Contexts shaping misdemeanor system interventions among people with mental illnesses: qualitative findings from a multi-site system mapping exercise

• Published in: Health & justice Vol. 11; no. 1; p. 20
• Main Authors: Wood, Jennifer D., Watson, Amy C., Pope, Leah, Warnock, Amanda, Nelson, Veronica, Gesser, Nili, Zern, Adria, Stagoff-Belfort, Aaron, de Bibiana, Jason Tan, Compton, Michael T.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 04.04.2023; Springer Nature B.V; BMC
• Subjects: Behavior; Case studies; Community and Environmental Psychology; Criminal charges; Criminal justice; Criminal legal system; Criminology and Criminal Justice; Decision making; Defendants; Diversion; Health needs; Housing; Intervention; Jurisdiction; Law; Law and Criminolgy; Legal system; Mental disorders; Mental health; Mental health services; Mental illnesses; Misdemeanors; Policy making; Public Health; Qualitative analysis; Qualitative research; Research Article; Shoplifting; Social Policy; Social services; System mapping; COVID-19; Criminal legal system; Misdemeanors; Mental illnesses; Criminal charges; Housing; Diversion; System mapping
• ISSN: 2194-7899; 2194-7899
• DOI: 10.1186/s40352-023-00219-8

Background People with mental illnesses are disproportionately entangled in the criminal legal system. Historically, this involvement has resulted from minor offending, often accompanied by misdemeanor charges. In recent years, policymakers have worked to reduce the footprint of the criminal legal system. This paper seeks to better understand how misdemeanor systems intervene in the lives of people with mental illnesses. Methods System mapping exercises were conducted with misdemeanor system stakeholders from the jurisdictions of Atlanta, Chicago, Manhattan, and Philadelphia. Narrative detail on decision-making and case processing, both generally and in relation to specific types of behavior, including trespassing, retail theft/shoplifting, and simple assault, were coded and analyzed for thematic patterns. Based on the qualitative analysis, this paper offers a conceptual diagram of contexts shaping misdemeanor system interventions among people with mental illnesses. Results All four sites have been engaged in efforts to reduce the use of misdemeanor charges both generally and in relation to people with mental illnesses. Decision-makers across all sites experience contexts that shape how, when, and where they intervene, which are: (1) law and policy environments; (2) location of the behavior; (3) expectations of stakeholders; (4) knowledge of mental illnesses; and (5) access to community resources. Law and policy environments expand or constrain opportunities for diversion. The location of offending is relevant to who has a stake in the behavior, and what demands they have. Clinical, experiential, and system-level knowledge of mental illnesses inform a chain of decisions about what to do. The capacity to address mental health needs is contingent on access to social services, including housing. Conclusion People making decisions along the criminal legal continuum are critical to illuminating the dynamic, inter-related contexts that facilitate and frustrate attempts to address defendants’ mental health needs while balancing considerations of public safety. Multi-sector, scenario-based or case study exercises could help identify concrete ways of improving each of the contexts that surround whole-of-system decisions.