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Paradis-Gagné E, Cader M, Holmes D, Bernheim E, Filion J. Exploring Social Interactions in the Context of Justice System Involvement: Perspectives of Patients and Psychiatric Nurses. Clin Nurs Res 2024:10547738241253882. [PMID: 38767250 DOI: 10.1177/10547738241253882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Psychiatric nurses who work with people who are involved with the justice system experience ethical and moral tension arising from their dual role (care and control). This is known to significantly affect the development of a therapeutic relationship between nurses and patients. (a) better understand how justice system involvement affects people living with mental disorders and the nurses who work with them; (b) explore the influence of judiciarization on social interactions between these actors. Grounded theory (GT) was used as the qualitative methodology for this research. Semi-structured interviews were conducted with participants. The study was carried out in three different units of a psychiatric institution: Psychiatric Intensive Care Unit, Emergency Department, and Brief Intervention Unit. A sample of 10 patients and 9 psychiatric nurses was recruited (n = 19). Theoretical sampling was used to recruit participants. We followed the iterative steps of qualitative GT analysis (open coding, axial coding, constant comparison, and modelization). Three main themes emerged from the qualitative analysis: (a) Experience of Justice System Involvement, (b) Crisis, (c) Relational Aspects and Importance of the Approach. These results will inform nurses and healthcare providers about the impacts of justice system involvement on people living with mental illness and how clinical practices can be better adapted to this population with complex health needs.
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Alon N, Macrynikola N, Jester DJ, Keshavan M, Reynolds CF, Saxena S, Thomas ML, Torous J, Jeste DV. Social determinants of mental health in major depressive disorder: Umbrella review of 26 meta-analyses and systematic reviews. Psychiatry Res 2024; 335:115854. [PMID: 38554496 DOI: 10.1016/j.psychres.2024.115854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 04/01/2024]
Abstract
There is a growing recognition of the impact of social determinants of mental health (SDoMHs) on people with, or at risk of, developing serious mental illnesses. Yet it is not known how associations of individual SDoMHs with risk for major depressive disorder (MDD) vary and roughly compare with one another. Following PRISMA guidelines, this umbrella review included 26 meta-analyses and systematic reviews that reported odds ratios, effect sizes, and/or pooled prevalence rates of MDD in samples with versus without specified SDoMHs. Childhood emotional, physical, or sexual abuse and neglect; intimate partner violence in females; and food insecurity were significantly associated with increased risk of MDD, with medium effect sizes. Natural disasters, terrorist acts, and military combat during deployment had small-size adverse effects, and homelessness, incarceration, and migration were associated with significantly elevated prevalence of MDD. Conversely, higher levels of parental care were significantly associated with reduced risk of MDD with medium effect sizes. Evidence supports the use of certain interventions at the individual and community level that can reduce the impact of these factors and promote health, although much more research is warranted in this area along with meaningful healthcare and societal policies to accomplish this goal.
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Affiliation(s)
- Noy Alon
- Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Psychiatry, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Natalia Macrynikola
- Department of Psychiatry, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Dylan J Jester
- Women's Operational Military Exposure Network Center of Excellence (WOMEN CoE), VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Matcheri Keshavan
- Department of Psychiatry, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | - Shekhar Saxena
- Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Michael L Thomas
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - John Torous
- Department of Psychiatry, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Dilip V Jeste
- Global Research Network on Social Determinants of Health, La Jolla, CA, USA.
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Luna MJ, Abram KM, Aaby DA, Welty LJ, Teplin LA. Inequities in Mental Health Services: A 16-Year Longitudinal Study of Youth in the Justice System. J Am Acad Child Adolesc Psychiatry 2024; 63:422-432. [PMID: 37516236 PMCID: PMC10818024 DOI: 10.1016/j.jaac.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 06/30/2023] [Accepted: 07/20/2023] [Indexed: 07/31/2023]
Abstract
OBJECTIVE To examine: (1) if youth who have mental health disorders receive needed services after they leave detention-and as they age; and (2) inequities in service use, focusing on demographic characteristics and type of disorder. METHOD We used data from the Northwestern Juvenile Project, a longitudinal study of 1,829 youth randomly sampled from detention in Chicago, Illinois in 1995. Participants were re-interviewed up to 13 times through 2015. Interviewers assessed disorders using structured diagnostic interviews and assessed service use using the Child and Adolescent Service Assessment and the Services Assessment for Children and Adolescents. RESULTS Less than 20% of youth who needed services received them, up to median age 32 years. Female participants with any disorder had nearly twice the odds of receiving services compared with male participants (OR: 1.82; 95% CI: 1.41, 2.35). Compared with Black participants with any disorder, non-Hispanic White and Hispanic participants had 2.14 (95% CI: 1.57, 2.90) and 1.50 (95% CI: 1.04, 2.15) times the odds of receiving services. People with a disorder were more likely to receive services during childhood (< age 18) than during adulthood (OR: 2.29; 95% CI: 1.32, 3.95). Disorder mattered: participants with an internalizing disorder had 2.26 times and 2.43 times the odds of receiving services compared with those with a substance use disorder (respectively, 95% CI: 1.26, 4.04; 95% CI: 1.49, 3.97). CONCLUSION Few youth who need services receive them as they age; inequities persist over time. We must implement evidence-based strategies to reduce barriers to services.
