Examining College Student Perceptions of Criminal Justice Outcomes Among Persons With Mental Illness

Abstract

An extensive body of literature has documented punitive responses to mental illness in the United States that have coalesced around arrest and incarceration. Similarly, studies have highlighted the lack of treatment options available to persons with mental illness, as well as the fact the persons with mental illness are particularly susceptible to offering false confessions. Research on perceptions of these realities is, however, comparatively limited. This study contributes to the literature through the use of survey methodology to examine the perceptions of college students at a mid-sized university in the Southeastern United States as they relate to criminal justice outcomes among persons with mental illness. Results of multinomial regression models suggest that these perceptions are shaped by factors such as political orientation, semester standing, and punitiveness.

Keywords

perceptions of mental illness false confessions political orientation and attitudes toward mental illness punitiveness

Introduction

According to a 2006 Bureau of Justice Statistics Special Report on mental illness, approximately 1 in 10 persons 18 or older living in the United States experienced symptoms of mental disorder (James & Glaze, 2006). By 2017, the National Institute of Mental Health (NIMH, 2017) reported that in 2017, approximately one in five adults residing in the United States (46.6 million) suffered from some form of mental illness. Of these, an estimated 11.2 million adults aged 18 years and older are considered to suffer from severe mental illness, a figure representing 4.5% of the total U.S. adult population. As these statistics only represent known cases, it is possible that the true number of people in the United States suffering from mental illness is even higher—representing a social crisis hidden in plain sight.

Relatedly, the number of people with mental illness being redirected into the criminal justice system has increased substantially since the 1960s (Bronson & Berzofksy, 2017; Holton, 2003; Johnson, 2011). Although this trend itself is concerning, there are specific problems that arise from treating U.S. jails and prisons as suitable alternatives to psychiatric hospitals. First, and perhaps most obvious, corrections institutions were not equipped to effectively manage an influx of offenders suffering from disorders ranging from chronic depression to schizophrenia (Bronson & Berzofksy, 2017; Fazel & Danesh, 2002). This has resulted in a number of undesirable and sometimes tragic consequences ranging from inappropriate use of punishment (Fellner, 2015) to suicide (Roth, 2018). Second, the distinctive “tough on crime” policies of the United States have incentivized arrests and case clearances as measures of police performance. In tandem with the defunding of mental health institutions, these policies have facilitated more frequent adversarial contact between police and a population that is highly susceptible to coercion and often lacks the ability to fully recognize protections against self-incrimination—both exacerbating and obscuring the problem of false confessions (Drizin & Leo, 2004; Leo, 2009; Rogal, 2017).

Despite these realities, research on perceptions of criminal justice outcomes for persons with mental illness is limited. Mainstream efforts to gauge public perceptions of mental illness have substantially increased since Star’s (1952, 1955) seminal efforts to explain popular conceptions of mental illness held by the general public. Indeed, there has been a proliferation of studies designed to examine perceptions of mental illness held by populations ranging from criminal justice and mental health practitioners (AbuDagga et al., 2016; Batastini et al., 2018; Berryessa, 2019; Knettel et al., 2018; Loeb et al., 2012; Wells & Schafer, 2006) to college students (Vidourek & Burbage, 2019) and those diagnosed with mental illness (DeSmet et al., 2015; Freidl et al., 2003).

Such efforts maintain tremendous value in terms of measuring mental health literacy within the United States. They do, however, suffer a limitation in their tendency to examine perceptions of mental illness in general. Rarely do such inquiries narrow their focus to a criminal justice context. Moreover, this body of literature often fails to consider the potential influence of respondent characteristics on the perceptions they hold. This gap in the literature prompted the current study to ask, “What factors influence college student perceptions of criminal justice outcomes among persons with mental illness?” This study contributes to the literature through the use of survey methodology to examine the perceptions of college students at a mid-sized university in the Southeastern United States as they relate to criminal justice outcomes among persons with mental illness. Specifically, we examine college student perceptions as they relate to (a) the prevalence of persons with mental illness in correctional settings; (b) the availability of effective corrections-based treatment services for people who are mentally ill; and (c) the likelihood that people with mental illness confess to crimes they did not commit. Furthermore, we examine the extent to which these perceptions are influenced by respondent characteristics through application of multinomial logistic regression.

Review of the Literature

Incarceration and Persons With Mental Illness

The defunding of mental health institutions that began in the late 1960s and early 1970s and its impact on the criminal justice system is well documented (e.g., Etter et al., 2008; Holton, 2003; Torrey, 1995). In addition to defunding of mental health institutions, increased sentence lengths and rates of incarceration for relatively minor offenses (e.g., drug and property crimes) (Constantine et al., 2010; Junginger et al., 2006), lack of diversion programs and mental health resources within correctional settings (Holton, 2003), and civil commitment laws allowing the use of jails as emergency detention centers for persons with mental illness (AbuDagga et al., 2016; Torrey et al., 1992) promoted a rapid and sustained influx of people with mental health concerns including severe depression, psychosis, antisocial personality disorder, borderline personality disorder, bipolar disorder, and schizophrenia into correctional settings (Ahonen et al., 2019; Bronson & Berzofksy, 2017; Fazel & Danesh, 2002; Rotter et al., 2002).

Further compounding these issues, police are often left with few noncustodial options despite their preference to refer suspects and arrestees with mental illness to mental health facilities (Watson et al., 2004; Wells & Schafer, 2006). For context, Johnson (2011) noted that in 1971 there were roughly 475,000 admissions to public psychiatric hospitals, but that the number fell to 47,000 in 2003—a decrease of 99%. Illustrating the extent to which persons with mental illness have been redirected into correctional settings, by 2008, Rikers Island, Cook County Jail, and Los Angeles County Jail were the three largest providers of psychiatric care in the United States (Slate & Johnson, 2008). Similarly, a 2010 report by the Treatment Advocacy Center (TAC, 2014) concluded that there were three times more seriously mentally ill persons found in U.S. jails and prisons than hospitals. Indeed, a Bureau of Justice Statistics Special Report indicated that 64% of local jail inmates, 56% of state prison inmates, and 45% of federal prison inmates reported a mental health problem (James & Glaze, 2006).¹

Treatment for Mental Illness in Correctional Settings

Jails and prisons, however, were poorly positioned—both in terms of training and available resources—to handle the influx of this at-risk population (Johnston, 2013; Roth, 2018; Torrey, 1995). Behavioral problems stemming from their illnesses often make these offenders less able to comply with even basic demands of custody staff (Roth, 2018). In turn, prisoners with serious mental illnesses are said to be disproportionately punished and more likely to be placed in segregation (Fellner, 2015; Johnston, 2013; Roth, 2018; Torrey et al., 2014). Unfortunately, solitary confinement for their misdeeds and/or noncompliance only aggravates their disorders and increases the risks of self-inflicted harm and suicide (Roth, 2018; Shames et al., 2016). Moreover, inmates with mental illness are more likely than their counterparts to be the victims of a variety of offenses, including assault and rape (James & Glaze, 2006; Johnston, 2013; Torrey et al., 1992).

