ABSTRACT
High numbers of justice-involved individuals suffer from mental illness. Conversely, a notable proportion of those in public psychiatric care have a history of criminal justice involvement. The intensive treatment unit (ITU) is a specialized 20-bed, all-male treatment unit housed in a civil psychiatric center. It addresses the complex needs of individuals released from prison who suffer from serious mental illness (SMI) and who possess an aggregate of non-SMI-related risk factors for violent recidivism. The treatment approach overtly targets violence and general recidivism. In this chapter, the authors outline the ITU’s historical background, context and rationale for development. Next, the authors describe the Risk-Needs-Responsivity (RNR) model and its role as the theoretical basis for ITU programming. Additional theoretical bases include cultural competence, cognitive therapy and biological psychiatry. The authors describe considerations and challenges that went into implementing the program, such as patient census, staffing, and training. At the time of this writing, the ITU has been in operation for approximately seven years. Preliminary outcome data illustrate that ITU has been successful in providing good psychiatric management and reducing recidivism. The authors close the chapter by considering the limitations of the ITU and ways that it could expand to meet the additional needs of the justice-involved SMI population.
