ACEs and the Possibility of Preventing the Past

Ashekun and colleagues' study of the association between adverse childhood experiences (ACEs) and arrests in persons with serious mental illness (SMI) provides more evidence for the importance of addressing the broader needs (beyond narrowly defined symptoms of mental illness) of clients with SMI and criminal legal contact. Furthermore, the article supports the need to appreciate fully the intersection of behavioral health and criminal justice and the intersectionality of mental health and race (i.e., the additive adversities experienced by individuals with SMI who also face race-based inequities). In this commentary, we apply this public health framing of criminal legal involvement among individuals with SMI, expanding on the social adversities, including ACEs, that contribute to adverse health and legal outcomes. We support the relevance of prevention approaches and note areas for further inquiry. In so doing, we aim to reinforce a role for forensic practitioners in addressing these challenges.