Multiple studies suggest that corrections staff and mental health professionals are keenly aware of their inability to effectively protect or manage the unique needs of these offenders (e.g., AbuDagga et al., 2016; Torrey et al., 1992). Medication management, rather than cognitive or behavioral rehabilitation, remains the most popular approach to treating offenders with mental illness (Harney & Riley, 2013). Furthermore, despite evidence that a holistic and individualized approach may be necessary, group psychotherapy appears to be the de facto therapeutic strategy for treating inmates with mental illness (Morgan & Flora, 2002; Morgan et al., 1999). Such findings should not be surprising given the ongoing disagreement over what constitutes the most effective corrections-based treatment for offenders with mental illness (Gannon, 2011; Leidenfrost et al., 2017; Morgan & Flora, 2002). Equally concerning, Harmon-Nary’s (2012) study of correctional officer attitudes revealed that although staff generally agreed that inmates can benefit from psychiatric treatment and therapy, they maintained that these individuals should be more proactive in seeking out mental health services on their own.

Such findings lend credence to Johnson’s (2011) assertion that there is no shortage of examples of jails and prisons that fail to meet constitutional standards of care. Yet, in response to the effects of the Great Recession that began in 2007, state prison budgets began experiencing cuts that led to further reductions in offender health care services (Scott-Hayward, 2009). Furthermore, states began to increase the number of inmates released under community supervision, including those suffering from mental illness (Johnson, 2011). Although the release of these individuals might seem a promising step forward, there is evidence that mental health service providers within the community are less supportive of and even discriminate against people with mental illness who have been incarcerated (Bandara et al., 2018; Frank et al., 2014).

Mental Illness and False Confessions

In addition to their increased redirection into correctional settings and the inability of correctional institutions to meet their needs, false confessions remain a salient concern as a criminal justice outcome for persons with mental illness. Although false confessions are not limited to a particular type of person with certain personality traits or dispositions, some individuals are more susceptible to being pressured into giving false confessions (Leo, 2009). This is particularly true when it comes to persons with mental illness. The literature has consistently demonstrated that persons with mental illness and cognitive development issues are more likely to falsely confess to a crime they did not commit (Cloud et al., 2002; Conley et al., 1992; Drizin & Leo, 2004; Gross et al., 2005; Kassin & Gudjonsson, 2004; Redlich, 2004). Mentally ill individuals with low self-image or low self-esteem are more likely than their nonmentally ill counterparts to seek validation of the “self” by falsely confessing to crimes. Among the mentally ill population, low self-image and/or self-esteem triggers an eagerness to please, a need to impress those in authority (e.g., law enforcement officer, judge, prosecutor), and a need to portray a sense of importance or competence (Drizin & Leo, 2004; Leo, 2009; Salas, 2004). In other words, a false confession may stem from a strong desire to see the interrogator as a friend rather than an adversary. Poor attention span and poor memories, which cause them to become easily confused, combined with poor critical thinking skills, further exacerbates the risk of a false confession (Drizin & Leo, 2004; Leo, 2009; Salas, 2004). Another common result of these interpersonal traits is the failure to understand and internalize one’s Miranda Rights. For many persons with mental health-related problems, being mirandized represents nothing more than empty words or the equivalent of listening to “words without meaning,” a problem that can compound vulnerability to false confessions (Cloud et al., 2002; Everington & Fulero, 1999; Fulero & Everington, 1995).

Further exacerbating the issue is the use of coercive interrogation techniques by the police. In tandem, they greatly increase the likelihood of a mentally ill suspect being manipulated into a false confession and, in turn, a false conviction (Drizin & Leo, 2004; Kassin & Gudjonsson, 2004; Redlich et al., 2010; Salas, 2004). Psychological manipulation, for example, is easily used against persons with mental health issues, considering their frequent need to please persons of authority. According to Leo and Drizin (2010), psychologically coercive police tactics are used to “sequentially manipulate a suspect’s perception of the situation, expectations for the future, and motivation to shift from denial to admission” (p. 17). Such techniques may be used to overbear a suspect’s will through the use of promises or threats and suggest to the suspect that he or she has no choice but to comply with the demands of the interrogator(s) (Kassin & Gudjonsson, 2004; Leo, 2009; Leo and Drizin, 2010; Salas, 2004). Combined with the stress materializing from the confrontation and isolation of the interrogation process, mentally ill suspects are particularly vulnerable because they are more easily influenced and, in some cases, lack the capacity to distinguish between fantasy and reality (Chapman, 2012; Salas, 2004). For example, after many hours of interrogation and being fed information about a crime, a mentally ill suspect may be more likely than a nonmentally ill suspect to believe what he is being told is true and subsequently confess to the crime as a form of confirmation bias (Chapman, 2012). Referred to as “coerced-internalized confession,” the extraction of false confession in this manner is, as described by Kassin (1997), “particularly frightening because the suspect’s memory of his or her own actions may be altered, rendering the original contents potentially irretrievable” (p. 226).

In response to these concerns, a few scholars (e.g., Leo et al., 2013; Rogal, 2017; Salas, 2004) have called for a ban on the admissibility of confessions from some mentally ill suspects. Salas (2004), for example, proposed an exclusionary rule preventing confessions from some mentally ill offenders from ever reaching the courtroom. She sees the inadmissibility of their confessions as justifiable given that the Fifth Amendment requires that confessions be “knowingly and intelligently” offered. According to Salas, since mentally ill suspects do not have the ability to “knowingly and intelligently” waive their Fifth Amendment rights, it is only fitting that the confession should be inadmissible. Similarly, Rogal (2017) has suggested that the Americans with Disabilities Act should serve as a preventive mechanism as it relates to stress-induced coercion of the mentally ill during police interrogation.

The assumption that all mentally ill suspects lack the ability to “knowingly and intelligently” waive their Fifth Amendments rights in all circumstances cannot, however, be squared with the reality that many persons with mental illness are fully capable of acting with autonomy in interrogative settings. Furthermore, the arguments of Salas (2004), in particular, stand in direct conflict with Article 12 of the Convention on the Rights of Persons with Disabilities (CRPD), which instructs that “States Parties shall recognize that persons with disabilities enjoy legal capacity on an equal basis with others in all aspects of life” (United Nations, 2019). Literal interpretation of this “equal recognition before the law” clause would dictate that police interrogate all individuals with little regard for their mental abilities. As it relates to the United States, the wording also suggests that suspects suffering from mental illness have the legal capacity to knowingly and intelligently waive their Fifth Amendment right to protection against self-incrimination. This assertion is equally difficult to square with existing evidence concerning the susceptibility of mentally ill persons to psychologically coercive interrogation techniques (Chapman, 2012; Drizin & Leo, 2004; Leo & Drizin, 2010). Indeed, the extant literature would seem to suggest the need to attach additional legal safeguards to those specific diagnoses and behaviors most likely to lend themselves to psychological manipulation and false confession. Alternatively, the adoption of the United Kingdom’s Preparation and planning, Engage and explain, Account, Closure, and Evaluation (PEACE) interviewing technique and Section 23 of the Criminal Procedures and Investigation Act (CPIA) of 1996 (2010) that requires recording of all interviews would likely reduce the likelihood of false confession through elimination of coercive interrogation techniques while simultaneously promoting the tenets of Article 12 of the CRPD.

Perceptions of Criminal Justice Outcomes for Persons With Mental Illness

Given these concerns, and others, it is not surprising that there has been increased interest in perceptions of mental illness held by both practitioners and the general public. The robustness of this body of literature is, however, limited. In general, public opinion polls indicate that nearly half of all respondents believe people with serious mental illness are more dangerous than the general public (e.g., McGinty, Webster, & Barry, 2013), while approximately 80% believe that current mental illness treatment approaches are effective (Kobau et al., 2012). Perhaps as a consequence of the latter, there is little public support for increasing expenditures directed toward treatment (Smith et al., 2012; Wagner, 2012). Thus, there is an obvious disconnect between public perception and the realities faced by criminal justice practitioners, who frequently lament the lack of “help-centered” treatment options available to justice-involved persons with mental illness (e.g., AbuDagga et al., 2016; Wells & Schafer, 2006). Additional studies of U.S.-based criminal justice personnel have made inquiry into attitudes toward people with mental illness and preference for therapeutic versus punitive responses, but these efforts frequently fail to consider the impact of respondent characteristics on the perceptions they hold (e.g., Louden et al., 2018; Lowder et al., 2019).

