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Decriminalizing severe mental illness by reducing risk of contact with the criminal justice system, including for forensic patients

Published online by Cambridge University Press:  06 May 2020

Kimberlie Dean Open the ORCID record for Kimberlie Dean [Opens in a new window] ,
Sara Singh  and
Yin-Lan Soon
Kimberlie Dean*
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia Justice Health and Forensic Mental Health Network, Matraville, New South Wales, Australia
Sara Singh
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
Yin-Lan Soon
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia Justice Health and Forensic Mental Health Network, Matraville, New South Wales, Australia
*
*Address correspondence to: Kimberlie Dean, School of Psychiatry, University of New South Wales, Level 1, AGSM Building, UNSW Sydney, Kensington, NSW 2052, Australia. (Email: [email protected])
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Abstract

Risk of contact with the criminal justice system (CJS) is greater among those with mental illness, including severe mental illness—an observation that many argue reflects a process of “criminalizing” mental illness. Forensic patients represent a subgroup at one end of a spectrum of such criminalization, typically with histories of serious violence and psychotic illness. Strategies for decriminalizing mental illness in this context should consider a range of approaches, including intervening to prevent CJS contact in those with severe mental illness, particularly in the early or emerging stages of psychosis. However, it may be that even gold standard mental healthcare applied universally is insufficient to address CJS contact risks. While there is now an extensive literature documenting the relatively low rates of repeat CJS contact for forensic patients released from secure care, appropriate comparison groups are lacking and the key ingredients of any benefits of treatment are unknown. The CJS may well have something to learn from forensic mental health systems and services given the abject failure to stem rates of prison-release reoffending internationally. Understanding how to best identify risk and effectively intervene to prevent CJS contact in those with mental illness, whether early in the course of psychosis or following release from secure care, remains a priority for those seeking to address the criminalization of mentally illness in our communities.

Keywords

Forensic patientssevere mental illnessoffendingdecriminalizationviolence introduction.
Type
Review
Information
CNS Spectrums , Volume 25 , Issue 5 , October 2020 , pp. 687 - 700
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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