WK 4 Assignment: Rehabilitation Program- Replies
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Conceptualizing Restorative Justice for People With Mental Illnesses Leaving Prison or Jail
Elizabeth C. Thomas Temple University
Andrea Bilger University of Pennsylvania
Amy Blank Wilson University of North Carolina at Chapel Hill
Jeffrey Draine Temple University
Individuals with psychiatric disabilities who are involved in the criminal justice system face a number of challenges to community integration upon release. There is a critical need to develop and evaluate interventions for these individuals that connect them to the community by enhanc- ing naturalistic social connections and helping them to participate meaningfully in valued roles. The purposes of this article are to describe, provide a theoretical rationale, and propose a conceptual model for the use of a particular restorative justice model, circles of support and accountability, to meet this need. We describe the principles of restorative justice (repairing harm, stakeholder involvement, and the transformation of community and governmental roles and relationships) and how these map on to elements of the circles intervention. These elements include a focus on community participation, positive social support, democratic decision making, collective ownership of crime problems, and connection to community-based resources. We then suggest how changes in identity transformation, moral development and motivation, and col- lective efficacy might mediate relationships between these intervention elements and community integration outcomes. Finally, we encourage the systematic evaluation of the circles intervention for people with mental health conditions leaving custody and provide recommendations for policy and practice.
Public Policy Relevance Statement The combined challenges associated with experiencing a mental health condition and justice system involvement put those with psychiatric disabilities leaving custody particularly at risk for social and community exclusion. Interventions like circles of support and accountability have the potential to positively impact both justice-involved individuals and the larger communities in which they live, but have not been implemented or studied for those with mental health conditions. By describing, providing a theoretical rationale, and proposing a conceptual model for the use of circles for this group, this article accomplishes a requisite step in advancing policy developments in this area.
This article was published Online First November 8, 2018. Elizabeth C. Thomas, Department of Rehabilitation Sciences, College
of Public Health, Temple University; Andrea Bilger, Department of Family Medicine and Community Health, Perelman School of Medicine, Univer- sity of Pennsylvania; Amy Blank Wilson, School of Social Work, Univer- sity of North Carolina at Chapel Hill; Jeffrey Draine, School of Social Work, College of Public Health, Temple University.
All authors declare that there are no financial conflicts of interest associated with this research. The contents of this article were developed
with the assistance of a grant from the National Institute on Disability, Independent Living and Rehabilitation Research. However, the contents do not necessarily represent the policy of the U.S. Department of Health and Human Services, and endorsement by the Federal government should not be assumed.
Correspondence concerning this article should be addressed to Elizabeth C. Thomas, Department of Rehabilitation Sciences, College of Public Health, Temple University, 1700 North Broad Street, Philadelphia, PA 19122. E-mail: [email protected]
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American Journal of Orthopsychiatry © 2018 Global Alliance for Behavioral Health and Social Justice 2019, Vol. 89, No. 6, 693–703
http://dx.doi.org/10.1037/ort0000316
693
C ommunity integration, an important priority for mental health service systems, is the “opportunity to live in the community and be valued for one’s uniqueness and abil-
ities, like everyone else” (Salzer, 2006, p. 1). A community inte- gration perspective favors individuals’ self-determined choices about how they participate in valued roles in their communities over participation that is forced or limited to a specific type of setting or social group. It encompasses physical integration—the degree to which individuals are present in various settings and activities—social integration—the extent to which individuals are able to engage in social exchanges and relationships—and psycho- logical integration—the subjective sense of belonging to a com- munity (Salzer, Baron, Menkir, & Breen, 2014). Although the enhancement of opportunity for community integration is at the heart of psychiatric rehabilitation, numerous studies suggest that those with psychiatric disabilities graduate from academic pro- grams, work, and recreate at disproportionately low rates com- pared to those without mental health conditions (Baron & Salzer, 2002; Davidson & Stern, 2013; Lipskaya-Velikovsky, Jarus, East- erbrook, & Kotler, 2016; Mojtabai et al., 2015). Further, 80% of individuals with psychiatric disabilities report feeling lonely, a proportion that is significantly greater than that reported by mem- bers of the general population (Badcock et al., 2015).