Studies of college student perceptions are similarly limited in scope. A recent qualitative study of college student perceptions by Vidourek and Burbage (2019) suggests that college students may overestimate the availability of community-based psychiatric care. Their methodology, however, precluded examination of the impact of respondent characteristics on their responses. As one of the few studies to consider the relation between respondent characteristics and perceptions, Wang et al. (2013) reported that Black students enrolled in social work classes were more likely than their White peers to stigmatize mental illness. Finally, although not linked directly with the mental health of the suspect, Henkel et al. (2008) found that roughly half of their sample, which comprised both college students and the general public, agreed that criminal suspects sometimes confess to crimes they did not commit. Their findings also suggested that women, in comparison with men, were more likely to agree with this statement. That their analyses did not extend beyond bivariate relationships, however, precluded a more robust understanding of the relationship between respondent characteristics and their outcome measure.

The Current Study

Prior works reviewed by the current study point to a number of troubling findings as they relate to criminal justice outcomes for persons with mental illness. Despite the implications of these findings, particularly in terms of social and procedural justice, the literature concerning perceptions of criminal justice outcomes for this at-risk population is comparatively limited. Prior studies have examined the perceptions of criminal justice practitioners as they relate to treatment options and availability, whereas studies utilizing public and college student samples coalesce around perceptions of mental illness in general. Furthermore, consideration of the potential influence of respondent characteristics on perceptions of criminal justice outcomes for persons with mental illness appears altogether absent from the peer reviewed literature. Considering the influence of such factors as gender, race, and political orientation, on perceptions of criminal justice issues ranging from punitiveness (Unnever & Cullen, 2005, 2010; Wozniak, 2017) to legal cynicism (Berg et al., 2016; Carr et al., 2007; Sampson & Bartusch, 1998), there seems ample face validity for such exploration. This gap in the literature prompted the current study to ask, “What factors influence college student perceptions of criminal justice outcomes among persons with mental illness?”

Data, Measures, and Method

Data

The data used in this study were collected from mid-size university in the Southeastern United States. At the time of the study, total undergraduate enrollment included 10,176 students. Study protocols were submitted to the institutional review board and designated as exempt from further review (IRB# 19-045). A stratified random sampling technique was initially selected whereby the strata of the sampling frame were defined by department and course level (e.g., 1,000–4,000), and classes would be selected from within the strata. This approach proved problematic, however, as a result of scheduling conflicts and unreturned emails from professors of selected courses. As a consequence, we adopted a convenience sampling technique resulting in the sampling of 16 different courses largely from the social sciences. These courses consisted of five 1,000-level, three 2,000-level, six 3,000-level, and two 4,000 level-courses nested within six academic programs. Members of the research team met with professors and their students during scheduled class times and explained the purpose and voluntary nature of the research. A total of 974 survey instruments were delivered to the selected classes based on enrollment records. Of these, 451 did not participate as a result of either absenteeism or prior completion of the survey. A total of 523 surveys were completed by the students. Forty-nine of the 523 completed surveys were not useable because of incomplete responses, resulting in a final sample of 474 completed surveys.

Dependent Variables

Multiple Likert-type-style statements were used to measure student perceptions of mental health-related concerns in the criminal justice system. These included the statements, “Prisons offer effective treatment programs for mental illness,”² “People with mental illness are more likely to confess to crimes they did not commit,” and “Approximately 50% of all prisoners suffer from mental illness or mental health concerns.” Response categories included: (a) strongly disagree, (b) disagree, (c) uncertain, (d) agree, and (e) strongly agree. Inspection of the data revealed a high degree of clustering in responses, resulting in limited variation across the five response categories for each of the dependent variables. The response categories were therefore collapsed into the following three categories: (a) disagree, (b) uncertain, (c) and agree.

Independent Variables

The primary goal of this study was to examine the relation between college student characteristics and their perceptions of criminal justice outcomes for persons with mental illness. To this end, a number of independent variables were included in our analyses. Biological sex (0 = female; 1 = male), race (0 = non-White; 1 = White), political affiliation (1 = Republican, 0 = other), and college major (0 = noncriminal justice; 1 = criminal justice) were each operationalized as dichotomous measures. Parents’ education was treated as a proxy of socioeconomic status and operationalized through a question asking respondents to indicate their parents’ highest level of education (1 = bachelor’s degree or higher; 0 = other).³ Semester standing was measured through a question asking respondents to indicate whether they were a (a) freshman, (b) sophomore, (c) junior, or (d) senior. Respondents were also asked to indicate whether they had a family or close friend who currently worked in the criminal justice system (1 = yes; 0 = no). Finally, to capture punitive attitudes, respondents were asked their preference between life in prison without the possibility of parole (0) or the death penalty (1) in cases of first-degree murder.

Analytic Strategy and Hypotheses

Although not applied to the subject of criminal justice outcomes among persons with mental illness, prior studies point to the influence of individual characteristics such as gender, political orientation, and education level on perceptions of numerous criminal justice issues (e.g., Berg et al., 2016; Unnever & Cullen, 2005; Wozniak, 2017). Furthermore, recognition among police and corrections officers of the paucity of effective treatment services for people with mental health concerns suggests that those from criminal justice backgrounds may maintain increased levels of awareness concerning this problem (AbuDagga et al., 2016; Wells & Schafer, 2006). In accordance with these findings, we hypothesize the following:

Hypothesis 1: Respondents majoring in criminal justice will be less likely to agree that prisons offer effective treatment programs for mental illness.

Hypothesis 2: Seniors, in comparison with underclassmen, will be less likely to agree that prisons offer effective treatment programs for mental illness.

Hypothesis 2a: Seniors, in comparison with underclassmen, will be more likely to agree that people with mental illness are more likely to confess to crimes they did not commit.

Hypothesis 2b: Seniors, in comparison with underclassmen, will be more likely to agree that approximately 50% of all prisoners suffer from mental illness or mental health concerns.

Hypothesis 3: Respondents who identify as Republican will be more likely to agree that prisons offer effective treatment programs for mental illness.

Hypothesis 3a: Respondents who identify as Republican will be less likely to agree that people with mental illness are more likely to confess to crimes they did not commit.

Hypothesis 3b: Respondents who identify as Republican will be less likely to agree that approximately 50% of all prisoners suffer from mental illness or mental health concerns.

Hypothesis 4: Male respondents will be more likely to agree that prisons offer effective treatment programs for mental illness.

Hypothesis 4a: Male respondents will be less likely to agree that people with mental illness are more likely to confess to crimes they did not commit.

Hypothesis 4b: Male respondents will be less likely to agree that approximately 50% of all prisoners suffer from mental illness or mental health concerns.

The distances between categories of noninterval, categorical dependent variables are unknown. As a result, a nonlinear regression analysis method is recommended (McCullagh, 1980; Winship & Mare, 1984). To test our hypotheses, this study adopted a multinomial logistic (mlogit) regression approach (Long & Freese, 2006) that was applied to each of the three dependent variables using SPSS 24.

