Qualitative methods in an outcomes evaluation for a community forensic mental health program

The large number of individuals involved in the criminal justice system with a mental illness and a co-occurring substance abuse disorder has generated the need for community mental health agencies to develop and implement specialized mental health programs. Evaluation of these programs has presented challenges, as these interventions are multifaceted, incorporating case management, psychiatric services, substance abuse treatment, and partnership with community criminal justice agencies. An innovation in evaluation is the use of qualitative methods to understand an individual's experiences in multifaceted programs as well as how components of these programs contribute to successful outcomes. As part of an outcomes evaluation for a community forensic mental health program, open-ended qualitative interviews were conducted with a small number of individuals. Individuals interviewed were court ordered to treatment, had psychosis as a primary symptom of their illness, and were currently under community supervision for a felony offense. Analysis of the interviews reveals that a strong support system, stable housing and income, consistent periods of sobriety, and insight into mental illness and substance abuse contribute to an individual's success in the community. Consumers focused on their relationship with the treating psychiatrist and participation in substance abuse treatment as crucial to maintaining stability in the community. This study demonstrates the utility of using qualitative methods within an outcomes evaluation for a forensic mental health program as well as providing insight into the lives of consumers with co-occurring disorders involved in the criminal justice system. Implications for forensic mental health program evaluation will be discussed.