disease. J. Health & Social Behavior
(special issue): 80-94.
B. G., & A. Stueve (1994). Psychotic symptoms and the
violent/illegal behavior of mental patients compared to
community controls. In J. Monahan & H. J. Steadman (Eds.),
Violence and Mental Disorder, pp. 137-60. University of
Snyder, & Merrill 1981
J. R., W. Snyder, & G. L. Merrill (1981). Under reporting
of assaults on staff in a state hospital. Hospital &
Community Psychiatry 32: 497-8.
Haynes, & Nelson 1993
J. K., R. L. Haynes, & C. Nelson (1993). Forensic
treatment at Atascadero State Hospital. Internat. J. Law &
Psychiatry 16: 57-70.
Rosner, & Harmon 1995
D. A., R. Rosner, & R. B. Harmon (1995). Base-rate
estimates of criminal behavior by homeless mentally ill
persons in New York City. Psychiatric Services 46: 596-601.
et al. 1989
B. H., L. R. Faulkner, J. D. Bloom, R. Hallaux, & J. D.
Bray (1989). Chronic mental illness and the criminal justice
system. Hospital & Community Psychiatry 40: 718-23.
Webster, & Menzies 1989
S., C. D. Webster, & R. J. Menzies (1989). The
postassessment careers of mentally disordered offenders.
Internat. J. Law & Psychiatry 12: 189-201.
et al. 1991
D. E., C. Hatcher, H. Zeiner, H. L. Wolfe, & R. S. Myers
(1991). Characteristics of persons referred by police to the
psychiatric emergency room. Hospital & Community
Psychiatry 42: 425-7.
& Binder 1987 McNiel & Binder 1994
D. E., & R. L. Binder (1987). Predictive validity of
judgments of dangerousness in emergency civil commitment.
Amer. J. Psychiatry 144: 197-200.
The relationship between acute psychiatric symptoms, diagnosis
and short-term risk of violence. Hospital & Community
Psychiatry 45: 133-7.
Steadman, & Cocozza 1979
M. E., H. J. Steadman, & J. J. Cocozza (1979). The
medicalization of criminal behavior among mental patients. J.
Health & Social Behavior 20: 228-37.
1987 Menzies et al.1994
R. J. (1987). Cycles of control: The transcarceral careers of
forensic patients. Internat. J. Law & Psychiatry 10:
R. J., C. D. Webster, S. McMain, S. Staley, & R. Scaglione
(1994). The dimensions of dangerousness revisited: Assessing
forensic predictions about violence. Law & Human Behavior
R. D. (1987). Involuntary Civil Commitment of the Mentally Ill
in the Post-Reform Era. Springfield, IL: Charles Thomas.
1992 Monahan, Caldeira, & Friedlander 1979; Monahan &
J. (1992). Mental disorder and violent behavior: Perceptions
and evidence. Amer. Psychologist 47: 511-21.
J., C. Caldeira, & H. D. Friedlander (1979). Police and
the mentally ill: A comparison of committed and arrested
persons. Internat. J. Law & Psychiatry 2: 509-18.
J., & H. J. Steadman (1982). Crime and mental disorder: An
epidemiological approach. In M. Tonry & N. Morris (Eds.),
Crime and Justice: An Annual Review of Research, vol. 4, pp.
145-89. University of Chicago Press.
& Goldman 1986
J. P., & H. H. Goldman (1984). Cycles of reform in the
care of chronically mentally ill. Hospital & Community
Psychiatry 35: 785-93.
Care and treatment of the mentally ill in the United States:
Historical developments and reforms. Ann. Amer. Acad Political
& Social Science 484: 12-27.
S. J. (1985). Excusing the crazy: The insanity defense
reconsidered. Southern California Law Rev. 58: 777-836.
& Calsyn 1986
G. A., & R. J. Calsyn (1986). Care and treatment of the
mentally ill in the United States: Historical developments and
reforms. Ann. Amer. Acad Political & Social Science 484:
et al. 1996
E. R, W. Gardner, C. W. Lidz, J. Graus, & E. C. Shaw
(1996). Symptomatology and violence among mental patients.
Unpublished manuscript, Western Psychiatric Institute,
Mulvey, & Lidz 1995
C. E., E. P. Mulvey, & C. W. Lidz (1995). Characteristics
of violence in the community by female patients seen in a
psychiatric emergency service. Psychiatric Services 46: 785-9.
J. C. (1961). Popular Conceptions of Mental Health. New York:
Holt, Rinehart, & Winston.
J. R. R (1991). A comparison of insanity defense standards on
juror decision making. Law & Human Behavior 15: 509-32.
& Pantle 1979 Pasewark & Seidenzahl 1979 Pasewark,
Pantle, & Steadman 1982 Pasewark, R. A., & M. L.
Pantle (1979). Insanity plea: Legislator's view. Amer. J.
Psychiatry 136: 222-3.
