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Abstract

Although research on e-mental health in criminal justice settings continues to accumulate, the evidence base on this topic remains limited. In recent years, technological innovations have increasingly entered forensic and correctional mental health care, and the COVID-19 pandemic has accelerated their diffusion. The present special issue aims to promote evidence-based best practices and inform clinical decision-making in criminal justice settings by presenting recent developments and findings relevant to the use of e-mental health. In this introduction, we summarize the eight articles in the special issue and discuss directions for future research.

Keywords

e-mental health technology forensic corrections criminal justice

The first investigations on the use of technology in forensic and correctional mental health date back more than two decades. The emerging literature with criminal justice populations focused mainly on the use of telecommunication technologies (Brodey et al., 2000; Cervenka et al., 1996), computerized assessments (Paperny, 1997; Wasserman et al., 2002), and video games (Gooch & Living, 2004; Resnick et al., 1986; Sherer, 1990). Since that time, the number of studies in this area has increased considerably, with four systematic reviews having identified approximately 100 relevant articles (Batastini et al., 2016; Grove et al., 2021; Kip et al., 2018; Leach et al., 2022). A catalyst for technology-based services in criminal justice settings has been the COVID-19 pandemic which necessitated a rapid increase in the adoption rate to comply with physical distancing regulations (Bernhard et al., 2021; Kois et al., 2021).

Based on the definition of the World Health Assembly (2005), e-mental health refers to the use of information and communication technologies for mental health. The range of technologies falling under this term is broad and covers telecommunication (e.g., telephone calls, videoconferencing, and emails), social media (e.g., internet fora, social networks, and wikis), digital platforms (e.g., mobile apps, desktop applications, and websites), and advanced technologies (e.g., decision support systems, virtual reality, and wearable technology; Kirschstein et al., 2023). In forensic and correctional mental health, such technologies have been used to perform expert testimony in court, monitor behavior in high-risk situations, and assess deviant sexual interests (Batastini et al., 2020; Fromberger et al., 2018; Renaud et al., 2014). In addition, e-mental health has been used to treat individuals exhibiting aggressive behavior, individuals with substance use disorders, and individuals who have committed sexual offenses against children (Elison et al., 2017; Fromberger et al., 2021; Tuente et al., 2020).

However, technological advances are not limited to forensic and correctional mental health, they also extend to other areas of the criminal justice system. Internationally, police are increasingly employing technologies such as body-worn cameras, records-management systems, predictive policing software, automatic license plate recognition systems, and drones (Rogers & Scally, 2018; Willis, 2019). Similarly, the provision of legal services using technologies is expanding. Defendants and victims are more often participating in court hearings via videoconference, and lawyers are more frequently providing legal counsel virtually (Donoghue, 2017). Correctional facilities are also improving access to digital services for individuals who are imprisoned, enabling them to remotely communicate with relatives, receive education, find employment, search for housing, manage finances, and participate in intervention programs (Batastini & Morgan, 2016; Champion & Kimmett, 2013; Kerr & Willis, 2018). Finally, mobile apps are now being used in community corrections to modernize traditional electronic monitoring systems using ankle bracelets and offer justice-involved individuals the ability to be reminded of appointments, to receive notifications of technical violations, and to monitor their blood alcohol level remotely (Pattavina & Corbett, 2019; Ross, 2018). Hence, the future of technology in criminal justice may involve integrating components of e-mental health within these other legal and correctional practices.

The aim of the present special issue is to promote evidence-based best practices and inform clinical decision-making in criminal justice settings by presenting recent developments and findings relevant to the use of e-mental health. In the following sections, we summarize the collection of articles in the special issue and discuss directions for future research.

Overview of the Special Issue

This special issue includes eight articles covering a myriad of topics of interest to an international readership and reflecting the current state of e-mental health research and practice in criminal justice settings. In the first article, Kirschstein and colleagues (2023) conducted an international online survey exploring the use of technology for providing clinical services among forensic and correctional mental health professionals. Results showed that mental health professionals are using a number of technologies in forensic and correctional practice with some frequency to accomplish a variety of clinical tasks. Although findings supported the COVID-19 pandemic as a cause for increased use of these technologies in criminal justice settings, they also revealed that fewer technologies were used by mental health professionals working in closed settings (e.g., psychiatric inpatient settings and correctional facilities) compared to those working in open settings (e.g., psychiatric outpatient settings and private practices). Furthermore, digital platforms designed specifically for justice-involved individuals were not being used.

