Article

Journal of Correctional Health Care

2017, Vol. 23(3) 336-346
ª The Author(s) 2017
Mental Disorders Among Reprints and permission:
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Criminal Offenders: A Review DOI: 10.1177/1078345817716180
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of the Literature

Emily D. Gottfried, PhD1, and

Sheresa C. Christopher, PhD1

Abstract
This article examines mental illness among adult, juvenile, male, female, jail, and prison inmates. It
also explores the way in which mental health diagnoses impact offending and violent behavior. A
review of literature pertaining to differences between the genders and age of offenders suggests that
psychiatric disorders are more common among criminal offenders than the population at large.
Furthermore, it appears that many mentally ill offenders do not receive sufficient treatment during
their incarcerations and that barriers inherent to incarceration prevent adequate treatment of
mental illnesses.

Keywords
prisoners, mentally ill criminal offenders, violence, corrections, jails

Introduction
More than half of all inmates in the jails and prisons of the United States have a mental illness (James
& Glaze, 2006). For some mentally ill criminal offenders, the criminal justice system appears to
serve as “an asylum of last resort” (Belcher, 1988, p. 193). This is a problem that is getting
increasingly worse and has caught the attention of the mainstream media, as two U.S. jails, instead
of psychiatric facilities, have been described as housing the largest number of mentally ill individ-
uals. For example, in 2008, National Public Radio described the Los Angeles County Jail as the
“nation’s largest mental institution” (Montagne, 2008) and housing more people suffering from
mental illness than any mental health hospital in the country (Council of State Governments, 2002).
In June 2015, The Atlantic described the Cook County Jail in Chicago, Illinois, as being “America’s
largest mental hospital” (Ford, 2015), and in 2014, the New York Times published an article about
this jail titled “Inside a mental hospital called jail” (Kristof, 2014). Not only is mental health

1
Community & Public Safety Psychiatry Division, Department of Psychiatry and Behavioral Sciences, Medical University of
South Carolina, Charleston, SC, USA

Corresponding Author:
Emily D. Gottfried, PhD, Community & Public Safety Psychiatry Division, Department of Psychiatry and Behavioral Sciences,
Medical University of South Carolina, 29-C Leinbach Drive, Charleston, SC 29407, USA.
Email: gottfrem@musc.edu
Gottfried and Christopher 337

treatment not always readily available for mentally ill criminal offenders, but individuals with
mental health problems have been reported to serve longer prison sentences than those without such
problems (James & Glaze, 2006).

