Journal of Traumatic Stress, Vol. 23, No. 2, April 2010, pp.

182–188 (
C 2010)

The Impact of Criminal Justice Involvement

on Victims’ Mental Health
Jim Parsons and Tiffany Bergin
Vera Institute of Justice, New York

The aftermath of violent crime can leave victims with persistent emotional and mental health problems. Although
research has shown the potential benefits of prosecuting cases through the courts, there is also a substantial literature
that suggests that common features of the criminal justice system can exacerbate the impact of the initial crime,
leading to a secondary victimization. The authors present a review of the research on the positive and negative
impact of criminal justice involvement, and common points of failure in the efforts of justice institutions to meet
the needs of victims. They conclude with recommendations for future work, including the need for research on
restorative justice, victim impact statements, court notification systems, victim services, and victim advocates.

The aftermath of violent crime can leave victims with persistent
emotional and mental health problems. In some cases, these mani-
fest as diagnosable psychiatric disorders: In others, the impacts are
harder to classify, but victims are nonetheless left feeling anxious,
distressed, and with a reduced quality of life.
In this article, we present a review of the literature on how
criminal justice system contact affects the mental health of adult
crime victims. Most criminal justice agencies are poorly equipped
to address the psychological needs of victims. Police and courts
staff members rarely receive training to recognize or deal with
mental health problems, and as a result, the needs of victims
often go unaddressed. In fact, there is evidence that a number of
common legal practices may actually exacerbate the trauma of the
original crime (Campbell & Raja, 1999; Herman, 2003; Orth,
2002).
PSYCHOLOGICAL CONSEQUENCES OF
VICTIMIZATION
The Bureau of Justice Statistics estimates that U.S. residents expe-
rienced 5.2 million violent crimes in 2007 (U.S. Department of
Justice, 2008). It is difficult to overstate the impact that violent
offending can have on victims’ emotional well-being. A num-
ber of studies have linked violent victimization and posttraumatic
stress disorder (PTSD; Boudreaux, Kilpatrick, Resnick, Best, &
Jim Parsons, Tiffany Bergin, Substance Use and Mental Health Program, Vera Institute of
Justice, New York.
Correspondence concerning this article should be addressed to Jim Parsons, Substance Use and
Mental Health Program, Vera Institute of Justice, 233 Broadway, 12th Floor, New York, New
York 10279. E-mail: jparsons@vera.org.

C 2010 International Society for Traumatic Stress Studies. Published online in Wiley Inter-
Science (www.interscience.wiley.com) DOI: 10.1002/jts.20505
Saunders, 1998; Breslau, Davis, Andreski, & Petersen, 1991;
Campbell & Raja., 1999; Kilpatrick & Acierno, 2003; Rothbaum,
Foa, Riggs, Murdock, & Walsh, 1992). Others describe the con-
nection between victimization and depression, substance abuse,
panic disorder, anxiety disorders, agoraphobia, social phobia, ob-
sessive compulsive disorder, and suicide (Boudreaux et al., 1998;
Breslau et al., 1991; Kilpatrick et al., 2003; Orth & Maercker,
2004; Resick, 1987; Salomon et al., 2004). Victims also report
a range of “nonclinical” effects including loss of confidence and
self-esteem, sleeplessness, and physical symptoms (Strang, 2003).
There are a number of potential benefits for victims who choose
to report violent crimes. Contact with the criminal justice system
can be cathartic and confronting reminders of the original crime
may aid in the process of recovery (Foa & Kozak, 1986; Orth,
2002). Studies of victims of intimate partner violence have found
that women who pursue their case through the courts report im-
provements in self-esteem, regardless of the outcome (Dobash,
Dobash, Cavanagh, & Lewis, 1999; Ford & Regoli, 1993). Partic-
ipants in a Canadian study of sexual abuse compensation claims
stated the need to report their experience, to be heard, and to
have “their abuse acknowledged, their experiences validated, and
to receive an apology” (Feldthusen, Hankivsky, & Greaves, 2002,
p. 75). In contrast, avoidant coping strategies have been linked to
increased PTSD symptoms for victims of both domestic violence
and rape (Ehlers & Clark, 2000).