Over 25% of people with psychiatric disabilities who receive services in the public mental health system will become involved in the criminal justice system at some point during their lifetime (Cuellar, Snowden, & Ewing, 2007; Fisher et al., 2006; Fisher et al., 2011) and 16% of people in prison and 14% to 31% of people in jails have a serious mental illness (Ditton, 1999; Steadman, Osher, Robbins, Case, & Samuels, 2009; Teplin, 1990; Teplin, Abram, & McClelland, 1996). This is an important point in dis- cussions of community integration, because people with psychiat- ric disabilities who are involved in the criminal justice system face barriers to community integration that are typical for justice- involved people and challenges that are unique to their status as individuals with a mental health condition and criminal record. Similar to others with criminal convictions, justice-involved peo- ple with psychiatric disabilities experience denial of general assis- tance benefits due to past offenses, hiring practices that render them ineligible for employment, and justice system policies and surveillance practices that restrict or discourage participation in community-based activities (Barrenger, Draine, Angell, & Her- man, 2017). They also face unique community integration chal- lenges related to their mental health conditions such as lack of access to community-based mental health resources, poor coordi- nation of care between service systems, and the multiple stigmata associated with having a mental health condition and a criminal history (Baillargeon, Hoge, & Penn, 2010; West, Vayshenker, Rotter, & Yanos, 2015). Further, the narratives of these individuals reflect difficulty with access to positive, supportive relationships (Harper, Kriegel, Morris, Hamer, & Gambino, 2017), which is associated with additional integration barriers, such as economic instability (Harding, Wyse, Dobson, & Morenoff, 2014). These combined challenges result in poorer community integration out- comes than what would be expected for people in the criminal justice system who do not have a psychiatric disability or for people with psychiatric disabilities who do not have any criminal justice involvement (Batastini, Bolanos, & Morgan, 2014; Senior et al., 2013). For example, finding safe and affordable housing and
employment are pressing issues for most people with psychiatric disabilities (Draine, Salzer, Culhane, & Hadley, 2002). The diffi- culties associated with finding housing and employment are heightened for justice-involved people generally (Grossi, 2017); however, justice-involved individuals with psychiatric disabilities are even more likely to experience homelessness and unemploy- ment than other individuals who are returning to the community (Baillargeon et al., 2010).
In the case of justice-involved people with psychiatric disabil- ities, community integration is an especially important treatment target for several reasons. First, research has found very low rates of community involvement among these individuals after release from incarceration (Wilson, Barrenger, Brusilovskiy, Draine, & Salzer, 2017) and very high rates of criminal recidivism (Baillar- geon, Binswanger, Penn, Williams, & Murray, 2009; Lovell, Gagliardi, & Peterson, 2002; Messina, Burdon, Hagopian, & Pren- dergast, 2004; Wilson, Draine, Hadley, Metraux, & Evans, 2011). Yet, existing interventions have not been able to obtain a population-consistent impact on participants’ subsequent involve- ment in the criminal justice system (Morrissey, Meyer, & Cudde- back, 2007; Osher & Steadman, 2007; Skeem, Manchak, & Peter- son, 2011; Steadman & Naples, 2005).
Second, prior research suggests that interventions focused on increasing community integration could positively impact criminal justice recidivism. For example, a study of positive adult behav- iors, including volunteerism, interpersonal interaction, and engage- ment in work and school activities, demonstrated that these be- haviors were negatively related to involvement in crime and substance use in young adults from high crime neighborhoods (Kosterman et al., 2005). Similarly, there is empirical evidence that involvement in ‘helping’ activities is associated with reduced recidivism rates (Bellamy, Rowe, Benedict, & Davidson, 2012; LeBel, Richie, & Maruna, 2015).
Third, community integration is a central target of psychiatric rehabilitation services generally because it is linked to a number of positive mental health outcomes. Participation in personally mean- ingful activities, such as employment and leisure, is associated with psychological health-related outcomes in the general popula- tion (Kachan et al., 2015; Kim, Heo, Lee, & Kim, 2015; Sato, Du, & Inoue, 2016), and with perceived recovery, quality of life, and life meaning among individuals with mental health conditions (Burns-Lynch, Brusilovskiy, & Salzer, 2016; Kaplan, Salzer, & Brusilovskiy, 2012). The size of one’s social network and satis- faction with social support are tied to both objective (i.e., psychi- atric symptoms, social functioning) and perceived recovery among individuals with psychiatric disabilities (Thomas, Muralidharan, Medoff, & Drapalski, 2016). Having a sense of belonging is also related to greater perceived mental health (Na & Hample, 2016) and is a strongly valued experience among those with psychiatric disabilities (Barut, Dietrich, Zanoni, & Ridner, 2016).
The rising number of individuals with psychiatric disabilities in prisons and jails has encouraged the development of mental health services that focus on reducing further involvement in the criminal justice system by stabilizing and treating an individual mental illness. The services that have been developed so far include pre- and postjail diversion services (Broner, Lattimore, Cowell, & Schlenger, 2004; Compton, Bahora, Watson, & Oliva, 2008), specialty community supervision caseloads (probation or parole; Skeem & Louden, 2006; Skeem et al., 2011), mental health courts
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694 THOMAS, BILGER, WILSON, AND DRAINE
(Cosden, Ellens, Schnell, & Yamini-Diouf, 2005), and reentry services (Osher, Steadman, & Barr, 2003). Although many of these services have had a positive impact on participants’ mental health, as noted previously, none have been able to achieve a consistent impact on criminal recidivism. Further, these services focus more prominently on symptom management rather than community integration.