Mental Illness and Inmates

Appendix Table A1 contains information for each study described.
Since 2000, the population of U.S. jails has increased approximately 1% each year (Minton &
Zeng, 2015). By midyear 2005, it was noted that more than half of all U.S. prison and jail inmates
had a “mental health problem” (i.e., recent diagnosis with a mental illness, mental health treatment,
or mental health symptoms; James & Glaze, 2006). Information regarding mental illness among
criminal offenders can be examined separately for individuals detained in a jail and those incar-
cerated in prison. In the United States, jails house individuals who are charged with a criminal
offense and are awaiting trial/sentencing/adjudication of these charges. Jails also house individuals
convicted of an offense who have been sentenced to 1 year or less of incarceration. In contrast, U.S.
prisons house individuals who have been convicted of a criminal offense and have been sentenced to
more than 1 year of incarceration.
With regard to the jail population, as of 2006, 75% of females and 63% of males were reported to
have a mental health problem. Nearly 25% of the jail inmates with a mental health problem reported
a history of physical or sexual abuse in contrast to 8% without a mental health problem. In terms of
symptoms of specific disorders, 30.4% endorsed five or more symptoms of major depressive dis-
order, 18.4% endorsed four symptoms of mania, and 7.2% reported delusions and hallucinations
(i.e., two symptoms of a psychotic disorder). Of the jail inmates with a mental health problem,
76.4% also reported substance use, contrasted with 53.4% reporting substance use without a mental
health problem. Of the jail inmates with a mental health problem, only 17.5% received mental health
treatment at the jail, and only 14.8% took prescribed medication (James & Glaze, 2006).
With regard to state prison inmates, 73% of females and 55% of males had a mental health problem.
In terms of symptoms of specific disorders, 23.9% endorsed five or more symptoms of major depres-
sive disorder, 13.1% endorsed four symptoms of mania, and 4.2% reported delusions and hallucina-
tions (i.e., two symptoms of a psychotic disorder). Of the prison inmates with a mental health problem,
74.1% also reported substance use, contrasted with 55.6% who reported substance use without a
mental health problem. Of the prison inmates with a mental health problem, only 33.8% received
mental health treatment at the jail, and only 26.8% took prescribed medication (James & Glaze, 2006).
The authors of these reports do not list reasons why the jail inmates appear more symptomatic and
were reporting more problems than the prison inmates. Possible explanations for these discrepancies
include stabilization and feigning. Individuals serving sentences in prison have already awaited their
court disposition in jail. Thus, they are less likely to have been homeless immediately prior to prison
incarceration and may have been receiving psychiatric medication at the jail. Additionally, they are
likely to be more stable than individuals who are housed at the jail from the streets/communities for
sometimes a short period of time, likely without medication. It is also possible that individuals who
are awaiting court disposition in jail have a greater external incentive (e.g., receive mental health
treatment instead of prison incarceration) to malinger, exaggerate, fabricate, or feign symptoms of a
mental illness. Therefore, it is possible that jail inmates appear sicker or endorse more problems than
prison inmates for these reasons.
Way, Sawyer, Lilly, Moffitt, and Stapholz (2008) examined all inmates admitted from May 17,
2007, to June 14, 2007, to a New York State prison (N ¼ 2,918). In that time period, 5.9% of the
inmates were diagnosed with serious mental illness, 36% with a psychotic disorder, 13% with major
depression, 31% with a bipolar disorder, and 19% with an unspecified mood disorder (Way, Sawyer,
Lilly, Moffitt, & Stapholz, 2008).
338 Journal of Correctional Health Care 23(3)

Steadman, Osher, Robbins, Case, and Samuels (2009) estimated the prevalence rates of serious
mental illness among jail inmates. Serious mental illness in this study included major depressive
disorder, bipolar disorder, and schizophrenia and other psychotic spectrum disorders. Results indi-
cated that 14.5% of male jail inmates had a serious mental illness, and this prevalence rate increased
to 17.1% when post-traumatic stress disorder (PTSD) was included as a serious mental illness. For
female jail inmates, the prevalence of serious mental illness was 31% and rose to 34.3% when PTSD
was included (Steadman, Osher, Robbins, Case, & Samuels, 2009).
Nationally, Fazel and Danesh (2002) reviewed 62 surveys assessing serious mental illness in
prisoners. These surveys included data on 22,790 prisoners (81% male) in 12 countries. Results
indicated that prisoners were significantly more likely than the general population to have a mental
illness and approximately one in seven prisoners in Western countries had been diagnosed with a
major mental illness of thought or mood. Moreover, one in two male offenders and one in five
female offenders met diagnostic criteria for antisocial personality disorder (Fazel & Danesh, 2002).
Fazel and Seewald (2012) reviewed 81 publications concerning serious mental illness in prisoners.
These publications included data on 33,588 prisoners (84.4% male) in 24 countries. Similar to Fazel
and Danesh’s (2002) study, results indicated that prisoners were significantly more likely than the
general population to have a mental illness and approximately one in seven prisoners in Western
countries were diagnosed with a major mental illness of thought or mood (Fazel & Seewald, 2012).