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Affiliation(s)
- María José Luna
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Karen M Abram
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - David A Aaby
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Leah J Welty
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Linda A Teplin
- Northwestern University Feinberg School of Medicine, Chicago, Illinois.
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Wood LL, Barrenger S, Bonfine N. Contextual Factors of Mental Health Crisis Calls to Law Enforcement: A Brief Report. Community Ment Health J 2024; 60:403-409. [PMID: 37768479 DOI: 10.1007/s10597-023-01185-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023]
Abstract
Law enforcement officers are frequent first responders to people experiencing mental health or suicide crises. Yet, as communities consider expanding crisis response options, we know very little about the nature of these calls that could inform decision making about which crisis response is best suited for the situation. This study is an exploratory, descriptive assessment of contextual factors, both individual and situational, of mental health and suicide crisis calls. Our dataset includes 166 calls to 9-1-1 related to a mental health emergency or suicide crisis. The majority were calls related to suicide (125 calls, 75%), which included more contextual factors than mental health crisis calls. Most calls resulted in the subject being transferred to the local emergency department (60%) or were resolved on scene (12%). Police use of force was rare, and no arrests were reported. The implications of these findings for communities developing alternatives to law enforcement crisis response are discussed.
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Affiliation(s)
- Leslie L Wood
- Department of Psychiatry, Northeast Ohio Medical University, Rootstown, OH, USA.
- Department of Sociology and Criminology, Kent State University, Kent, OH, USA.
| | - Stacey Barrenger
- Department of Psychiatry, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Natalie Bonfine
- Department of Psychiatry, Northeast Ohio Medical University, Rootstown, OH, USA
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Zarzar TR, Pruette ME. Development of a Medical Student Elective in Correctional Psychiatry with a Focus on Structural Competency. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2024; 48:106-107. [PMID: 36788194 DOI: 10.1007/s40596-023-01756-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Affiliation(s)
- Theodore R Zarzar
- University of North Carolina School of Medicine, Chapel Hill, NC, USA.
| | - Megan E Pruette
- University of North Carolina School of Medicine, Chapel Hill, NC, USA
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Pro G, Horton H, Tody B, Gu M, Washington T, Williams A, Gorvine MM, Johnson O, Lovelady N, Jackson T, Ray A, Montgomery B, Zaller N. National and state-level trends in the availability of mental health treatment services tailored to individuals ordered to treatment by a court: United States, 2016, 2018, and 2020. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-023-02589-8. [PMID: 38193943 DOI: 10.1007/s00127-023-02589-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/30/2023] [Indexed: 01/10/2024]
Abstract
PURPOSE We sought to identify trends and characteristics associated with the availability of tailored mental health services for individuals involved in the criminal justice system and ordered to treatment by a court, nationally in the US and by state. METHODS We used National Mental Health Services Survey to identify outpatient mental health treatment facilities in the US (2016 n = 4744; 2018 n = 4626; 2020 n = 4869). We used clustered multiple logistic regression to identify changes over time as well as facility- and state-level factors associated with the availability of specialty court-ordered services. RESULTS Slightly more than half of the outpatient mental health treatment facilities offered specialized services for individuals ordered to treatment by a court, with wide variation between states. Nationally, there was a significant increase in the odds of offering court-ordered treatment in 2020 compared to 2016 (aOR = 1.16, 95% CI = 1.06-1.27, p < 0.01). Notable associations included offering integrated substance use treatment (versus none, aOR = 2.95, 95% CI = 2.70-3.22, p < 0.0001) and offering trauma therapy (versus none, aOR = 2.05, 95% CI = 1.85-2.27, p < 0.0001). CONCLUSION The availability of mental health services for individuals ordered to treatment by a court is growing nationally but several states are lagging behind. Court ordered treatment is a promising strategy to improve health and reduce reliance on the carceral system as a healthcare provider. At the same time, we express caution around disparities within behavioral health courts and advocate for equity in access to incarceration alternatives.
