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Browne CC, Korobanova D, Chemjong P, Harris AWF, Glozier N, Basson J, Spencer SJ, Dean K. Continuity of mental health care during the transition from prison to the community following brief periods of imprisonment. Front Psychiatry 2022; 13:934837. [PMID: 36203827 PMCID: PMC9530150 DOI: 10.3389/fpsyt.2022.934837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 08/18/2022] [Indexed: 11/13/2022] Open
Abstract
PURPOSE The prison-to-community transition period is one of high risk and need, particularly for those with mental illness. Some individuals cycle in and out of prison for short periods with little opportunity for mental health stabilization or service planning either in prison or the community. This study describes the socio-demographic, clinical and criminal justice characteristics of individuals with mental illness and frequent, brief periods of imprisonment, examines continuity of mental health care between prison and the community for this group, and reports on their post-release mental health and criminal justice outcomes. DESIGN/METHODOLOGY/APPROACH This study examined a sample of 275 men who had recently entered prison in New South Wales (NSW), Australia, who had been charged with relatively minor offenses and had been identified on reception screening as having significant mental health needs. Baseline demographic and mental health information was collected via interview and file review and contacts with the prison mental health service were recorded for the period of incarceration. Follow-up interviews were conducted 3 months post-release to determine level of health service contact and mental health symptoms. Information on criminal justice contact during the 3 month period was also collected. FINDINGS The majority (85.5%) of the sample had contact with a mental health professional during their period of incarceration. Mental health discharge planning was, however, lacking, with only one in 20 receiving a referral to a community mental health team (CMHT) and one in eight being referred for any kind of mental health follow-up on release. Of those followed up 3 months post-release (n = 113), 14.2% had had contact with a CMHT. Of those released for at least 3 months (n = 255), one in three had received new charges in this period and one in five had been reincarcerated. CONCLUSION Continuity of mental health care for those exiting prison is poor, particularly for those with mental health needs experiencing brief periods of imprisonment, and rates of CMHT contact are low in the immediate post-release period. These findings suggest a need for early identification of individuals in this group for timely commencement of intervention and release planning, and opportunities for diversion from prison should be utilized where possible.
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Affiliation(s)
- Christie C Browne
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.,Justice Health and Forensic Mental Health Network, Sydney, NSW, Australia
| | - Daria Korobanova
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.,Justice Health and Forensic Mental Health Network, Sydney, NSW, Australia.,Western Sydney Local Health District, Sydney, NSW, Australia
| | - Prabin Chemjong
- Justice Health and Forensic Mental Health Network, Sydney, NSW, Australia.,Western Sydney Local Health District, Sydney, NSW, Australia
| | - Anthony W F Harris
- Western Sydney Local Health District, Sydney, NSW, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Nick Glozier
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,Sydney Local Health District, Sydney, NSW, Australia.,Australian Research Council Centre of Excellence for Children and Families Over the Life Course, Indooroopilly, QLD, Australia
| | - John Basson
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.,Western Sydney Local Health District, Sydney, NSW, Australia
| | - Sarah-Jane Spencer
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.,Justice Health and Forensic Mental Health Network, Sydney, NSW, Australia
| | - Kimberlie Dean
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.,Justice Health and Forensic Mental Health Network, Sydney, NSW, Australia
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Cossar RD, Stewart AC, Wilkinson AL, Dietze P, Ogloff JRP, Aitken C, Butler T, Kinner SA, Curtis M, Walker S, Kirwan A, Stoové M. Emergency department presentations in the first weeks following release from prison among men with a history of injecting drug use in Victoria, Australia: A prospective cohort study. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 101:103532. [PMID: 34871944 DOI: 10.1016/j.drugpo.2021.103532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 10/26/2021] [Accepted: 11/11/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Rates of emergency department (ED) use are higher among people released from prison than in the general population. However, little is known about ED presentations specifically among people with a history of injecting drug use (IDU) leaving prison. We measured the incidence of ED presentation in the three months following release from prison, among a cohort of men with histories of IDU, and determined pre-release characteristics associated with presenting to an ED during this period. METHODS We analysed linked survey and administrative data from the Prison and Transition Health (PATH) study (N = 400) using multiple-failure survival analysis. RESULTS Twenty-one percent (n = 81/393) of the cohort presented to an ED at least once within the three months after release from prison. The incidence of ED presentation was highest in the first six days after release. Cox proportional hazards modelling showed that a history of in-patient psychiatric admission and housing instability were associated with increased hazard of an ED presentation, and identifying as Aboriginal and Torres Strait Islander was associated with decreased hazard. CONCLUSIONS In our study, ED presentations following release from prison among people with a history of IDU was linked to acute health risks related to known mental health and social vulnerabilities in this population. Greater collaboration and systems integration between prison and community health and support services is needed to reduce presentations to ED and associated morbidities among people with a history of IDU after release from prison.