The relationship between offending and mental illness

Although it may be thought that mentally ill criminal defendants commit crimes due to or because of their
mental illness, recent research has indicated that only approximately one fifth of criminal behavior is
mostly or completely related to mental health symptoms (Peterson, Skeem, Kennealy, Bray, & Zvonkovic,
2014). Furthermore, it was noted that a large proportion of the offenders whose symptoms contributed to
the criminal behavior also committed at least one crime that was independent of the symptoms. Addition-
ally, specific crimes were inconsistently related to symptoms within a specific offender (Peterson et al.,
2014). Morgan, Fisher, Duan, Mandracchia, and Murray (2010) examined prison inmates with mental
illnesses to explore the prevalence of a criminal thinking style/attitudes. Results indicated that mentally ill
offenders are similar to psychiatric patients who have not been charged with an offense in terms of
symptom presentation and are similar to individuals who commit crimes but do not have a mental illness
in terms of thinking style and attitudes (Morgan, Fisher, Duan, Mandracchia, & Murray, 2010).

Schizophrenia and criminal offending

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the
characteristic symptoms of schizophrenia include cognitive, behavioral, and emotional dysfunctions,
which could include delusions (fixed, false beliefs), hallucinations (the apparent perception of some-
thing not present, such as voices), disorganized speech (evidence of nonlinear thought process),
disorganized or catatonic behavior (difficulty formulating and producing goal-directed behavior), and
negative symptoms (such as lack of motivation or diminished emotional expression). These symptoms
persist for at least 6 months and impair functioning in life areas including work, relationships, or self-
care (American Psychiatric Association [APA], 2013).
A study conducted in Australia examined the relationship between criminal offending and a
diagnosis of schizophrenia in a sample of 2,861 individuals over a 25-year period (Wallace,
Mulleen, & Burgess, 2004). A clinical sample of individuals with a diagnosis of schizophrenia was
matched on age, gender, and place of residence with a community sample that had not been
diagnosed with schizophrenia. Results indicated that individuals diagnosed with schizophrenia were
significantly more likely to be convicted of a criminal offense than their community sample
Gottfried and Christopher 339

counterparts (Wallace et al., 2004). This significant relationship was observed in both males (31.3%
of those with schizophrenia were convicted vs. 11.7% of the community sample) and females (7.7%
vs. 2.2%, respectively; Wallace et al., 2004). Additionally, male patients with a schizophrenia
diagnosis had a significantly higher mean number of convictions than the community controls.
Specifically, the mean number of convictions for males with schizophrenia was 15.4 convictions,
whereas the community sample had a mean number of convictions of 5.3. The number of convic-
tions was not significantly different between the female patients and the female community sample.
With regard to the type of offending, the overall frequency of violent offenses was significantly
higher in the patients with a diagnosis of schizophrenia (8.2% overall, 13% for males, 1.4% for
females) than the community sample (1.8% overall, 2.9% for males, 0.3% for females). This finding
remained consistent for property offenses (patients with schizophrenia: 14.5% overall, 20.7% for
males, 5.6% for females; community sample: 4.4% overall, 6.2% for males, 1.9% for females),
substance-related offenses (patients with schizophrenia: 9.4% overall, not provided for males, 1.9%
for females; community sample: 2.3% overall, not provided for males, 0.3% for females), and sexual
offending (males with schizophrenia: 1.8%; community males: 0.7%). With regard to substance use
disorders, 11.4% of the individuals diagnosed with schizophrenia had a co-occurring substance use
disorder and there was a significant relationship between having a substance use disorder and being
convicted of an offense (68.1% of those with a substance use disorder vs. 11.7% without a substance
use disorder). Individuals with a substance use disorder (26.1%) were also significantly more likely
to be convicted of a violent offense than individuals without a substance use disorder (4.4%).