However, the justice system’s response to victims who choose
to report crimes can make the difference between a healing ex-
perience and one that exacerbates the initial trauma. Reporting a
crime to the police can be distressing; recounting experiences in
court is often traumatic, and failure to prosecute a case may leave
victims feeling embittered and disappointed (Herman, 2003; Koss,
2000). Most studies that address the question find that victims of
violent crime perceive the legal system as potentially traumatizing
(Campbell & Raja, 2005; Renck & Svensson, 1997), and many

182
 The Impact of Criminal Justice Involvement
are dissatisfied with their experiences in court (Kilpatrick, Beatty,
& Howley, 1998). In one longitudinal study, testifying in court
was among the top five most “fearful cues” for rape victims and was
also the main cause of anxiety one year after the offense (Calhoun,
Atkeson, Resick, & Ellis 1982).
A number of studies suggest that contact with the justice system
can lead to a ‘secondary victimization’ - where crime victims feel
blamed by the justice system or experience other negative societal
reactions as a consequence of their initial (primary) victimization
(Orth, 2004; Renck & Sevensson, 1997; Williams, 1984). Re-
search conducted with victims of rape and other forms of violent
crime has found that experiences in court added to the trauma
of the original crime (Campbell, Wasco, Ahrens, Sefl, & Barnes,
2001; Orth, 2002). In one study, based on interviews with mental
health professionals, the majority of those interviewed believed
that reporting a rape was psychologically detrimental to victims
(Campbell & Raja, 1999).
Negative perceptions of the justice system, and concerns about
treatment by the police and courts, likely contribute to low report-
ing rates of violent crime. A 1996 literature review found that only
about 60% of rapes in the United States are reported to the police
(Frazier & Haney, 1996). Studies of intimate partner violence have
shown that victims often hesitate to call the police because they
fear further abuse, blame themselves for the assault, or because
they do not want to lose the support of an abusive relationship
(Hoyle & Sanders, 2000).
Despite the potential for harm, and in the face of evidence of
underreporting, there is still a dearth of reliable studies that seek to
quantify the experiences of crime victims (Frazier & Haney, 1996).
As a result, the jury is still out on the impact of criminal justice
system contact on victims’ mental health; some researchers report
that victims experience exacerbation of mental health problems
(Koss, 2000) and others report no effect (Frazier & Haney, 1996;
Orth et al., 2004). One major weakness of existing research in
this area is the absence of studies that use control groups. As one
commentator notes, “It is conceivable that victims who decide not
to report the crime experience even more negative consequences”
(Orth, 2002, p.323).
COMMON FEATURES OF THE CRIMINAL JUSTICE
SYSTEM THAT CAN AFFECT VICTIMS’ MENTAL
HEALTH
The following section presents research on key aspects of law en-
forcement and the courts that have been shown to mediate the
emotional repercussions of crime. These include the impact of law
enforcement practices; the adversarial nature of trials; the avail-
ability of information for victims; the importance of participation
in courtroom proceedings; and the role of prosecutors. We also
discuss procedural justice as a useful concept for understanding
victims’ experiences and the particularly pernicious impact of bias
Journal of Traumatic Stress DOI 10.1002/jts. Published on behalf of the International Society for Traumatic Stress Studies.
183
and hate crimes. In the second part of this section, we describe
three promising and innovative approaches to improving services
for victims.
Law Enforcement and Crime Reporting
Although most of the secondary victimization literature focuses
on the negative impact of courtroom experiences, for most crime
victims, law enforcement officers are the first, and often only, point
of contact with the justice system (Rosenbaum, 1987). As such,
the police have a particular responsibility to respond to their needs
(Seymour, Gaboury, & Edmunds, 2002). In the best-case scenario,
law enforcement officers address immediate needs for emergency
services, inform victims of their rights, explain the process for
prosecuting a case, and make referrals to victim services (Frazier &
Haney, 1996). However, a poor record of responding to victims’
need, particularly in cases of rape and domestic violence (Jordan,
2001), has tarnished the reputation of law enforcement agencies.
