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Fionna Tam
ENG 123 KE
Prof. Morris
Spring 2016
Research Proposal

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The lack of rehabilitative help for individuals with mental illness in the United States
criminal justice system raises the risk of recidivism. In order to properly combat this issue,
additional programs need to be introduced within and outside of the prison system. When ill
prepared, those individuals face difficulties in situations that range from human interaction to
employment, thus raising their chances of recidivism. Currently, this issue is under debate in the
criminal justice and mental healthcare systems stemming from the growing incarceration rates.
For the purpose of this proposal, the topic of mental health in relation to recidivism will
be discussed with focus in establishing more mental health programs for rehabilitation as the
solution. The proposal will start off with a review of the sources. This is where I will discuss my
methods of research and credibility of those sources. Next, I will go into the history of how the
mental health issue came to be related to recidivism. Following the history, I will lay out the
noted solutions available and explain which one is the best for the issue. To tie my research
project together, I will introduce my working thesis as well as the design choices I have made.

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Research of mental health and recidivism started off as an interest in the potential effects
of incarceration on mental health. Through narrowing down my research, I found articles such
as, "Public Health And Solitary Confinement In The United States written by David H. Cloud,
JD, MPH, Ernest Drucker, PhD, Angela Browne, PhD, and Jim Parsons, MsC, that led me further
into the subject. A scholarly journal written by authors Jennifer M. Reingle Gonzalez, PhD, and
Nadine M. Connell, PhD, named "Mental Health Of Prisoners: Identifying Barriers To Mental
Health Treatment And Medication Continuity" was the main catalyst to my decision on the
proposed topic. It is also imperative to mention that this source is the one of the most important
sources in my research as it offers an introduction, abundance of data and explanation on the
topic. The credibility of the mentioned journal solidifies its importance, because Jennifer M.
Reingle Gonzalez and her co-author Nadine M. Connell are members of the Department of
Epidemiology, Human Genetics, and Environmental Sciences at the University of Texas School
of Public Health. In addition, the data used for analysis and research was provided by the Bureau
of Justice Statistics, which further argues for their credibility. Gonzalez and Connells article also
led me to find other scholarly journals similar to Greg A. Greenberg and Robert A. Rosenhecks
"Psychiatric Correlates Of Past Incarceration In The National Co-Morbidity Study Replication,"
and David C. Kondrat, William S. Rowe, and Melanie Sosinskis "An Exploration Of Specialty
Programs For Inmates With Severe Mental Illness: The United States And The United Kingdom,"
which are both equally important for my research.
For the history section of this research project, I will mention the topic of
deinstitutionalization, which will support and pave way for the solutions. The start of my
research project will begin with the start of psychiatric medicine back in 1954. This led to the
Community Mental Health Centers Act, which was instated by President Kennedy in 1963. This

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act created community based mental health facilities, allowing institutionalized patients to
become outpatients (Harcourt 65-66). This is an important event to begin with because changes
in the perception of mental illness began with the changes in mental health treatment. Another
key event to the decline in inpatient psychiatric facility population would be the United States
Supreme Court decision on the case of OConner versus Donaldson in 1975. This decision
caused many states to change their involuntary-commitment laws, which made the act of
involuntary commitment more challenging to carry out (Raphael and Stoll 191).
Before deinstitutionalization in the 1950s, the psychiatric inpatient rate was three times
that of the incarceration rate (Raphael and Stoll 188). Many of those individuals suffering from
mental illness were housed in state and county psychiatric institutions. Also, treatments in those
facilities included electroconvulsive therapy, insulin coma therapy, and lobotomy procedures,
which included significant side effects like brain damage. As a result, the side effects were
common and required indefinite support and facilitation (Harcourt 65).
After deinstitutionalization began, many of the patients were released due to new
psychiatric medication made available. Many inpatients were considered incurable before
deinstitutionalization. However, with the new medication, they were able to rejoin their
communities and be treated on an outpatient basis. The release of patients caused the inpatient
population of psychiatric facilities to drop. On the other hand, soon after it was observed, the
population in prisons began to rise. Individuals with mental health issues had a higher rate of
committing violent crimes than others (Raphael and Stoll 191). In recent times, an estimated
40,000 to 72,000 inmates with severe mental health issues should have been inpatients at a
mental hospital (Raphael and Stoll 219).