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Affiliation(s)
- George Pro
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
| | - Heather Horton
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Brooklyn Tody
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Mofan Gu
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Taylor Washington
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Ashley Williams
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Margaret M Gorvine
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - O'Dell Johnson
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Nakita Lovelady
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Timikia Jackson
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Azizi Ray
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
| | - Brooke Montgomery
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Nick Zaller
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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Lawson SG, Foudray CMA, Lowder EM, Ray B, Carey KL. The role of co-occurring disorders in criminal recidivism and psychiatric recovery among adults with opioid use disorder and criminal-legal involvement: A statewide retrospective cohort study. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 156:209192. [PMID: 37866440 DOI: 10.1016/j.josat.2023.209192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/25/2023] [Accepted: 10/10/2023] [Indexed: 10/24/2023]
Abstract
INTRODUCTION Individuals with opioid use disorder (OUD) in the criminal-legal system commonly present co-occurring mental health disorders. However, evidence-based treatment for high-risk populations such as those with co-occurring disorders is often unavailable within jails and prisons. Coordination of timely and affordable access to behavioral health treatment following incarceration is critical to address the multidimensional needs of people with co-occurring needs. However, the role of co-occurring disorders among adults with OUD and criminal-legal involvement who are accessing community-based treatment is understudied. METHODS This retrospective cohort study investigated community and recovery outcomes among 2039 adults with OUD and criminal-legal involvement enrolled in a statewide forensic treatment initiative between October 2015 to March 2018. Using court records and clinical data, we assessed the impact of co-occurring OUD and mental health disorders on criminal recidivism and psychiatric recovery and the moderating role of co-occurring disorders on the relationship between community-based treatment and these outcomes. RESULTS We found that 47 % of those with OUD also had an underlying mental health disorder. Co-occurring OUD and mental health disorders predicted higher rates of recidivism during the early stages of treatment. Furthermore, group and individual therapy services were associated with lower odds of recidivism. A co-occurring disorder was an important predictor of more severe behavioral health needs when exiting community-based services and did moderate the relationship between service utilization-specifically group therapy and substance use outpatient services-and psychiatric recovery (i.e., behavioral health needs at exit). CONCLUSIONS Co-occurring mental health disorders are highly prevalent among adults with OUD who have criminal-legal involvement, but it appears that they can benefit from social support services in the community. Given the multidimensional needs of this high-risk population, criminal-legal stakeholders and community-based clinicians must work in tandem to develop tailored treatment plans that give individuals with co-occurring OUD and mental health disorders the best chance for success post-incarceration rather than a siloed approach to overlapping disorders.
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Affiliation(s)
- Spencer G Lawson
- Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, USA.
| | - Chelsea M A Foudray
- Department of Criminology, Law and Society, George Mason University, Fairfax, VA, USA
| | - Evan M Lowder
- Department of Criminology, Law and Society, George Mason University, Fairfax, VA, USA
| | - Bradley Ray
- Division for Applied Justice Research, RTI International, Research Triangle Park, NC, USA
| | - Kory L Carey
- Indiana Family and Social Services Administration, Indianapolis, IN, USA
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Paradis-Gagné E, Holmes D, Bernheim E, Cader M. The Judiciarization of People Living with Mental Illness: A Grounded Theory on the Perceptions of Persons Involuntary Admitted in Psychiatric Institution. Issues Ment Health Nurs 2023; 44:1200-1208. [PMID: 37913502 DOI: 10.1080/01612840.2023.2265468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
The involvement of people living with mental illness in the judicial process, whether in civil or criminal justice system, is a growing phenomenon that can be defined as judiciarization. Such over-representation of people with mental illness in the justice system is related to several issues, including stigma, experienced coercion, loss of autonomy and social isolation. To explore this understudied phenomenon in nursing research, we conducted a study to better understand how judiciarization affects people living with mental illness. The specific objectives were: 1) to understand how insertion into a judicial process affects people living with mental illness; 2) to explore the perception of these people and their lived experience within the judicial trajectory. For the methodology, grounded theory was used as a research model. The theoretical framework of the total institution, proposed by Erwin Goffman, was used conceptually. Participants were recruited from a university-affiliated hospital. Hospitalized persons who had been involved in the justice system were interviewed (n = 10). Three conceptualizing categories were identified through the analyzed data: 1) Diversity of Judicial Trajectories; 2) Involuntary Psychiatric Admission Process; 3) Judiciarization Lived as a Complex Experience. The results of this research can be used to better inform nurses, clinicians, and policy makers about the impacts of the judiciarization of mental illness, and how clinical practices can be better adapted to populations with very complex health needs.
