Supervision and Treatment Experiences of Probationers with Mental Illness

Analyses of Contemporary Issues in Community Corrections

Babatunde Adekson

• Publisher: Routledge
• Year: 2018
• Print ISBN: 9780367606855
• eBook ISBN: 9781351719254
• Topic: Psicología
• Subtopic: Psicología clínica

Emerging from a qualitative research study on the rehabilitation experiences of adult male probationers with mental health illness, this book describes the treatment and rehabilitation experiences of these individuals and contextualizes their experiences within the landscape of mental health treatment in the United States. Often underserved in outpatient community support programs, probationers with mental health illness (PMIs) face stigma and obstacles in seeking mental health treatment and rehabilitation. Examining the lived experiences of both PMIs and their probation officers, this book offers insights into the study of stigma as it relates to probationers and the work of probation officers in furthering treatment and rehabilitation options for PMIs.

1 Introduction

Summary of this Investigation

The number of individuals legally committed to community corrections and probation sentences has increased dramatically in recent years (Ditton, 1999; Glaze & Bonzcar, 2007). This growing population of offenders experiences challenges in multiple domains of life, including rehabilitation/recidivism, housing, employment, education, and access to therapeutically effective and culturally relevant mental health care (Skeem, Emke-Francis, & Louden, 2006). Skeem et al. (2006) argued that individuals with mental illness who are forced into the criminal justice system are a particularly vulnerable group. This vulnerability is related to the fact that they simultaneously experience barriers and challenges related to their criminal history, the stigma of deviance, and the stigma of mental illness (Falk, 2001).

More than 50 years ago, Goffman (1963) defined “stigma” as any label that conveys a discrediting influence on the target individual or population. This term is particularly germane to this study of Probationers with Mental Illness (PMIs) in that they are often marginalized as a result of their prior criminal activity and psychosocial integration challenges. Moreover, the institutional and structural make-up of probation—coupled with the potential for stigma to impact and/or overshadow the experience of PMIs and their mandated interactions with their Probation Officers (POs)—present formidable barriers to effective post-incarceration services. To elucidate the influence of stigma, commonly constructed public perceptions about mental illness and deviant behaviors are described, along with the influences of these social constructions to the processes of stigma maintenance. By focusing on the experiences of PMIs relative to the potential of stigma-laden processes in probation work—coupled with the views of the POs assigned to assist them—this qualitative investigation is expected to fill a gap in the existing literature.

Overview of the Problem

In comparison to the “average” probationer, probationers with mental illness are likely to experience the criminal justice system and subsequent rehabilitation services quite differently due to their special needs and challenges (Allen, 1985). However, a thorough understanding of the experiences of PMIs with agencies targeted to help them has yet to be achieved. This lack of attention to the experiences of probationers has, in fact, limited the success of rehabilitation programs and leads to the perception that former inmates released into the community are “less than complete human beings, unworthy, and less deserving than citizens who have not violated the law” (Allen, 1985, p. 67). In support of the need to provide a voice for probationers, Chui (2003) asserted that if the field of probation and the larger criminal justice system is to make a comprehensive ideological transition toward addressing the types of identified deficits, probationers must be allowed to describe their opinions as service consumers.

Probation work in the American criminal justice system has evolved in the last century and a half. The structure and process of probation as a service have also grown from strictly law enforcement to include rehabilitation and care. In addition, the nature of probation work, the types of skills and expertise that POs have—coupled with the dispositions and attitudes they employ in their work—necessitates the use of client-centered techniques to aid in the “assessment, planning, interventions and evaluation” (Durnsecu, 2011, p. 194) of PMIs’ mental health and rehabilitative needs. PMIs have specific service needs, which are too often constrained in the structure of probation, rehabilitation, and treatment experiences. Specifically, their probationary experiences are shaped by the nature of their mental health issue(s), their treatment protocols, their relationship with their POs, and the potentially pernicious influence of stigmatization on rehabilitation services. All these issues impact how they utilize probation as a service.

Significance of the Problem

Probationers with Mental Illness

According to a 2006 Bureau of Justice Statistics report, 64% of incarcerated individuals will present with a recent mental health issue (Steadman, Osher, Robbins, Case, & Samuels, 2009). This finding supports earlier research that a disproportionately large number of people with a mental illness (diagnosed or undiagnosed) are arrested in comparison to the general population (Lamb & Weinberger, 1998); moreover, approximately 6% to 15% of individuals in city and county criminal justice institutions and 10% to 15% of individuals in state institutions are dealing with severe mental illness. Important for this investigation is that from 6% to 9% of the nation’s probationers present with a serious mental illness (Lurigio & Swartz, 2000).

In addition to meeting standard conditions of probation (i.e., maintaining employment and meeting requirements for medication compliance), the PMI is typically required to participate in mental health treatment as a special condition of probation—often in complex and overburdened mental health care and rehabilitation systems (Louden, Skeem, Camp, & Christensen, 2008; Skeem et al., 2006). Indeed, the literature shows that only 15% of the probation departments that responded to a national survey indicated that they operated targeted programs for PMIs (Lurigio & Swartz, 2000). Moreover, PMIs who present with less outwardly expressed symptoms of mental illness usually receive scant attention from probation officers, particularly in traditional probation rehabilitation models. Compounding the problem is that the vast majority of probation officers generally lack the experience and background necessary to deal effectively with emotionally troubled clients.

In short, PMIs are an underserved population, and most traditional-model probation officers are unable to adequately handle the complexities of care that these individuals need (Lurigio & Swartz, 2000). Thus, much more needs to be done to improve the programmatic delivery process, particularly in terms of communicating expectations in more humane ways (i.e., positive attitudinal, relational, and professional competencies) for these individuals.

