Aging, Mental Health, and the Criminal Justice System: A Content Analysis of the Literature

Abstract

Whereas older adults in the criminal justice system are a significant public health concern, there has been little research examining mental health among this population. This content analysis attempts to fill that gap by examining the international peer-reviewed empirical journal articles on mental health and older adults in the criminal justice system. English-language articles that examined mental health among older adults in the criminal justice system were locating through a comprehensive search of peer-reviewed journals of Academic Search Premier Literature databases, which included MEDLINE and PsycLIT. Trained researchers extracted data on the research methods and major findings on mental health among older adults in the criminal justice system. Thirty-one empirical studies were identified as meeting the study criteria. Content analysis was conducted using deductive (frequency counts) and analytic strategies (thematic analysis of major findings across studies). Results indicated that between 1988 and 2012, 31 empirical studies were published on mental health among older adults in the criminal justice system. Most of the studies were conducted in secure care settings that were prisons (n = 16) or forensic psychiatric hospital or units (n = 8). Of the 31 studies, schizophrenia, major depressive disorder, dementia, and substance use disorder were the most widely diagnosed mental illness. Comorbid physical ailments were noted in the 10 studies. Common themes across studies were related to the mental health detection and access to services, group differences, comorbid conditions, and the relationship of age, mental health, and criminal behavior, including potential risk and protective factors. Relatively few studies have focused on the mental health needs of older adults in the criminal justice system, especially at the time of arrest, court processing, probation, and parole. These results suggest that mental illness, including serious mental illness, needs to be addressed at all stages of the criminal justice process.

Notes

*Articles used multiple methods of data collection N ≠ 31.

**Articles used multiple methods of mental health assessments N ≠ 31.

Note. FPH/U = forensic psychiatric hospital/unit; AA = African American; Asian = Asian American; NA = Native American; PI = Pacific Islander. Empty cells indicate data not reported.

^a African/Caribbean.

Note. ASP = antisocial personality disorder; BPD = borderline personality disorder; OMD = organic mood disorder; PTSD = posttraumatic stress disorder. Empty cells indicate data not reported.

Note. Tx Hx = treatment history; VOP = violation of probation; PV = parole of violation. Empty cells indicate data not reported.

Note. Themes identified across studies include mental health detection and access to services, group differences, comorbid conditions, and the relationship of age to mental health and/or criminal behavior. Empty cells indicate data not reported.