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Affiliation(s)
| | - Dave Holmes
- School of Nursing, University of Ottawa, Ontario, Canada
| | | | - Myriam Cader
- Faculty of Nursing, Université de Montréal, Québec, Canada
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Narita Z, Oh H, Koyanagi A, Wilcox HC, DeVylder J. Association of a History of Incarceration and Solitary Confinement with Suicide-Related Outcomes in a General Population Sample from Two U.S. Cities. Arch Suicide Res 2023:1-12. [PMID: 37937913 DOI: 10.1080/13811118.2023.2279523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
OBJECTIVES To evaluate whether a history of incarceration was associated with increased odds of suicidal ideation and suicide attempts, and to determine if this association was further strengthened when combined with a history of solitary confinement. METHODS We collected cross-sectional data from a general population sample in New York City and Baltimore in March 2017. Participants were categorized based on their history of incarceration and solitary confinement: (1) no incarceration, (2) incarceration-only, and (3) incarceration plus solitary confinement. We compared these three groups, utilizing hierarchical adjustments for sociodemographic factors and adverse childhood experiences. Missing data were accounted for utilizing multiple imputation via chained equation. RESULTS A total of 1221 individuals were analyzed. Those who experienced both incarceration and solitary confinement consistently had higher odds of suicidal ideation (OR, 2.80; 95% CI, 1.43 to 5.48) and suicide attempts (OR, 6.98; 95% CI, 2.77 to 17.61) than never incarcerated individuals. Those who experienced incarceration without solitary confinement had higher odds of suicide attempts (OR, 3.77; 95% CI, 1.35 to 10.56) than never incarcerated individuals, whereas this association was not evident for suicidal ideation. Solitary confinement increased the odds of suicidal ideation even compared to incarceration without solitary confinement (OR, 2.71; 95% CI, 1.09 to 6.74). CONCLUSIONS Our findings support the need to address the higher likelihood of suicide-related outcomes among those in contact with the criminal justice system, and to consider alternatives to solitary confinement.
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Hood BJ, Komoski MC. Treating Trauma in Criminal Justice-Involved with SMI: "Trauma Is a Huge Part of It". Community Ment Health J 2023; 59:1537-1548. [PMID: 37268846 DOI: 10.1007/s10597-023-01141-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 05/17/2023] [Indexed: 06/04/2023]
Abstract
Individuals with serious mental illness are both disproportionately represented in the criminal justice system and more likely to experience correlates with offending (e.g., trauma, substance abuse, and homelessness). Moreover, research using the Adverse Childhood Experiences has found strong correlation between childhood trauma and later negative outcomes, including criminal justice involvement. Despite this, research has yet to examine how trauma can influence treatment decisions for criminal justice-involved individuals with SMI. Using a qualitative approach and in-depth semi-structured interviews with 61 community mental health service providers, the current study addresses this gap in the literature. Findings confirm the high prevalence of trauma in this population as well as suggests a number of key findings for this population including (1) how trauma affects treatment decisions, (2) the existing barriers related to the treatment of trauma, and (3) what service providers need to effectively treat trauma. Implications for policy and practice are extensive.
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Affiliation(s)
- Brittany J Hood
- Texas A&M International University, 5201 University Boulevard, Academic Innovation Center (AIC) 314, Laredo, TX, 78041, USA.
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Pope LG, Patel A, Fu E, Zingman M, Warnock A, Ellis S, Ashekun O, Watson A, Wood J, Compton MT. Crisis Response Model Preferences of Mental Health Care Clients With Prior Misdemeanor Arrests and of Their Family and Friends. Psychiatr Serv 2023; 74:1163-1170. [PMID: 37070262 DOI: 10.1176/appi.ps.20220363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
The overrepresentation of people with serious mental illnesses in the criminal legal system has spurred the development of crisis response models to improve or reduce police response to a mental health crisis. However, limited research has explored preferences for crisis response, and no research in the United States has examined the responses desired by mental health care clients or their family members. This study aimed to understand the experiences of people with serious mental illnesses interacting with police and to learn about their preferences for crisis response models. The authors interviewed 50 clients with serious mental illnesses and a history of arrest who were enrolled in a randomized controlled trial of a police-mental health linkage system, as well as 18 of their family members and friends. Data were coded with deductive and inductive approaches and were grouped into larger themes. Clients and family or friends described needing a calm environment and empathy during a crisis. They selected a nonpolice response as their first choice and response from a crisis intervention team as their last choice among four options, highlighting the importance of trained responders and past negative interactions with police. However, they also noted concerns about safety and the shortcomings of a nonpolice response. These findings build understanding about clients' and family members' preferences for crisis response and highlight concerns that are relevant for policy makers.