Stigma

Stigma has long been linked to those dealing with mental illness. The term “stigma” is a mark of disgrace meant to discredit the targeted individual (Byrne, 2000; Goffman, 1963). Modern conceptualizations of stigma emphasize the connections between labeling, stereotyped attributions, emotional or prejudicial reactions (i.e., attitudes), and various types of discrimination (Arboleda-Florez & Stuart, 2012). “Unpredictable,” “dangerous,” and “violent” are just some of the types of characterizations and labels that individuals with severe mental illness are given in the larger cultural milieu—and this type of labeling is increasing as a result of killing events that seem to occur far too frequently (e.g., Roseburg, Sandy Hook, Virginia Tech, Columbine, etc.).

Additionally, there is the potential for individuals with relatively less-stigmatized mental illnesses to self-stigmatize based on the commonly accepted misconceptions and societal beliefs about mental illness in our culture (Corrigan & Kleinlein, 2005). In addition to the particular relationship processes mentioned above, the role of stigma in the relationship between service professionals and their clientele with mental health issues is an important consideration. As such, one must consider the kinds of relational practices of POs and contextualized ideologies and structural arrangements within the probation systems that PMIs could potentially perceive as stigmatizing. These considerations are important both in terms of the mental health status of PMIs as well as the likelihood of them staying out of jails and prison. In short, mental illness stigma can take several forms (self, public, and structural) and is known to be debilitating for those who experience it.

In addition to mental illness stigma, Falk (2001) pointed out that individuals who are convicted of a crime also possess a stigma (i.e., the stigma of criminality, deviance, or stigma of conviction) that labels them long after incarceration—and, depending on the crime, perhaps forever. There are inherent challenges associated with this devalued identity in that these individuals often find it difficult to assimilate back into mainstream society due to employment hindrances and other social impediments. They also experience a change in status and therefore seek the company of others with similar devalued identities; thus, in some instances they transform their stigma into a status symbol within their circle of “criminals.” In essence, the stigma of criminality or deviance does not normally culminate when a probationer has finished his or her prison sentence or probationary period. Those who have been impacted by the “criminal” or “convict” label continue to be perceived with a good deal of suspicion.

The problem, therefore, is that PMIs are at risk for the “double-stigma” of being labeled a criminal-deviant and also possessing the label of being mentally ill (Corrigan & Kleinlein, 2005). In addition, the institutional mandates that are built into the probation system could be potentially structurally stigmatizing. Once a person gets involved in the criminal justice system, he or she enters “a parallel universe in which discrimination, stigma, and exclusion are perfectly legal … It does not matter whether [the criminally deviant] actually spent time in prison; [his or her] second-class citizenship begins the moment [he or she is arrested and charged with a crime]” (Alexander, 2012, p. 94).

Purpose of the Study

This qualitative study was designed to investigate the treatment and rehabilitation experiences of PMIs, who are often underserved in outpatient and community support programs (Arboleda-Florez & Stuart, 2012; Byrne, 2000; Shoham & Rahav, 1982). To ensure a comprehensive understanding of this issue, I also examined the experiential context and perspectives of the service professionals/probation officers who were tasked with helping the PMIs fully transition back into the community after their release. This dual lens facilitated an examination of how PMIs self-report about the “what” and “how” aspects of their probation sentence, while the POs’ perspectives offered a look into how treatment and rehabilitation practices (i.e., structural and institutional ideologies of probation work) are conceptualized and implemented. A third aim was to understand the role of stigma in the practice of probation. This study was designed to fill a scholarly gap by conceptualizing the discourses that probationers use to describe their experience(s) in the mental health and criminal justice systems.

Research Question

To guide this investigation, the researcher developed the following overarching research question: How do PMIs experience probation with a particular probation officer? This question was prompted by the need to explore the probationary experiences of PMIs and how they perceive the impact of the practices of POs and the resultant structure and expectations of POs, as well as the institutional ideologies of the probation process on PMIs’ treatment and rehabilitation experiences.

Significance of the Study

By expanding our understanding of the lived experiences of PMIs as they transition back into society—with a particular emphasis on how the discourses, perceptions, and practices of their PO impacted and shaped the experience of the PMI (Marshall & Rossman, 2011)—this study is expected to add to the literature by offering some conceptual insights into the study of stigma as it relates to the experience of PMIs and the work of service professionals in three areas: knowledge, public policy, and treatment options for practitioners.

Contribution to Knowledge

The findings from this study may increase our understanding of (1) the debilitating and pervasive influence of mental illness in our nation’s probationer population, (2) the structural limitations in society that are likely to hinder their progress toward wellness and their ability to re-enter society as contributing members, and (3) the crippling role that stigma plays in their lives. Indeed, this study suggests that stigma plays a major role in thwarting their ability to overcome both their stamp as a former prisoner—but even more so as a person with a diagnosed mental illness in need of empathy and understanding instead of vilification.

Relevance to Public Policy

Although researchers, policy makers, and clinicians are aware of the high prevalence of mental disorders among incarcerated individuals, there is little empirical work to assess the burden of such conditions on probationers—despite the fact that probation is the most commonly used disposition in the criminal justice system (Crilly, Caine, Lamberti, Brown, & Friedman, 2009). And as noted earlier, available post-incarceration justice programs tend to be deficient in terms of their services for PMIs. Also germane to any discussion of policy changes for probationers with mental illness is that they are typically at higher risk for substance abuse disorders (drugs and alcohol), homelessness, non/under-employment, and physical abuse (Ditton, 1999). Thus, findings from this study may add to a growing discourse on the structural p...

Table of contents

• Cover
• Half-Title
• Title
• Copyright
• Contents
• List of Figures
• 1 Introduction
• 2 Methodology
• 3 Results
• 4 POs’ Demographics
• 5 Discussion
• Appendices
• Index