While some recent studies suggest that police/victim interactions
have improved (Frazier & Haney, 1996; U.S. Department of Jus-
tice, 1998) there is also substantial evidence for persistent problems
in this area (Campbell, 2005) and rates of prosecution for those
who do report crimes are generally low (Frazier & Haney, 1996).
Campbell has studied the impact of interactions with police
on postrape traumatic stress (Campbell & Raja., 1999; Campbell
et al., 2001; Campbell, 2005, 2006). Her findings indicate that
the majority of victims do not receive the services they need from
the police or medics (Campbell et al., 2001), and that a negative
interaction with the legal system is an important predictor of
postrape traumatic stress symptoms (Campbell & Raja, 1999). Law
enforcement officers play an important gatekeeping role, deciding
whether a crime has been committed and if the victim is credible
(Frazier & Haney, 1996). Research conducted in the UK indicated
that between 23% and 43% of rape cases are dropped following a
police decision that the events did not constitute a crime (Gregory
& Lees, 1996). A similar U.S. study also found that the majority
of cases were dropped and that the decision not to prosecute was
associated with increased posttraumatic stress reactions (Campbell
et al., 2001). Of particular concern, studies have shown that police
officers’ decision to pursue or drop cases are influenced by factors
unrelated to the facts of the crime, including the victim’s level of
distress, their age, race, socioeconomic status, and history of drug
or alcohol use (Baldry, 1996; Brown, Hamilton & O’Neill, 2007;
Campbell & Raja, 1999; Campbell et al., 2001; Frazier & Haney,
1996; Howerton, 2006; Rose & Randall, 1982).
The U.S. Department of Justice and National Institute of Jus-
tice recommend that law enforcement agencies establish victim
assistance programs, partner with local social service agencies,
coordinate their response with victim advocate programs, and
adopt community policing models (U.S. Department of Justice,
Office of Justice Programs, 1998).
184
The Courts and Adversarial Process
In the United States and many other countries, criminal trials are
structured as a contest between the victim and defendant. The ad-
versarial nature of this arrangement can be particularly traumatic
for victims of violent crime (Herman, 2003). Researchers have
found that facing the perpetrator in court, remembering details of
the crime, and confronting others who were present at the time
of the original offense (such as witnesses or the police) can all
trigger secondary responses to the initial trauma (Rothbaum et al.,
1992). Victims are often subjected to detailed and aggressive ques-
tioning about personal and often traumatic events, and defense
attorneys may try to apportion blame for the crime or question
their credibility and reliability (Bell, 2007; Herman, 2003; Orth,
2002; Rothbaum et al., 1992). Researchers describe the partic-
ularly distressing impact that the adversarial justice system can
have on intimate partner violence (Bell & Goodman, 2001) and
rape victims. Despite rape shield law, victims often have to pro-
vide graphic details of an assault and endure detailed and highly
personal questions about their sexual history (Koss, 2000).
The procedures and rules for hearing cases have developed to
protect the rights of defendants. However, the unblinking focus
of modern jurisprudence on the rights of the accused has led to
court systems which are often blind to the needs of crime victims
(Herman, 2003; Kilpatrick et al., 1998; Orth, 2002).
Providing Victims With Information on the Legal Process
The process of prosecuting a case in the court system is compli-
cated and relies on detailed sets of rules and procedures (Bibas,
2006). For many crime victims—who may expect that their ex-
periences in court will be fairly straightforward and result in
quick resolution—the reality can seem complicated, the process
opaque, and the outcome arbitrary (Bibas, 2006). A 1995 survey of
1,308 crime victims from four states found that many victims did
not receive information about basic details of the trial, includ-
ing postponements, sentencing decisions, plea bargain offers, or
the decision to release defendants. Unsurprisingly, the researchers
found that a minority were satisfied with their experience of the
justice system (Kilpatrick et al., 1998). Other research has found
that victims may be unclear about the difference between criminal
and civil proceedings. In Bennett, Goodman, and Dutton’s study
of domestic violence victims, participants felt let down when bat-
terers were given what they saw as a “slap on the wrist” as part
of a civil settlement (Bennett et al.,1999). They describe how a
number of the women interviewed were disappointed by a system
that failed to meet their expectations and, as a result, decided to
drop charges.