Results

Descriptives

Descriptive statistics are displayed in Table 1. Overall, 60.8% of respondents disagreed with the statement that “Prisons offer effective treatment programs for mental illness.” Comparatively, 15.2% agreed with this statement and 24.1% were uncertain. The majority of respondents (52.8%) agreed with the statement “People with mental illness are more likely to confess to crimes they did not commit,” compared with 15.8% who disagreed and 31.9% who were unsure. Roughly half (50.2%) of respondents agreed with the statement “Approximately 50% of all prisoners suffer from mental illness or mental health concerns,” compared with 13.7% who disagreed and 36.1% who were unsure. Of the respondents included in the final sample, the majority were female (67%) and White (77%).⁴ Nearly a third of the sample identified as Republican and 32% indicated that their college major was Criminal Justice. More than 60% of the sample indicated that at least one parent had earned a bachelor’s degree or higher. Overall, 19.4% of respondents were Freshmen, 23% were sophomores, 21.9% were juniors, and 35.7% were seniors. Forty-five percent of respondents reported that they had a family member or close friend working within the criminal justice system. Finally, 31% of respondents preferred the death penalty over life in prison as a punishment for first-degree murder.

Table 1.

Descriptive Statistics for Variables in Analysis (N = 474).

Variable	M	Mo	%	Minimum	Maximum	SD
Prisons offer effective mental health programs	1.54	1		1	3
People with mental illness more likely to confess to crimes they did not commit	2.37	3		1	3
Approximately 50% of all prisoners suffer mental illness/health concerns	2.37	3		1	3
Biological sex (1 = male)	0.33			0	1	0.47
Race (1 = White)	0.77			0	1	0.42
Republican	0.32			0	1	0.47
Parent college graduate	0.61			0	1	0.49
Major (CJ or Other)	0.32			0	1	0.47
Semester standing	2.74	4		1	4	1.14
Freshman			19.4
Sophomore			23.0
Junior			21.9
Senior (reference category)	35.7
Friend/family employed in CJ	0.45			0	1	0.50
Support death penalty	0.31			0	1	0.46

Note. CJ = criminal justice.

Multinomial Regression Analyses

Table 2 reports the results of the mlogit model predicting perceptions that prisons offer effective treatment programs for mental illness. The overall model fit statistics were appropriate and, as additional independent variables were added, −2 log likelihood became smaller than the constant-only model which represented model improvement (−2 log likelihood = 587.079, χ² = 41.597, p < .01). Given that the final operationalization of the dependent variable included three response categories, a total of two contrast models were used and the first response (disagree) was used as the reference category. The first model (Contrast 1) examined the odds of choosing “uncertain” relative to “disagree.” The second model (Contrast 2) examined the odds of choosing “agree” relative to “disagree.”

Table 2.

MLR Model Predicting Perceptions of Prison Mental Health Programs (N = 474).

Independent variables	Contrast 1: Uncertain/Disagree			Contrast 2: Agree/Disagree
Independent variables	B	SE	OR	B	SE	OR
Major	−0.589	0.269	0.591*	−0.578	0.329	0.561^†
Semester standing
Freshman	0.827	0.314	2.286**	0.885	0.360	2.424*
Sophomore	0.297	0.301	1.346	−0.132	0.386	0.877
Junior	−0.157	0.336	0.857	0.045	0.381	1.047
Republican	0.468	0.256	1.597^†	0.538	0.312	1.712^†
Parent college graduate	−0.074	0.239	0.854	0.030	0.283	1.030
Biological sex	0.454	0.245	1.575^†	−0.199	0.318	0.819
Friend/family works in CJ	0.080	0.234	1.083	−0.264	0.282	0.768
Race	−0.386	0.287	0.679	−0.794	0.323	0.452*
Support for death penalty	0.190	0.252	1.209	−0.247	0.322	0.781
Constant	−1.027	0.338	—	−0.748	0.376	—
Pseudo R² (Nagelkerke)	.099
−2 log likelihood	587.079, χ² = 41.597**

Note. MLR = multinomial logistic regression; CJ = criminal justice; OR = odds ratio.

†

p ≤ . 10. *p ≤ .05. **p ≤ .01. ***p ≤ .001.

In Contrast 1, college major and semester standing emerged as statistically significant predictors of perceptions that prisons offer effective mental health programs for mental illness. Students who reported that their major was criminal justice were significantly less likely to choose “uncertain” relative to “disagree” when asked whether prisons offered effective treatment for mental illness (B = −0.589, odds ratio = 0.591, p < . 05). Freshmen, in comparison with seniors, were significantly more likely to choose “uncertain” relative to “disagree” (B = 0.827, odds ratio = 2.286, p < .01). Although failing to meet traditional thresholds of statistical significance, positive trends were also observed between political affiliation, biological sex, and the perception that prisons offer effective treatment programs for persons with mental illness. Students affiliated with the Republic party (B = 0.468, odds ratio = 1.597, p = .067), as well as male students (B = 0.454, odds ratio = 1.575, p < .064), were more likely to choose “uncertain” relative to “disagree” in response to this statement. In their totality, these findings provided partial support for Hypotheses 1 to 4.

In Contrast 2, semester standing maintained a positive relation with perceptions of that prisons offered effective treatment programs for mental illness. The relative influence of biological sex, however, was reduced to statistical nonsignificance. Much like the model presented in Contrast 1, students majoring in criminal justice were less likely to agree, relative to disagree, with the statement that prisons offer effective treatment programs for mental illness (B = −0.578, odds ratio = 0.561, p = .079). Similarly, freshmen, in comparison with seniors, were more likely to agree, relative to disagree, that prisons offer effective mental health treatment (B = 0.885, odds ratio = 2.424, p < .05). Considered in tandem with the findings presented in Contrast 1, these results may suggest increased levels of awareness among criminal justice students, as well as students nearing completion of their undergraduate experience, concerning the availability of effective mental health programs in prison settings. A positive trend was again observed in relation to the influence of political affiliation. Specifically, students affiliated with the Republican party were more likely to agree, relative to disagree, that prisons offer effective treatment programs for mental illness (B = 0.538, odds ratio = 1.712, p = .085). Although failing to achieve statistical influence in Contrast 1, race emerged as a statistically significant predictor in Contrast 2. Specifically, students who identified as White were less likely to agree, relative to disagree, with the statement that prisons provide effective treatment programs for mental illness (B = −0.794, odds ratio = 0.452, p < .05). In their totality, these findings were generally supportive of Hypotheses 1 to 3. Support for Hypothesis 4 was comparatively limited.

Table 3 reports the results of the mlogit model predicting perceptions of the likelihood of false confessions among persons with mental illness. The overall model fit statistics were appropriate and, as additional independent variables were added, −2 log likelihood became smaller than the constant-only model which represented model improvement (−2 log likelihood = 624.485, χ² = 37.719, p < .01). In Contrast 1, distinct trends were observed in terms of the influence of semester standing and political affiliation on perceptions of the likelihood of false confessions among persons with mental illness. The odds of choosing “uncertain” relative to “disagree” in response to the statement “People with mental illness are more likely to confess to crimes they did not commit” were higher among sophomores (B = 0.695, odds ratio = 2.003, p = .088) and juniors (B = 0.797, odds ratio = 2.219, p = .084) in comparison with seniors, though these relationships failed to achieve traditional levels of statistical significance. In contrast, the odds of choosing “uncertain” relative to “disagree” were lower among students who identified as Republican (B = −0.811, odds ratio = 0.481, p < .05).

Table 3.