R. A., M. L. Pantle, & H. J. Steadman (1982). Detention
and rearrest rates of persons found not guilty by reason of
insanity and convicted felons. Amer. J. Psychiatry 139: 892-7.
R. A., & D. Seidenzahl (1979). Opinions concerning the
insanity plea and criminality among mental patients. BulL
Amer. Acad. Psychiatry & Law 7: 199-202.
& Motiuk 1995
F. J., & L. L. Motiuk (1995). The prison careers of
mentally disordered offenders. Internat. J. Law &
Psychiatry 18: 29-44.
News (1995). Violence among mentally ill found to be
concentrated among those with comorbid substance abuse
disorders. Psychiatric News (December 2): 8.
1972 Rabkin 1979
J. G. (1972). Opinions about mental illness: A review of the
literature. Psychological Bull. 77: 153-71,
Criminal behavior of discharged mental patients: A critical
appraisal of the research. Psychological Bull. 86: 1-27.
Pam, & Milton 1975
S., A. Pam, & J. Milton (1975). Civil liberties versus
involuntary hospitalization. Amer. J. Psychiatry 132: 189-92.
& Harris 1992 Rice & Harris 1995
M., & G. T. Harris (1992). A comparison of criminal
recidivism among schizophrenic and nonschizophrenic offenders.
Internat. J. Law & Psychiatry 15: 397-408.
Psychopathy, schizophrenia, alcohol abuse and violent
recidivism. Internat. J. Law & Psychiatry 18: 249-63.
L. N. (1993). Childhood conduct problems, adult
psychopathology and crime. In Hodgins (1993: 173-93).
& Corrado 1983 Roesch & Golding 1980 Roesch &
Golding 1985 Roesch, Ogloff, & Eaves 1995
R., & R. Corrado (1983). Criminal justice system
interventions. In E. Seidman (Ed.), Handbook of Social
Intervention, pp. 385-407. Beverly Hills, CA: Sage.
R., & S. L. Golding (1980). Competency to Stand Trial
Urbana: University of Illinois Press.
The impact of deinstitutionalization. In D. R Farrington &
J. Gunn (Eds.), Aggression and Dangerousness, pp. 209-39. New
R., J. R. P. Ogloff, & D. Eaves (1995). Mental health
research in the criminal justice system: The need for common
approaches and international perspective. Internat. J. Laws
& Psychiatry 18: 1-14.
Bloom, & Manson 1984
Jeffrey L., J. D. Bloom, & S. M. Manson (1984). The first
five years of the psychiatric security review board. Bull.
Amer. Acad Psychiatry & Law 12: 383-403.
G. (1968). Madness in Society. University of Chicago Press.
& Hafemeister 1984
B., & T. Hafemeister (1984). Empiricism and legal policy
on the insanity defense. In Teplin (1984b: 253-78).
& Kobrin 1984
L. A., & S. Kobrin (1984). Exposure of community mental
health clients to the criminal justice system: Client/criminal
or patient/prisoner. In Teplin (1984b: 87-118).
1995 Silver, Cirincione, & Steadman 1994
E. (1995). Punishment or treatment? Comparing the lengths of
confinement of successful and unsuccessful insanity
defendants. Law & Human Behavior 19: 375-88.
E., C. Cirincione, & H. J. Steadman (1994).
Demythologizing inaccurate perceptions of the insanity
defense. Law & Human Behavior 18: 63-70.
L. (1980). Explaining the increased arrest rate among mental
patients: A cautionary note. Amer. J. Psychiatry 137: 1602-5.
& Cocozza 1978 Steadman, Cocozza, & Melick 1978
Steadman & Morrissey 1982 Steadman et al.1984 Steadman et
al.1986 Steadman & Morrissey 1987 Steadman et al. 1987
Steadman, McCarty, & Morrissey 1989 Steadman et al.1993
Steadman, Morris, & Dennis 1995
H. J., & J. J. Cocozza (1978). Selective reporting and the
public's misconceptions of the criminally insane. Public
Opinion Q. 42: 523-33.
H. J., J. J. Cocozza, & M, E. Melick (1978). Explaining
the increased crime rate of mental patients: The changesin
clientele of state hospitals. Amer. J. Psychiatry 135: 816-20.
H. J., S. Fabisiak, J. Dvoskin, & E. J. Holohean (1987). A
survey of mental disability among state prison inmates.
Hospital & Community Psychiatry 38: 1086-90.
H. J., D. W. McCarty, & J. P. Morrissey (1989). The
Mentally Ill in Jail: Planning for Essential Services. New
H. J., M. A. McGreevy, J. Morrissey, L. A. Callahan, P. C.
Robbins, & C. Cirincione. (1993). Before and After Hinkley:
Evaluating Insanity Defense Reform. New York: Guilford.
H. J., J. Monahan, B. Duffee, E. Hartstone, & P. C.
Robbins (1984). The impact of state mental hospital
deinstitutionalization on U.S. prison populations,1968-1978.
