Skip to main content

Advertisement

SpringerLink
Log in

The Battlefield Behind Bars: How Mental Disorder and Suicidal Behavior Impacts the Prison Experience for Veterans

  • Published:
American Journal of Criminal Justice Aims and scope Submit manuscript

Abstract

Military veteran status has been associated with a variety of criminal justice outcomes as well as higher rates of mental illness and suicide when compared to the general population. Although research has generally focused on why veterans become involved with the justice system, less is known about their experiences while incarcerated. In particular, studies of veterans in the community context indicate that they are unwilling to seek out mental health treatment due to potential stigmas, suggesting that this reluctance may extend into the prison environment. Using a sample of 14,278 veteran and nonveteran inmates, we find that veterans do not necessarily fare worse in prison and are actually more likely to obtain treatment. However, this effect is largely mediated by the greater history of mental disorders and suicidal behaviors among veterans. Our findings lend credence to recent efforts designed to screen and manage justice-involved veterans as a distinct, at-risk group.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Notes

  1. The coding for “General discharge or worse” included the following: General (honorable conditions), General (without honorable conditions), Other than honorable, Bad conduct, Dishonorable, or Other. It should be noted that a General (honorable conditions) discharge still qualifies for Veterans Affairs health-related benefits. However, some veterans discharged “under conditions other than honorable” can also become eligible for benefits following a successful “character of discharge” determination (U.S. Department of Veterans Affairs, 2014, p. 1).

  2. To clarify, alternative multilevel analyses were conducted in Stata, including multilevel multinomial logistic regression via the “gsem” command, but these models returned substantively similar results as robust clustering across all outcomes and key predictor variables.

  3. Relative risk ratios (RRR) are provided for key variables.

  4. Under special circumstances, veterans that have received an “other than honorable” discharge may still be eligible for Veterans Affairs healthcare benefits, including emergency admission, for issues such as an “active psychosis or mental illness” related to their military service (U.S. Department of Veterans Affairs, 2017, p. 2).

References

  • Accordino, M. P., Porter, D. F., & Morse, T. (2001). Deinstitutionalization of persons with severe mental illness: Context and consequences. Journal of Rehabilitation, 67(2), 16–21.

    Google Scholar 

  • Adams, K., & Ferrandino, J. (2008). Managing mentally ill inmates in prisons. Criminal Justice and Behavior, 35(8), 913–927.

    Article  Google Scholar 

  • Albertson, K., Banks, J., & Murray, E. (2017). Military veteran-offenders: Making sense of developments in the debate to inform service delivery. Prison Service Journal, 234, 23–30.

    Google Scholar 

  • Andrews, D. A., & Bonta, J. (2010). Rehabilitating criminal justice policy and practice. Psychology, Public Policy, and Law, 16(1), 39–55.

    Article  Google Scholar 

  • Armor, D. J., & Sackett, P. R. (2004). Manpower quality in the all-volunteer force. In B. A. Bicksler, C. L. Gilroy, & J. T. Warner (Eds.), The all-volunteer force: Thirty years of service (pp. 90–107). Washington, DC: Brassey’s.

  • Athens, L. H., & Ulmer, J. T. (2003). Violent acts and violentization: Assessing, applying, and developing Lonnie Athens’ theories. Amsterdam, The Netherlands: Elsevier.

  • Blodgett, J. C., Avoundjian, T., Finlay, A. K., Rosenthal, J., Asch, S. M., Maisel, N. C., & Midboe, A. M. (2015). Prevalence of mental health disorders among justice-involved veterans. Epidemiologic Reviews, 37(1), 163–176.

    Article  Google Scholar 

  • Blonigen, D. M., Bui, L., Elbogen, E. B., Blodgett, J. C., Maisel, N. C., Midboe, A. M., Asch, S. M., McGuire, J. F., & Timko, C. (2016). Risk of recidivism among justice-involved veterans: A systematic review of the literature. Criminal Justice Policy Review, 27(8), 812–837.