MLR Model Predicting Perceptions of Mental Health and False Confessions (N = 474).

Independent variables	Contrast 1: Uncertain/Disagree			Contrast 2: Agree/Disagree
Independent variables	B	SE	OR	B	SE	OR
Major	0.012	0.421	1.012	0.025	0.314	1.025
Semester standing
Freshman	0.002	0.369	1.002	−0.914	0.354	0.401**
Sophomore	0.695	0.407	2.003^†	0.207	0.382	1.230
Junior	0.797	0.446	2.219^†	0.619	0.415	1.857
Republican	−0.811	0.322	0.481*	−0.879	0.300	0.415**
Parent college graduate	−0.111	0.301	0.895	0.118	0.285	1.125
Biological sex	−0.220	0.312	0.803	−0.407	0.297	0.665
Friend/family works in CJ	0.165	0.297	1.180	0.103	0.280	1.109
Race	0.044	0.362	1.045	0.463	0.351	1.589
Support for death penalty	−0.092	0.316	0.912	−0.198	0.299	0.820
Constant	0.782	0.420	—	1.285	0.397	—
Pseudo R² (Nagelkerke)	.089
−2 log likelihood	624.485, χ² = 37.719**

Note. MLR = multinomial logistic regression; CJ = criminal justice; OR = odds ratio.

†

p ≤ .10. *p ≤ .05. **p ≤ .01. ***p ≤ .001.

In Contrast 2, the relative influence of semester standing and political affiliation on perceptions of the likelihood of false confessions by persons with mental illness each maintained salience. In comparison with seniors, the odds of choosing “agree” relative to “disagree” were lower among freshmen (B = −0.914, odds ratio = 0.401, p < .01). Similarly, students who identified as Republican were less likely to agree, relative to disagree, with the statement that “People with mental illness are more likely to confess to crimes they did not commit” (B = −0.879, odds ratio = 0.415, p < .01). Considered in conjunction with the results of Contrast 1, these finding suggest that students who maintain a more conservative political ideology are less open to the possibility that persons with mental illness may be more likely to confess to crimes they did not commit. Again, these findings provided general support for Hypotheses 2a and 3a. In comparison, the results prompted rejection of Hypothesis 4a.

Table 4 reports the results of the mlogit model predicting perceptions of the prevalence of mental illness among incarcerated populations. The overall model fit statistics were appropriate and, as additional independent variables were added, −2 log likelihood became smaller than the constant-only model which represented model improvement (−2 log likelihood = 623.004, χ² = 58.706, p < .001). In Contrast 1, students who identified as Republican were less likely to choose “uncertain” relative to “disagree” in response to the statement that “Approximately 50% of all prisoners suffer from mental illness/mental health concerns” (B = −0.633, odds ratio = 0.531, p = .057), though this relationship fell short of statistical significance. In Contrast 2, and in support of Hypotheses 3b and 4b, the influence political affiliation and biological sex achieved statistical significance—as did support for the death penalty. Each of these characteristics was negatively associated with the outcome measure. Specifically, the odds of choosing “agree” relative to “disagree” were significantly lower among students who identified as Republican (B = −0.702, odds ratio = 0.496, p < .05) and male (B = −0.645, odds ratio = 0.525, p < .05), as well as students who preferred the death penalty to life in prison (B = −0.726, odds ratio = 0.484, p < .05). By comparison, the relation between semester standing and the perception that approximately half of all prisons suffer from mental illness/mental health concerns was statistically nonsignificant and prompted rejection of Hypothesis 2b.

Table 4.

MLR Model Predicting Perceptions of Mental Illness Among Prisoners (N = 474).

Independent variables	Contrast 1: Uncertain/Disagree			Contrast 2: Agree/Disagree
Independent variables	B	SE	OR	B	SE	OR
Major	−0.341	0.342	0.711	0.146	0.324	1.157
Semester standing
Freshman	0.563	0.419	1.756	−0.610	0.431	0.543
Sophomore	−0.222	0.392	0.801	−0.430	0.373	0.651
Junior	0.128	0.439	1.136	0.226	0.413	1.254
Republican	−0.633	0.332	0.531^†	−0.702	0.321	0.496*
Parent college graduate	−0.061	0.309	0.941	0.337	0.301	1.401
Biological sex	−0.476	0.315	0.803	−0.645	0.306	0.525*
Friend/family works in CJ	−0.146	0.311	0.864	0.393	0.299	1.481
Race	0.433	0.369	0.240	0.530	0.362	1.700
Support for death penalty	−0.417	0.319	0.659	−0.726	0.311	0.484*
Constant	1.323	0.427	—	1.369	0.416	—
Pseudo R² (Nagelkerke)	.135
−2 log likelihood	623.004, χ² = 58.706***

Note. MLR = multinomial logistic regression; CJ = criminal justice; OR = odds ratio.

†

p ≤ .10. *p ≤ .05. **p ≤ .01. ***p ≤ .001.

Discussion and Conclusion

The purpose of this study was to examine the relation between college student characteristics and perceptions of criminal justice outcomes for persons with mental illness. The findings presented here represent a substantive contribution to the literature given that, to our knowledge, no prior studies have considered the factors that might influence the perceptions of college students as they relate to this topic. In this vein, several of our findings merit further discussion.

Political affiliation emerged as a robust predictor of perceptions of criminal justice outcomes among persons with mental illness. Specially, students who identified as Republican were more likely to agree that prisons offer effective treatment for persons with mental illness. In contrast, these students were less likely than their peers to agree that approximately half of all incarcerated persons are affected by mental illness or that this demographic is more likely to confess to crimes they did not commit. Although these results may well be an artifact of the linkage between conservative political ideology and preference for crime control over due process models of justice (Clark & Wink, 2012; Jost et al., 2009; Kugler et al., 2014; Loader & Sparks, 2016), they also carry with them important implications for both the field and societal approaches to mental illness. Similarly, in terms of the availability of effective prison-based treatment services for mental illness and the increased susceptibility of persons with mental illness to false confessions, seniors maintained statistically significantly higher levels of awareness in comparison with freshmen—but not sophomores or juniors. Furthermore, semester standing failed to exert statistically significant influence over perceptions of the prevalence of mental illness among incarcerated persons. The importance of these findings should not be understated. There are obvious concerns related to the extent to which college students, many of whom may pursue careers in the field of criminal justice, are poorly informed regarding the prevalence of mental illness among offending populations (James & Glaze, 2006; TAC, 2014), their vulnerability to abuse by criminal justice actors (Cloud et al., 2002; Redlich et al., 2010), and lack of effective corrections-based treatment for people with mental illness (Johnson, 2011; Scott-Hayward, 2009). The nonsignificant influence of majoring in criminal justice in relation to two of our three dependent variables, and relatively high degree of uncertainty in response to our Likert-type statements, are concerning for similar reasons.

Together, these findings strongly suggest the need for discussions of the nexus between mental illness and the criminal justice system to maintain a more central and consistent place in the classroom, particularly in core courses and popular general education classes within the criminal justice discipline (e.g., Introduction to Criminal Justice). In turn, students should become increasingly aware of the ties between mental illness, offending, and incarceration as they progress through their undergraduate experience. The defunding and deprioritization of mental health institutions that began in the United States in the 1960s gave rise to both an exponential increase in the prison population and an ineffective “war” against street-level drug users—many of whom may be self-medicating (Wallace et al., 2004; Wilson et al., 2011). Furthermore, the relation between coercive and manipulative police interrogation techniques and false confessions by suspects suffering from mental health concerns is well documented (Drizin & Leo, 2004; Leo, 2009; Redlich et al., 2010). To the extent that such knowledge remains obscured, particularly among college-educated people, we can expect more of the same, as well as resistance (passive and active) to necessary reforms.