Research in the correctional rehabilitation field has found that the development of positive social supports and natural supports improves the reentry and integration process after release from incarceration (Baumer, O’Donnell, & Hughes, 2009; Tolson & Klein, 2015). This has led to the development of several interven- tions. In their Citizenship Project, Rowe and colleagues (2009) designed a group-based intervention for those with co-occurring disorders and criminal justice involvement that included a didactic, skill-building component, a valued role project, and wraparound peer mentor support to increase access to community-based re- sources and facilitate integration. Other approaches, such as citi- zenship community supervision, integrate community-based sup- ports into more traditional correctional supervision methods to enhance the justice-involved individual’s connections outside of the criminal justice setting (Pearson, McDougall, Kanaan, Torg- erson, & Bowles, 2016). Another group of interventions, typically referred to as restorative justice interventions, is characterized by service strategies that promote the development of positive social ties that provide the social, emotional, and instrumental supports needed to facilitate integration efforts (Draine, Wolff, Jacoby, Hartwell, & Duclos, 2005). Like the Citizenship Project (Rowe et al., 2009) and citizenship community supervision (Pearson et al., 2016), restorative justice practices focus on community integra- tion, but achieve this aim by engaging community members as the primary drivers of the intervention. Although a growing body of research supports the use of restorative justice approaches in criminal justice settings, this intervention approach has yet to be applied to people with psychiatric disabilities involved in the justice system. The aforementioned challenges to community in- tegration suggest that restorative justice interventions may be particularly beneficial for this population, especially by helping individuals build, strengthen, and extend positive social support.
One restorative justice model that has the potential to positively impact the community integration efforts of people with psychi- atric disabilities after release from incarceration is circles of sup- port and accountability (Wilson & Prinzo, 2001). This intervention has been used in community integration efforts of ex-offenders, most notably among people convicted of a sexual offense (Bates, Macrae, Williams, & Webb, 2012; Cesaroni, 2001; Wilson, Cor- toni, & McWhinnie, 2009; Wilson, McWhinnie, Picheca, Prinzo, & Cortoni, 2007). However, it has not been implemented or evaluated among justice-involved people with psychiatric disabil- ities. Requisite steps in the development of this intervention as an evidence-based practice, generally, and for justice-involved people with psychiatric disabilities, specifically, are to describe the inter- vention elements, explicate the theoretical basis for its use as an intervention to address community integration after release from incarceration, and provide a conceptual model of the intervention that identifies treatment targets and links them to expected out- comes. We address each of these objectives in the subsequent sections.
Restorative Justice and Circles of Support and Accountability
We propose that conceptualizing crime response according to a restorative justice framework offers promise for addressing barri- ers to reentry and enhancing community integration. This frame- work seeks to respond to crime from the perspective of solving an underlying social problem that causes crime, namely by restoring positive, functional relationships that support community integra- tion efforts, but which are typically harmed by crime and its punish- ment (Zehr, 1990). Justice system experts, researchers and authorities have seen promise in these intervention models. Thus, they have been implemented in countries across the globe, with concentration in former Commonwealth nations of Great Britain, such as Canada, Australia, and New Zealand (Braithwaite, 2014; Butler & Maruna, 2016; Fox, 2015b; Paterson & Clamp, 2012).
A particular restorative justice model, called circles of support and accountability (hereinafter referred to as circles or a circle), might be particularly well suited to address the specific challenges of return to community from prison or jail. Circles are small communities of support, typically comprising laypersons, that are intentionally built around an individual undergoing a specific challenge or transition (i.e., focal person; Wilson & Prinzo, 2001). A primary goal of circles is to enhance opportunity for community integration. For example, Jay (2003) described the application of circles to assist young adults with intellectual, physical, and psy- chiatric disabilities with the transition to adulthood by supporting them with achieving their community participation goals. Bradley (2000) has advocated for the use of circles for individuals with developmental disabilities to assist them with making social con- nections within the community, acquiring access to services and supports, and minimizing health and safety risks. One study, which used circles to enhance community-based practical, emotional, and spiritual support among African Americans with serious medical conditions, found that participants of circles reported having fewer unmet needs and needing less help finding community resources and services at postassessment compared with participants in the comparison condition (Hanson et al., 2014).
