Lecture – Applying Group Psychotherapy Principles to Vulnerable Populations to Advance Public Health

Presented by Jennifer E. Johnson, PhD, Michigan State University – The Joseph P. Powers Memorial Lecture

The United States has one of the highest incarceration rates in the world. As a result, the U.S. criminal justice system has become one of the country’s largest mental health care systems, one that is forced to address the many psychiatric challenges facing those it interacts with.

In this lecture, Johnson discusses the high rates of mental illness recorded among individuals involved at different levels of the criminal justice system in the U.S.

Presentation highlights include:

• A review of the intersection of the justice/legal systems and community-based mental health systems
• A discussion of ways to increase treatment and service capacity of low-resource systems serving high-need patients
• An explanation of the relevance of the justice/legal system to mental health practice and policy efforts
• A look at how interpersonal group therapy can help incarcerated patients
• Advice for mental health professionals on working with police, prisons, crisis centers, and others to help this underserved population

Statistics show that 10 times as many individuals with severe mental illness are incarcerated as are in state hospitals. Among those incarcerated, 56% have mental health issues. These challenges include substance use disorders, borderline personality disorder, psychosis, mania, and PTSD. Despite the depth of the problem, there are few behavioral health interventions available to serve this population.

Johnson details the barriers to providing and accessing care. She also outlines the actions that can be taken in policy, health care, and the legal system to address this public health issue. She suggests that one solution may be the introduction of interpersonal group therapy and related interventions.

In the talk, she describes her own experiences treating individuals with depression in the criminal justice system. She explains that one-on-one therapy—a common approach for the condition—can be hard to implement in prison settings and is not always effective. In response, she started a pilot randomized trial to test the effectiveness of interpersonal group therapy within under-resourced systems.

Johnson presents study findings indicating that the approach is popular with patients and providers. Her work and related projects show that interpersonal group therapy can lead to reductions in depression, hopelessness, and PTSD. However, she asserts, there is a need for cost-effective training, more resources, and scalable models for implementing these programs.