Toward this end, students would likely benefit from an international perspective. As noted in our review of the literature, for example, the PEACE interviewing technique developed in the United Kingdom shows tremendous promise. Conceived as an investigative interview, rather than an accusatory interrogation, the PEACE technique allows the suspect to tell his or her story without interjections by the interviewer. This approach has demonstrated widespread international appeal, having been adopted by police in a variety of countries, including New Zealand, Australia, Norway, and parts of Canada (Schollum, 2017). Furthermore, it is currently being explored by police agencies in the Republic of Ireland, Vietnam, Indonesia, Hong Kong, Singapore, and Malaysia. Importantly, exposure to PEACE would provide students with point of comparison and viable alternative to coercive and deceptive interrogation techniques commonly used in the United States that have been heavily criticized for their potential to lead to false confessions (e.g., Reid technique). Similarly, exposure to international practices related to the collection and evidentiary value of testimony may prove beneficial. Section 23 of Britain’s CPIA of 1996 (2010), for example, requires that all interrogations be recorded, retained, and made available to all parties in the criminal justice process (Leo et al., 2009). Furthermore, as a safeguard against the temptation to utilize coercive interrogation techniques in weak cases, many countries (e.g., Mexico and Russia) require that confessions be supported by corroborating circumstantial or physical evidence. In short, students armed with such knowledge may be better positioned to engage in ethical practices and advocate progressive police reforms.

Sadly, the U.S. prison system is not alone in its struggle to accommodate the needs of mentally ill prisoners. Indeed, multiple studies have also pointed to the lack of both adequate space and care for prisoners suffering from mental health concerns across Europe (Blaauw et al., 2000; Dressing & Salize, 2009). Although our study does not address this issue directly, the findings of these and U.S.-based studies move us to reiterate two important realities: (a) prisons are neither designed nor positioned to act as the primary providers of psychiatric care and (b) any viable solution to this crisis will require reprioritization of and reinvestment in mental health institutions and services. Recognition of these facts, coupled with shifts in policy, practice, and public awareness campaigns (e.g., Hayes et al., 2008; Kirsch et al., 2014), may not only divert large numbers of mentally ill persons from the criminal justice system but also allow prison staff to focus on their efforts on a smaller number of offenders.

Despite its contribution to the literature, this study does maintain several limitations that should be acknowledged. First, the cross-sectional nature of our data does not permit inference of causality. Second, the representativeness of our sample is a concern. Although the sample demographics aligned with the classes in which the survey was distributed, our sample cannot be said to be representative of the university as a whole. Similarly, our findings cannot be generalized beyond the study site. Third, although pseudo-R² does not provide a true measure of explained variance, our models likely suffer from omitted variable bias. Fourth, the use the broad term “mental illness” in our Likert-type-style statements is problematic given that it does not allow for a more nuanced exploration of varying perceptions and awareness of distinct mental illnesses and disorders.

As a consequence, we strongly encourage future studies to further explore the mechanics of the relationships described here, as well as to consider and incorporate other potentially important predictors of perceptions of criminal justice outcomes among persons with mental illness—such as contact or familial relationships with justice-involved persons with mental illness. Furthermore, future studies should build on our methodology by incorporating items designed to test familiarity with specific mental illnesses and disorders, their associated symptoms and behaviors, and specific needs. Finally, in accordance with our recommendation related to education, future works should examine the extent to which respondents are familiar with current evidence-based practices, both domestically and internationally, as they relate to criminally and justice-involved persons with mental illness. Application of such a study design to samples of both students and practitioners should provide a baseline of current knowledge that may be used to identify and target specific knowledge deficits while building a foundation for meaningful improvement in how society and the criminal justice system approach and manage this at-risk population.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Rick Dierenfeldt

Notes

References

AbuDagga

Wolfe

Carome

Phatdouang

Torrey

E. F.

(2016). Individuals with serious mental illness in county jails: A survey of jail staff’s perspectives. Public Citizen’s Health Research Group; Treatment Advocacy Center.

Ahonen

Loeber

Brent

(2019). The association between serious mental health problems and violence: Some common assumption and misconceptions. Trauma, Violence & Abuse, 20(5), 613–625.

Bandara

S. N.

Daumit

G. L.

Kennedy-Hendricks

Linden

Choksy

McGinty

(2018). Mental health providers’ attitudes about criminal justice-involved clients with mental illness. Psychiatric Services, 69(4), 472–475.

Batastini

A. B.

Lester

M. E.

Thompson

R. A.

(2018). Mental illness in the eyes of the law: Examining perceptions of stigma among judges and attorneys. Psychology, Crime and Law, 24(7), 673–686.

Berg

M. T.

Stewart

E. A.

Intravia

Warren

P. Y.

Simons

R. L.

(2016). Cynical streets: Neighborhood social processes and perceptions of criminal injustice. Criminology, 54(3), 520–547.

Berryessa

(2019). Judicial stereotyping associated with genetic essentialist biases toward mental disorders and potential negative effects on sentencing. Law & Society Review, 53(1), 202–238.

Blaauw

Roesch

Kerkhof

(2000). Mental disorders in European prison systems. Arrangements for mentally disordered prisons in the prison system of 13 European countries. International Journal of Law and Psychiatry, 23(5–6), 649–663.

Bronson

Berzofksy

(2017). Indicators of mental health problems reported by prisoners and jail inmates, 2011–2012 (No. NCJ 250612). Bureau of Justice Statistics, Office of Justice Programs, U.S. Department of Justice. https://www.bjs.gov/index.cfm?ty=pbdetail&iid=5946

Carr

P. J.

Napolitano

Keating

(2007). We never call the cops and here is why: A qualitative examination of legal cynicism in three Philadelphia neighborhoods. Criminology, 45, 445–480.

10.

Carrillo

Crittenden

C. A.

Garland

T. S.

(2019). Faculty perceptions of consensual sexual relationships between university faculty and students. Journal of Academic Ethics, 17(4), 331–343.

11.

Chapman

F. E.

(2012). Coerced internalized false confessions and police interrogations: The power of coercion. Law and Psychology Review, 37, 159–249.

12.

Clark

J. W.

Wink

(2012). The relationship between political ideology and punishment: What do jury panel members say? Applied Psychology in Criminal Justice, 8(2), 130–146.

13.

Cloud

Shepherd

Barkoff

Shur

J. V.

(2002). Words without meaning: The constitution, confessions and developmentally disabled suspects. The University of Chicago Law Review, 69, 495–624.

14.

Conley

Luckasson

Bouthilet

(1992). The criminal justice system and mental retardation: Defendants and victims. Paul H. Brookes.

15.

Constantine

R. J.

Petrila

Andel

Givens

E. M.

Becker

Robst

. . .Howe

(2010). Arrest trajectories of adult offenders with a serious mental illness. Psychology, Public Policy, and Law, 16(4), 319–339.

16.

Criminal Procedures and Investigation Act of 1996. (2010). Criminal investigations: Part II. http://www.legislation.gov.uk/ukpga/1996/25/part/II

17.

Crittenden

C. A.

Gimlin

A. M.

Bennett

Garland

T. S.

(2018). Exploring faculty and students’ attitudes about consensual sexual relationships and sexual harassment on college campuses. Educational Policy. Advance online publication. https://doi.org/10.1177/0895904818810522

18.

