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Resource constraints at all levels of the criminal justice system as well as the lack of a widely accepted, validated screening scale have made it difficult to screen adequately for serious mental illnesses (SMI) in offender populations. This study examined the use of the K6 scale, a recently developed and validated screening tool for SMI, using a sample of past-year arrestees. Among the main findings were that 18% of the sample screened positive for SMI. In contrast, commonly used screening questions misidentified a large proportion of arrestees with SMI. Based on these findings, we recommend the use of K6 scale to more accurately identify offenders with SMI.

Since 1963, the promise of the Community Mental Health Centers Construction Act (1963), the planned provision of community-based mental health services, and advances in psychotropic medication and treatment suggested that the mentally ill might be better managed and served in the community than in hospital (Bachrach & Lamb, 1989; Grob, 1991). While “dehospitalization” proceeds today (Geller, 2000), large numbers of individuals with mental illness also return to the community from correctional custody and bring with them complicated clinical profiles and service needs (Laberge & Morin, 1995; Rice & Harris, 1997; Lamb & Weinberger, 1998; Lamb et al., 1999). An increasing awareness of this phenomenon has resulted in estimates that prisons contain four to five times the rate of persons with mental illness found in the community (Morris & Tonry, 1990; Regier et al., 1990; Morris et al., 1997; Rice & Harris, 1997; Wolff et al., 1997). According to the 2000 Prison Census, about 150,900 or 1 in 10 state inmates were in mental health programs; 114,400 or 1 in 13 were receiving psychotropic medication; and 18,900 or 1 in 80 were in 24-hour psychiatric care (Bureau of Justice Statistics, 2000). While the recent estimates suggest that approximately 16% of all those incarcerated in state prisons (16% of all males and 24%of all females) have some sort of mental illness (Ditton, 1999), a meta-analysis examining the prevalence of mental disorder with a narrow criterion found that 10% of male and 18% of female inmates had an Axis I major mental disorder of thought or mood (Pinta, 2001).

Current thinking suggests that specialized services are needed for the successful community reintegration of ex-inmates with psychiatric disabilities (Hartwell & Orr (1999). Psychiatric Services, 50, 1220–1222; Healey (1999). National Institute of Justice, February; Hartwell, Friedman, & Orr (2001). New England Journal of Public Policy, 19, 73–82). Nevertheless, stable community re-entry after criminal incarceration involves the response of multiple organizations due to the complexity of community re-entry factors. This chapter presents findings from the analysis of secondary data collected since 1998 and a qualitative interview study with ex-inmates with psychiatric disabilities that identified pathways and turning points influencing community re-entry. Using Sampson and Laub's life course theory as a framework (Sampson & Laub (1993). Crime in the making: Pathways and turning points through life. Cambridge, MA: Harward University Press.), the pathways and turning points offer a point of departure for agencies and organizations in responding to ex-inmates with psychiatric disabilities in the community. Pathways related to service needs at release include race, age, education, diagnosis, and criminal history; whether an individual is on probation or parole; and whether an individual has a history of homelessness, mental health services, and/or substance abuse. Turning points post release include institutional resource availability, living arrangements, psychotropic medication compliance, outpatient therapy and substance abuse treatment, and having entitlements and benefits in place at release.

In 1948, South Africa's Apartheid legislation imposed modernist spatial planning on its populations and created worlds Black people struggled to connect with. Crime, poverty and unemployment have emerged as legacies of Apartheid that continue to impact the lives of Black people living in the townships. In 1994, the new democratic government identified community engagement (CE) as a critical process that could help restore the values of Black people and the places they live in.

This chapter explores a CE process as storytelling to trace the spatiality of agency. As a researcher-architect living in a township, I examined the voluntary community organisation (VCO), Studiolight's CE process, and an exhibition entitled Who we are Macassar, which was conducted between 2016 and 2018 in the community of Macassar, a township in the Western Cape of South Africa. The VCO worked with local youth to produce story maps and a street photography project that reauthors (retells and rewrites) the stories of life in Macassar to critically engage the spatial legacies of Apartheid. Brazilian theorist Paulo Freire's writings on how neglected population groups can self-organise to create knowledge that can restore social narratives is useful to make sense of the CE process. I highlight the spaces of the CE process and use Freire's concepts of critical action, praxis and co-creation to structure the study. I then reflect on the nomadic and sporadic spatiality that emerges in Macassar to discuss how architects can think about forging places with a sense of community identity and belonging.

There remains a gap in the research on the characteristics, service needs, and experiences of persons with mental illness post incarceration. This analysis uses data collected by the Massachusetts Forensic Transition Team program to describe the characteristics of the offenders with mental illness and to examine the relationship of particular characteristics towards community reintegration and adaptation post release from correctional custody. Length of incarceration (misdemeanor or felony sentence structure) and service needs at release are expected to be associated with the ability to adapt, stigma, and, in turn, short-term dispositions in the community or more structured settings.I first met Andrew in a medium security prison in the fall of 2001. He had spent the majority of his adult life in prison. During the first of three incarcerations, he served five years and was released to live in the community, which he did for almost a year, until he was re-arrested and sentenced for 2 more years. This time, when he was released, he was in the community for only 2 weeks before being arrested and re-incarcerated. Andrew grew up in South Boston. His family has a history of mental illness and alcoholism. Andrew is bipolar, suffering bouts of manic depression, and has a substance abuse problem. His drug of choice is cocaine, which he uses intravenously. He is HIV positive. He is in his early 30s. Andrew's current sentence is 5 years for 26 counts of malicious destruction of property and motor vehicle theft. While he is attempting to get his sentence revised based on his health status, he acknowledges he has difficulty living in the community. Of prison life he says, “I excel in here!” He works a half an hour a day sweeping his unit, “and then I have the rest of the day to myself”. Andrew is presentable and articulate. He participates in release planning. When he is in the community he seeks out appropriate services. Nonetheless, he has difficulty staying out of prison.