    Article  Google Scholar 

  • Blonigen, D. M., Rodriguez, A. L., Manfredi, L., Britt, J., Nevedal, A., Finlay, A. K., Rosenthal, J., Smelson, D., & Timko, C. (2017). The availability and utility of services to address risk factors for recidivism among justice-involved veterans. Criminal Justice Policy Review, 28(8), 790–813.

    Article  Google Scholar 

  • Blue-Howells, J. H., Clark, S. C., van den Berk-Clark, C., & McGuire, J. F. (2013). The US Department of veterans affairs veterans justice programs and the sequential intercept model: Case examples in national dissemination of intervention for justice-involved veterans. Psychological Services, 10(1), 48–53.

  • Bonett, D. G., & Price, R. M. (2005). Inferential methods for the tetrachoric correlation coefficient. Journal of Educational and Behavioral Statistics, 30(2), 213–225.

    Article  Google Scholar 

  • Bronson, J., Carson, A., Noonan, M., & Berzofsky, M. (2015). Veterans in prison and jail, 2011– 12. Washington, DC: Office of Justice Programs, Bureau of Justice Statistics.

  • Cesaroni, C., & Peterson-Badali, M. (2010). Understanding the adjustment of incarcerated young offenders: A Canadian example. Youth Justice, 10, 107–125.

    Article  Google Scholar 

  • Christy, A., Clark, C., Frei, A., & Rynearson-Moody, S. (2012). Challenges of diverting veterans to trauma informed care: The heterogeneity of intercept 2. Criminal Justice and Behavior, 39(4), 461–474.

    Article  Google Scholar 

  • Clemmer, D. (1958). The prison community. New York, NY: Holt.

  • Connor, T. (2017). Prisons experiment with cell blocks for military veterans. NBC news. Retrieved from https://www.nbcnews.com/news/us-news/prisons-experiment-cell-blocks-military-veterans-n721306.

  • Cullen, F. T., Blevins, K. R., Trager, J. S., & Gendreau, P. (2005). The rise and fall of boot camps: A case study in common-sense corrections. Journal of Offender Rehabilitation, 40(3–4), 53–70.

    Article  Google Scholar 

  • Culp, R., Youstin, T. J., Englander, K., & Lynch, J. (2013). From war to prison: Examining the relationship between military service and criminal activity. Justice Quarterly, 30, 651–680.

    Article  Google Scholar 

  • DeLisi, M., Trulson, C. R., Marquart, J. W., Drury, A. J., & Kosloski, A. E. (2011). Inside the prison black box: Toward a life course importation model of inmate behavior. International Journal of Offender Therapy and Comparative Criminology, 55(8), 1186–1207.

    Article  Google Scholar 

  • Diamond, P. M., Wang, E. W., Holzer, C. E., & Thomas, C. (2001). The prevalence of mental illness in prison. Administration and Policy in Mental Health and Mental Health Services Research, 29(1), 21–40.

    Article  Google Scholar 

  • Edelman, B., Berger, T. J., Crawford, G. (2016). Veterans treatment courts: A second chance for vets who have lost their way (AN 13CS20A001). Washington, DC: U.S. Department of Justice, National Institute of Corrections.

  • Finlay, A. K., Binswanger, I. A., Smelson, D., Sawh, L., McGuire, J., Rosenthal, J., et al. (2015). Sex differences in mental health and substance use disorders and treatment entry among justice-involved veterans in the veterans health administration. Medical Care, 53(4 Suppl 1), S105–S111.

    Article  Google Scholar 

  • Finlay, A. K., Smelson, D., Sawh, L., McGuire, J., Rosenthal, J., Blue-Howells, J., et al. (2016). US Department of veterans affairs veterans justice outreach program: Connecting justice-involved veterans with mental health and substance use disorder treatment. Criminal Justice Policy Review, 27(2), 203–222.

    Article  Google Scholar 

  • Finlay, A. K., Stimmel, M., Blue-Howells, J., Rosenthal, J., McGuire, J., Binswanger, I., Smelson, D., Harris, A. H. S., Frayne, S. M., Bowe, T., & Timko, C. (2017). Use of veterans health administration mental health and substance use disorder treatment after exiting prison: The health Care for Reentry Veterans program. Administration and Policy in Mental Health and Mental Health Services Research, 44(2), 177–187.