DeSmet

VanHecke

Verte

Broekaert

Ryan

Vandevelds

(2015). Treatment and control: A qualitative study of older mentally ill offenders’ perceptions on their detention and care trajectory. International Journal of Offender Therapy and Comparative Criminology, 59(9), 964–985.

19.

Dressing

Salize

H.-J.

(2009). Pathways to psychiatric care in Europe prison systems. Behavioral Sciences & the Law, 27(5), 801–810.

20.

Drizin

S. A.

Leo

R. A.

(2004). The problem of false confessions in the post-DNA world. North Carolina Law Review, 82, 891–1008.

21.

Etter

G. W.

Birzer

M. L.

Fields

(2008). The jail as a dumping ground: The incidental incarceration of mentally ill individuals. Criminal Justice Studies, 21(1), 79–89.

22.

Everington

Fulero

S. M.

(1999). Competence to confess: Measuring understanding and suggestibility of defendants with mental retardation. Mental Retardation, 37, 212–220.

23.

Fazel

Danesh

(2002). Serious mental disorder in 23000 prisoners: A systematic review of 62 surveys. The Lancet, 359, 545–550.

24.

Fellner

(2015). Callous and cruel: Use of force against inmates with mental disabilities in U.S. jails and prisons. https://www.hrw.org/report/2015/05/12/callous-and-cruel/use-force-against-inmates-mental-disabilities-us-jails-and

25.

Frank

J. W.

Wang

E. A.

Nunez-Smith

Lee

Comfort

(2014). Discrimination based on criminal record and healthcare utilization among men recently released from prison: A descriptive study. Health and Justice, 2(6), 1–8.

26.

Freidl

Lang

Scherer

(2003). How psychiatric patients perceive the public’s stereotype of mental illness. Social Psychiatry and Psychiatric Epidemiology, 38(5), 269–275.

27.

Fulero

S. M.

Everington

(1995). Assessing competency to waive Miranda rights in defendants with mental retardations. Law and Human Behavior, 19, 533–543.

28.

Gannon

J. L.

(2011). Mental health: Not just a program. Corrections Today, 73(5), 59–61.

29.

Garland

T. S.

Policastro

Richards

T. N.

McGuffee

(2016). Blaming the victim: University student attitudes toward bullying. Journal of Aggression, Maltreatment & Trauma, 26, 69–87.

30.

Gross

S. R.

Jacoby

Matheson

D. J.

Montgomery

Patil

(2005). Exonerations in the United States 1989 through 2003. The Journal of Criminal Law and Criminology, 95, 523–560.

31.

Harmon-Nary

(2012). Correctional officer perceptions: Opinions on mental illness, mental health treatment and officer training. ProQuest.

32.

Harney

H. M.

Riley

(2013). The impact of incarceration on women’s mental health: Responses from women in a maximum-security prison. Qualitative Health Research, 23(1), 26–42.

33.

Hayes

B. G.

Freeman

M. S.

Vogel

J. E.

Clonch

Clarke

Duffey

(2008). Destigmatizing college counseling first-year students: A psychodrama approach. Journal of College Student Development, 49(3), 250–254.

34.

Henkel

Coffman

K. A. J.

Dailey

(2008). A survey of people’s attitudes and beliefs about false confessions. Behavioral Sciences and the Law, 26, 555–584.

35.

Holton

S. M.

(2003). Managing and treating mentally disordered offenders in jails and prisons. In Fagan

T. J.

R. K.

(Eds.), Correctional mental health handbook (pp. 101–122). Sage.

36.

James

D. J.

Glaze

L. E.

(2006). Mental health problems of prison and jail inmates [Bureau of Justice Statistics Special Report]. Office of Justice Programs, U.S. Department of Justice. https://www.bjs.gov/content/pub/pdf/mhppji.pdf

37.

Johnson

W. W.

(2011). Rethinking the interface between mental illness, criminal justice and academia. Justice Quarterly, 28(1), 15–22.

38.

Johnston

E. L.

(2013). Vulnerability and just dessert: A theory of sentencing and mental illness. Journal of Criminal Law and Criminology, 103(1), 147–230.

39.

Jost

J. T.

Kay

A. C.

Thorisdottir

(2009). Social and psychological bases for ideology and system justification. Oxford University Press.

40.

Junginger

Claypoole

Laygo

Cristanti

(2006). Effects of serious mental health illness and substance abuse on criminal offenses. Psychiatric Services, 57, 879–882.

41.

Kassin

S. M.

(1997). The psychology of confession evidence. American Psychologist, 52(3), 221–233.

42.

Kassin

S. M.

Gudjonsson

G. H.

(2004). The psychology of confessions: A review of the literature and issues. Psychological Science in the Public Interest, 5(2), 33–67.

43.

Kirsch

D. J.

Pinder-Amaker

S. L.

Morse

Ellison

M. L.

Doerfler

L. A.

Riba

M. B.

(2014). Population-based initiatives in college mental health: Students helping students overcome obstacles. Current Psychiatry Reports, 16(12), Article 525.

44.

Knettel

B. A.

Rugira

Cornett

J. A.

(2018). Mental health diagnostic frameworks, imputed causes of mental illness, and alternative treatments in northern Tanzania: Exploring mental health providers’ perspectives. Culture, Medicine, and Psychiatry, 42(3), 483–503.

45.

Kobau

Zack

M. M.

Luncheon

Barile

J. P.

Marshall

Bornemann

Manderscheid

R. W.

(2012). Attitudes toward mental illness: Results from the behavioral risk factor surveillance system. Centers for Disease Control and Prevention.

46.

Kugler

Jost

J. T.

Noorbaloochi

(2014). Another look at moral foundations theory: Do authoritarianism and social dominance orientation explain liberal-conservative differences in “moral” intuitions? Social Justice Research, 27(4), 413–431.

47.

Leidenfrost

C. M.

Schoelerman

R. M.

Maher

Antonius

(2017). The development and efficacy of a group intervention program for individuals with serioius mental illness in jail. International Journal of Law and Psychiatry, 54, 98–106.

48.

Leo

R. A.

(2009). False confessions: Causes, consequences, and implications. The Journal of the American Academy of Psychiatric and the Law, 37, 332–343.

49.

Leo

R. A.

Costanzo

Shaked-Schroer

(2009). Psychological and cultural aspects of interrogations and false confessions: Using research to inform legal decision-making. In Krauss

D. A.

Liberman

J. D.

(Eds.), Psychological expertise in court: Psychology in the courtroom (Vol. 2, pp. 25–55, University of San Francisco Law Research Paper No. 2011-06). Ashgate Publishing. https://ssrn.com/abstract=1537331

50.

Leo

R. A.

Drizin

S. A.

(2010). The three errors: Pathways to false confession and wrongful conviction. In Lassiter

G. D.

Meissner

(Eds.), Police interrogations and false confessions: Current research, practice, and policy recommendations (pp. 9–30, University of San Francisco Law Research Paper No. 2012-04). American Psychological Association. https://ssrn.com/abstract=1542901

51.

Leo

R. A.

Neufeld

P. J.

Drizin

S. A.

Taslitz

A. E.

(2013). Promoting accuracy in the use of confession evidence: An argument for pretrial reliability assessments to prevent wrongful convictions. Temple Law Review, 85, 759–951.

52.

Loader

Sparks

(2016). Ideologies and crime: Political ideas and the dynamics of crime control. Global Crime, 17, 314–330.

53.

