Risk Factors for Criminal Recidivism Among Persons With Serious Psychiatric Diagnoses: Disentangling What Matters for Whom

Abstract

Reducing criminal legal system involvement requires an understanding of the factors that promote repeat offending (i. e., recidivism), and the dissemination of relevant interventions to those most likely to benefit. A growing body of research has established common recidivism risk factors for persons with serious psychiatric disorder diagnoses. However, research to date has not examined the degree to which these risks apply to those with serious psychiatric disorders with and without co-occurring substance use disorders. To clarify what risk and need factors are greatest and for whom, this cross-sectional study drew from an original dataset containing data on 14 social and economic, psychological, and criminal risk areas for a cohort of people on probation (n = 4,809). Linear regression models indicated that, compared to those without a serious psychiatric disorder, people on probation with a serious psychiatric disorder are at greater risk in a minority of areas and those areas are mostly social and economic in nature. Meanwhile, those withco-occurring disorders are at relatively high risk across almost all areas. The results from this study suggest that justice involved persons with serious psychiatric disorders will benefit from interventions that increase social support and economic well-being and that interventions that broadly reduce risk among people with co-occurring serious psychiatric and substance use disorders will likely yield meaningful reductions in system involvement. Ultimately, understanding and intervening upon risk for recidivism among persons with serious psychiatric disorders requires differentiating between those with and without co-occurring substance use disorders.

Keywords: co-occurring disorders; criminal recidivism; risk factors; serious mental disorders; substance use disorder.

Figure 1

Predicted risk score by diagnostic group. Bars represent predicted mean risk decile scores across diagnostic groups for the typical person on probation (i.e., a 35-year-old, Black man); whiskers represent 95% Confidence Intervals. Predicted means are calculated based on the regression equations presented in Table 3. Categories are coded as mutually exclusive. SPD, serious psychiatric disorder; COD, co-occurring serious psychiatric and substance use disorder. See Appendix for further information on the interpretation of scores.