David Khey

Magic Mint, the Internet, and Peer Associations: A Test of Social Learning Theory Using Patterns of Salvia Divinorum Use

As new drugs are introduced into the market, it becomes the role of policy makers to assess the dangers associated with each drug and its potential to be misused by the populace. The focus of this research is to better understand how young adults learn about a new drug and subsequently engage in its use. Salvia divinorum is a plant species whose leaves contain psychoactive components. Its recreational use among teenagers and young adults has received increased media and policy attention. Several states have taken the initiative to ban this substance. Despite this legal action, little is known about why this substance has gained in popularity and what factors contribute to its use. Akers’ social learning theory offers one explanation for why individuals experiment with drugs. We employ a sample of college students from a large public university to test Akers’ propositions, finding support for his theory.

Treatment: Intersection with Criminal Justice

When hearing the terms “mental health” or “mental illness,” the stereotype is to think of “crazy.” This stereotypical image is of a person suffering from radical delusions and/or hallucinations, which is also often associated with violence. This common distortion of the realities of mental illness is certainly one leading reason why data collection is important. That is, the best way to combat stereotypes and educate the public on the true face of mental health or mental illness is to gather and deploy factual information. These facts detailing the actual number of people diagnosed with a mental illness help with educating the public of problems in their community. Additionally, friends and families can better understand the needs of their loved ones. Communities can create ways to address the needs of those with a diagnosis or help to prevent symptoms before onset occurs.

What Works and What’s Promising

This book came about through the collective experience of both authors. Jada and Dave independently and together on various projects have seen a need to bring crime and mental health to the forefront of many conversations not only in the professional realm but also in working with students. As it stands today, students graduating in criminal justice will more than likely encounter justice-involved individuals with mental health concerns. It is important that those students turned professional understand the obstacles and cracks in the system that individuals face. This book is just a starting point for many conversations to come on these topics. The hope is that beginning the discussion can also begin the solution.

Self-Care for Professionals

The idea of burnout exists in many different professions, especially those related to both mental health and criminal justice. No matter the political stance or outlook, most would agree that the job of police officers is a difficult one. For the most part, when police are involved in an incident, it is a negative one. Police patrol for traffic stops or speeding on highways, respond to emergency calls, and escort inmates when transferred or appearing in court. Often traffic stops and speeding result in tickets, and emergency calls can result in arrests and/or involvement of medical personnel. All of these are negative, again, much of the job of police. Now, consider repeating this scenario daily for years—tough thoughts, right? This is the reality for most that serve on the “front line,” yet, this sentiment can be widespread throughout the entire system coming into contact with individuals with mental illness.

Release and Reentry

Reentering society can be one of the most difficult obstacles a justice-involved person can face in their lifetime. All facets of one’s life change instantly upon release from prison. The controlled environment of a prison facility allows an inmate to create a routine and have stability in relationships and daily activities. A person behind bars knows exactly when the next phone call to a loved one will take place, the next meal, activity time, etc. These things are no longer regular, or controllable, on the outside in society. Often times, individuals struggle in the chaos that exists outside the prison walls. The best chance for success involves planning and preparing for those changes and learning coping skills to handle them in a healthy manner. Unfortunately, this is not always realistic on many levels. The most comprehensive evaluation of prisoner (e.g., excludes jail inmate) recidivism available reveals that 30.4% of prisoners return to prison within a year, 43.3% return in 2 years, 49.7% return in 3 years, 52.9% return in 4 years, and 55.1%—over half—return in 5 years (Durose, Cooper, & Snyder, 2014). If one simply looks at prisoners being arrested after release, many of which require stays in jail as arrestees await criminal justice processing, the statistics are even bleaker: 43.4% are arrested within a year, 59.5% within 2 years, 67.8% within 3 years, 73.0% in 4 years, and 76.6% in 5 years. Further, a large proportion of individuals rearrested after release from prison are drawn back into the criminal justice system (including jails and diversion programs), typically through a sanction by the court and/or by probation/parole violations and revocations. Ultimately, the plan to reduce contact with the criminal justice system exists within the transition planning before, in the moment of, and after release from incarceration, with the courts and probation/parole being key players in the reentry movement. This needs to include both jails and prisons, but importantly, it needs to include a mental health element more substantial than just attending to substance abuse treatment issues.

Mental Illness, Then and Now

Mental illness impacts millions of people as well as their loved ones. It can take many forms; it can ebb and flow throughout the life course; it can be the root of a life of suffering; yet, in most cases, it does not have to be a life sentence of misery. The intersection of crime and mental health has been a long-standing issue spanning across many decades, even centuries. In more recent times, professionals in the United States have begun to detail the “cracks” within the criminal justice system with better precision, especially in relation to inmates with mental health concerns. Unfortunately, despite the recognition of these cracks and their potential “fixes,” the implementation of change continues to be a struggle. The federal system, state system, and local county/parish jail system each have their own obstacles to overcome. Furthermore, these systems do not always work together for the common cause of public health for various reasons. Even further, integrating the mental health system into the criminal justice system at these levels can at times seem impossible; yet, the capacity for coordinated change has never been more possible. This text serves to educate students and professionals not only on the system of interconnected cracks, but also on the recommendations and innovations set forth by different interests at varying levels of the said system. All of the answers may not have been discovered yet, but the impetus for change is on the horizon for those with mental illness in the criminal justice system. The hopes of change begin with discussion on the problems, particularly in a historical context. This text seeks to be that vehicle for change in the future to ensure the care and safety of justice-involved individuals with mental illness.

