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Book Reviews   |    
Community-Based Interventions for Criminal Offenders With Severe Mental Illness
Reviewed by Daniel W. Phillips, III, Ph.D.
Psychiatric Services 2004; doi: 10.1176/appi.ps.55.7.841
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edited by William H. Fisher, Ph.D.; Oxford, England, Elsevier, Ltd., 2003, 220 pages, $86

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This work focuses on offenders with mental illness and the limitations in diverting them from the criminal justice system. The inaccurate belief that deinstitutionalization directly caused the "criminalization" of mental health consumers has led many to become overly optimistic about diversion programs. In other words, they erroneously believe that a lack of mental health resources is the main reason people with mental illnesses are in the criminal justice system and that we need simply divert them into mental health treatment to correct the situation.

Unfortunately, according to the authors represented in Community-Based Interventions for Criminal Offenders With Severe Mental Illness, diversion is not that simple, and there are many limitations to the complex issue. The multidisciplinary authors of this work write to a broad audience—the fields of psychiatry, psychology, public health, social work, and sociology. Novice and expert readers alike will find valuable information here. The authors provide readers with current research on the intersection of offenders with mental illness, community mental health treatment, and the criminal justice system. Specific topics include case management, jail diversion, new-generation antipsychotics, forensic psychiatry, mental health courts, and institutions such as prisons and hospitals.

The book specifies many specific limitations to diversion. Some offenders with mental illness are not jailed specifically because of their mental illness. There is no relationship between "levels and availability" of community-based supports and the chances of a consumer's becoming involved with the criminal justice system. Women who take new-generation antipsychotic medication are more likely to be involved with the criminal justice system than women who do not. Jail diversion programs have limited proof of success. Mental health courts are effective only under certain conditions and will most likely not be successful with all offenders who have mental illness.

The book is well written by accomplished authors who have published extensively in the area of criminal justice and mental illness. Although the book deals with theoretical issues, the authors also provide information to those who work in practical settings. The book has several strengths. First, it explains the history of the intersection of mental illness and criminal justice. Some chapters begin with a history of mental illness and criminal justice that includes deinstitutionalization in the 20th century and Dorothea Dix's crusade to free jailed mental health consumers in the 19th century. Second, the book examines previous theories about offenders with mental illness, tests them, and provides the reader with information on what works, what does not, what needs to be examined further, and new ways of conceptualizing the issue. Readers are even provided with a new taxonomy of offenders with mental illness. Finally, the book provides information that will be useful to policy makers in making decisions about programs.

The book has few faults. Its main "fault" is that although it provides a wealth of information from the mental health services research side of the issue, it would be even better if it included more from criminal justice researchers. That would only help to better explore the complex issue of offenders with mental illness.

Dr. Phillips is assistant professor and program coordinator of the criminal justice program at Lindsey Wilson College in Columbia, Kentucky. He also serves as a program evaluator for the Substance Abuse and Mental Health Services Administration.

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