Severe mental illness and violent crime

Results regarding severe symptoms of mental illness and violence have been mixed. For example, a
study using data from the MacArthur Violence Risk Assessment Study found that delusions were not
associated with higher risk of violent behavior (Appelbaum, Robbins, & Monahan, 2000). Another study
using these data examined 1,136 male and female individuals who had been diagnosed with a mental
illness and had been admitted to inpatient psychiatric facilities and compared them to 519 individuals
who had not been psychiatrically hospitalized and were residing in the same neighborhoods as the
patients (Steadman et al., 1998). Results indicated that there were no differences between the patients
and nonpatients in terms of violence. However, substance abuse significantly increased the rate of
violence in both groups (Steadman et al., 1998). A more recent study using the MacArthur data found
that 2% of individuals discharged from inpatient psychiatric facilities used a firearm in the commission
of a violent act, 6% offended violently against a stranger, and 1% used a firearm in the commission of a
violent act against a stranger (Steadman, Monahan, Pinals, Vesselinov, & Robbins, 2015).
A study conducted in Sweden examined the 98,082 patients who had been discharged from a
hospital with a diagnosis of a severe mental illness (psychotic disorder, bipolar disorders, and
depression with psychosis) between 1988 and 2000 to assess the impact of severe mental illness
on violent crime (Fazel & Grann, 2006). During that time frame, 6.6% of individuals diagnosed with
a severe mental illness were convicted of a violent offense compared to 1.8% of the general
population without a diagnosis of a severe mental illness who had a conviction for a violent offense
(Fazel & Grann, 2006). The authors noted that individuals with a diagnosis of a severe mental illness
committed 1 in 20 violent crimes (Fazel & Grann, 2006). Furthermore, in James and Glaze’s (2006)
report, there appeared to be no difference in the use of a weapon during the commission of the crime
between prison inmates with a mental health problem (37.2% used a weapon) and those without a
mental health problem (36.9% used a weapon). With regard to violent offending, 61% of prison
inmates with a mental health problem had a history of “any violent offending,” while 56% without a
mental health problem had a history of violent offending (James & Glaze, 2006).
340 Journal of Correctional Health Care 23(3)

Female inmates
Between 2010 and 2014, the male jail inmate population declined 3.2% while the female inmate jail
population increased 18.1% (Minton & Zeng, 2015). The experience of trauma has been shown to be
very prevalent among female offenders, with an estimated 6 in 10 female offenders reporting
physical or sexual abuse histories (Greenfeld & Snell, 2000). A large proportion (85%) of female
jail inmates assessed for a study by DeHart, Lynch, Belknap, Dass-Brailsford, and Green (2013) met
diagnostic criteria for a lifetime substance use disorder and over half met criteria for PTSD at some
point in their lives. Additionally, 50% met criteria for a severe mental illness at some point in their
lives. Many of the participants of this study had also been the victim of crime, with 86% endorsing
experiencing sexual abuse (DeHart, Lynch, Belknap, Dass-Brailsford, & Green, 2013).
Abram, Teplin, and McClelland (2003) examined 1,272 female jail inmates and reported that 8% of
the sample met diagnostic criteria for both a major disorder of thought or mood and a substance use
disorder. Substance use disorders were also shown to be very prevalent in the female inmates who met
diagnostic criteria for a serious mental illness. Specifically, of the 155 inmates who met criteria for a
serious mental illness, 72% also met criteria for a substance use disorder. Notably, the diagnostic
interview data also revealed that there did not appear to be a significant effect of the order of the onset
of the mental illness or substance abuse. Specifically, 43.4% had their onset of mental illness a year or
more before the onset of the substance use disorder and 46% had their onset of mental illness a year or
more after the onset of the substance use disorder. Finally, odds ratios indicated that the female jail
inmates with a severe mental illness were 1.5 to 4.9 times more likely to have a substance use disorder
than those inmates without a severe mental illness (Abram, Teplin, & McClelland, 2003).
Compared to men in the Way and colleagues’ (2008) study, 15% of the newly admitted female New York
State prison inmates were diagnosed with a severe mental illness. The women were more likely than male
inmates to be diagnosed with major depression or bipolar disorder and less likely to be diagnosed with an
unspecified mood disorder (Way et al., 2008). Another study examined mental illness in female prison
inmates in Pennsylvania from January 1, 2007, to June 30, 2009 (N ¼ 2,164; Houser & Belenko, 2015).
Results indicated that women in the sample who were diagnosed with co-occurring disorders were more than
4 times more likely to receive disciplinary sanction than those without a diagnosis (Houser & Belenko, 2015).