In the second article, Jones and colleagues (2023) conducted an online experiment examining how mock jurors’ perceptions of a qualified forensic psychologist and her expert testimony on a defendant’s competency to stand trial differed when such testimony was viewed using one of three videotaped modalities: (a) in-person testimony in the courtroom, (b) remote testimony via videoconferencing in the courtroom, or (c) remote testimony via telephone in the courtroom. To our knowledge, such an investigation has not been conducted, even though technology has been used for criminal and civil legal proceedings for decades (see United States v. Baker, 1995) and courts have ruled that hearings conducted via videoconferencing do not necessarily deny an individual due process (Thornton v. Snyder, 2005). The authors found no statistically significant differences between the three conditions with regard to the perception of the expert’s credibility, testimony efficacy, or social presence. While the authors recognized additional research is needed, they concluded there is no clear evidence that providing testimony remotely negatively impacts perceptions of psychological experts.

In the third article, Lewis and colleagues (2023) outline the problems associated with traditional competency restoration and point out that jail-based services may not only offer an accessible and cost-effective solution but also one that reduces the negative effects of untreated mental health conditions due to increased timeliness of care. In the United States, jail-based competency restoration services have emerged as a way to help address the national shortage of forensic psychiatric hospital beds (Ash et al., 2020). However, research on the efficacy of these relatively novel services is scarce, and there has been criticism that jails do not provide a sufficiently therapeutic milieu (Kirkorsky et al., 2020). In their study, the authors compared the restoration rate of justice-involved individuals at a jail-based competency restoration unit in Georgia, depending on whether they received in-person services (pre-pandemic) or telehealth services (during the pandemic). Results showed that the proportion of individuals restored to competence was significantly higher in the group receiving these services remotely than in the matched comparison group. These findings are promising for demonstrating the feasibility of jail-based competency restoration services delivered virtually.

In the fourth article, Viglione and Nguyen (2022) conducted an online survey of over 300 community corrections agencies in the United States to examine factors related to changes in the use of telecommunication technologies before and after the COVID-19 pandemic. People under community supervision in the United States make up approximately 70% of the total correctional population (Kluckow & Zeng, 2022) and such supervision is approximately eight times less costly than incarceration (United States Courts, 2017). As with many services in other settings and sectors, the pandemic created barriers to in-person contact between community corrections supervisors and supervisees. During this time, the use of telecommunication technologies offered community corrections agencies a viable alternative to reach individuals under their care for supervision and treatment purposes aimed at reducing recidivism risk and improving overall health and well-being. The survey findings indicated regional differences in the use of telecommunication technologies and pointed to the relevance of available infrastructure in community corrections agencies for enabling remote services.

In the fifth article, Schröder and colleagues (2023) performed a review of the literature on current web-based interventions for individuals who committed sexual offenses against children or who have a sexual interest in children. The literature review identified six web platforms, five of which were developed in the last 5 years. Although no research to date has been published on the effectiveness of these web platforms, two are currently being evaluated in randomized controlled trials (Fromberger et al., 2021; Parks et al., 2020). In their article, the authors presented criteria for the design, evaluation, and implementation of web-based interventions based on the best available scientific research in forensic and correctional mental health and related fields. Although the article focused on individuals who have committed sexual offenses against children, the criteria the authors have established are also relevant to web-based interventions for individuals who have committed other types of offenses.

In the sixth article, Lively and colleagues (2023) performed online experiments examining whether delivering youth interrogation rights in multimedia formats improves juveniles’ and adults’ understanding of these rights. Participants were randomly assigned to conditions involving various combinations of audio (i.e., speech) and visual content delivery (i.e., text and animation). Although levels of comprehension were largely comparable across conditions, the study highlighted potential benefits of delivering youth interrogation rights via multimedia presentations. As the authors note, multimedia technology would allow for the standardized administration of the police caution and ensure that youth interrogation rights are presented accurately, consistently, and completely. In addition to benefiting juveniles and their caretakers, such standardized administration would also protect law enforcement personnel from accusations of inadequately delivering youth interrogation rights.

In the seventh article, Smith and colleagues (2023) conducted a randomized feasibility trial to explore the user acceptance, usability, and engagement of a monitor-based job interview simulator and also collected pilot data on the effectiveness of this training program with justice-involved individuals in prisons. Participants were randomly assigned to an experimental group receiving virtual reality job interview training in addition to training-as-usual or to a control group receiving only training-as-usual. Unemployment has been found to be one of the eight main risk factors for recidivism and, thus, is an important target of change for promoting successful rehabilitation (Bonta & Andrews, 2017). Hence, correctional employment programs are critical to addressing the high unemployment rates of formerly incarcerated individuals upon release (Nally et al., 2014; Visher et al., 2011). The authors used non-immersive virtual reality (VR) to simulate scenarios in which participants could train their job interview skills. This VR training led to significantly greater improvements in job interview skills, increased training motivation, reduced interview anxiety, and was associated with higher rates of employment at 6-month follow-up compared to standard vocational training.