Similar to the general field of circles, research on circles within the criminal justice context has yielded promising findings per- taining to community integration outcomes. For example, Bates et al. (2012), who evaluated the impact of circles among 60 individ- uals convicted for sex crimes, found that many were encouraged and supported to obtain employment and education and to access resources to meet basic needs (e.g., housing support, financial assistance). Further, approximately 50% of the sample reported greater engagement in age-appropriate relationships, an improve- ment in family relationships, an increase in their support networks, and a reduction in loneliness and social isolation. Qualitative findings also support the role of circles in promoting community integration among those convicted for sex crimes (Fox, 2015a; Höing, Bogaerts, & Vogelvang, 2013).
Although evidence suggests that circles may improve commu- nity integration within and outside of the criminal justice context, there is very little explication of theory for how circles can work as an intervention. Guided by Bazemore’s theoretical writing about restorative justice practices in general (Bazemore & Erbe, 2003; Bazemore & Maruna, 2009), and depicted in Figure 1, we describe the principles of restorative justice and how these map onto ele-
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695RESTORATIVE JUSTICE AND MENTAL ILLNESS
ments of the circles intervention. We then identify treatment tar- gets for the intervention that, when successfully addressed, explain how the intervention elements may impact key community inte- gration outcomes.
Principles of Restorative Justice Through a restorative justice approach, community integration
is achieved by helping individuals to take responsibility for their crimes, as opposed to being punished for their actions. In this model, taking responsibility for a crime involves three main prin- ciples: repairing harm, stakeholder involvement, and the transfor- mation of community and governmental roles and relationships (Bazemore & Maruna, 2009).
Repairing Harm
Repairing harm is a primary goal in restorative justice. It as- sumes an all-encompassing healing process that happens between justice-involved persons, victims, and communities that have been affected by the criminal behavior or activity that took place. Identifying the harm and repairing it using this community-based
approach aligns with social support theory (Cullen, Wright, & Chamlin, 1999) and the concept of relationship building. These theories suggest that the support from family, friends, and com- munity members will aid in repairing harm through interconnect- edness and building community ties that will foster a full integra- tion upon release from prison.
Stakeholder Involvement
Repairing harm cannot be fully effective without the involve- ment of community stakeholders, which is the second principle of restorative justice. Increasing the participation of community members not only enhances support to the justice-involved indi- vidual but enforces the use of democratic decision making and investment in the outcome of a community (Bazemore & Erbe, 2003).
Transformation in Community and Government Role and Relationships
Historically, responsibility for crime control has been viewed as lying within the purview of the criminal justice system (Gill,
Principle 1:
Repairing harm
Principle 2:
Stakeholder involvement
Principle 3:
Transformation in community &
government roles & relationships
Element 2:
Positive social support
Element 1:
Community participation
Element 3:
Democratic dialogue between Circle
members
Element 4:
Collective ownership of crime problems
Element 5:
Connection to community-based
resources
Target 1
(person-level):
Identity transformation
Target 2
(person-level):
Enhanced capacity & motivation for moral
behavior
Target 3
(community-level):
Enhanced collective efficacy
Proximal Outcome (person-level):
Greater degree of community integration
Figure 1. Restorative justice principles, and elements, targets, and proximal outcomes of the circles intervention.
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696 THOMAS, BILGER, WILSON, AND DRAINE
1964). However, the causes of crime are diverse and intercon- nected, spanning both individual (e.g., self-efficacy; Brezina & Topalli, 2012) and contextual factors (e.g., social and physical disorder of the community; Skogan, 2015). Reliance on the crim- inal justice system alone to fully ameliorate crime problems ig- nores the need to modify contributing factors that could be ad- dressed through community members’ collective ownership. Further, integration does not usually occur through government surveillance, but rather through the collective roles of a community. However, the current justice system does very little to accommodate this concept. Through the transformation of these roles and relationships, criminal justice structures are changed, leaving individuals and communities empowered (Gill, Bazemore, & Schiff, 2006). Subsequently, commu- nities have the opportunity to be a part of the decision-making process about addressing the harm done and responding effectively (Ba- zemore & Maruna, 2009).
Circles Intervention Elements The elements of the circles intervention reflect the underlying
principles of restorative justice. Particularly related to the principle of repairing harm is the circles’ emphasis on fostering community participation and the giving and accepting of positive social sup- port between the focal person and other circle members. Stake- holder involvement is manifested by a democratic dialogue among all circle participants. Finally, circle members operate on a phi- losophy that assumes collective ownership of crime problems, and connect the focal person to community-based services, which promote transformation in community and government roles and relationships.