The Front Line: EMS, Law Enforcement, and Probation and Parole

First responders—which typically include emergency medical services (EMS), “line” (or patrol) law enforcement officers, and firemen—are workers who are dispatched to crime scenes, accidents, and emergencies. Aside from bystanders and witnesses, they are often the first to encounter people in crisis and even more likely to be the first to engage with these individuals. These professionals routinely encounter the turmoil, panic, and pain in its rawest form and thus are often dealing with difficult and serious situations—perhaps even daily. In regard to confronting mental illness, the primary concern lies in the lack of relevant training for the vast majority of these professions. For example, EMS personnel commonly have some level of training to enhance their ability to work with individuals experiencing mental health crises and/or who have a mental illness (diagnosed or undiagnosed); on the other hand, law enforcement officers commonly have little to no required training in mental health-related topics. This training deficiency is beginning to be addressed as some departments are moving to require officers, or a subset of law enforcement agencies’ patrol units, to be trained to serve on Crisis Intervention Teams (CIT), but this is not yet universal. Therefore, it is imperative to carefully consider the unintended consequences of having citizens routinely encountering professionals who are not properly trained to work with individuals experiencing mental health crises when emergency services are dispatched. While many urban and suburban areas have created a mobile crisis unit that provides immediate services in the event of a mental health crisis, these units are often underfunded or work in isolation. Ideally, these mobile crisis units work together with local law enforcement when emergency services are called. This chapter discusses the current picture of first responders’ work with individuals with mental illness and citizens experiencing mental health crises. It further identifies probation and parole officers as part of the first responder definition as these professionals confront the very same issues as do their colleagues in patrol law enforcement and EMS.

Community-Based and Grassroots Programs

Community members can aid in making change in mental health awareness and improving the system of care and reentry. In fact, there appears to be substantial growth in nonprofit organizations of all sizes to affect such change, as well as the volunteer hours needed to sustain this momentum. In 2015, the Urban Institute released their annual Nonprofit Sector in Brief, which supports this claim (McKeever, 2015). This report reveals that the number of 501(c)(3) public charities grew 19.5% from 2003 to 2013, and 25.3% of American adults had volunteered for a nonprofit organization in 2014. While this proportion of adults who volunteer at least once per year is on a slightly downward trend, the number of total volunteer hours in any given year is at the highest ever recorded at 8.7 billion hours in 2014—valued at

Size and Scope of Justice-Involved Mental Illness

179.2 billion. This volunteerism is consistently concentrated in social service and care activities, including food preparation, cleanups, food, goods, and clothing collection and delivery, direct care and/or services, teaching, mentoring, and counseling. In the cases of local mental health-care system improvements and criminal justice reform (e.g., reentry), this momentum has been buttressed by grant opportunities through the Substance Abuse and Mental Health Services Administration, the Bureau of Justice Assistance, and other Federal government funding agencies specifically tailored to support public nonprofit collaborations. For example, the Bureau of Justice Assistance Second Chance Act Comprehensive Community-Based Adult Reentry Program is specifically geared for community-based nonprofits who engage in reentry activities such as mentoring support, treatment services, legal aid, and more. These opportunities also seem to be on the rise; however, it is uncertain how the current administration will shape this trend in the upcoming years. With momentum in Congress and local governments for justice and mental health reform, it appears that the trajectory of improvements will continue to some degree. This chapter focuses on promising nonprofit activity led by icons, world leaders, and everyday people to give readers some orientation of the rigorous activity that is affecting changes in mental health and justice.

An Implementation and Process Evaluation of the Louisiana 22nd Judicial District’s Behavioral Health Court

Before starting a discussion on just how many justice-involved individuals have a diagnosable mental illness, what those diagnoses tend to be, their severity of symptoms, and their rates of relapse, it will be helpful to keep a few caveats in mind. First, diagnosing mental illness can prove difficult as it impinges on the full cooperation of the patient. This cooperation may be influenced by stigma; varying levels of acceptance of mental health care by gender, race, and culture; and, likely, the “us versus them” relationship of medical staff to inmate, probation and parole officer to client, drug court case manager to client, and so on. Second, there is evidence of moderate amounts of malingering in the justice-involved population; in other words, justice-involved individuals are known to feign illness, including mental illness, if doing so will provide a benefit, such as getting out of assigned work duties, obtaining higher-quality meals, to get out of their jail or prison cell, to be able to be in an air-conditioned facility, or just to feel the reward of gaining a privilege or advantage, no matter how trivial it is to an average person. Last, there is considerable variation in applying mental health screening tools in professional circles, and, further, there can be dynamic differences in how mental health professionals apply diagnoses over time, by place or region, or given other factors (that will be discussed later). To make the long story short, there is a substantial amount of gray area when trying to estimate the prevalence of mental illness among the justice-involved population. This chapter will discuss the most current prevalence estimates—or the overall rate of mental illness among each segment of the justice-involved population.