Research Day


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CONTEXT: Within Kalamazoo County, as across the United States, individuals with severe or persistent mental illness (SPMI) report high levels of crime victimization. Systematic screening for crime victimization is not widely implemented in community mental health settings. Additionally, victims with a mental illness face multiple barriers to criminal justice protections. To date, criminal justice responses to individuals with mental illness has largely focused upon perpetrators. Less is known about victims’ experiences.

OBJECTIVE: The overall research goal is to examine the relationship between a crime victim’s mental illness and adjudication within the criminal justice system. Specifically, research study questions are:

1) Do victims with severe and persistent mental illness (SPMI) have different adjudication outcomes than those without?

2) Is the perpetrators’ SPMI status (having a mental illness or not) significantly associated with adjudication outcome, when other criminogenic characteristics are controlled for?

STUDY DESIGN: This was a cross-sectional study of all consumers receiving services from Kalamazoo Community Mental Health and Substance Abuse Services (KCMHSAS) in 2009 (N=5906) as a surrogate marker for SPMI. A database was built integrating administrative records from KCMHSAS and crime records from Kalamazoo County prosecutor’s office for the study period 2008-2010. The study outcome was highest level of adjudication reached: (1) not prosecuted, (2) prosecuted but no conviction, (3) perpetrator convicted. The primary predictor was whether victim had an SPMI or not. Covariates included demographics, crime incident characteristics and perpetrator characteristics (criminal history, SPMI). Statistical analyses were conducted using sequential Generalized Estimating Equation (two-sided statistical significance set at α<.05), to account for nesting of individuals within crime incidents; first modelling the progression from level 1 to 2.

RESULTS: Of the 9,622 crimes where the final disposition was known, 37.6% were not prosecuted, 22.5% were prosecuted but there was no conviction and 40.0% were convicted. Individuals with SPMI had double the crime victimization rate compared to those without SPMI: 10.8 charges submitted to the prosecuting attorney versus 5.1 charges per 100 population, respectively. Crimes with SPMI victims resulted in significantly fewer convictions (34.1% versus 40.4%, p=.008), with fall-out equally split between each of the two prior adjudication steps. Multivariable analyses reveal that, once other crime factors are taken into account, there is no statistical difference in adjudication outcomes associated with victim SPMI status (aOR 1.00 (CI 0.78, 1.29)). Instead, SPMI victims’ lower conviction rates may be explained by differences in their crime characteristics; characteristics which strongly predict adjudication and subsequent conviction and include whether crime was assault-related or not, whether it was a misdemeanor or felony, the number of crime counts, and criminal history of the perpetrator. Of note, victims with SPMI are twice as likely to have been victimized by a perpetrator with SPMI (13.6% versus 6.5%) and, unlike victim SPMI status, perpetrator SPMI status significantly increases the odds of conviction (aOR 1.54 (CI 1.23, 1.94).

CONCLUSION: The higher rates of victimization experienced by individuals with SPMI, coupled with lower conviction rates, speaks to the need for greater advocacy for victims’ rights and safety, within criminal justice settings as well as community mental health service settings. This same advocacy is arguable necessary for perpetrators with SPMI, as well. While conviction rates for victims with SPMI are not explained by their mental health status, their higher rates of victimization can adversely impact their overall health and SPMI treatment.

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