Community Participation
The World Health Organization’s International Classification of Functioning, Disability, and Health Framework (World Health Organization, 2001) describes community participation domains such as daily living (e.g., shopping), social relationships, education and employment, civic engagement, and leisure. In mental health research, the construct is typically distinguished from “functional outcome” or “community functioning,” given that it is based on how individuals choose to spend their time in areas of community living, rather than how well they perform various tasks. Thus, community participation is best measured by instruments that assess time use in community participation domains (Birchwood, Smith, Cochrane, Wetton, & Copestake, 1990; Salzer, Brusilovs- kiy, Prvu-Bettger, & Kottsieper, 2014).
Restorative justice research conceptualizes community partici- pation as a way for the focal person to make amends for crimes that have been committed (Bazemore & Erbe, 2003). It moves individuals away from being passive recipients of correctional treatment and rehabilitation to active contributors to their commu- nities, thereby facilitating community integration. Thus, the pro- motion of community participation is considered to be a primary goal of the circles intervention. This may be achieved through discussing the focal person’s community participation interests and the resources and natural supports available to help him/her pursue them, making and reviewing a plan for participation, problem-solving obstacles to participation, or even participating
with the focal person in a desired area. As proximal predictors of community participation among individuals with mental health conditions include beliefs about the self and others as well as motivation for task-related behavior (Thomas, Luther, Zullo, Beck, & Grant, 2016), circle members might especially focus on eliciting and helping the focal person modify dysfunctional beliefs about participating in community life, and helping him or her identify areas of community participation that are personally important.
Positive Social Support
Although various definitions exist, we conceptualize positive social support according to Cullen et al.’s (1999) theory as it applies to criminology, consistent with other restorative justice research (Bazemore & Erbe, 2003). In this context, positive social support is the “provision of affective and/or instrumental (or material) resources . . . [through] intimate or confiding relation- ships” (Cullen et al., 1999, p. 190). A number of positive social support measures of this nature have been validated for use with individuals with mental health conditions, such as the Social Support Questionnaire (Sarason, Levine, Basham, & Sarason, 1983; Sarason, Sarason, Shearin, & Pierce, 1987) and the Medical Outcomes Study Social Support Survey (Sherbourne & Stewart, 1991).
Positive social support is likely to have the strongest impact on community integration outcomes when it is not limited to that provided by professionals but also includes assistance from infor- mal or natural supporters. Although professional relationships can usefully complement natural supports (Tsai, Desai, & Rosenheck, 2012), they are often time-limited, hierarchical, and planned. By contrast, relationships that develop organically through familial, friendship, or community ties enable justice-involved individuals to maintain connections once professional services are terminated and offer greater opportunity for these individuals to give, rather than simply receive, support (Bazemore & Erbe, 2003). Like active contribution to society through community participation, it is this reciprocity that allows individuals to make amends for past crimes and to experience positive change. In the context of the circles intervention, positive social support is provided to the focal person by other members in the form of validation, encouragement, and information about resources. As the structure of circles is intended to be nonhierarchical in nature, the focal person should also be given the opportunity to provide support to other members. Addi- tional resources, for example, housing, food, and financial assis- tance are expected to be garnered as individuals become more active and connected within the community (Harding et al., 2014).
Peer Involvement in Circles
Justice-related peer support, defined as support provided by those with lived experience of a mental health condition and criminal justice involvement (Baron, 2011), may be integrated into circles by including peers as circle members. Peers “draw upon their lived experiences to share ‘been there’ empathy, insights, and skills . . . serve as role models, inculcate hope, engage patients in treatment, and help patients access supports [in the] community” (Chinman et al., 2008). Peer specialists who have personal expe- rience with the criminal justice system are in a unique position to provide supports needed for successful community living after
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697RESTORATIVE JUSTICE AND MENTAL ILLNESS
release from jail or prison (Baron, 2011). Although additional quantitative research is needed, evidence of the effectiveness of justice-related peer support is promising (Collica, 2010; Kaplan, 1988; Rowe et al., 2007). Including peers as circle members may help to promote the focal person’s self-determination, hope, and community participation, as well as encourage mutuality and equality among all participants.
Democratic Dialogue Among Circle Members
As members of the community, circle members are considered to be key stakeholders, who, along with the focal person, are to be engaged in a democratic discussion, particularly as it relates to decision-making. Especially important is the ability of the focal person to contribute as an equal to these discussions. As individ- uals with mental health conditions and criminal justice involve- ment are a particularly marginalized group, the opportunity to have their voices heard can be quite powerful. Democracy in circle meetings can be achieved by structuring meetings according to one of several formats. For example, circles can use sequential formats, in which speakers talk in order around the circle, or members may use a talking piece that designates whose turn it is to speak (Wachtel, 2014). Members can also protect against the develop- ment of power differentials through their own self-disclosure rather than solely relying upon questioning of the focal member. Finally, all decisions are arrived at by consensus. Decisions are made by taking into account and balancing the needs of all stakeholders.
