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: 10689140
• 负责人: AMY Blank Wilson
• 金额: $ 23.93万
• 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/10689140
• 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; 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; behavioral health; community intervention; community setting; effectiveness trial; effectiveness/implementation trial; evidence base; flexibility; forging; future implementation; high risk; implementation design; implementation strategy; information gathering; 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 传统心理健康服务未能大大减少不成比例的参与 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： 精神疾病不是刑事司法参与的主要驱动力。研究一直表明 患有精神疾病的人面临着司法参与的相同风险因素（即“犯罪”风险因素） 那些没有精神疾病的人。研究还发现，具有SMI的司法人员的水平很高 犯罪风险因素，这些危险因素介导了其累犯的风险。但是，大多数干预措施 对于涉及司法的人，SMI的人并不以犯罪危险因素为目标。这个差距 研究和服务条款之间代表降低司法参与率的未开发潜力 在有SMI的人中，通过扩大其继续服务以包括直接针对的干预措施 犯罪风险因素。我们最近由NIMH资助的随机对照试验（1R34MH111855-01; PI：Wilson） 证明当适应与SMI的人一起使用时，以犯罪为中心的干预措施可以 成功参与与犯罪风险因素相关的关键治疗目标和结果 与SMI的囚犯。鉴于多达50％的SMI患者在社区中接受治疗 精神卫生系统有一些刑事司法系统的参与，发展为以犯罪为中心 在社区心理健康环境中提供的干预措施具有优化其潜力的巨大潜力 影响，无论是就可以从中受益的人数和潜在减少而受益的人数 未来的刑事司法参与。这项R34提案汇集了一个全国认可的专家团队 聘请以部署为中心的方法，以开发和初步测试新的，可扩展的和 基于可持续的小组，以犯罪为中心的认知行为疗法开发了 专门用于在基于社区的心理健康环境中使用SMI的人。这项建议的研究 包括三个目标。第一个目的将吸引以用户为中心的设计方法，以优化 开发新干预措施。第二个目标将进行小型飞行员随机对照试验 测试新干预措施的初步有效性。该试点试验将进行实验 治疗方法研究新干预措施如何与预期的治疗目标和 结果。第三个目标将使用与主要利益相关者的定性研究方法来确定实施 最高和极端的策略是新干预的可伸缩性和可持续性 基于社区的心理健康环境。