Decarceration of older adults with mental illness in the USA - beyond the COVID-19 pandemic.

PURPOSE: Aging and mental illness both represent significant public health challenges for incarcerated people in the USA. The COVID-19 pandemic has further highlighted the vulnerabilities of incarcerated people because of the risks of infectious disease transmission in correctional facilities. Focusing on older adults with mental illness, this paper aims to examine efforts to decarcerate US correctional facilities during the COVID-19 pandemic and whether these approaches may lead to sustainable reforms beyond the pandemic. DESIGN/METHODOLOGY/APPROACH: A narrative literature review was conducted using numerous online resources, including PubMed, Google Scholar and LexisNexis. Search terms used included "decarceration pandemic," "COVID-19 decarceration," "aging mental illness decarceration," "jails prisons decarceration," "early release COVID-19" and "correctional decarceration pandemic," among others. Given the rapidly changing nature of the COVID-19 pandemic, this narrative literature review included content from not only scholarly articles and federal and state government publications but also relevant media articles and policy-related reports. The authors reviewed these sources collaboratively to synthesize a review of existing evidence and opinions on these topics and generate conclusions and policy recommendations moving forward. FINDINGS: To mitigate the risks of COVID-19, policymakers have pursued various decarceration strategies across the USA. Some efforts have focused on reducing inflow into correctional systems, including advising police to reduce numbers of arrests and limiting use of pretrial detention. Other policies have sought to increase outflow from correctional systems, such as facilitating early release of people convicted of nonviolent offenses or those nearing the end of their sentences. Given the well-known risks of COVID-19 among older individuals, age was commonly cited as a reason for diverting or expediting release of people from incarceration. In contrast, despite their vulnerability to complications from COVID-19, people with serious mental illness (SMI), particularly those with acute treatment needs, may have been less likely in some instances to be diverted or released early from incarceration. ORIGINALITY/VALUE: Although much has been written about decarceration during the COVID-19 pandemic, little attention has been paid to the relevance of these efforts for older adults with mental illness. This paper synthesizes existing proposals and evidence while drawing attention to the public health implications of aging and SMI in US correctional settings and explores opportunities for decarceration of older adults with SMI beyond the COVID-19 pandemic.

Forensic e-mental health: Review, research priorities, and policy directions

Forensic e-mental health is an area of psychology that is relatively underdeveloped considering technological advancements and the many mental health needs of justice-involved individuals. It includes the procurement, storage, sharing, and provision of forensic mental health information and services via electronic means and is associated with improved accessibility, efficiency, cost-savings, and safety. During the COVID-19 pandemic, clinics, hospitals, jails, prisons, and the courts rapidly adopted these modalities for service continuity out of necessity, rather than choice. In the absence of formal guidelines, practitioners, researchers, and policymakers were left searching for answers: what forensic e-mental health technologies are available, what was their research evidence, and what could the future hold? A "primer" covering the many aspects of technology-assisted forensic practice and research was overdue. To address this knowledge gap, we reviewed the e-mental health research base encompassing forensic evaluations and interventions. Considering stakeholders' needs, cost, and feasibility, we prioritized key topics that should rise to the top of the forensic e-mental health research agenda: the psychometric properties of forensic e-mental health assessments, impact of video recording evaluations, how to assess and treat diverse populations, restoration of competence to proceed, continuum of care, minimizing treatment attrition, and decreasing substance use. We report how to plan for and overcome logistical hurdles when implementing forensic e-mental health policy, utilize technology for training and education, and harness digitized data across the forensic realm. In conclusion, we find that there is ample opportunity for leveraging technology to improve forensic mental health practice, research, and policy. (PsycInfo Database Record (c) 2020 APA, all rights reserved)