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Affiliation(s)
- Leah G Pope
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Pope, Patel, Fu, Warnock, Compton), and New York State Psychiatric Institute (Pope, Compton), New York City; New York University Langone Medical Center, New York City (Zingman); Gateway Behavioral Health Services, Savannah, Georgia (Ellis); DeKalb Community Service Board, Atlanta (Ashekun); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood)
| | - Ashnee Patel
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Pope, Patel, Fu, Warnock, Compton), and New York State Psychiatric Institute (Pope, Compton), New York City; New York University Langone Medical Center, New York City (Zingman); Gateway Behavioral Health Services, Savannah, Georgia (Ellis); DeKalb Community Service Board, Atlanta (Ashekun); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood)
| | - En Fu
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Pope, Patel, Fu, Warnock, Compton), and New York State Psychiatric Institute (Pope, Compton), New York City; New York University Langone Medical Center, New York City (Zingman); Gateway Behavioral Health Services, Savannah, Georgia (Ellis); DeKalb Community Service Board, Atlanta (Ashekun); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood)
| | - Michael Zingman
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Pope, Patel, Fu, Warnock, Compton), and New York State Psychiatric Institute (Pope, Compton), New York City; New York University Langone Medical Center, New York City (Zingman); Gateway Behavioral Health Services, Savannah, Georgia (Ellis); DeKalb Community Service Board, Atlanta (Ashekun); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood)
| | - Amanda Warnock
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Pope, Patel, Fu, Warnock, Compton), and New York State Psychiatric Institute (Pope, Compton), New York City; New York University Langone Medical Center, New York City (Zingman); Gateway Behavioral Health Services, Savannah, Georgia (Ellis); DeKalb Community Service Board, Atlanta (Ashekun); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood)
| | - Samantha Ellis
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Pope, Patel, Fu, Warnock, Compton), and New York State Psychiatric Institute (Pope, Compton), New York City; New York University Langone Medical Center, New York City (Zingman); Gateway Behavioral Health Services, Savannah, Georgia (Ellis); DeKalb Community Service Board, Atlanta (Ashekun); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood)
| | - Oluwaytoyin Ashekun
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Pope, Patel, Fu, Warnock, Compton), and New York State Psychiatric Institute (Pope, Compton), New York City; New York University Langone Medical Center, New York City (Zingman); Gateway Behavioral Health Services, Savannah, Georgia (Ellis); DeKalb Community Service Board, Atlanta (Ashekun); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood)
| | - Amy Watson
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Pope, Patel, Fu, Warnock, Compton), and New York State Psychiatric Institute (Pope, Compton), New York City; New York University Langone Medical Center, New York City (Zingman); Gateway Behavioral Health Services, Savannah, Georgia (Ellis); DeKalb Community Service Board, Atlanta (Ashekun); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood)
| | - Jennifer Wood
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Pope, Patel, Fu, Warnock, Compton), and New York State Psychiatric Institute (Pope, Compton), New York City; New York University Langone Medical Center, New York City (Zingman); Gateway Behavioral Health Services, Savannah, Georgia (Ellis); DeKalb Community Service Board, Atlanta (Ashekun); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood)
| | - Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Pope, Patel, Fu, Warnock, Compton), and New York State Psychiatric Institute (Pope, Compton), New York City; New York University Langone Medical Center, New York City (Zingman); Gateway Behavioral Health Services, Savannah, Georgia (Ellis); DeKalb Community Service Board, Atlanta (Ashekun); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood)
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Plummer N, Guardado R, Ngassa Y, Montalvo C, Kotoujian PJ, Siddiqi K, Senst T, Simon K, Acevedo A, Wurcel AG. Racial Differences in Self-Report of Mental Illness and Mental Illness Treatment in the Community: An Analysis of Jail Intake Data. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023; 50:966-975. [PMID: 37733128 PMCID: PMC10543583 DOI: 10.1007/s10488-023-01297-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2023] [Indexed: 09/22/2023]
Abstract
