A Pilot Evaluation of the ARRAY Program With Offenders With Mental Illness

The U.S. criminal justice system was established to promote public safety but has also evolved into a significant provider of mental health services. Survey research has revealed that, among offenders, approximately 15% of men and 30% of women meet the criteria for a mental health disorder (Steadman, Osher, Robbins, Case, & Samuels, 2009) and that an estimated 356,268 offenders with mental illness (OMI) were incarcerated during 2012 (Torrey et al., 2014). Among OMI, cooccurring substance use disorders were reported by almost 75% of state prison and jail inmates (Sarteschi, 2013). Consequently, prison and jail administrators have been challenged with the task of treating mental illness within correctional settings (R. D. Morgan et al., 2012; Sarteschi, 2013; Torrey et al., 2014). Therefore, it is a prudent activity for counselors to identify treatment programs that develop attitudes and skills that may promote optimal functioning in offenders following their release from incarceration. The symptoms of depression and anxiety disorders are endemic in prisons (Sarteschi, 2013; Torrey et al., 2014). James and Glaze (2006) reported that one third of prisoners reported at least one depressive symptom (according to the Diagnostic and Statistical Manual of Mental Disorders', American Psychiatric Association, 2013), with many of those endorsing five or more symptoms. Although state anxiety can often function as an adaptive response in correctional settings, many inmates complain about the associated hypervigilance, sleep disturbance, defensiveness, and irritability (Reinhardt & Rogers, 1998). Coid and Ullrich (2010) detected a positive relationship between degree of reported anxiety and recidivism risk factors, including substance abuse, suicide risk, and lifestyle instability. In addition to reported depression and anxiety, OMI also tend to report a high incidence of chronic health problems, which may further perpetuate mental illness (Wilper et al., 2009). The most common interventions for mental illness in correctional facilities are mental health screening during intake, psychopharmacological medication management, and referral to community-based service providers upon release (Brandt, 2012; Lovell, Gagliardi, & Peterson, 2002). Although each of these interventions bears merit for inclusion within criminal justice rehabilitation protocols, the notable absence of group-based counseling interventions as a standard of care is concerning. Once a psychiatric background is identified, OMI typically receive an evaluation that may lead to taking prescriptions. The secure, compliance-oriented milieu of correctional facilities may promote adherence to recommendations for dosage and frequency to a greater degree than in the community. Given the well-documented ability of medication-based interventions to stabilize delusions, hallucinations, and mood swings (Preston, O'Neal, & Talaga, 2013), it is plausible that adjunctive interventions, such as group counseling, may promote recovery and prevent relapse (Lurigio, 2011). Despite this supposition, adjunctive counseling practices, especially those that target cooccurring substance use disorders, are largely missing from correctional treatment programming (Rice & Harris, 1997; R. D. Morgan et al., 2012). Group counseling interventions that promote the use of coping skills, such as challenging criminal thinking, alternative self-concept, relapse prevention planning, and prosocial interactions, may offer a promising compliment to medication alone. In the absence of these skills, OMI are at risk for substance use and psychiatric relapse (Daniel, 2007), low utilization of community-based mental health services (Lovell et al., 2002), and difficulty meeting the challenges of independent living (Solomon, Draine, & Meyerson, 1994). Without adequate intervention, these risks are notably higher among individuals with cooccurring psychiatric and substance-use disorders (Wilson, Draine, Hadley, Metraux, & Evans, 2011). …