Individuals with SMI who have been involved in the criminal justice system face numerous challenges including additional stigma. They may also exhibit behaviors that were adaptive in correctional settings but become maladaptive in other settings. Many of these persons have histories of trauma and their exposure to criminal justice processes can be further traumatizing. Many will have antisocial personality features that the mental health treatment provider may feel ill-equipped to support and may even not enjoy the work of working with these individuals, which can lead to personal burn out and difficulty with compassion. This can be especially true for patients with histories of aggression or even violence. In addition, individuals with SMI in the criminal justice system often have co-occurring substance use disorders and medical conditions that compound their complexity. The criminal justice system utilizes a rubric called the Risk-Need-Responsivity paradigm to identify individual risk of criminal recidivism. Interventions such as specific cognitive behavioral strategies are often used in criminal justice contexts to address some of the criminogenic thinking associated with such recidivism. This framework has been applied to broad populations even while more research is needed to determine how these methods can best fit for persons with SMI. This presentation reviews these various topics to assist mental health professionals in supporting their patients who have had criminal justice involvement.

Learning Objectives

• Describe some of the challenges clinicians face in working with clients who have been criminal justice-involved
• Discuss approaches used by the criminal justice system to identify and reduce criminal recidivism
• Describe how trauma-informed approaches can facilitate working with individuals who have been justice involved

Target Audience

Instructional Level

Introductory; Intermediate; Advanced

Estimated Time to Complete

Estimated Duration: 1.0 hour 
Program Start Date: December 20, 2019 
Program End Date: December 20, 2025

Program Review Date: January 4, 2023

How to Earn Credit

Participants who wish to earn AMA PRA Category 1 Credit™, CE credit for psychologists, or a certificate of participation may do so by completing all sections of the course, including the evaluation. A multiple choice quiz is provided based on the content. A passing score of 75% must be achieved. Retakes are available for the test. After evaluating the program, course participants will be provided with an opportunity to claim hours of participation and print an official CME certificate (physicians), CE certificate (psychologists), or certificate of participation (other disciplines) showing the completion date and hours earned.

Continuing Education Credit

Physicians

The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The APA designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Psychologists

The American Psychiatric Association is approved by the American Psychological Association to sponsor continuing education for psychologists. The American Psychiatric Association maintains responsibility for this program and its content.

Continuing education requirements vary from state to state. Many state boards grant reciprocity with national accrediting organizations and other state boards. It is the responsibility of each professional to understand the requirements for license renewal or check with the state or national licensing board and/or professional organization to become more familiar with their policies for acceptable continuing education credit. Social workers and Psychologists should contact their regulatory board to determine course approval.

Faculty and Planner Disclosures

Instructor

• Debra Pinals, MD, is the director of the Program in Psychiatry, Law, and Ethics and a clinical professor of psychiatry at the University of Michigan Medical School. Dr. Pinals reports no financial relationships with commercial interests. 

Planners

• Teri Brister, PhD, LPC, National Alliance on Mental Illness. Reports no financial relationships with commercial interests. 
• Amy N. Cohen, PhD, American Psychiatric Association. Reports no financial relationships with commercial interests. 
• Tristan Gorrindo, MD, American Psychiatric Association. Reports no financial relationships with commercial interests.

Reviewers

• John Torous, MD, Beth Israel Deaconess Medical Center. Dr. Torous has no relevant financial relationships to disclose. (Reviewed on 1/4/23)
• Amy N. Cohen, PhD, American Psychiatric Association. Dr. Cohen has no relevant financial relationships to disclose. (Reviewed on 12/28/22)
• Teri Brister, PhD, LPC, National Alliance on Mental Illness. Dr. Brister has no relevant financial relationships to disclose. (Reviewed on 1/4/23)

Accessibility for Participants with Disabilities

The American Psychiatric Association is committed to ensuring accessibility of its website to people with disabilities. If you have trouble accessing any of APA’s online resources, please contact us at 202-559-3900 for assistance.

Technical Requirements

This internet-based CME activity is best experienced using any of the following:

• The latest and 2nd latest public versions of Google Chrome, Mozilla Firefox, or Safari
• Internet Explorer 11+

This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Adobe Acrobat Reader, Microsoft PowerPoint, and Windows Media Player.

Optimal System Configuration:

• Browser: Google Chrome (latest and 2nd latest version), Safari (latest and 2nd latest version), Internet Explorer 11.0+, Firefox (latest and 2nd latest version), or Microsoft Edge (latest and 2nd latest version)
• Operating System: Windows versions 8.1+, Mac OS X 10.5 (Leopard) +, Android (latest and 2nd latest version), or iOS/iPad OS (latest and 2nd latest version)
• Internet Connection: 1 Mbps or higher

Minimum Requirements:

• Windows PC: Windows 8.1 or higher; 1 GB (for 32-bit)/2 GB (for 64-bit) or higher RAM; Microsoft DirectX 9 graphics device with WDDM driver; audio playback with speakers for programs with video content
• Macintosh: Mac OS X 10.5 or higher with latest updates installed; Intel, PowerPC G5, or PowerPC G4 (867MHz or faster) processor; 512 MB or higher RAM; audio playback with speakers for programs with video content

For assistance: Contact educme@psych.org for questions about this activity | Contact SMIAdviserHelp@psych.org for technical assistance