Jails and prisons in the United States house people with elevated rates of mental health and substance use disorders. The goal of this cross-sectional study was to evaluate the frequency of racial/ethnic differences in the self-report of mental illness and psychiatric medication use at jail entry. Our sample included individuals who had been incarcerated between 2016 and 2020 at the Middlesex Jail & House of Correction, located in Billerica, MA. We used data from the "Offender Management System," the administrative database used by the jail containing data on people who are incarcerated, and COREMR, the electronic medical record (EMR) used in the Middlesex Jail & House of Correction. We evaluated two primary outcomes (1) self-reported mental illness history and (2) self-reported use of psychiatric medication, with the primary indicator of interest as race/ethnicity. At intake, over half (57%) of the sample self-reported history of mental illness and 20% reported the use of psychiatric medications. Among people who self-reported a history of mental illness, Hispanic (AOR: 0.73, 95% CI: 0.60-0.90), Black (AOR: 0.52, 95% CI: 0.43-0.64), Asian/Pacific Islander (Non-Hispanic) people (AOR: 0.31, 95% CI: 0.13-0.74), and people from other racial/ethnic groups (AOR: 0.33, 95% CI: 0.11-0.93) all had decreased odds of reporting psychiatric medications. Mental illness was reported in about one-half of people who entered jail, but only 20% reported receiving medications in the community prior to incarceration. Our findings build on the existing literature on jail-based mental illness and show racial disparities in self-report of psychiatric medications in people who self-reported mental illness. The timing, frequency, and equity of mental health services in both the community and the jail setting deserves further research, investment, and improvement.
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Affiliation(s)
- Narcissa Plummer
- Department of Population Health, Northeastern University, Boston, MA USA
| | - Rubeen Guardado
- Division of Geographic Medicine and Infectious Diseases, Department of Medicine, Tufts Medical Center, Boston, MA USA
| | - Yvane Ngassa
- Division of Geographic Medicine and Infectious Diseases, Department of Medicine, Tufts Medical Center, Boston, MA USA
| | - Cristina Montalvo
- Department of Psychiatry, Tufts Medical Center, Boston, MA USA
- Tufts University School of Medicine, Boston, MA USA
| | | | | | | | - Kevin Simon
- Harvard Medical School, Boston, MA USA
- Children’s Hospital, Boston, MA USA
| | - Andrea Acevedo
- Department of Community Health, Tufts University, Medford, MA USA
| | - Alysse G. Wurcel
- Division of Geographic Medicine and Infectious Diseases, Department of Medicine, Tufts Medical Center, Boston, MA USA
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13
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Scanlon F, Morgan RD, Mitchell SM, Bolaños AD, Bartholomew NR. Criminal risk and mental illness in psychiatric inpatient units: An opportunity to provide psychological services for unmet criminogenic needs. Psychol Serv 2023; 20:565-575. [PMID: 34968121 PMCID: PMC9243185 DOI: 10.1037/ser0000612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although the overrepresentation of people with mental illness in the criminal justice system is known, research is needed to identify the frequency of criminal justice involvement and criminogenic treatment needs in inpatient populations to improve continuity of care and access to appropriate treatments. The purpose of this study is to document the frequency of criminal justice involvement among people receiving inpatient community care, as has been done for persons with mental illness in correctional institutions, and to test the association between criminogenic risk and psychiatric symptomatology. The present study uses two samples (n = 94 and n = 142) of adults from two separate acute psychiatric inpatient hospitals in Texas. Data on psychiatric symptoms, mental health history, criminal risk, and criminal justice history were gathered from file review and self-report. Linear and negative binomial regressions were used to test associations of interest. In both samples, the frequency of prior criminal justice involvement was over 50%. The current results indicate there is a significant, positive association between measures of criminal risk and psychiatric symptoms. These findings highlight the need to address the reciprocal association between mental illness and criminal risk among people receiving inpatient psychiatric treatment with appropriate assessment and treatment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Faith Scanlon
- Department of Psychological Sciences, Texas Tech University
| | - Robert D. Morgan
- College of Health and Human Sciences, Southern Illinois University Carbondale
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Jester DJ, Thomas ML, Sturm ET, Harvey PD, Keshavan M, Davis BJ, Saxena S, Tampi R, Leutwyler H, Compton MT, Palmer BW, Jeste DV. Review of Major Social Determinants of Health in Schizophrenia-Spectrum Psychotic Disorders: I. Clinical Outcomes. Schizophr Bull 2023; 49:837-850. [PMID: 37022779 PMCID: PMC10318890 DOI: 10.1093/schbul/sbad023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