Providing information on the process for prosecuting a case,
time scales, court procedures, and the availability of support ser-
vices may help dispel misunderstandings about the justice system
Journal of Traumatic Stress DOI 10.1002/jts. Published on behalf of the International Society for Traumatic Stress Studies.
Parsons and Bergin
and furnish victims with more realistic expectations. Keeping vic-
tims’ informed about release dates for convicted offenders may
increase their feelings of safety (Frazier & Haney, 1996).
The Opportunity to Participate in Trials
Those who are seeking a public apology from the perpetrator,
or the opportunity to discuss their ordeal, may be frustrated by
cases which are settled quickly through a plea bargain or other-
wise do not offer an opportunity to participate. Research shows
that participation in the trial can help victims come to terms
with their experience and increase their sense of control and self-
determination (Kilpatrick & Otto, 1987; Young, 2001). In one
study, having an opportunity to participate in the trial was one of
the strongest predictors of positive mental health outcomes (Orth,
2002). However, victims often report that they are marginal to the
operation of the courts and that the process is taken out of their
hands (Bibas, 2006).
The Role of Prosecutors
Victims may falsely assume that their relationship with the pros-
ecutor is equivalent to legal counsel for the defendant, when in
fact the prosecutor’s main objective is to ensure the successful
prosecution of the case (Davis, Kunreuther, & Konnick, 1984;
Seymour, Gaboury, & Edmunds, 2002). Prosecutorial decisions
may be guided by factors unrelated to the facts of the case or the
needs of victims, including the need to divert cases from overloaded
courts or to meet performance targets. These unofficial concerns
can lead to more difficult or contentious cases being dropped
(Frazier et al., 1996). A number of studies report that victims are
often unhappy with the information they receive from prosecutors
on what to expect in court (Bennett et al., 1999, Frazier & Haney,
1996; Konradi, 1997). Victims who expect to receive supportive
services and legal advice may also be disappointed by the degree
of collaboration between prosecutors and defense attorneys (Davis
et al., 1984).
The Department of Justice recommends that prosecutors adopt
consistent policies for informing victims of their rights, provide
timely notice of court proceedings, and inform victims of decisions
to drop charges and plea bargain negotiations. (U.S. Department
of Justice, Office of Justice Programs, 1998). The importance of
providing information on the reasons for not pursuing a case, or for
not including victim statements as part of plea bargain decisions,
has also been emphasized (Frazier & Haney, 1996; Konradi, 1997).
Procedural Justice
Procedural justice encompasses several of the concepts that have
already been discussed in this review. As the term suggests, proce-
dural justice is concerned with the way that decisions are reached
in the courtroom, rather than the outcome (Tyler & Lind, 1990).
 The Impact of Criminal Justice Involvement
Research has shown that both the degree of satisfaction with the
outcome of a case and improvements in emotional well-being are
strongly associated with victims’ perception that the process was
fair and equitable (Bell, 2007) and that perceptions of procedu-
ral unfairness are associated with lowered self-esteem (Koper, Van
Knippenberg, Bouhuijs, Vermunt, & Wilke, 1993).
Enhancing defendants’ sense of procedural justice may also
improve victim safety. In her review of the literature on intimate
partner violence, Bell quotes studies which link abusive partners’
perceptions of procedural justice with increased compliance with
court protection orders and reduced rates of violent revictimization
(Bell, 2007; Lind & Tyler, 1988; Paternoster, Brame, Bachman,
& Sherman, 1997). Unfortunately, current court practices tend
to rate poorly on most measures of procedural justice (Kilpatrick
et al., 1998).
Bias Crimes and Biased Criminal Practices
Some groups face an increased risk of hate, or bias, crime. Research
shows that victims of bias crimes tend to experience more serious
mental health consequences than other crime victims (Barnes &
Ephross, 1994; Herek, Cogan & Gillis, 2002; McDevitt, Farrell,
Rousseau, & Wolff, 2007). For example, in their California-based
study of gay men, lesbians, and bisexuals, Herek and colleagues
found that victims of bias crimes reported higher rates of PTSD
than those individuals who experienced personal crimes that were
not motivated by bias (Herek, Gillis, Cogan, & Glunt, 1997).
