# What works, for whom? Applying novel precision medicine methods to people with mental illness in the justice system.

> **NIH NIH R00** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2024 · $248,999

## Abstract

PROJECT SUMMARY/ABSTRACT
People with serious mental illness (SMI) are substantially overrepresented in the US criminal justice system. In
an effort to reduce recidivism among this vulnerable population, average effects of administering single
interventions to all have been studied in recent years. These interventions include ones that target SMI symptoms
(such as mandated psychiatric services) and others that target criminogenic risk factors (such as cognitive
behavioral therapy). However, justice-involved people with SMI are diverse in their characteristics, needs, and
risk factors; there is no “one-size-fits-all” solution to prevent recidivism. Decreasing adverse criminal outcomes
for this population requires recognizing its heterogeneity. Therefore, the broad objective of this proposal is to
understand which interventions work best for which justice-involved people with SMI using state-of-the-art
precision medicine methods drawn from causal inference, statistical theory, and machine learning. This is a step
toward the long-term goal of identifying optimal ways to reduce criminal behavior in this population by matching
interventions to those who need and benefit from them. Supported by a dedicated and talented mentorship team,
the training portion of this grant will fill gaps key to achieving this goal: 1) subject-matter training and field
experience on SMI in the criminal justice system, 2) development of novel technical methods in precision
medicine, 3) skills in translating technical findings to high-impact recommendations for practice and policy, and
4) professional skills development. This rich training will provide a foundation for accomplishing the following
research aims to reach the proposal's broad objective: 1) understand the differential pathways that situate this
population at risk for re-offending, 2) identify tailored rules for administering interventions to those who benefit
from them based on individual characteristics, and 3) assess whether and how the identified rules for matching
interventions generalize across the US. This research will leverage randomized controlled trial data, federal data
from the Administrative Office of the US Courts, and state data from the North Carolina Department of Public
Safety to achieve these aims. Importantly, research from this grant will result in novel statistical precision
medicine methods for transporting rules to settings different than those on which they are learned. The aims of
this grant are well-aligned with NIMH's strategic goal of striving for prevention and treatments among people with
SMI, including, but not limited to, the objectives of: a) advancing methods to match interventions to individuals
and populations (especially marginalized and underserved communities) and b) strategies for scaling up
interventions for the greatest public health impact. By learning who benefits from which interventions using the
latest advances in precision medicine methods, this work has the potent...

## Key facts

- **NIH application ID:** 11089900
- **Project number:** 4R00MH133985-02
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Lina Montoya
- **Activity code:** R00 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $248,999
- **Award type:** 4N
- **Project period:** 2024-07-01 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11089900

## Citation

> US National Institutes of Health, RePORTER application 11089900, What works, for whom? Applying novel precision medicine methods to people with mental illness in the justice system. (4R00MH133985-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/11089900. Licensed CC0.

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