BACKGROUND Social determinants of health (SDoHs) are receiving growing attention and are particularly relevant to persons with schizophrenia-spectrum psychotic disorders (SSPDs), considering their heightened risk of comorbidities, cognitive and functional decline, and early mortality. Yet, we did not find any comprehensive review of multiple SDoHs in SSPD. STUDY DESIGN We conducted a scoping review of meta-analyses and systematic reviews of nine major SDoHs in SSPD. STUDY RESULTS Childhood abuse, parental psychopathology, parental communication problems, bullying, and urban settings with lower socioeconomic status were major risk factors for the greater incidence of SSPD and/or worse health. Social network size was inversely associated with overall psychopathology and negative symptoms. Experiences of racial/ethnic discrimination correlated with the prevalence of psychotic symptoms and experiences. Compared to native populations, the risk of psychosis was higher in immigrants, refugees, and asylees. Social fragmentation was associated with an increased prevalence of schizophrenia. Homeless populations had a 30-fold higher prevalence of schizophrenia than the general population. Seriously mentally ill people were 2.7 times more likely to report food insecurity than controls. The prevalence of non-affective psychosis in prisoners was 2.0%-6.5%, compared to 0.3% in the general population. Certain potentially positive factors like family and community resilience remain poorly studied. CONCLUSIONS SDoHs are associated with higher rates of and worse outcomes in SSPD. Well-designed longitudinal studies are needed to understand SDoHs' contribution to health in persons with SSPD, to develop interventions, and to implement changes in clinical care and public health policies that would reduce adverse health impacts of SDoHs. Positive SDoHs deserve greater attention.
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Affiliation(s)
- Dylan J Jester
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Michael L Thomas
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Emily T Sturm
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Philip D Harvey
- Department of Psychiatry, University of Miami Miller School of Medicine, and Research Service, Bruce W. Carter Miami VA Medical Center, Miami, FL, USA
| | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess medical Center and Harvard Medical School, Boston, MA, USA
| | - Beshaun J Davis
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Shekhar Saxena
- Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Rajesh Tampi
- Department of Psychiatry, Creighton University School of Medicine, Omaha, NE, USA
| | - Heather Leutwyler
- Department of Physiological Nursing, University of California, San Francisco, CA, USA
| | - Michael T Compton
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Barton W Palmer
- Department of Psychiatry, University of California, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, Mental Illness Research, Education, and Clinical Center, San Diego, CA, USA
| | - Dilip V Jeste
- Department of Psychiatry, University of California, San Diego, CA, USA
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15
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Han BH, Bronson J, Washington L, Yu M, Kelton K, Tsai J, Finlay AK. Co-occurring Medical Multimorbidity, Mental Illness, and Substance Use Disorders Among Older Criminal Legal System-Involved Veterans. Med Care 2023; 61:477-483. [PMID: 37204150 PMCID: PMC10330246 DOI: 10.1097/mlr.0000000000001864] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
BACKGROUND Older veterans involved in the criminal legal system (CLS) may have patterns of multimorbidity that place them at risk for poor health outcomes. OBJECTIVES To estimate the prevalence of medical multimorbidity (≥2 chronic medical diseases), substance use disorders (SUDs), and mental illness among CLS-involved veterans aged 50 and older. RESEARCH DESIGN Using Veterans Health Administration health records, we estimated the prevalence of mental illness, SUD, medical multimorbidity, and the co-occurrence of these conditions among veterans by CLS involvement as indicated by Veterans Justice Programs encounters. Multivariable logistic regression models assessed the association between CLS involvement, the odds for each condition, and the co-occurrence of conditions. SUBJECTS Veterans aged 50 and older who received services at Veterans Health Administration facilities in 2019 (n=4,669,447). METHODS Mental illness, SUD, medical multimorbidity. RESULTS An estimated 0.5% (n=24,973) of veterans aged 50 and older had CLS involvement. For individual conditions, veterans with CLS involvement had a lower prevalence of medical multimorbidity compared with veterans without but had a higher prevalence of all mental illnesses and SUDs. After adjusting for demographic factors, CLS involvement remained associated with concurrent mental illness and SUD (adjusted odds ratio [aOR] 5.52, 95% CI=5.35-5.69), SUD and medical multimorbidity (aOR=2.09, 95% CI=2.04-2.15), mental illness and medical multimorbidity (aOR=1.04, 95% CI=1.01-1.06), and having all 3 simultaneously (aOR=2.42, 95% CI=2.35-2.49). CONCLUSIONS Older veterans involved in the CLS are at high risk for co-occurring mental illness, SUDs, and medical multimorbidity, all of which require appropriate care and treatment. Integrated care rather than disease-specific care is imperative for this population.
