News & Stories

Reducing Risk

At least a quarter of the people with serious mental illnesses in the public mental health system will have contact with the criminal justice system in their lifetime. The mental health system is becoming aware that treating the mental illness alone is not the total answer to reducing the risk of individuals with serious mental illness being involved with the justice system.

Working to find answers, faculty in the Department of Psychiatry at Northeast Ohio Medical University and collaborators from the University of North Carolina Chapel Hill recently convened national experts with a variety of clinical and substantive expertise to explore new approaches to cognitive behavioral interventions for people with serious mental illness. The goal? To help people with serious mental illness who have been involved with the criminal justice system avoid future justice involvement, and work toward interventions that will serve them in a more proactive and comprehensive way.

Finding the right interventions

A small but growing number of interventions are being developed to reduce justice involvement by directly targeting criminogenic needs, which are those factors that place individuals at risk for continued involvement in the justice system. Primarily, these interventions target:

  • prior and current antisocial behavior and activities;
  • antisocial personality patterns, including tendencies for impulsive behavior, aggression or disregard for others;
  • criminal thinking, meaning attitudes, beliefs and values that are favorable to crime and
  • criminal associates (e.g., hanging out with the wrong crowd)


Many of these interventions use a cognitive behavioral therapy as an approach to address criminogenic needs. While many existing interventions show promise, they were not necessarily developed to be used with individuals with serious mental illness. Further, most of these interventions are designed for use in criminal justice settings, such as jail or prison.

“We believe there is a need for the development of an intervention that takes an integrated approach to addressing the mental health, substance use and criminogenic needs of people who receive services in community mental health settings,” says Mark R. Munetz, M.D., The Margaret Clark Morgan Chair in Psychiatry. “Such an approach would fill a gap in community-based services for people who have justice involvement.”

Joining forces

At the recent meeting at NEOMED, Department of Psychiatry faculty partnered with the Ohio Criminal Justice Coordinating Center of Excellence (CJCCoE) at NEOMED and Cognitive Behavioral Therapy for Psychosis practice experts from NEOMED’s Best Practices in Schizophrenia Treatment (BeST) Center to bring together a diverse group of experts – many of them internationally known – to discuss cognitive behavioral interventions for justice involved people with serious mental illness. Key community-based service providers, state-level policy makers and representatives from the Laura and John Arnold Foundation, National Institute of Mental Health, and Council of State Governments Justice Center also participated in the discussion.

“Together, we reviewed existing interventions and examined the need for and feasibility of developing a criminogenic intervention that is explicitly designed to be delivered in community mental health centers by mental health professionals working in those settings,” adds Dr. Munetz.

Hudson, Ohio-based Peg’s Foundation supported the symposium.