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Affiliation(s)
- Reece David Cossar
- Behaviours and Health Risks, Burnet Institute, Melbourne, VIC, Australia; Centre for Forensic Behavioural Science, Swinburne University of Technology and Forensicare, Melbourne, VIC, Australia.
| | - Ashleigh Cara Stewart
- Behaviours and Health Risks, Burnet Institute, Melbourne, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Anna Lee Wilkinson
- Behaviours and Health Risks, Burnet Institute, Melbourne, VIC, Australia; Centre for Forensic Behavioural Science, Swinburne University of Technology and Forensicare, Melbourne, VIC, Australia
| | - Paul Dietze
- Behaviours and Health Risks, Burnet Institute, Melbourne, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; National Drug Research Institute, Curtin University, Perth, Australia
| | - James R P Ogloff
- Centre for Forensic Behavioural Science, Swinburne University of Technology and Forensicare, Melbourne, VIC, Australia
| | - Campbell Aitken
- Behaviours and Health Risks, Burnet Institute, Melbourne, VIC, Australia
| | - Tony Butler
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Stuart A Kinner
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia; Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia; Griffith Criminology Institute, Griffith University, Brisbane, QLD, Australia; Mater Research Institute-UQ, University of Queensland, Brisbane, QLD, Australia
| | - Michael Curtis
- Behaviours and Health Risks, Burnet Institute, Melbourne, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Monash Addiction Research Centre, Monash University, Melbourne, VIC, Australia
| | - Shelley Walker
- Behaviours and Health Risks, Burnet Institute, Melbourne, VIC, Australia
| | - Amy Kirwan
- Behaviours and Health Risks, Burnet Institute, Melbourne, VIC, Australia
| | - Mark Stoové
- Behaviours and Health Risks, Burnet Institute, Melbourne, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Nathani J, Morris RW, Glozier N, Sara G. Amphetamine use and psychiatric admissions: a 10-year perspective. Australas Psychiatry 2021; 29:655-658. [PMID: 34010586 DOI: 10.1177/10398562211014227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE We aimed to (i) describe the 10-year trend in admissions associated with amphetamine use, (ii) describe the distinguishing characteristics of people with an amphetamine-related diagnosis (ARD) and (iii) examine predictors of repeated admissions among people with an ARD. METHOD We conducted a retrospective cohort study. We (i) counted the number of admissions with an ARD and evaluated any trends, and using univariate and multivariate tests, (ii) compared those who had an ARD with those who did not and (iii) compared those with an ARD who had one, two to four, and five or more admissions. RESULTS Admissions associated with amphetamine use increased between 2009 and 2015. Those with an ARD had significant differences in demographics, diagnosis and pattern of service use relative to those without an ARD. Amongst those with an ARD, a higher number of admissions was positively associated with a schizophrenia diagnosis but inversely associated with a transient psychotic disorder diagnosis. CONCLUSIONS The increase in admissions associated with amphetamine use indicates that people with an ARD posed major demands on inpatient services. Targeting amphetamine treatment to those with psychotic disorders, both schizophrenia and transient psychotic disorders, may reduce hospital-related costs and re-admissions.
