This is a comprehensive review of the literature pertinent to the effectiveness of treatment for offenders with serious mental illness (i.e., schizophrenia, schizoaffective disorder, bipolar disorder, or major depression) in jail, prison, or forensic hospital, as well as facilities involved in transitioning from a correctional institution to the community (e.g., home, halfway house).
The review identified some promising treatments for individuals with serious mental illness during incarceration or transition from incarceration into community settings. Treatment with antipsychotics other than clozapine apparently improves psychiatric symptoms in an incarceration setting. Two interventions. i.e., discharge planning with Medicaid-application assistance and integrated dual-disorder treatment programs, apparently are effective interventions for seriously mentally ill offenders transitioning back into the community. The authors caution that the applicability of the review's findings may be limited to the populations and settings in the included studies. The review included 19 publications that describe 16 comparative trials. The studies were conducted in the United States, Canada, the United Kingdom, New Zealand, and Australia. The risk of bias for all reported outcomes was medium for 15 trials and low for 1 trial. The topic, key questions, and protocol for the review were refined with experts in the field. Because of the nature of the available evidence, a qualitative review rather than meta-analysis was performed. The strength of evidence was graded for each treatment comparison and outcome based on the size, risk of bias, and results of the evidence base. Applicability was increased by focusing on the populations, interventions, and settings of the studies. 21 tables, 3 figures, 95 references, and 9 appendixes with supplementary information on methodology