Collective Ownership of Crime Problems
The circles intervention assumes that community members have a primary responsibility to prevent and control crime (Bazemore & Erbe, 2003). Although circle members hold the focal person ac- countable for adhering to agreed upon plans to prevent future offenses, they also acknowledge the complex and dynamic influ- ences contributing to criminal behavior and are committed to doing their part. Circle members may affirm and reinforce norma- tive behavior, develop new plans with the focal person, provide positive social support, and connect the focal person to community- based resources that can also help censure harmful behavior and build relationships needed to promote community integration (Bazemore & Erbe, 2003).
Connection to Community-Based Resources
A fundamental tenet of community integration is that, to the degree possible, opportunities for participation are created in the community rather than in an institution or agency. For example, competitive employment is more preferable than a sheltered work- shop, going to a social event at a church or community center is favored over an agency-organized gathering, and going shopping at a department or grocery store is preferred over selecting from items available within an institution. Similarly, a marker of com- munity integration is interaction with a variety of community members instead of only other program participants (Salzer et al., 2014). Therefore, circle members focus primarily on connecting the focal person to community-based resources and supports.
These are selected based on the focal person’s stated community participation goals, as well as features of the resources and sup- ports themselves, such as their accessibility. For example, if fi- nancial constraints are a barrier to community participation, circle members can help the focal person find and access low-cost resources or brainstorm about how to obtain funding for higher cost options. As mentioned previously, connection to mainstream resources not only helps to promote the community integration of the focal person, but facilitates the transformation of community and government roles and relationships. Community members assume greater responsibility for crime prevention by actively contributing to the integration and inclusion of individuals with mental health conditions who are leaving jail or prison, and exert- ing informal social control by reinforcing positive social norms and setting tolerance limits (Bazemore & Erbe, 2003).
Targets
We propose that there are three targets that connect the elements of the circles intervention to community integration outcomes. Two of these targets (i.e., identity transformation and enhanced capacity and motivation for moral/healthy behavior) apply at the person level; that is, they are change processes lying within the focal person. The final target, collective efficacy, is relevant at the community-level, affecting families, friends, community and neighborhood members, and others.
Identity transformation. On the basis of the concept of recovery capital (Lyons & Lurigio, 2010), social capital theory (Portes, 1998), and social identity theory (Tajfel & Turner, 2001), we posit that community participation and the giving and receiving of positive social support impact community integration outcomes through associated changes in identity. The construct of recovery capital grew out of the substance use literature, but has clear implications for recovery in the context of mental illness. It is the “resources that can be accumulated throughout time (e.g., health, mental health, housing, crime free [status], employment, strong family and social relations, and life satisfaction)” as individuals move forward in recovery (Dennis, Foss, & Scott, 2007, p. 587). Social capital is considered to be a central element of recovery capital, and refers to the benefits and resources that arise out of participation and membership in various social networks and other social institutions (Portes, 1998). Finally, social identity theory states that individuals tend to embrace the values and norms of groups in which there is a subjective sense of belonging and to devalue those of groups to which they feel that they do not belong (Tajfel & Turner, 2001). Following these theories, as formerly incarcerated individuals with psychiatric disabilities build recov- ery and social capital through participation in community-based activities and involvement in reciprocal, supportive relationships, they are able to establish new reference groups, thereby replacing former identities with those of law-abiding citizens who are both accepted by and able to give back to the community. To the degree that individuals have the opportunity to form and express these new identities, community integration is expected.
Enhanced capacity and motivation for moral behavior. We use Kohlberg’s theory of moral development (Kohlberg & Hersh, 1977; Kohlberg, Kauffman, Scharf, & Hickey,
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698 THOMAS, BILGER, WILSON, AND DRAINE
2010) and the resulting Just Community movement as a frame- work for conceptualizing the relationship between democracy in the circle process and community integration outcomes. According to moral development theory, (1) moral reasoning evolves over time in a series of progressive stages, and (2) higher stages of development are associated with a greater capacity for empathy, stronger desire for justice, and increase in moral behavior (Kohl- berg & Hersh, 1977). Kohlberg discovered that moral development occurred when individuals were engaged in moral discussion and democratic decision-making. He proposed that exposure to these discussions expands individuals’ capacity to consider diverse points of view and select the fairest and most just solution (Kohl- berg et al., 2010). Additional research has highlighted the role of moral motivation, the “willingness to bridge moral insights to pro- social and moral action” (Oser, Althof, & Higgins-D’Alessandro, 2008, p. 407) in producing moral behavior. Participation in demo- cratic environments can build feelings of loyalty and trust and culti- vate moral motivation as well (Kohlberg et al., 2010; Oser et al., 2008). Taken together, this research suggests that as the focal person participates in democratic decision making as part of the circle pro- cess, s/he might develop a more sophisticated moral reasoning ability, and a greater commitment to engage in moral behavior. This en- hanced capacity and motivation for moral behavior, in turn, is ex- pected to increase opportunity for physical, social, and psychological integration within the community.
