As discussed here, the hotly contested topic of criminal behavior among those with mental illness has endured a long and winding path among researchers, advocacy groups, and policymakers. For many years the standard mantra was that those with mental illnesses were no more likely to be violent than people in the general population. New studies have challenged that idea. Likewise, as discussed here, the prevailing notion of a mental health crisis in our jails and prisons is also under scrutiny. Yet, there is little doubt that some people with severe mental illnesses cycle through our criminal justice system. The question many ask is why? With intensive services like Assertive Community Treatment in existence since the early 1960s, some have begun to question whether management of psychiatric symptoms is enough for prevention's sake. A new article (subscription required) published in this month's issue of Psychiatric Services provides a new conceptual framework for thinking about the mentally ill offender. While some ardently argue against notions of legal leverage for persons with severe mental illness who cycle through the criminal justice system, such leverage appears effective and, as author Lamberti points out, suggests other mechanisms are at play besides untreated psychiatric symptoms among this subpopulation.