Mental Health Treatment for Adult Offenders

Many prison facilities provide mental health treatment, but these services vary greatly. Although a
review of the services available in jails and prisons is beyond the scope of this article, a promising
avenue for the diversion of mentally ill offenders is the mental health court (MHC). MHCs are
voluntary specialty/problem-solving courts (similar to the drug court model) that divert the offender
from incarceration and into mental health treatment. A large number of studies have found that these
courts reduce recidivism rates in mentally ill criminal offenders (see, e.g., Anestis & Carbonell,
2014; Burns, Hiday, & Ray, 2013; Christy, Poythress, Boothroyd, Petrila, & Mehra, 2005; Goodale,
Callahan, & Steadman, 2013; Herinckx, Swart, Ama, Dolezal, & King, 2005; Hiday & Ray, 2010;
Moore & Hiday, 2006; Steadman, Redlich, Callahan, Robbins, & Vesselinov, 2011).

Juvenile offenders
In 2014, 42,000 juveniles (17 years old) accounted for 0.6% of the total U.S. jail population (Minton &
Zeng, 2015). According to Puzzanchera (2014), law enforcement made 1.3 million arrests of juveniles in
2012 (10% of total arrests). These arrests are reported to account for 12% of total violent crime and 18%
of total property crime arrests. A meta-analysis regarding the prevalence of psychiatric diagnoses in
detained youth was conducted by Fazel, Doll, and Langstrom (2008). A total of 25 studies (N ¼ 16,750;
Gottfried and Christopher 341

13,778 males and 2,972 females) were included for meta-analysis (15 studies from the United States, 4
from the United Kingdom, and 1 from each of the following countries: Australia, Russia, Holland,
Denmark, Canada, and Spain). Results of the meta-analysis indicated that legally involved youth are
significantly more likely than same-aged peers in the general population to experience a variety of
mental health problems and to be diagnosed with a psychiatric disorder.
The Northwestern Juvenile Project, a longitudinal study of youth residing at the Cook County
Juvenile Temporary Detention Center in Chicago, Illinois, examined the prevalence of psychiatric
disorders in 1,829 detained male and female youth (Teplin, Abram, McClelland, Dulcan, & Mericle,
2002). Results add to the literature finding that more than 60% of detained youth met diagnostic
criteria for at least one mental illness even when controlling for the presence of conduct disorder. The
most common disorders were found to be substance use disorders (51% of males and 47% of females)
and disruptive behavior disorders (41% of males and 46% of females). Anxiety disorders were noted to
occur in 21% of males and 31% of females and mood disorders in 19% of males and 28% of females.
Psychotic disorders were less common with a prevalence rate of 1% for both males and females.
Given the longitudinal nature of this study, Teplin, Welty, Abram, Dulcan, and Washburn (2012)
examined the prevalence and persistence of such disorders postdetention. Findings indicate that
although prevalence rates decreased overall, a large number of both male (more than 45%) and female
(more than 30%) youth continued to meet criteria for at least one mental illness upon follow-up, 5
years after the initial interview. Males had higher rates of substance use and disruptive behavior
disorders (2–3 times more likely than females), while females had higher rates of depression over time.
The Northwestern Juvenile Project also examined the prevalence of trauma exposure and PTSD in a
subset (N ¼ 898) of youth from the sample outlined above (Abram et al., 2013). Researchers found high
rates of traumatic exposure to single events (92.5%) and multiple events (84%). Of those youth, 56.8%
had experienced more than six traumatic events. Within 1 year prior to the interview, 11.2% of youth
(10.9% of males and 14.7% of females) were found to meet criteria for a diagnosis of PTSD. Further-
more, 93% of those youth met criteria for at least one comorbid disorder. Of note, rates of PTSD have
been found to be much higher in other studies of detained youth. For example, Burton (2008) found 24%
of detained youth in their sample met criteria for PTSD, and Cauffman, Feldman, Waterman, and Steiner
(1998) found a PTSD prevalence rate of 49% in a sample of delinquent adolescent females. Taken
together, findings are more than double, if not as high as 10 times, the rates of PTSD found in a nationally
representative sample of 10,123 youth aged 13 to 18 (5%; Merikangas et al., 2010).
Despite the high need for mental health treatment for legally involved youth, the juvenile justice
system has not demonstrated the ability to adequately address the mental health needs of the youth
they serve (Desai et al., 2006). Desai and colleagues highlight several potential barriers to providing
mental health treatment to detained youth including lack of consensus on which services are needed
and lack of data regarding the efficacy of such services if implemented. They further highlight the
potential limitations associated with funding and available resources as well as the short length of
stay, which is commonplace in many juvenile detention facilities. Despite the inherent barriers
present, the need to provide legally involved youth with adequate mental health services remains high.
Regarding interventions for juvenile offenders, a movement related to trauma-informed care has begun.
Given the prevalence and severity of trauma exposure in addition to the complexity of symptoms found to be
associated with complex trauma, the importance of developing evidence-based treatments (EBTs) for trauma
in this population is paramount. Cognitive behavioral interventions for trauma in this population have only
recently begun to emerge and the effectiveness of such programs is in need of further study. Although there is
much room for growth, interventions to include protocol modifications to trauma-focused cognitive behavior
therapy appear to be promising (Cohen, Mannarino, & Deblinger, 2006). As the field continues to move
toward the identification of treatment modalities to more effectively treat the effects of mental illness in these
populations, the need to study the efficacy of such programs arises. Future research in this area is important,
given the need to treat this vulnerable population and promote their ability to contribute positively to society.
342 Journal of Correctional Health Care 23(3)