Collective efficacy. Circles provide a mechanism for community building through the development of ties both within and outside of the group (Bazemore & Erbe, 2003). As these relationships develop and community members take greater own- ership for crime problems, communities can be expected to grow in collective efficacy. Collective efficacy, defined as the capacity of community members to exert informal social control in support of the common good (Bazemore, 1998; Sampson, Raudenbush, & Earls, 1997), is viewed as a form of social capital at the community- level that can lead to the reduction of crime (Bazemore & Erbe, 2003). Informal social control refers to a variety of actions that community members take to signal unacceptable behavior and maintain public order. It can function at multiple levels within a community, from families to street blocks to whole neighbor- hoods, and is strengthened by repeated exposure between individ- uals, which allows for the development of norms, trust, and group cohesiveness (Groff, 2015). With sufficient repetition, Circles may lead to regrowth or restructuring of social networks that can exert informal social control, potentially causing restorative practices to leak into other social structures (Bazemore & Erbe, 2003). In addition to having clear implications for crime control, the rela- tionship building and collective efficacy gains that occur as part of the circle process are expected to increase the capacity of com- munity members to facilitate the inclusion and integration of those with psychiatric disabilities leaving custody.
Proximal Outcomes
Community Integration Outcomes
Given the aims of circles and restorative justice, we suggest prioritizing outcomes that are intimately connected to change and progress for the focal person. These outcomes might include
increased time spent in community spaces, such as colleges, work- places, or religious organizations (i.e., physical integration), a more diversified social network (i.e., social integration), and a greater sense of trust and affiliation with fellow members of the community (i.e., psychological integration). These outcomes sig- nal integration in community life, the ultimate goal of the circles intervention model. As suggested by previous research (Bellamy et al., 2012; Burns-Lynch et al., 2016; Kachan et al., 2015; Kaplan et al., 2012; Kim et al., 2015; Kosterman et al., 2005; LeBel et al., 2015; Na & Hample, 2016; Sato et al., 2016; Thomas et al., 2016), improvement in this area has the potential to impact more distal outcomes, such as recidivism rates and mental health and wellness.
Circles in Practice
Although the structure and content of circles is expected to vary slightly depending upon the needs of the focal person and the group make up (e.g., peer specialists vs. those without lived experience), fundamental circles elements described previously should be consis- tently observed. The following case example illustrates what a circle could look like in practice:
“Joe” was a person with a mental health condition who had recently been released from prison and was on parole when his circle com- menced. Joe’s circle comprised five members, one of whom was a peer specialist and four of whom were recruited from the community, including the focal person’s neighborhood. The peer specialist also acted as the “Circle Keeper,” who opened and closed the discussions by sounding a meditation bell. Circle meetings were held in a con- ference room at a peer-run facility. Tables were cleared so that members could sit facing each other in a circular formation. Meetings typically opened with a “check in” about each person’s current state and an update of any notable events since last meeting. The conver- sation then progressed according to a preplanned agenda developed by the circle keeper. Discussions ended with a commitment from each member about what they would do between meetings, reflecting collective ownership of crime problems. A talking piece was passed in sequential order to facilitate democratic dialogue. Every attempt was made to keep power differentials from emerging among members. For example, questions that were asked to Joe were also answered by Circle members. Meetings generally lasted 60 min (with additional time as needed) and were held approximately every other week for 6 months.
Circle content was characterized by several recurring themes, including Joe’s desire for and actual community participation, his sources of and satisfaction with social support, and his progress with meeting expecta- tions of his parole. Discussions about community participation included Joe’s community participation goals, his personal strengths for achieving these goals, and obstacles that stood in the way. Circle members provided feedback about their perceptions of Joe’s strengths, recommended community-based resources and natural supports that could help him achieve his goals, and shared insights learned through their own struggles with community participation. For example, Joe mentioned that he used to enjoy going to concerts, but felt that he could no longer do this because of the presence of alcohol at most music venues. Circle members, especially those with similar experiences, encouraged him to open him- self up to the possibility of going to a concert with trusted others (e.g., family members) who could support his sobriety effort. Similarly, Joe expressed that he enjoyed art, but felt he could not take classes at most venues because of limited financial resources. Circle members helped him think creatively about alternatives, including taking free classes at a local craft store. One circle member (the peer specialist) also accompa-
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699RESTORATIVE JUSTICE AND MENTAL ILLNESS
nied Joe to community-based activities (e.g., going to a dog park) where he had the opportunity to interact with others with shared interests. Circle discussions also focused on Joe’s struggle with his self-confidence and tendency to focus on his mistakes and discount the positives in his life. Circle members empathized with this struggle, and provided encourage- ment and affirmations.