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The important sources of the historical part of my research project are Bernard E,
Harcourts journal Reducing Mass Incarceration: Lessons from the Deinstitutionalization of
Mental Hospitals in the 1960s and Assessing the Contribution of the Deinstitutionalization of
the Mentally Ill to Growth in the U.S. Incarceration Rate by Steven Raphael and Michael A.
Stoll. Both of these scholarly journals offer extensive history on deinstitutionalization with
relation to incarceration in the United States. However more research will be needed to find other
historical events important to the topic.
Currently, the most debated policy solutions to the problem of mental health and
recidivism are directing resources towards more educational and economic help, or resources
towards additional mental health programs. Both these solutions are being debated and discussed
in the criminal justice community as well as the mental health community. Scholars like Greg A.
Greenberg, and Robert A. Rosenheck argue for resources towards educational and economic help
(Greenberg and Rosenheck 29-30). To come to the proposed solution, they have studied the
correlations between mental illness history and incarceration records. In their study, they used
data gathered from 2001 to 2003 from the National Comorbidity Survey Replication (Greenberg
and Rosenheck 18). They found that all factors did contribute in some way. However, out of all
other factors, homelessness was actually the factor that had the most weight. People who
experienced homelessness had a higher chance of being incarcerated than anyone else
(Greenberg and Rosenheck 30). Their study was completed for the United States Government
work, which gives this study credibility.
Scholars in favor of directing resources toward mental health programs would be David
C. Kondrat, William S. Rowe, and Melanie Sosinski. As concluded in their study, in order to
break the cycle of mental disorder and recidivism, specialty programs inside and outside the

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prison systems are needed. For their study, they assessed the different programs in the United
States that help inmates with severe mental health problems. They also evaluated transition
planning and the Forensic Assertive Community Treatment program, also known as FACT in the
United States (Kondrat et al. 101). Transition planning is a program that arranges community
services for inmates with mental illness before release from prison. Transition from Prison to
Community or also known as TPC, is an example of transition planning (Kondrat et al. 102). The
FACT program involves a team of providers, psychiatrists, social workers, nurses and specialists
to work with individuals suffering from mental illness (Kondrat et al. 102). The proposed
solution is credible due to that fact that these types of programs were shown to be successful in
lowering recidivism in individuals with mental illness. The authors are also credible as their
reviews are peer-reviewed journals. There is no organization supporting their study, but their
policy still sounds the most comprehensive since they draw data from working programs. This
solution is the most relevant to the proposed topic, as it is specific to mental health. Further
research will be needed for this solution to have solidified credibility.
The following is my working thesis. Due to the lack of rehabilitative services in the
United States, individuals with mental illness face higher chances of recidivism (relapse into
criminal behavior) than their counterparts. This creates a situation where reintegration into their
communities becomes difficult due to their mental instability, thus placing them at a higher
disadvantage than others. I will argue for the solution of directing resources towards mental
health programs, because it offers a more comprehensive plan than the solution of education and
economic support. It is also the only solution that can properly help the individuals suffering
from mental illness. However, the solution of education and economic support does offer help for
the general incarcerated population, while mental health programs do not. Both are plausible

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solutions to the issue, but mental health programs will need to come before the solution of
education and economic support. This is due to lack of detail in the solution and need in
specified treatment for the mental illnesses.
The design choice of my research project will be a website. I believe the website format
will be the best and effective method for presenting my research, because it offers the ability to
separate and section off different subtopics and information on separate pages. This creates a
clean and concise design that will complement my research. A design example of this would be
the layout for www.aclu.org. The design sections off information on separate webpages with the
header and navigation bar staying as a constant on each page. It also summarizes topics within
the webpage so that the public can quickly skim through the site to get the desired information.

Works Cited

Cloud, David H., et al. "Public Health And Solitary Confinement In The United States."
American Journal Of Public Health 105.1 (2015): 18-26. Academic Search Premier. Web.
14 Jan. 2016.
Greenberg, Greg A., and Robert A. Rosenheck. "Psychiatric Correlates Of Past Incarceration In
The National Co-Morbidity Study Replication." Criminal Behaviour & Mental Health
24.1 (2014): 18-35. Academic Search Premier. Web. 26 Jan. 2016.

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Harcourt, Bernard E. "Reducing Mass Incarceration: Lessons From The Deinstitutionalization Of
Mental Hospitals In The 1960S." Ohio State Journal Of Criminal Law 9.1 (2011): 5388.Criminal Justice Abstracts. Web. 26 Jan. 2016.
Kondrat, David C., William S. Rowe, and Melanie Sosinski. "An Exploration Of Specialty
Programs For Inmates With Severe Mental Illness: The United States And The United
Kingdom." Best Practice In Mental Health 8.2 (2012): 99-108. Academic Search
Premier. Web. 26 Jan. 2016.
Raphael, Steven, and Michael A. Stoll. "Assessing The Contribution Of The
Deinstitutionalization Of The Mentally Ill To Growth In The U.S. Incarceration Rate."
Journal Of Legal Studies (0047-2530) 42.1 (2013): 187-222. Criminal Justice Abstracts.
Web. 26 Jan. 2016.
Reingle Gonzalez, Jennifer M., and Nadine M. Connell. "Mental Health Of Prisoners:
Identifying Barriers To Mental Health Treatment And Medication Continuity." American
Journal Of Public Health 104.12 (2014): 2328-2333. Academic Search Premier. Web. 26
Jan. 2016.