Loeb

D. F.

Bayliss

E. A.

Binswanger

I. A.

Candrian

deGruy

F. V.

(2012). Primary care physician perceptions on caring for complex patients with medical and mental illness. Journal of General Internal Medicine, 27(8), 945–952.

54.

Long

J. S.

Freese

(2006). Regression models for categorical dependent variables using Stata (2nd ed.). Stata Press.

55.

Louden

J. E.

Manchak

S. M.

Ricks

E. P.

Kennealy

P. J.

(2018). The role of stigma toward mental illness in probation officers’ perceptions of risk and case management decisions. Criminal Justice and Behavior, 45(5), 573–588.

56.

Lowder

E. M.

Ray

B. R.

Gruenewald

J. A.

(2019). Criminal justice professionals’ attitudes toward mental illness and substance use. Community Mental Health Journal, 55, 428–439.

57.

McCullagh

(1980). Regression models for ordinal data. Journal of the Royal Statistical Society (Series B), 42(2), 109–142.

58.

McGinty

M. S.

Webster

D. W.

Barry

C. L

. (2013). Effects of news media messages about mass shootings on attitudes toward persons with serious mental illness and public support for gun control policies. American Journal of Psychiatry, 170, 494–501.

59.

Morgan

R. D.

Flora

D. B.

(2002). Group psychotherapy with incarcerated offenders: A research synthesis. Group Dynamics Therapy, Research, and Practice, 6(3), 203–218.

60.

Morgan

R. D.

Winterowd

C. L.

Ferrell

S. W.

(1999). A national survey of group psychotherapy services in correctional facilities. Professional Psychology: Research and Practice, 30(6), 600–606.

61.

National Institute of Mental Health. (2017). Mental health information statistics. https://www.nimh.nih.gov/health/statistics/mental-illness.shtml#part_154785

62.

Redlich

A. D.

(2004). Mental illness, police interrogations, and the potential for false confession. Psychiatric Services, 55, 19–21.

63.

Redlich

A. D.

Summers

Hoover

(2010). Self-reported false confessions and false guilty pleas among offenders with mental illness. Law and Human Behavior, 34(1), 79–90.

64.

Rogal

(2017). Protecting persons with mental disabilities from making false confessions. The Americans with disabilities act as a safeguard. New Mexico Law Review, 47, 64–98.

65.

Roth

(2018). Insane: America’s criminal treatment of mental illness. Basic Books.

66.

Rotter

Way

Steinbacher

Sawyer

Smith

(2002). Personality disorders in prison: Aren’t they all antisocial? Psychiatric Quarterly, 73(4), 337–349.

67.

Salas

(2004). Note: The case for excluding the criminal confessions of the mentally ill. Yale Journal of Law and the Humanities, 16(1), 1–25.

68.

Sampson

R. J.

Bartusch

D. J.

(1998). Legal cynicism and (subcultural?) tolerance of deviance: The neighborhood context of racial differences. Law & Society Review, 32(4), 777–804.

69.

Schollum

(2017, November). Bringing PEACE to the United States: A framework for investigative interviewing. The Police Chief. https://www.fis-international.com/assets/Uploads/resources/Schollum-PEACE.pdf

70.

Scott-Hayward

(2009). The fiscal crisis in corrections: Rethinking policies and practices. Vera Institute of Justice.

71.

Shames

Wilcox

Subramanian

(2016). Position statement: Solitary confinement (isolation). Journal of Correctional Health Care, 22(3), 257–263.

72.

Slate

Johnson

W. W.

(2008). Criminalization of mental illness: Crisis and opportunity for the justice system. Carolina Academic Press.

73.

Smith

D. M.

Damschroder Kim

L. J.

Ubel

P. A.

(2012). What’s it worth? Public willingness to pay to avoid mental illnesses compared with general illnesses. Psychiatric Services, 63(4), 319–324.

74.

Star

S. A.

(1952). What the public thinks about mental health and mental illness [Paper presentation]. A paper presented at the Annual Meeting of the National Association for Mental Health, Indianapolis, IN, United States.

75.

Star

S. A.

(1955). The public’s ideas about mental illness [Paper presentation]. A paper presented at the Annual Meeting of the National Association for Mental Health, Indianapolis, IN, United States.

76.

Torrey

E. F.

(1995). Editorial: Jails and prisons —America’s new mental hospitals. American Journal of Public Health, 85(12), 1611–1613.

77.

Torrey

E. F.

Stieber

Ezekiel

Wolfe

S. M.

Sharfstein

Noble

J. H.

Flynn

L. M.

(1992). Criminalizing the seriously mentally ill: The abuse of jails as mental hospitals. https://books.google.com/books/about/Criminalizing_the_Seriously_Mentally_Ill.html?id=kR_t_xV5RJIC&printsec=frontcover&source=kp_read_button#v=onepage&q&f=false

78.

Torrey

E. F.

Zdanowicz

M. T.

Kenard

A. D.

Lamb

H. R.

Eslinger

D. F.

Biasotti

M. C.

Fuller

D. A.

(2014). The treatment of persons with mental illness in prisons and jails: A state survey. Treatment Advocacy Center.

79.

Treatment Advocacy Center. (2014, April 8). The treatment of persons with mental illness in prisons and jails: A state survey. https://www.treatmentadvocacycenter.org/storage/documents/treatment-behind-bars/treatment-behind-bars.pdf

80.

United Nations (2019). Department of Economic and Social Affairs – Disability: Article 12. https://www.un.org/development/desa/disabilities/convention-on-the-rights-of-persons-with-disabilities/article-12-equal-recognition-before-the-law.html

81.

Unnever

J. D.

Cullen

F. T.

(2005). Executing the innocent and support for capital punishment: Implications for public policy. Criminology and Public Policy, 4(1), 3–38.

82.

Unnever

J. D.

Cullen

F. T.

(2010). The social forces of Americans’ punitiveness: A test of three competing models. Criminology, 48(1), 99–130.

83.

Vidourek

R. A.

Burbage

(2019). Positive mental health and mental health stigma: A qualitative study assessing student attitudes. Mental Health and Prevention, 13, 1–6.

84.

Wagner

P. E.

(2012). I’m oK, you’re not: Assessing variable influence on perceptions of the mentally ill among college students (Unpublished Master’s Thesis). Liberty University.

85.

Wallace

Mullen

Burgess

(2004). Criminal offending in schizophrenia over a 25-year period marked by deinstitutionalization and increasing prevalence of comorbid substance use disorders. American Journal of Psychiatry, 161, 716–727.

86.

Wang

Locke

Chonody

(2013). Differences by race in social work students’ social distancing, treatment options, and perceptions of causes of mental illness. Journal of Social Service Research, 39(5), 646–661.

87.

Watson

A. C.

Corrigan

P. W.

Ottati

(2004). Police officers’ attitudes toward and decisions about persons with mental illness. Psychiatric Services, 55(1), 49–53.

88.

Wells

Schafer

J. A.

(2006). Officer perceptions of police responses to persons with a mental illness. Policing: An International Journal of Police Strategies and Management, 29(4), 578–601.

89.

Wilson

A. B.

Draine

Hadley

Metraux

Evans

(2011). Examining the impact of mental illness and substance use on recidivism in a county jail. International Journal of Law and Psychiatry, 34(4), 264–268.

90.

Winship

Mare

R. D.

(1984). Regression models with ordinal variables. American Sociological Review, 49(4), 512–525.

91.

Wozniak

K. H.

(2017). The relationship between perceptions of prison and support for the death penalty versus life without parole. Journal of Crime and Justice, 40(2), 222–237.