Recidivism is simply put the tendency of any convicted criminal to commit another offense. This is a big problem with many individuals who have taken to a life of crime and have become inured to the lifestyle through need or necessity. For those that are labeled as criminally insane the act of recidivism is considered to be treatable given that their mental state is less stable and requires an added boost in the form of medication or therapy. It has been shown that cognitive training and psychotropic medications do affect recidivism rates.

As mental illness has been examined throughout the past several decades one of the main problems has been what is known as the “revolving door syndrome” (Delaney, 1998). In essence, patients that are treated and deemed to be functioning members of society are released from care and are allowed back into the population. What has happened in the past and still happens in the present is that they are quickly readmitted when it becomes evident that they cannot act as functioning members of their community. In many cases these individuals commit crimes that cannot to be tolerated and thus are admitted into a psychiatric ward or are shipped off to jail, or prison, once again.

Those exhibiting such illnesses as bipolar disorder and schizophrenia are often considered to be a danger to the general public and themselves. In truth such individuals are often more of a danger to themselves than others, but the statistical data that is evident implies that they are often jailed for minor offenses that are often the cause of misunderstandings between the affected individual and another person. These individuals are more often in need of medical and psychiatric help as they are more of a danger to themselves than to others.  Far too often they are linked to the act of recidivism simply because they have yet to be successfully treated and made to feel like a normally functioning human being.

What has been noticed over the years is that those with bipolar disorder and/or diagnosed schizophrenia are at a great risk for cardiometabolic comorbidity that can cause long-term problems for the individual and those around them (Corell, Ng-Mak, Stafkey-Mailey, Farrelly, Rajagopalan, & Loebel, 2017). Their more violent and antisocial tendencies are only aggravated by the continuing lack of understanding that allows them check in to be treated and then be readmitted at a later date when the treatment wears off. A greater level of comprehension concerning these disorders are needed in order to lessen the chance of recidivism amongst patients exhibiting such conditions. This is why cognitive training and psychotropic medications are considered to be among the only treatments that are seen to cause any change in individuals that suffer from such disorders.

Quite often it is seen that medication and therapeutic techniques when used independently of one another have a tendency to work only a certain percentage of the time. When used together, the two methods tend to create a much stronger effect as it lends more support and a much more positive impact to the conditions suffered by the individual. Recidivism rates tend to decline when medication and therapy are combined to alleviate a patient’s disorders, as they are less likely to continue their offensive behaviors when properly monitored and medicated. It has been noted in many studies that patients that do not choose to follow the advice of psychiatrists and doctors alike tend to become far more erratic in manner and will eventually perform the same behaviors that end with them being re-hospitalized or arrested once again.

The association between mental illness and criminal actions is only around ten percent

(Yates, Kunz, Kahn, Volavka, and Rabinowitz, 2010), but this is still considered a very

significant number. There are two categories in which the factors behind criminal behavior

among mentally ill patients can be grouped. One is that of crimogenic characteristics that the individual shares with the rest of the population. The other has to do with the personal and environmental factors that contribute to the illness and therefore how the individual reacts to their surroundings and any given situation.

Much of the problem is that those with conditions such as bipolar disorder and schizophrenia lack any type of impulse control that is generally needed to control behavior. In this manner they are unable to stop themselves from simply acting out in one way or another. This does not mean that these individuals will become violent as a rule. The likelihood that they will commit a violent act is slightly greater than that of the average citizen that is not afflicted with poor impulse control. In this manner it is necessary to diagnose the problem when possible and assign these individuals to a program that is designed to help them deal with their condition.

Cognitive training, or Cognitive Behavioral Therapy, has been seen as a highly effective method used to teach individuals the consequences of their actions by thinking forward instead of in the moment. This allows the individual to stop and assess the choices they are about to make before they continue. In this manner they are taught how to apply critical thinking to their own lives and thereby use logic and reason to better understand the world around them. On its own, cognitive training is quite effective, but individuals have been known to relapse when presented with extremely stressful situations. This is where medication tends to become a useful tool.

There are many documented cases in which the use of psychotropic medications,

medicines that are designed to affect brain chemistry and the nervous system, have led to a

marked decrease in recidivism. Some argue that a dependence upon such drugs is dangerous and

can be very costly. However, the success rate when coupled with cognitive training is enough to

convince researchers that the pairing is worthwhile.  Between the act of critical thinking and the calming effect that such medication can have upon the brain chemistry of an affected individual, there is hope that recidivism rates will continue to lower significantly so long as individuals stick with their assigned programs.

Very often the only reason why cognitive training and medication do not work has to do with a number of factors that are difficult if not possible to control (Yates, et al, 2010). The individual might not be able to afford a health care provider that can help with their needed treatment, or could possibly have to move from the area in which their provider operates. It could also occur that the individual simply does not wish to undergo the cognitive training and actively resists the treatment. In such cases only a court order can be used to compel an individual to undergo the needed treatment, and only if they are deemed a threat to themselves and to others. Such cases are not entirely common and the individual is usually compelled to undergo a psych evaluation in order to determine the seriousness of their disorder. If they are found to be reasonably well-adjusted there is little that can be done to make them undergo treatment.

The issue of recidivism is very real and requires a great amount of study into why certain affected individuals will lean towards violent acts when dealing with various mental disorders. Much of the problem consists of how they are treated and if the disorders are even addressed and/or diagnosed properly. Unfortunately mental disorders are very difficult to predict and are often subject to being missed or misdiagnosed. The overall goal is to keep such individuals from being admitted time and again to the hospital or being arrested multiple times only to be let loose into the population again without having addressed the issue at hand. This problem has been seen to negatively affect the chances of positive treatment techniques that can and have helped many individuals to lead a relatively normal life.

References

Corell, C.U., et al. (2017). Cardiometabolic comorbidities, readmission, and costs

in schizophrenia and bipolar disorder: a real-world analysis. Annals of General Psychiatry, 16(9).

Delaney, C. RN, PsyD. (1998). Reducing Recidivism: Medication Versus Psychosocial

Rehabilitation. Journal of Psychosocial Nursing & Mental Health Services, 36(11), 24-34.

Yates, K.F., et al. (2010). Psychiatric patients with histories of aggression and crime five years

after discharge from a cognitive-behavioral program. The Journal of Forensic Psychiatry and Psychology, 21(2), 167-188.

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