Throughout the circle process, Joe became more active in valued areas in his community. He started making contributions to his family by babysitting his nephew and repairing his mother’s house, made a new friend at a dog park, and even ventured out to a music venue with a peer. As a consequence, Joe began focusing less on his limitations and mistakes, and more on his strengths, potential, and goals. He started to view himself as a person with something to offer others. Because of his progress, certain restrictions of his parole were lifted. Circle members were also empowered through accomplishments that were made by their collective efforts.
Conclusions and Implications for Research, Policy, and Practice
Implications for research. We have offered a concep- tual model that may explain how circles may lead to positive community integration outcomes among justice-involved individ- uals with psychiatric disabilities. This is a developmental model that needs to be further refined and tested in future research. Using designs such as randomized controlled trials, it would be possible to compare individuals with mental health conditions leaving custody who take part in circles relative to those who are not involved in circles. Following the theories and findings discussed previously, these studies might focus on comparing groups based on levels of community participation, positive social support, and involvement in decision making, and examining processes such as identity transformation and moral development. These studies might also examine differences in outcomes such as physical, social, and psychological integration within the community.
Although potentially more difficult to assess, it would also be important to evaluate the impact of circles on the larger commu- nity in which justice-involved people with psychiatric disabilities live. At a microlevel, community members who participate in circles might be evaluated before and after the intervention relative to a demographically matched control group, especially to assess for changes in beliefs about ownership of crime problems, collec- tive efficacy, and informal social control. Researchers would es- pecially need to consider issues related to selection bias and restriction of range, given that those who volunteer to participate as circle members may be more likely to be high in these beliefs already. It may be necessary to not only randomize focal persons, but circle members as well. To assess the extent to which restor- ative justice practices “leak” into other social structures, represen- tatives from groups and organizations within the community, such as families and friends of formerly incarcerated individuals, schools or workplaces, faith-based organizations, and others might also be evaluated within settings where circles are versus are not being implemented.
Implications for policy and practice. We recommend that policy and practice efforts focus on increasing the availability of restorative justice practices such as circles for individuals with psychiatric disabilities leaving custody. As research is needed in
this area, an important part of these efforts would be the provision of research funding to programs that utilize restorative justice interventions so that these may be systematically studied.
With respect to implementation, restorative justice approaches can be structured as an integral part of justice system mechanisms, or they can be adjunctive efforts that could be completely inde- pendent of formal justice authority. It has been suggested that successful implementation of circles is facilitated by having cor- rections officials support (rather than direct) community members as they deliver the intervention, and by securing the cooperation of local police. This may require relationship building on the part of circle members so that corrections and police officers understand the value of the intervention and feel confident in members’ ability to hold the focal person accountable (Fox, 2017). There are also specific recommendations for supporting circle members in effec- tively providing support and accountability. Although members have been recruited from a variety of settings, including colleges and universities, faith-based organizations, and criminal justice activism groups, it is recommended that they be properly vetted and trained to ensure that they can maintain objectivity needed to provide accountability, recognize high risk situations, and know the limitations and restrictions pertinent to the focal person and to their relationship with him or her (Fox, 2017).
Restorative justice approaches can also serve as a useful com- plement to existing psychiatric rehabilitation and other treatment programs. Although circle members and treatment providers could collaborate to connect the focal person to community-based re- sources (e.g., housing assistance programs, employment resources), circle members in particular could increase connections with natural supports and help build social capital. Where there are skill develop- ment needs, rehabilitation might focus on skills training, whereas circles could help the focal person put these into practice. For exam- ple, rehabilitation efforts might focus on improving social skills needed for successful community integration, whereas circles could help the focal person execute them in real-world situations. Finally, circle members could support and hold the focal person accountable in implementing plans that are developed with treatment providers, and vice versa.
Conclusions. Additional interventions are needed to ad- dress the multiple barriers to community integration faced by justice-involved individuals with psychiatric disabilities. We have proposed that crime response according to a restorative justice framework, and specifically the circles intervention, could offer a number of benefits to persons with mental health conditions leav- ing custody and to the larger community. By describing interven- tion elements, proposing a theoretical rationale for the use of circles to promote community integration, and offering a concep- tual model based on hypothesized intervention elements, targets, and proximal outcomes, we hope that we can facilitate research, policy, and practice efforts in this important area.
Keywords: psychiatric disabilities; circles of support and account- ability; recidivism; criminal justice; community integration
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703RESTORATIVE JUSTICE AND MENTAL ILLNESS
