Toward evidence-based practice for probationers and parolees mandated to mental health treatment

Psychiatr Serv. 2006 Mar;57(3):333-42. doi: 10.1176/


Objectives: Many individuals with serious mental illness are on probation or parole. These individuals are twice as likely as those without mental illness to fail on supervision-that is, to have their community term revoked for a technical violation or a new offense. This article reviews a small but growing body of research on this problem and on practices designed to respond to it.

Methods: Eight publication databases were searched for articles in English published between January 1975 and April 2005 that focused on adult probationers or parolees with mental illness. Unpublished evaluations were also included.

Results: Three studies suggest that the link between mental illness and supervision failure is indirect and complex. A national survey of probation described five key features of specialty agencies, where offenders with mental illness are assigned to officers with relatively small caseloads. Two studies suggest that stakeholders perceive specialty caseloads as more effective than traditional caseloads. Three studies (two randomized controlled trials and one uncontrolled cohort study) suggest that specialty agencies are more effective than traditional agencies in linking these probationers with treatment services, improving their well-being, and reducing their risk of probation violation. Evidence is mixed on whether specialty agencies reduce probationers' longer-term risk of rearrest. With respect to parole, two uncontrolled studies suggest that specialty agencies are effective in reducing these individuals' short-term risk of violation.

Conclusions: A growing body of literature indicates that specialty agencies hold promise for improving clinical and criminal outcomes for probationers and parolees with mental illness.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Crime* / psychology
  • Evidence-Based Medicine
  • Forensic Psychiatry*
  • Humans
  • Mental Disorders / psychology
  • Mental Disorders / therapy*
  • Mental Health Services / legislation & jurisprudence*
  • Patient Compliance
  • Program Evaluation