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Criminal Justice and Behavior, Vol. 34, No. 2, 197-210 (2007)
DOI: 10.1177/0093854806290326

The Impact of Perceived Need for Treatment on Risk of Arrest and Violence Among People With Severe Mental Illness

Eric B. Elbogen

Duke University Medical Center, eric.elbogen{at}duke.edu

Sarah Mustillo

Duke University Medical Center

Richard van Dorn

Duke University Medical Center

Jeffrey W. Swanson

Duke University Medical Center

Marvin S. Swartz

Duke University Medical Center

One clinical strategy for managing risk of arrest and violence among people with severe mental illness (SMI) involves targeting potentially treatable factors related to these risks. The current study examines the association between individuals’ perceived need for psychiatric treatment and their risk of arrest and violence among people with SMI. Adults meeting criteria for psychotic and affective disorders receiving public mental health services in four states are interviewed (N = 907), with 26% reporting being arrested or violent in the past year. Participants in this group are more likely to deny needing psychiatric treatment. Multivariate analyses confirm this pattern for participants both arrested and violent, controlling for clinical and demographic covariates. As a result, clinical interventions that address a patient’s perceived need for psychiatric treatment, such as compliance therapy and motivational interviewing, appear to hold promise as risk management strategies for clinicians providing services for individuals with SMI.

Key Words: violence • arrests • severe mental illness • risk factors • treatment engagement


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