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Affiliation(s)
- Jai Nathani
- The Sydney Local Health District, Camperdown, NSW, Australia
| | - Richard W Morris
- Sydney Medical School, University of Sydney, Camperdown, NSW, Australia
| | - Nicholas Glozier
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Grant Sara
- Sydney Medical School, Northern Clinical School, University of Sydney, North Ryde, NSW, Australia
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Magee LA, Fortenberry JD, Rosenman M, Aalsma MC, Gharbi S, Wiehe SE. Two-year prevalence rates of mental health and substance use disorder diagnoses among repeat arrestees. HEALTH & JUSTICE 2021; 9:2. [PMID: 33411067 PMCID: PMC7789256 DOI: 10.1186/s40352-020-00126-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 12/02/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Individuals with mental illness and co-occurring substance use disorders often rapidly cycle through the justice system with multiple arrests. Therefore, is it imperative to examine the prevalence of mental health and substance use diagnoses among arrestees and repeat arrestees to identify opportunities for intervention. METHODS We linked police arrest and clinical care data at the individual level to conduct a retrospective cohort study of all individuals arrested in 2016 in Indianapolis, Indiana. We classified arrestees into three levels: 1 arrest, 2 arrests, or 3 or more arrests. We included data on clinical diagnoses between January 1, 2014 and December 31, 2015 and classified mental health diagnoses and substance use disorder (SUD) based on DSM categories using ICD9/10 diagnoses codes. RESULTS Of those arrested in 2016, 18,236 (79.5%) were arrested once, 3167 (13.8%) were arrested twice, and 1536 (6.7%) were arrested three or more times. In the 2 years before the arrest, nearly one-third (31.3%) of arrestees had a mental health diagnosis, and over a quarter (27.7%) of arrestees had an SUD diagnosis. Most of those with a mental health or SUD diagnosis had both (22.5% of all arrestees). Arrestees with multiple mental health (OR 2.68, 95% CI 2.23, 3.23), SUD diagnoses (OR 1.59, 95% CI 1.38, 1,82), or co-occurring conditions (1.72, 95% CI 1.48, 2.01) in the preceding 2 years had higher odds of repeat arrest. CONCLUSIONS Our findings show that linked clinical and criminal justice data systems identify individuals at risk of repeat arrest and inform opportunities for interventions aimed at low-level offenders with behavioral health needs.
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Affiliation(s)
- Lauren A Magee
- O'Neill School of Public and Environmental Affairs, Indiana University Purdue University Indianapolis, 801 W. Michigan St, Indianapolis, IN, 46202, USA.
| | - J Dennis Fortenberry
- Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Marc Rosenman
- Department of Pediatrics, Lurie Children's Hospital, Northwestern University, Chicago, IL, USA
| | - Matthew C Aalsma
- Adolescent Behavioral Health Research Program, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sami Gharbi
- Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sarah E Wiehe
- Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
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Simpson PL, Settumba S, Adily A, Ton B, Butler T. Defining Optimal Post-prison Care for Those With Psychosis: A Delphi Study. Front Psychiatry 2021; 12:760904. [PMID: 34744842 PMCID: PMC8569300 DOI: 10.3389/fpsyt.2021.760904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 09/20/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Early treatment (considered as early contact with community mental health services) and treatment retention are associated with reduced reoffending among those with a previous diagnosis of psychosis, yet the attributes of care required to best achieve this is largely unexplored for people with psychosis leaving prison. This study sought consensus from a sample of experts and consumers regarding the attributes of an "optimal model of care" for those with a prior episode of psychosis leaving prison in New South Wales, Australia. Methods: A Delphi method was used, which involved establishing a consensus from a panel of 25 experts and consumers. Following three meetings, 34 model of care attributes and 168 attribute levels were generated for two rounds of online scoring. All attributes and levels were included in the final model if they scored "very important" or "extremely important;" or if the attribute was agreed on by 70% or more of participants. The participant retention rate across scoring rounds was 96% for Round 1 and 84% for Round 2, where consensus was reached. Two "member checking" procedures were undertaken to enhance the integrity of findings: a model "stress test" and an online consumer poll. Results: Thirty-two attributes and 72 attribute levels were included in the final model across four components: pre-release care planning and coordination; treatments in community; diversion from prison; and evaluation. Member checking endorsed a person-centered approach with carers and peer-support central to care. Conclusions: Participants agreed that an optimal model of care should involve a specialized team who works independent of community health service teams to directly deliver certain treatments and services while helping consumers to access external social an economic supports and services.
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Affiliation(s)
- Paul L Simpson
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Stella Settumba
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Armita Adily
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Bianca Ton
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Tony Butler
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
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