    Article  Google Scholar 

  • Fontana, A., & Rosenheck, R. A. (2005). The role of war-zone trauma and PTSD in the etiology of antisocial behavior. The American Journal of Psychiatry, 193, 203–209.

    Google Scholar 

  • Fox, J. (2008). Applied regression analysis, linear models, and related methods. Thousand Oaks, CA: Sage.

  • Friedman, M. (2004). Acknowledging the psychiatric cost of war. New England Journal of Medicine, 351, 75–77.

    Article  Google Scholar 

  • Goetting, A., & Howsen, R. M. (1986). Correlates of prisoner misconduct. Journal of Quantitative Criminology, 2(1), 49–67.

    Article  Google Scholar 

  • Greenberg, G. A., & Rosenheck, R. A. (2009). Mental health and other risk factors for jail incarceration among male veterans. Psychiatry Quarterly, 80, 41–53.

    Article  Google Scholar 

  • Hajjar, R. M. (2014). Emergent postmodern US military culture. Armed Forces & Society, 40, 118–145.

    Article  Google Scholar 

  • Hardyman, P. L., Austin, J., & Peyton, J. (2004). Prisoner intake systems: Assessing needs and classifying prisoners. US Department of Justice, National Institute of corrections.

  • Hartley, R. D., & Baldwin, J. M. (2016). Waging war on recidivism among justice-involved veterans: An impact evaluation of a large urban veterans treatment court. Criminal Justice Policy Review, 1–27.

  • Hawkins, M. D. (2009). Coming home: Accommodating the special needs of military veterans to the criminal justice system. Ohio State Journal of Criminal Law, 7, 563–573.

    Google Scholar 

  • Hill III, J. J., Mobo Jr., B. H. P., & Cullen, M. R. (2009). Separating deployment-related traumatic brain injury and posttraumatic stress disorder in veterans: Preliminary findings from the veterans affairs traumatic brain injury screening program. American Journal of Physical Medicine and Rehabilitation, 88(8), 605–614.

    Article  Google Scholar 

  • Hill, M. (2018). Veterans behind bars: US jails set aside special cellblocks. Associated Press. Retrieved from https://apnews.com/49b2b1d3ef534cd3b5ef00da01936349/US-jails-increasingly-setting-aside-cellblocks-for-veterans.

  • Hoge, C. W., Castro, C. A., Messer, S. C., McGurk, D., Cotting, D. I., & Koffman, R. L. (2004). Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. New England Journal of Medicine, 351(1), 13–22.

    Article  Google Scholar 

  • Hoge, C. W., McGurk, D., Thomas, J. L., Cox, A. L., Engel, C. C., & Castro, C. A. (2008). Mild traumatic brain injury in US soldiers returning from Iraq. New England Journal of Medicine, 358(5), 453–463.

    Article  Google Scholar 

  • Institute of Medicine. (2013). Returning home from Iraq and Afghanistan: Assessment of the readjustment needs of veterans, service members, and their families. Washington, DC: Institute of Medicine of the National Academies.

  • Irwin, J., & Cressey, D. (1962). Thieves, convicts, and the inmate culture. Social Problems, 10, 142–155.

    Article  Google Scholar 

  • Kang, H. K., Bullman, T. A., Smolenski, D. J., Skopp, N. A., Gahm, G. A., & Reger, M. A. (2015). Suicide risk among 1.3 million veterans who were on active duty during the Iraq and Afghanistan wars. Annals of Epidemiology, 25(2), 96–100.

    Article  Google Scholar 

  • Logan, M. W., & Pare, P. P. (2016). Are inmates with military backgrounds “army strong?”. Criminal Justice Policy Review, 28(8), 814–841.

    Article  Google Scholar 

  • Lunasco, T. K., Goodwin, E. A., Ozanian, A. J., & Loflin, E. M. (2010). One shot-one kill: A culturally sensitive program for the warrior culture. Military Medicine, 175(7), 509–513.