Conclusion
A review of the literature highlights the fact that psychiatric disorders are much more common in
incarcerated individuals across age, gender, and type of facility in which they are detained. High
rates of substance use and substance use disorders are found in both adults and juveniles across
gender. Rates of traumatic exposure in detained individuals for both single and multiple events as
well as the prevalence of PTSD were found to far exceed those expected in the general population.
Furthermore, prevalence rates of other disorders, including mood and anxiety, follow a similar
pattern. Of note, symptoms of psychosis were more prevalent in adult offenders than juvenile
offenders, which is not surprising, given the age of onset for psychotic disorders ranges (early to
mid-20s for males and late 20s for females; APA, 2013).
Given the data outlined above, the need for mental health treatment for detained individuals is of
the upmost importance. In an effort to increase the accessibility of mental health services available
to these populations, researchers and clinicians alike will need to work to overcome several barriers
to implementing these services. Specifically, there is a need for research to identify effective
treatment methodologies for the mental health disorders found in the literature and to study the
efficacy of implementation with populations of detained individuals. Future research should work to
identify and develop EBT that will function despite the constraints inherent in detention facilities,
such as short length of stay for juvenile offenders and limited resources and mental health staff.
Clear barriers to the way in which the justice system effectively addresses the needs of those they
serve have been identified. Given these limitations, the importance of identifying strategies to help
improve service delivery and more effectively treat mental illness is highlighted. For instance, early
identification and classification of detained individuals through adequate screening procedures is likely
to improve access to mental health services for those in need. Likewise, effective training in mental
health for support staff and the use of EBT modalities is likely to improve the efficacy of mental health
services provided. The implementation of programming designed to facilitate growth, maintain treat-
ment goals, and promote successful reentry into the community would serve this population well. Lastly,
there is a need to implement programs that successfully transition mentally ill offenders from the justice
system to community-based mental health treatment services, such as MHCs.

Appendix

Table A1. Mental Illness Among Criminal Offenders.

Study Population Findings

Abram et al. (2013) Detained youth (N ¼ 898; 59.2% 11.2% PTSD (10.9% males, 14.7% females)
male)
Abram, Teplin, and Female jail inmates (N ¼ 1,272) 8% major thought or mood and SUD
McClelland (2003)
Burton (2008) Detained youth (N ¼ 74 adjudicated 24% PTSD
sexual abusers and 53 nonsexual
abusers)
Cauffman, Feldman, Delinquent adolescent females (N ¼ 49% PTSD
Waterman, and 96)
Steiner (1998)
DeHart, Lynch, Belknap, Female jail inmates (N ¼ 115) 85% lifetime SUD, >1/2 lifetime PTSD, 50%
Dass-Brailsford, and lifetime SMI, 86% sexual abuse
Green (2013)
(continued)
Gottfried and Christopher 343

