Forging New Paths: Building Interventions to Treat Criminogenic Needs in Community Based Mental Health Settings (FNP)

University of North Carolina (UNC)

Status: Enrolling

Conditions: Mental Illness

Treatments: Behavioral: Forging New Paths

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT06290648

5R34MH130555 (U.S. NIH Grant/Contract)

22-0868

Details and patient eligibility

About

The goal of this clinical trial is to conduct a preliminary test of the effectiveness of Forging New Paths for people with mental illness with criminal legal system contact. The main question[s] it aims to answer are:

1. To examine the effectiveness of Forging New Paths at improving the primary study outcomes (aggression and community tenure).
2. To test the ability of Forging New Paths to engage the study treatment targets (impulsivity and criminal attitudes)

Participants will complete a screening interviews to see if they are eligible. Participants who are eligible will be randomly assigned to participate in one of two study conditions: Forging New Paths and usual care or usual care alone. All participants who are assigned to a study condition will participate in up to three additional research interviews. Researchers will also collect information about study outcomes using administrative records.

Full description

The failure of traditional mental health services to significantly reduce the disproportionate involvement of people with serious mental illnesses (MI) in the criminal justice system highlights a basic but overlooked fact: mental illness is not a primary driver of criminal justice involvement. Research has consistently shown that people with mental illness face the same risk factors for justice involvement (i.e., "criminogenic" rick factors) as those without mental illnesses. Research has also found that justice-involved people with MI have high levels of criminogenic risk factors and that these risk factors mediate their risk of recidivism. Yet, most interventions for justice-involved people with MI do not target criminogenic risk factors as a goal of treatment.

This gap between research and service provision represents untapped potential to reduce rates of justice involvement among people with MI by expanding their continuum of services to include interventions that directly target criminogenic risk factors. Given that up to 50% of people with MI receiving treatment in the community-based mental health system have had some criminal justice system involvement, developing criminogenic-focused interventions designed specifically for delivery in community mental health settings has great potential to optimize their potential impact, both in terms of numbers of people with MI who can benefit and in terms of potential reductions in future criminal justice involvement.

This study will engage a pilot effectiveness trial of a newly developed intervention to examine the extent to which Forging New Paths (FNP) impacts its intended targets (mediating mechanisms) and outcomes among individuals with MI who have been involved in the criminal justice system receiving services through the community mental health system. The study will use a randomized controlled design to assign participants to one of the two study arms: 1) the study intervention FNP and usual care (experimental condition) or 2) usual care alone (control condition). This small scale randomized controlled trial explores the potential effectiveness of FNP at improving outcomes (aggression and community tenure) and engaging treatment targets (impulsivity and criminal attitudes).

All study participants will complete a screening interview to determine study eligibility. Participants who meet the study eligibility criteria will be randomized into one of the two study arms. All participants who are randomized to a study arm will complete up to three additional interviews: the baseline interview and 3- and 6-month follow-up interviews. Additionally, administrative data related study outcomes is collected at the 9-month time point.

Enrollment: 72 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• aged 18 years or older,
• have a diagnosis of schizophrenia spectrum and other psychotic disorders or major depression or bipolar disorder, ( - have a history of any type of criminal justice system involvement (i.e., arrest, conviction, incarceration, or probation/parole),
• reside in the community and receive services from the Center for Excellence in Community Mental Health or one of their partner agencies and,
• have moderate or higher levels of criminogenic risk factors as determined by the Level of Service and Case Management Inventory (LS/CMI).

Exclusion criteria

• an intellectual or developmental disability,
• incarceration at the point of study enrollment,
• non-English speakers.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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72 participants in 2 patient groups

Experimental: Forging New Paths + Usual Care

Experimental group

Description:

The experimental condition receives Forging New Paths in addition to community based mental health services as determined by their treatment providers.

Treatment:

Behavioral: Forging New Paths

Control: Usual Care Alone

No Intervention group

Description:

The control condition receives community based mental health services as determined by their treatment providers.