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Co-Occurring Disorders in Criminal Justice Settings

Screening for Criminal Risk

Justice-involved people are at risk for continued criminal activity. Many risk factors are the same for people with or without co-occurring disorders. Risk factors include:

  • Adult criminal history
  • Juvenile delinquency
  • Family strife
  • Unstable housing

Substance abuse and antisocial personality disorder have also been identified as risk factors for continued criminal activity.

Screening informs behavioral health services.

Screening for criminal risk and need informs the planning and delivery process for behavioral health services and criminal justice supervision. Screening provides behavioral health practitioners and criminal justice professionals with information they can use when working with individuals on behavioral health and criminal risk reduction goals. When working with justice-involved people with co-occurring disorders, services focused on criminogenic needs are designed to be integrated with behavioral health services.

Screening for criminal risk is driven by three principles:

The risk principle means that the level of service is matched to an individual's likelihood of committing a crime. Based on the risk principle, a person who is at high risk for criminal activity receives more resources targeting criminogenic needs than a person who is at low risk. In part, this is a resource allocation strategy. Research has also shown that low-risk individuals do not need high levels of risk-reduction services. Moreover, when low-risk individuals receive a high level of service, it may actually increase criminal risk.

The need principle helps determine how to target interventions so as to reduce criminal risk. Screening instruments for criminal risk are centered on the following eight major risk factors:

  • Antisocial behavior, such as criminal activity, juvenile delinquency.
  • Antisocial personality pattern, such as low self control, aggression.
  • Antisocial cognition, such as attitudes, values, or identity supportive of crime.
  • Antisocial associates, such as friends or family members supportive of crime.
  • Family/marital factors, such as domestic conflict and lack of monitoring.
  • School/work factors, such as low school/work performance/satisfaction.
  • Leisure/recreation factors, such as low involvement or satisfaction with prosocial activities.
  • Substance abuse, such as abuse alcohol or drugs and social support for abuse.

The responsivity principle means matching the treatment intervention to an individual's learning style and ability. It also means providing supports for new skills. Cognitive behavioral treatment targeted to an individual's criminogenic needs is one of the main strategies that behavioral health and criminal justice agencies use to achieve risk reduction.

Screening instruments for criminal risk

Criminal risk screening instruments have evolved over the past decade. Current instruments attend to the principles of risk, need, and responsivity. One prominent instrument is the Level of Service Inventory-Revised exit disclaimer. Another set of instruments combine the principles with follow-up supports for clinicians. This category includes Correctional Offender Management Profiling for Alternative Sanctions exit disclaimer and the Level of Service/Case Management Inventory exit disclaimer.

Remember these key points about screening for criminal risk.

  • Risk factors for criminal activity among justice-involved people with co-occurring disorders are often the same as for people without co-occurring disorders.
  • Criminal risk screening is driven by the principles of risk, need, and responsivity.
  • Services focused on criminogenic needs are designed to be integrated with behavioral health services.

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