    Article  Google Scholar 

  • Maguire, K. E., Flanagan, T. J., & Thornberry, T. P. (1988). Prison labor and recidivism. Journal of Quantitative Criminology, 4(1), 3–18.

    Article  Google Scholar 

  • May, D. C., Stives, K. L., Wells, M. J., & Wood, P. B. (2017). Does military service make the experience of prison less painful? Voices from incarcerated veterans. Criminal Justice Policy Review, 28(8), 770–789.

    Article  Google Scholar 

  • McCormick-Goodhart, M. A. (2012). Leaving no veteran behind: Policies and perspectives on combat trauma, veterans courts, and the rehabilitative approach to criminal behavior. Penn State Law Review, 117, 895–926.

    Google Scholar 

  • McCuish, E. C., & Corrado, R. R. (2017). Do risk and protective factors for chronic offending vary across indigenous and white youth followed prospectively through full adulthood? Crime & Delinquency, 1–27.

  • Myers, T. A. (2011). Goodbye, listwise deletion: Presenting hot deck imputation as an easy and effective tool for handling missing data. Communication Methods and Measures, 5(4), 297–310.

    Article  Google Scholar 

  • National Institute of Corrections. (2018). Prisons and jails with dorms for veterans. Retrieved from https://info.nicic.gov/jiv/node/27.

  • Noonan, M. & Mumola, C. (2007). Veterans in state and federal prison, 2004. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.

  • Pietrzak, R. H., Johnson, D. C., Goldstein, M. B., Malley, J. C., & Southwick, S. M. (2009). Perceived stigma and barriers to mental health care utilization among OEF-OIF veterans. Psychiatric Services, 60(8), 1118–1122.

    Article  Google Scholar 

  • Pinals, D. A. (2010). Veterans and the justice system: The next forensic frontier. Journal of the American Academy of Psychiatric Law, 38, 163–167.

    Google Scholar 

  • Prins, S. J. (2014). Prevalence of mental illnesses in US state prisons: A systematic review. Psychiatric Services, 65(7), 862–872.

    Article  Google Scholar 

  • Reger, M. A., Smolenski, D. J., Skopp, N. A., Metzger-Abamukang, M. J., Kang, H. K., Bullman, T. A., Perdue, S., & Gahm, G. (2015). Risk of suicide among US military service members following operation enduring freedom or operation Iraqi freedom deployment and separation from the US military. Journal of the American Medical Association Psychiatry, 72(6), 561–569.

    Google Scholar 

  • Rogers, W. H. (1993). Regression standard errors in clustered samples. Stata Technical Bulletin, 13, 19–23.

    Google Scholar 

  • Sappington, A. A. (1996). Relationships among prison adjustment, beliefs, and cognitive coping style. International Journal of Offender Therapy and Comparative Criminology, 40, 54–62.

    Article  Google Scholar 

  • Sayers, S. L., Farrow, V. A., Ross, J., & Oslin, D. W. (2009). Family problems among recently returned military veterans referred for a mental health evaluation. Journal of Clinical Psychiatry, 70(2), 163–170.

    Article  Google Scholar 

  • Schaffer, B. J. (2016). Incarcerated veterans outreach program. Journal of Evidence-Informed Social Work, 13(3), 293–304.

    Article  Google Scholar 

  • Seamone, E. R. (2011). Reclaiming the rehabilitative ethic in military justice: The suspended punitive discharge as a method to treat military offenders with PTSD and TBI and reduce recidivism. Military Law Review, 208, 1–212.

    Google Scholar 

  • Sreenivasan, S., Garrick, T., McGuire, J., Smee, D. E., Dow, D., & Woehl, D. (2013). Critical concerns in Iraq/Afghanistan war veteran-forensic interface: Combat-related postdeployment criminal violence. Journal of the American Academy of Psychiatry and the Law Online, 41(2), 263–273.

    Google Scholar 

  • Street, A. E., Vogt, D., & Dutra, L. (2009). A new generation of women veterans: Stressors faced by women deployed to Iraq and Afghanistan. Clinical Psychology Review, 29(8), 685–694.