Biases and prejudices within the criminal justice system can
also hinder the efforts of some victims to receive justice. A study
of rape victims in one Midwestern city found that authorities
were much more likely to prosecute rape cases if the victims were
White women than if the victims were African American women
(Campbell et al., 2001). Other researchers report that anxiety
about potential secondary victimization is one of the most frequent
explanations offered by gay and lesbian bias crime victims who do
not report their victimization to authorities (Comstock, 1989).
EMERGENT BEST PRACTICES
We focus on three concrete suggestions for reducing the traumatiz-
ing potential and enhancing the positive aspects of victims’ contact
with the criminal justice system: (a) the use of victim services and
victim advocates, (b) victim impact statements, and (3) nonad-
versarial methods of dispute resolution and specifically, restorative
justice.
Victim Services and Victim Advocates
Research with victims of domestic violence has shown that women
without a support network are more likely to drop their case
(Bennett et al., 1999). A number of programs use victim advocates
to provide social support throughout the trial, explain the court
Journal of Traumatic Stress DOI 10.1002/jts. Published on behalf of the International Society for Traumatic Stress Studies.
185
process, provide referrals to social services, and in some cases,
accompany the victim to court (Bennett et al., 1999; Herman,
2003; Konradi, 1997).
The Victim Involvement Project of the Vera Institute of Jus-
tice tested this model by providing advocates to support victims
with cases appearing at New York’s Brooklyn Criminal Court.
Advocates were charged with informing victims of hearing dates,
providing general information on court processes, and ensuring
that their concerns were communicated to the prosecutor and
other court staff (Davis et al., 1984). The evaluation of the Victim
Involvement Project found that contact with advocates improved
victims’ understanding of the process for hearing cases, and that
their notification service reduced the number of unnecessary court
visits. The project did not, however, lead to improvements in the
overall experience of court appearances. According to the program
evaluators, the project’s location in the prosecutor’s office and the
reliance on prosecutors to convey victims’ concerns to the bench
limited the effectiveness of the services provided (Davis & Smith,
1984).
The Judicial Oversight Demonstration initiative recommends
that advocacy programs specifically targeting domestic violence
victims should provide information on community services and
other resources (such as emergency shelters and protection or-
ders) and help women devise plans to escape victimization (Bell &
Goodman, 2001; DeStefano, Harrell, Newmark, & Visher, 2001).
One such program partnered survivors of intimate partner vio-
lence with law students who offered legal advice and informal help
in preparing for court, provided emotional support, and referred
victims to community agencies. Women who received advocacy
services as part of the program reported lower levels of revictimiza-
tion and marginal improvements in the level of emotional support
(Bell & Goodman, 2001). Contact with student advocacy services
did not, however, lead to improvements in tangible social support
or symptoms of depression.
Victim Impact Statements
One option for increasing victim participation is the use of impact
statements. Impact statements allow victims to communicate their
experiences to the court in written form, via the prosecutor. Ac-
cording to one study, the use of these statements was linked to dra-
matic increases in victim satisfaction with prosecutors (Alexander
& Lord, 1994). However, other longitudinal studies have shown
that impact statements do not increase overall satisfaction with the
court process (Davis & Smith, 1994; Giliberti, 1991). In one sur-
vey, the vast majority of victims who were informed of their right
to submit an impact statement chose to do so, which suggests they
at least have a symbolic value (Kilpatrick et al., 1998). On the
other hand, although impact statements offer the impression of
inclusiveness, they often have little or no bearing on sentencing
decisions, which may then have a negative impact on victim’s sense
of participation. (Kilpatrick & Otto, 1987). Other studies report
186
that oral allocution during sentencing hearings have more value to
victims than written statements (Bibas, 2006).
Restorative Justice
Restorative justice is probably the most widely researched alterna-
tive to adversarial court hearings. Restorative justice hearings typi-
cally consist of mediated dialogues between a victim and offender.
