Forging New Paths: Building Interventions to Treat Criminogenic Needs in Community Based Mental Health Settings

开辟新道路：在社区心理健康环境中制定干预措施来治疗犯罪需求

• 批准号: 10509138
• 负责人: AMY Blank Wilson
• 金额: $ 25万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10509138
• 关键词: Address; Administrator; Adoption; Adult; Aggressive behavior; Attitude; Belief; Client; Clinical; Clinical Treatment; Clinical Trials; Cognitive Therapy; Communities; Criminal Justice; Development; Effectiveness; Face; Failure; Focus Groups; Funding; Funding Agency; Future; Goals; Health system; Imprisonment; Impulsivity; Individual; Intervention; Interview; Investigational Therapies; Justice; Light; Logistics; Mediating; Mental Health; Mental Health Services; Mental disorders; Methodology; Methods; Mission; National Institute of Mental Health; Outcome; Persons; Phase; Pilot Projects; Prisoner; Process; Public Health; Qualitative Research; Randomized Controlled Trials; Research; Research Methodology; Risk; Risk Factors; Service provision; Services; Structure; Supervision; Symptoms; System; Testing; Therapeutic Intervention; Thinking; base; behavioral health; community intervention; community setting; effectiveness implementation study; effectiveness trial; evidence base; flexibility; forging; future implementation; high risk; implementation design; implementation strategy; innovation; intervention delivery; novel; parole; pilot trial; preventive intervention; primary outcome; probation; recidivism; service intervention; service providers; severe mental illness; therapy development; treatment as usual; usability; user centered design

ABSTRACT The failure of traditional mental health services to significantly reduce the disproportionate involvement of people with serious mental illnesses (SMI) in the criminal justice system highlights a basic but overlooked fact: mental illness is not a primary driver of criminal justice involvement. Research has consistently shown that people with mental illness face the same risk factors for justice involvement (i.e., “criminogenic” risk factors) as those without mental illnesses. Research has also found that justice-involved people with SMI have high levels of criminogenic risk factors and that these risk factors mediate their risk of recidivism. Yet, most interventions for justice-involved people with SMI do not target criminogenic risk factors as a goal of treatment. This gap between research and service provision represents untapped potential to reduce rates of justice involvement among people with SMI, by expanding their continuum of services to include interventions that directly target criminogenic risk factors. Our recent NIMH-funded randomized controlled trial (1R34MH111855-01; PI: Wilson) demonstrated that when adapted for use with people with SMI, criminogenic-focused interventions can successfully engage key treatment targets and outcomes associated with criminogenic risk factors among prisoners with SMI. Given that up to 50% of people with SMI receiving treatment in the community-based mental health system have had some criminal justice system involvement, developing criminogenic-focused interventions for delivery in community mental health settings has great potential to optimize their potential impact, both in terms of the numbers of people with SMI who can benefit and in terms of potential reductions in future criminal justice involvement. This R34 proposal brings together a team of nationally recognized experts to engage a deployment-focused approach to the development and preliminary testing of a new, scalable, and sustainable group-based, criminogenic-focused cognitive-behavioral therapy intervention developed specifically for use among people with SMI in community-based mental health settings. This proposed study includes three aims. The first aim will engage user-centered design methodologies to optimize the development of the new intervention. The second aim will conduct a small pilot randomized controlled trial to test the preliminary effectiveness of the new intervention. This pilot trial will engage an experimental therapeutics approach to examine how the new intervention engages the intended treatment targets and outcomes. The third aim will use qualitative research methods with key stakeholders to identify implementation strategies that both maximize and expediate the scalability and sustainability of the new intervention in community based mental health settings.

抽象的 传统的精神卫生服务未能显着减少不成比例的心理健康服务 刑事司法系统中患有严重精神疾病（SMI）的人强调了一个基本但被忽视的事实： 精神疾病并不是参与刑事司法的主要驱动因素。研究一致表明 精神疾病患者面临与司法介入相同的风险因素（即“犯罪”风险因素） 那些没有精神疾病的人。研究还发现，患有 SMI 的参与正义的人具有较高水平 犯罪风险因素，并且这些风险因素介导了他们再犯的风险。然而，大多数干预措施 对于参与司法的 SMI 患者，不将犯罪风险因素作为治疗目标。这个差距 研究和服务提供之间存在着尚未开发的降低司法参与率的潜力 通过扩大服务连续性以包括直接针对 SMI 患者的干预措施 犯罪危险因素。我们最近进行的 NIMH 资助的随机对照试验（1R34MH111855-01；PI：Wilson） 证明，当适用于 SMI 患者时，以犯罪为重点的干预措施可以 成功地将与犯罪风险因素相关的关键治疗目标和结果纳入其中 患有 SMI 的囚犯。鉴于高达 50% 的 SMI 患者在社区接受治疗 精神卫生系统已经有一定程度的刑事司法系统参与，正在发展以犯罪为重点的 在社区心理健康环境中提供的干预措施具有极大的潜力，可以最大限度地发挥其潜力 影响，既包括可以受益的 SMI 患者数量，也包括潜在的减少 未来刑事司法的参与。这项 R34 提案汇集了国家认可的专家团队 采用以部署为中心的方法来开发和初步测试新的、可扩展的、 开发了可持续的、基于群体的、以犯罪为重点的认知行为治疗干预措施 专门用于社区心理健康环境中的 SMI 患者。这项拟议的研究 包括三个目标。第一个目标是采用以用户为中心的设计方法来优化 新干预措施的发展。第二个目标将进行一项小型试点随机对照试验 测试新干预措施的初步效果。该试点试验将进行实验 治疗方法来检查新的干预措施如何实现预期的治疗目标 结果。第三个目标将与主要利益相关者一起使用定性研究方法来确定实施情况 最大限度地提高和加快新干预措施的可扩展性和可持续性的策略 以社区为基础的心理健康环境。