THE NORTHWESTERN VICTIMIZATION PROJECT
Begun in 1995, the Northwestern Victimization Project was the first large-scale, longitudinal study of crime victimization patterns in severely mentally ill persons living in the community. Prior studies of violence and mental disorder had focused on perpetration, not victimization. We examined the rates, risk factors, and patterns of crime victimization in 936 persons with chronic severe mental disorders. More than one-quarter of the sample had been victims of a violent crime in the past year, a rate more than 11 times higher than general population rates, even after controlling for demographic differences between the two samples. The Northwestern Victimization Project has been replicated in the Netherlands and other countries, where public health officials now realize that victimization in persons with severe mental illnesses is a far more serious threat to public health than the perpetration of violence.
PSYCHIATRIC DISORDERS IN MALE AND FEMALE ADULT JAIL DETAINEES
The Health Disparities and Public Policy lab conducted the first large-scale epidemiologic studies of psychiatric disorders among male and female adult jail detainees. Between 1983 And 1995, a series of investigations examined (1) the prevalence of psychiatric disorders in jail detainees, and (2) whether detainees who had severe mental illnesses received treatment while in jail. Our findings highlight the discrepancy between jail detainees’ service needs and the services that they receive. The data showed that of male detainees who needed psychiatric services, only 37% received them. Only 20% of female detainees who needed psychiatric services received them. Because jails were never intended to be psychiatric hospitals, few have the resources necessary to adequately treat the increasing numbers of detainees entering jails nationwide. The studies provided a model for epidemiologic research at other institutions. They also underscore the need for jails to systematically screen detainees upon admission, provide treatment during their stay, and refer for services after they are released.
CONSEQUENCES OF DEINSTITUTIONALIZATION: THE POLICE AS STREETCORNER PSYCHIATRIST
Incarceration of the mentally ill disproportionately affects minorities, who are least likely to be able to afford mental health care. In an observational study of police officers, Health Disparities and Public Policy found that mentally ill persons had an arrest rate nearly double that of non–mentally ill persons. Police reluctantly arrested mentally ill persons when a mental health evaluation and treatment would have been preferable but was not available. The findings suggested that reduced community services had resulted in mentally ill persons being “criminalized”; for many, arrest had supplanted hospitalization. The findings supported the thesis, set forth by public health experts, that for poor persons—especially racial/ethnic minorities—arrest and incarceration had become the entrée for receiving mental health services. The findings of this study were cited in amicus briefs to the Supreme Court, were used in many hearings by Congress, and highlighted the need for special diversion programs for mentally ill persons in the criminal justice system.
MAJOR PUBLICATIONS FROM OTHER STUDIES
Choe JY, Teplin LA, Abram KM (2008). “Perpetration of Violence, Violent Victimization and Severe Mental Illness.” Psychiatric Services 59:153-164. PMID: 18245157. http://www.ncbi.nlm.nih.gov/pubmed/18245157
Teplin LA, McClelland GM, Abram KM, Weiner DA (2005). “Crime Victimization in Adults with Severe Mental Illness: Comparison with the National Crime Victimization Survey.” Archives of General Psychiatry 62:911-921. PMID: 16061769. PMCID: PMC1389236. http://www.ncbi.nlm.nih.gov/pubmed/16061769
Abram KM, Teplin LA, McClelland GM (2003). “Comorbidity of Severe Psychiatric Disorders and Substance Use Disorders Among Women in Jail.” American Journal of Psychiatry 160:1007-1010. PMID: 12727711. http://www.ncbi.nlm.nih.gov/pubmed/12727711
Teplin LA, Abram KM, McClelland GM, Dulcan MK, Mericle AA (2002).“Psychiatric Disorders in Youth in Juvenile Detention.” Archives of General Psychiatry 59:1133-1143. PMID:12470130. PMCID: PMC2861992. http://www.ncbi.nlm.nih.gov/pubmed/12470130
McClelland GM, Teplin LA, Abram KM, Jacobs N (2002). “HIV/AIDS Risk Behaviors among Female Jail Detainees: Implications for Public Health Policy.” American Journal of Public Health 92: 818-825. PMID: 11988453 .PMCID:PMC1447167. http://www.ncbi.nlm.nih.gov/pubmed/11988453
McClanahan SF, McClelland GM, Abram KM, Teplin LA (1999). “Pathways to Prostitution Among Female Detainees and Their Implications for Mental Health Services.” Psychiatric Services 50:1606-1613. PMID: 10577881. http://www.ncbi.nlm.nih.gov/pubmed/10577881
Teplin LA, Abram KA, McClelland GM (1997). “Detecting Mentally Disordered Women in Jail: Who Receives Services?” American Journal of Public Health 87:604-609. PMID:9146439. PMCID:PMC1380840. http://www.ncbi.nlm.nih.gov/pubmed/9146439
Teplin LA, Abram KA, McClelland GM (1996). “The Prevalence of Psychiatric Disorder Among Incarcerated Women: I. Pretrial Jail Detainees.” Archives of General Psychiatry 53: 505-512. PMID: 8639033. http://www.ncbi.nlm.nih.gov/pubmed/8639033
Teplin LA (1994). “Psychiatric and Substance Abuse Disorders Among Male Urban Jail Detainees.” American Journal of Public Health 84:290-293. PMID: 8296957. PMCID:PMC1614991. http://www.ncbi.nlm.nih.gov/pubmed/8296957
Teplin LA, Abram KM, McClelland GM (1994). “Does Psychiatric Disorder Predict Violent Crime Among Released Jail Detainees? A Six-Year Longitudinal Study.” American Psychologist 49:335-342. PMID:8203805. http://www.ncbi.nlm.nih.gov/pubmed/8203805
Abram KM, Teplin LA (1991). “Co‑Occurring Disorders Among Mentally Ill Jail Detainees: Implications for Public Policy.” American Psychologist 46:1036-1045. PMID:1746771. http://www.ncbi.nlm.nih.gov/pubmed/1746771
Teplin LA (1990). “Detecting Disorder: The Treatment of Mental Illness Among Jail Detainees.” Journal of Consulting and Clinical Psychology 58:233-236. PMID:2335639. http://www.ncbi.nlm.nih.gov/pubmed/2335639
Teplin LA (1990). “The Prevalence of Severe Mental Disorder Among Male Urban Jail Detainees: Comparison with the Epidemiologic Catchment Area Program.” American Journal of Public Health 80:663-669. PMID:2343947. PMCID: PMC1404724. http://www.ncbi.nlm.nih.gov/pubmed/2343947
Teplin LA (1985). “The Criminality of the Mentally Ill: A Dangerous Misconception.”American Journal of Psychiatry 142:593-599. PMID:3985198. http://www.ncbi.nlm.nih.gov/pubmed/3985198
Teplin LA (1984). “Criminalizing Mental Disorder: The Comparative Arrest Rate of the Mentally Ill.” American Psychologist 39:794-803. PMID: 6465666. http://www.ncbi.nlm.nih.gov/pubmed/6465666
Teplin LA (1983). “The Criminalization of the Mentally Ill: Speculation in Search of Data.” Psychological Bulletin 94:54-67. PMID:6353466. http://www.ncbi.nlm.nih.gov/pubmed/6353466