From a victim’s perspective, restorative justice offers greater oppor-
tunities for participation in both mediation and sentencing than
the conventional adversarial model, allowing them to confront the
offender in a controlled environment, free of the restrictions of
the conventional court room (Umbreit, 1998). In his review of
the literature on the psychological outcomes of restorative justice,
Poulson (2003) found that victims were likely to view both the
process and the outcome as fair, reported that they were able to
tell their stories, and felt that the offender was held accountable
for his, or her actions.
Unfortunately, there has been no research to date contrasting
the mental health impact of restorative justice with that of con-
ventional trials (Herman, 2003; Sered, 2006). However, a number
of studies do compare victim satisfaction between the two models
(Beven & Hall, 2005). One study contrasted outcomes for 72 par-
ticipants in an Australian restorative justice community court with
victims whose case was heard in a conventional court. The restora-
tive justice group was significantly more likely to understand the
offender’s motivations, reported greater levels of satisfaction with
their participation in the trial, and felt at less risk than the compar-
ison group (Beven & Hall, 2005). For both groups, greater overall
satisfaction was attributable to the degree of participation in the
trial rather than differences in case outcome.
CONCLUSION
This review has highlighted a number of strands in the litera-
ture describing how contact with the criminal justice system can
have both positive and negative impacts on the mental health of
crime victims. It has also identified several large gaps in the research
on the needs of victims, their experiences of the justice system, and
the mental health impacts of reporting and prosecuting crimes.
Contact with the justice system holds the promise of support-
ing victims in their efforts to seek redress—allowing them to come
to terms with their experiences by facing their attacker and con-
fronting perpetrators with the damage that they have caused. In
an ideal scenario reaching a settlement in court can be part of
the healing process, providing a public recognition of the harm
that victims have suffered and legitimizing their need for support.
Studies have shown that improvements in victims’ mental health
outcomes are linked to their perception of justice systems as fair
and transparent entities that are able to reach a considered and just
outcome. Existing research, however, suggests that criminal jus-
tice systems are not fulfilling this role for many victims of violent
Journal of Traumatic Stress DOI 10.1002/jts. Published on behalf of the International Society for Traumatic Stress Studies.
Parsons and Bergin
crime. Commonly held perceptions of justice systems as confusing
and arbitrary are almost certainly damaging victims’ confidence
and leading to cases being dropped before they are resolved. Con-
fusion about the criminal justice system may be exacerbated by
both a lack of social support for victims and a dearth of timely
information on what to expect in court.
However, much of the research literature in this area is outdated
and many of those studies which have been conducted suffer from
methodological problems. As a result, we do not know enough
about the (positive or negative) impact of reporting a crime on the
mental health of victims. Without large-scale, experimental design
or carefully structured quasi-experimental studies, it is impossible
to know whether disparities in mental health outcomes are the
result of criminal justice system contact, as opposed to underlying
differences in those who choose to report crimes. Studies are needed
that adopt structured clinical interviews and assess changes in
mental health outcomes in both the long and short term.
In some cases, promising practices have yet to be implemented.
However, in other areas there are programs underway that have
yet to be assessed. Research is needed to test (a) the potential of
restorative justice courts to improve mental health outcomes for
victims of certain types of violent crime; (b) the effectiveness of
victim advocates and differential outcomes for victims who receive
advocacy services from the police, courts, and community groups;
(c) whether automatic victim notification systems are improving
victim participation, procedural justice, and ultimately, emotional
and mental health; and (d) the effectiveness of victim impact
statements, including the use of alternative methods for presenting
statements that do not rely on prosecutors, and their use at both the
plea bargaining and sentencing stage. In each of these areas there
may be naturally occurring opportunities for experimental design
studies, comparing outcomes for clients of new pilot programs with
those who receive “services as usual.” Threading through all of this
work is the need for research which includes rigorous measures of
satisfaction and mental health that assess outcomes for victims in
the long term. There is also a need for further research that expands
and builds on the existing body of research on rape and domestic
violence and includes the experiences of those who typically do not
approach the justice system—especially recent immigrants, those
with English as a second language, and noncitizens.
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