Table A1. (continued)

Study Population Findings

Fazel and Danesh (2002) Prisoners (N ¼ 22,790; 81% male) 1:7 mood or thought disorder; 1:2 men and
1:5 women ASPD
Fazel and Grann (2006) 98,082 psychiatric patients (women 6.6% convicted of a violent offense
¼ 55.8%)
Fazel and Seewald (2012) Prisoners (N ¼ 33,588; 84.4% male) 1:7 mood or thought disorder
Fazel, Doll, and Legally involved youth (N ¼ 16,750; Detained youth more likely to be diagnosed
Langstrom (2008) 82.3% male) with mental illness compared to general
population
Greenfeld and Snell Female offenders 6:10 physical abuse/sexual abuse history
(2000)
Houser and Belenko 2,164 female Pennsylvania prison Women with a co-occurring disorder more
(2015) inmates than 4 times likely to receive disciplinary
sanction than those without
James and Glaze (2006) Jail and prison inmates More than half have a mental illness
Merikangas et al. (2010) National Comorbidity Survey— 5% of adolescent population meet criteria for
Adolescent Supplement data (N ¼ PTSD
10,123; 51.3% male)
Minton and Zeng (2015) Jail inmates Jail inmate population in the United States
increasing, including women and juveniles
Peterson, Skeem, 143 offenders with SMI (64.1% male) One fifth of criminal behavior attributable to
Kennealy, Bray, and mental health symptoms
Zvonkovic (2014)
Steadman, Monahan, MacArthur data (N ¼ 1,136 patients) 2% of patients used a firearm in a violent act;
Pinals, Vesselinov, and 6% offended against a stranger (1% used a
Robbins (2015) firearm against stranger)
Steadman et al. (1998) MacArthur data (N ¼ 1,136 patients) No differences in violence; substance use
matched with 519 community increased violence in both groups
controls
Steadman, Osher, Jail inmates (N ¼ 822; male ¼ 50.7%) Total sample: 14.5% SMI (MDD, bipolar,
Robbins, Case, and schizophrenia, psychotic spectrum); 17.1%
Samuels (2009) (including PTSD)
Females: 31% SMI (MDD, bipolar,
schizophrenia, psychotic spectrum); 34.3%
(including PTSD)
Teplin, Abram, Detained youth (N ¼ 1,829; >60% met criteria for at least one mental
McClelland, Dulcan, male ¼ 64.1%) illness; 51% males, 47% females SUD; 41%
and Mericle (2002) males, 46% females disruptive behavior;
21% males, 31% females anxiety disorders;
19% males, 28% females mood disorders,
1% psychotic disorder
Teplin, Welty, Abram, Youth postdetention: 5-year follow- 45% male and 30% female had at least one
Dulcan, and up of 2002 study mental disorder
Washburn (2012) (N ¼ 997; 60% male)
Wallace, Mulleen, and Psychiatric patients (N ¼ 2,861; 59% 31.3% of patients with schizophrenia were
Burgess (2004) male) matched to community convicted of criminal offense compared to
sample 11.7% of the community sample
Wasserman, Ko, and 296 male youth in detention 18.9% anxiety disorder, 9.1% mood disorder,
Reynolds (2004) 31.8% disruptive behavior disorder, 49.3%
SUD
Way, Sawyer, Lilly, 2,918 New York prison inmates 5.9% diagnosed with a SMI; 15% of females
Moffitt, and Stapholz (7.3% female) diagnosed with a SMI
(2008)
Note. SUD ¼ substance use disorder; SMI ¼ serious mental illness; ASPD ¼ antisocial personality disorder; MDD ¼ major
depressive disorder; PTSD ¼ post-traumatic stress disorder.
344 Journal of Correctional Health Care 23(3)

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or
publication of this article. For information about JCHC’s disclosure policy, please see the Self-Study Program.

Funding
The authors received no financial support for the research, authorship, and/or publication of this article.

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