J. Criminal Law & Criminology 75: 474-90.
H. J., S. M. Morris, & D. L. Dennis (1995). The diversion
of mentally ill persons from jails to community based
services: A profile of programs. Amer. J. Public Health 85:
H. J., & J. P. Morrissey (1982). Predicting violent
behavior: A note on a cross-validation study. Social Forces
The impact of deinstitutionalization on the criminal justice
system: Implications for understanding changing modes of
social control. In J. Lawman, R. J. Menzies, & T. S. Palys
(Eds.), Transcarceration: Essays in the Sociology of Social
Control, pp.227-48. Aldershot, UK: Gower.
H. J., J. P. Morrissey, J. Braff, & J. Monahan (1986).
Psychiatric evaluations of police referrals in a general
hospital emergency room. Internat. J. Law & Psychiatry 8:
& Test 1985
L. I., & M. A. Test (1980). An alternative to mental
hospital treatment: I. Conceptual model, treatment program,
and clinical evaluation. Arch. General Psychiatry 37: 409-12.
The evolution of the training in community living model. New
Directions for Mental Health Services 26: 7-16.
S. (1979). From the hospital to the prison: A step forward in
deinstitutionalization? Hospital & Community Psychiatry
Allen A. (1975). Mental Health and Law: A System in
Transition. Washington, DC: Department of Health, Education,
& Winer 1976
G. E., & D. Winer (1976). Occurrence of psychiatric
disorder in a county jail population. Amer. J. Psychiatry 133:
1994 Swanson et al.1990 Swanson et al. 1996
J. W. (1994). Mental disorder, substance abuse and community
violence: An epidemiological approach. In J. Monahan & H.
J. Steadman (Eds.), Volence and Mental Disorder, pp. 101-36.
University of Chicago Press.
J. W., R. Borum, J. Monahan, & M. Swartz (1996). Psychotic
symptoms and the risk of violent behavior: Evidence from the
Epidemiologic Catchment Area surveys. Criminal Behavior &
Mental Health 6: 309-29.
J. W., C. K. Holzer, V. K. Ganju, & R. T. Jono (1990).
Violence and psychiatric disorder in the community: Evidence
from the Epidemiologic Catchment Area surveys. Hospital &
Community Psychiatry 41: 761-70.
et al.1980 Teplin 1983 Teplin 1984a Teplin 1984b Teplin 1985
Teplin 1990a Teplin l990b Teplin & Pruett 1992 Teplin,
McClelland, & Abram 1993 Teplin 1994 Teplin, Abram, &
McClelland 1994 Teplin et al.1996
L. A. (1983). The criminalization of the mentally ill:
Speculation in search of data. Psychological Bull. 94: 54-67.
Criminalizing mental disorder: The comparative arrest rate of
the mentally ill. Amer. Psychologist 39: 794-803.
Mental Health and Criminal Justice. Beverly Hills, CA: Sage.
The criminality of the mentally ill: A dangerous
misconception. Amer. J. Psychiatry 142: 593-9.
The prevalence of severe mental disorder among male urban jail
detainees: Comparison with the Epidemiologic Catchment Area
program. Amer. J. Public Health 80: 1-7.
Detecting disorder: The treatment of mental illness among jail
detainees. J. Consulting & Clinical Psychology 58: 233-6.
Psychiatric and substance abuse disorders among male urban
jail detainees. Amer. J. Public Health 84: 290-3.
L. A., K. M. Abram, & G. M. McClelland (1994). Does
psychiatric disorder predict violent crime among released jail
detainees? A six-year longitudinal study. Amer. Psychologist
Prevalence of psychiatric disorders among incarcerated women.
Arch. General Psychiatry 53: 505-12.
L. A., W J. Filstead, G. M. Hefler, & E. P. Sheridan
(1980). Police involvement with the psychiatric emergency
patient. Psychiatric Ann. 10: 46-54.
L. A., G. M. McClelland, & K. M. Abram (1993). The role of
mental disorder and substance abuse in predicting violent
crime among released offenders. In Hodgins (1993: 86-103).
L. A., & N. S. Pruett (1992). Police as street corner
psychiatrists: Managing the mentally ill. Internat. J. Law
& Psychiatry 15:157-70.
E. F. (1995). Jails and prisons - America's new mental
hospitals. Amer. J. Public Health 85: 1611-13.
Carroll, & Hart 1986
E. B., K. R. Carroll, & A. J. Hart (1986). A study of
offenses committed by psychotic inmates in a county jail.
Hospital & Community Psychiatry 37: 163-6.
R. C. (1993). Treatment services at Kirby forensic psychiatric
center. Internat. J. Law & Psychiatry 16: 83-104.
O. (1995). Media Madness: Public Images of Mental Illness. New
Brunswick, NJ: Rutgers University Press.
& Diamond 1985
P., & R. J. Diamond (1985). Prevalence of mental illness
among women incarcerated in five California county jails. Res.
in Community Mental Health 5: 33-41.