    Article  Google Scholar 

  • Sun, I. Y., Sung, H. E., & Chu, D. C. (2007). Collateral gains from the military? A crossnational analysis of the armed forces–crime relationship. International Journal of Offender Therapy and Comparative Criminology, 51, 599–614.

    Article  Google Scholar 

  • Sykes, G. M. (1958). The society of captives: A study of a maximum security prison. Princeton, NJ: Princeton University Press.

  • Timko, C., Flatley, B., Tjemsland, A., McGuire, J., Clark, S., Blue-Howells, J., et al. (2016). A longitudinal examination of veterans treatment courts’ characteristics and eligibility criteria. Justice Research and Policy, 17(2), 123–136.

    Google Scholar 

  • Timko, C., Midboe, A. M., Maisel, M. C., Blodgett, J. C., Asch, S. M., Rosenthal, J., & Blonigen, D. M. (2014). Treatments for recidivism risk among justice-involved veterans. Journal of Offender Rehabilitation, 53(8), 620–640.

    Article  Google Scholar 

  • Tsai, J., Rosenheck, R. A., Kasprow, W. J., & McGuire, J. F. (2013). Risk of incarceration of Iraq and Afghanistan era veterans in state and federal prisons. Psychiatric Services, 64(1), 36–43.

    Article  Google Scholar 

  • U.S. Department of Veterans Affairs. (2014). Claims for VA benefits and character of discharge. Washington, DC: Veterans Benefits Administration.

  • U.S. Department of Veterans Affairs. (2017). Other than honorable discharges: Impact on eligibility for VA health care benefits (IB 10–448). Washington, DC: Veterans Health Administration.

  • Van Dyke, K., & Orrick, E. A. (2017). An examination of the influence of veteran status on offense type among an inmate sample. American Journal of Criminal Justice, 42(2), 426–442.

    Article  Google Scholar 

  • Van Voorhis, P., Wright, E. M., Salisbury, E., & Bauman, A. (2010). Women’s risk factors and their contributions to existing risk/needs assessment: The current status of a gender-responsive supplement. Criminal Justice and Behavior, 37(3), 261–288.

    Article  Google Scholar 

  • Vogt, D. (2011). Mental health-related beliefs as a barrier to service use for military personnel and veterans: A review. Psychiatric Services, 62(2), 135–142.

    Article  Google Scholar 

  • Webb, R. T., Shaw, J., Stevens, H., Mortensen, P. B., Appleby, L., & Qin, P. (2012). Suicide risk among violent and sexual criminal offenders. Journal of Interpersonal Violence, 27(17), 3405–3424.

    Article  Google Scholar 

  • White, M. D. (2013). Prevalence and problem of military veterans in the Maricopa County arrestee population.

  • White, M. D., Mulvey, P., Fox, A. M., & Choate, D. (2012). A hero’s welcome? Exploring the prevalence and problems of military veterans in the arrestee population. Justice Quarterly, 29, 258–286.

    Article  Google Scholar 

  • Wooldredge, J. D. (1999). Inmate experiences and psychological well-being. Criminal Justice and Behavior, 26(2), 235–250.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Justice and Community Studies, Miami University, 1601 University Boulevard, 103F Phelps Hall, Hamilton, OH, 45011-3316, USA

    Mark Alden Morgan

  2. Department of Criminal Justice, California State University, San Bernardino, 5500 University Parkway, San Bernardino, CA, 92407-2393, USA

    Matthew W. Logan

  3. School of Criminal Justice, University of Cincinnati, 660-O Teacher-Dyer Hall, Clifton Avenue, Cincinnati, OH, 45221-0389, USA

    Francis T. Cullen

Authors
  1. Mark Alden Morgan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Matthew W. Logan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Francis T. Cullen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mark Alden Morgan.

Electronic supplementary material

ESM 1

(DOCX 41 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Morgan, M.A., Logan, M.W. & Cullen, F.T. The Battlefield Behind Bars: How Mental Disorder and Suicidal Behavior Impacts the Prison Experience for Veterans. Am J Crim Just 44, 746–769 (2019). https://doi.org/10.1007/s12103-018-9458-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12103-018-9458-2

Keywords

Search

Navigation