In the eighth and final article, Barbe and colleagues (2023) described the logic and functionality of an open-source VR-training framework they developed as well as its possible areas of application within the criminal justice system. Although the use of VR to train forensic and correctional mental health professionals is not a new concept, its actual application in this context has received little attention compared to its use for the assessment and treatment of justice-involved individuals (Fromberger et al., 2014). As the authors note, possible uses of their VR-training framework within the criminal justice system include training conversational skills in realistic situations without consequential mistakes, interviewing witnesses in police investigations or defendants for forensic mental health evaluations, and practicing psychotherapeutic skills. The authors also highlight the great potential of the platform’s immersive interactive virtual environment and dialogue system enabling users to communicate with virtual characters using natural language. Not only is the virtual environment highly controllable, reproducible, and standardized, but it also allows trainees to interview children and other vulnerable populations, which is usually not possible in conventional in vivo training paradigms.

Directions for Future Research

Based on the current state of research on e-mental health in criminal justice settings as well as the contributions in this special issue, there are two key directions for future research. First, more research is needed not only on technologies that already have a growing evidence base in forensic and correctional mental health (e.g., videoconferencing, web platforms, and virtual reality) but also for technologies for which no or few studies exist (e.g., decision support systems, augmented reality, and wearable technology; Kip et al., 2018; Leach et al., 2022). Furthermore, empirically supported technologies designed specifically for justice-involved individuals are necessary (Grove et al., 2021). To increase access to such technologies for professionals, emphasis should be placed on transferring e-mental health solutions developed and validated via scientific research into commercially available products. Relatedly, the field would benefit from the commercialization of custom software developed for specific institutions or organizations. Such commercialization would also open the possibility for further research comparing the economic efficiency of technological service modalities relative to the status quo.

The second key direction for future research involves the replication and generalization of findings to varying populations such as individuals with different ages, sexes, genders, mental health conditions, races/ethnicities, socioeconomic statuses, and offense types among other factors (Leach et al., 2022). With regard to study design, previous reviews have called for investigations with larger sample sizes that include one or more control groups, random assignment, and blinding to avoid bias (cf. Kois et al., 2021; Leach et al., 2022). Moreover, future research should compare different technologies used for the same purpose (e.g., Northpointe Suite Risk Needs Assessment [COMPAS; Equivant, 1998] versus Global Institute of Forensic Research Electronic Assessment & Reporting System [G.E.A.R.S.; Multi-Health Systems, 2017] software) and observe various justice-relevant outcomes (e.g., reduced recidivism, fewer mental health symptoms, and increased treatment compliance; Grove et al., 2021). Finally, as most research in this area has been conducted in the United States, international studies (such as those published in this special issue from Canada, Germany, and Switzerland) are particularly valuable at this time.

Conclusion

Technological innovations offer great potential for forensic and correctional mental health services across all stages of the criminal justice process. Although there is much work yet to be done—in academia, practice, and industry—to bring awareness of these novel e-mental health solutions to the forefront and to promote uptake at both the individual as well as the systemic levels, the rapid increase in interest driven by the COVID19 pandemic leads us to believe that the precipitous growth that this subliterature has seen over the past several years will continue to intensify. The present special issue attempts to establish the international state-of-the-art regarding the use of e-mental health in criminal justice settings and presents recent research efforts in this area by teams across the globe.

Footnotes

Authors’ Note:

We have no conflicts of interest to disclose.

Madeleine A. Kirschstein, MSc, is a PhD student in the Department of Clinical Research at the University of Basel and the Forensic Clinic of the University Psychiatric Clinics Basel. She serves as a researcher in the Research and Development Division of the Office of Corrections and Rehabilitation of the Canton of Zürich in Switzerland. Her research interests include the evaluation of interventions for justice-involved individuals and technology use in forensic and correctional settings.

Ashley B. Batastini, PhD, received her PhD in Counseling Psychology at Texas Tech University and is currently an assistant professor at the University of Memphis in the Department of Counseling, Educational Psychology, and Research. Her professional interests include the development of and research on mental health interventions for justice-involved populations and best practices in forensic mental health assessment.

Jay P. Singh, PhD, is a Fulbright Scholar and the internationally award-winning founder of both Publication Academy and the Global Institute of Forensic Research. He is a former senior clinical researcher in forensic psychiatry and psychology for the Department of Justice and Home Affairs in Switzerland, and the author of more than 85-peer reviewed publications, including four books. He completed his graduate doctoral studies in psychiatry at the University of Oxford and clinical psychology at the University of Konstanz.

Marc Graf, MD, is the director of the Forensic Clinic of the University Psychiatric Clinics Basel, professor of Forensic Psychiatry at the University of Basel, and lecturer in the Department of Criminal Law at the University of Basel. He studied medicine at the University of Basel, completed his doctorate in 1998, and received his habilitation in 2013. His research focuses on the assessment and treatment of individuals diagnosed with disorders of sexual preference and the application of neurophysiological methods and implicit procedures in virtual environments.

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Technological Innovations in Forensic and Correctional Mental Health: An Introduction to the Special Issue

Abstract

Keywords

Overview of the Special Issue

Directions for Future Research

Conclusion

Footnotes

Authors’ Note:

References