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Co-Occurring Disorders in Criminal Justice Settings

Creating an Effective Workforce to Serve Individuals with Co-Occurring Disorders in Criminal Justice Settings

The behavioral health and criminal justice workforces each have sets of competencies for working with justice-involved people with co-occurring disorders. Each workforce also faces challenges when carrying out their jobs.

For the behavioral health workforce, challenges include the impact of incarceration on a person's behavior, which may affect an individual's ability to engage in treatment. For the criminal justice workforce, working with people with co-occurring disorders demands attention to clinical factors that affect motivation, perception, thinking and cognition.

Cross-training helps workforces and agencies work well together

Cross-training or conducting trainings that include both behavioral health and criminal justice staff, promotes integration. Cross-training can enhance understanding and respect between workforces. Members learn about each system's:

  • Staff roles
  • Organizational culture
  • Administrative approaches
  • Policies and procedures

Understanding the language and organization of each system helps agencies reduce communication barriers and develop effective partnerships. Although cross-training may not be a part of either workforce's requisite education, such training is available through continuing education providers and professional associations.

Criminal Justice Workforce

The criminal justice system is made up of multiple settings such as prison, jails and probation. Accordingly, staff come from different disciplines and have different skill sets. Training for working with justice-involved people with co-occurring disorders is most effective when tailored to type of staff. For example, a correctional officer trained at an academy and a public defender educated at a law school may need different trainings to provide a competent response to individuals with co-occurring disorders.

In general, staff in the criminal justice workforce can benefit from a better understanding of co-occurring disorders, how they impact psychosocial functioning and are associated with multiple service needs such as housing, social services, and vocational skills.

Staff working in criminal justice settings may also benefit from training to recognize signs and symptoms of co-occurring disorders and understand how symptoms may present and interact. Training may promote correctional management, community supervision and court monitoring for people with co-occurring disorders. For attorneys, ethics training relating to suicide prevention is also important.

Behavioral Health Workforce

The experience of incarceration has an impact on an individual's behaviors, attitudes, and beliefs. Many individuals adopt behaviors that provide a degree of security and safety while incarcerated. However, these behaviors may also be barriers to treatment engagement in correctional and community settings. For example, inmate "rules" such as do not snitch or do not appear weak may cause individuals to avoid sharing any information with staff, or demonstrating "intimidating shows of strength".

Practitioners may misinterpret such behaviors as treatment resistance or signs of acute mental disorder. Practitioners who are able to identify and understand the behaviors and patterns specific to incarceration are better able to tailor services to the unique needs of the individual.

Competencies for practitioners who work with justice-involved people with co-occurring disorders include understanding the impact incarceration on behavior. They also need training in cognitive behavioral approaches to address antisocial attitudes, behaviors, and beliefs not addressed through integrated treatment for co-occurring disorders. These specific cognitive behavioral approaches focus more on interpersonal skills than on intrapersonal factors.

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