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Affiliation(s)
- Benjamin H. Han
- University of California San Diego Department of Medicine, Division of Geriatrics, Gerontology, and Palliative Care, San Diego, CA
- Veterans Affairs San Diego Healthcare System, Jennifer Moreno Department of Veterans Affairs Medical Center, San Diego, CA
| | - Jennifer Bronson
- National Association of State Mental Health Program Directors Research Institute (NRI), Falls Church, VA
| | - Lance Washington
- National Association of State Mental Health Program Directors Research Institute (NRI), Falls Church, VA
| | - Mengfei Yu
- Center for Innovation to Implementation, VA Palo Alto Healthcare System, Menlo Park, CA
| | - Katherine Kelton
- South Texas Veteran Health Care System, Audie L. Murphy Veteran Hospital San Antonio, TX
| | - Jack Tsai
- School of Public Health, University of Texas Health Science Center at Houston, Houston, TX
| | - Andrea K. Finlay
- Center for Innovation to Implementation, VA Palo Alto Healthcare System, Menlo Park, CA
- National Center on Homelessness Among Veterans, Department of Veterans Affairs
- Schar School of Policy and Government, George Mason University
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Pope LG, Stagoff-Belfort A, Warnock A, de Bibiana JT, Watson AC, Wood J, Compton MT. Competing Concerns in Efforts to Reduce Criminal Legal Contact Among People with Serious Mental Illnesses: Findings from a Multi-City Study on Misdemeanor Arrests. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023; 50:476-487. [PMID: 36717527 PMCID: PMC9886548 DOI: 10.1007/s10488-023-01252-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/15/2023] [Indexed: 02/01/2023]
Abstract
People with serious mental illnesses are disproportionately involved in the criminal legal system, often for low-level, non-violent misdemeanors. This paper examines how decision-makers at different stages of the criminal legal system articulate unique visions of the "best approach" for addressing this problem of over-representation. Focus groups and in-depth interviews were conducted with 94 stakeholders from Atlanta, Chicago, New York City, and Philadelphia to understand how decision-makers from different agencies use and process specific misdemeanor charges in relation to people with serious mental illnesses. Data were analyzed using a thematic approach. The data reveal a series of tensions regarding how criminal legal system stakeholders process people with serious mental illnesses through the misdemeanor system. Three key themes emerged from analysis. The first characterizes the shared commitment across agencies to reducing system contact among people with mental illnesses. The second explores how agencies differ on how to make good on that commitment because of the distinct values and goals they bring to the table. The final theme explores the limits of current approaches to reducing system contact for people with mental illnesses. Findings are discussed in the context of literature on "loose coupling" and the focal concerns framework and demonstrate that decisions about how and when to intervene with people with mental illnesses in the criminal legal system are influenced by the varying orientations, goals, and values of stakeholder agencies. Understanding these core differences is a critical step toward value alignment in strategies to reduce system involvement among people with mental illnesses.
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Affiliation(s)
- Leah G Pope
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
- New York State Psychiatric Institute, New York, NY, USA.
| | | | - Amanda Warnock
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | | | - Amy C Watson
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Jennifer Wood
- Department of Criminal Justice, College of Liberal Arts, Temple University, Philadelphia, PA, USA
| | - Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
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Wood JD, Watson AC, Pope L, Warnock A, Nelson V, Gesser N, Zern A, Stagoff-Belfort A, de Bibiana JT, Compton MT. Contexts shaping misdemeanor system interventions among people with mental illnesses: qualitative findings from a multi-site system mapping exercise. HEALTH & JUSTICE 2023; 11:20. [PMID: 37014478 PMCID: PMC10071260 DOI: 10.1186/s40352-023-00219-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 03/20/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND People with mental illnesses are disproportionately entangled in the criminal legal system. Historically, this involvement has resulted from minor offending, often accompanied by misdemeanor charges. In recent years, policymakers have worked to reduce the footprint of the criminal legal system. This paper seeks to better understand how misdemeanor systems intervene in the lives of people with mental illnesses. METHODS System mapping exercises were conducted with misdemeanor system stakeholders from the jurisdictions of Atlanta, Chicago, Manhattan, and Philadelphia. Narrative detail on decision-making and case processing, both generally and in relation to specific types of behavior, including trespassing, retail theft/shoplifting, and simple assault, were coded and analyzed for thematic patterns. Based on the qualitative analysis, this paper offers a conceptual diagram of contexts shaping misdemeanor system interventions among people with mental illnesses. RESULTS All four sites have been engaged in efforts to reduce the use of misdemeanor charges both generally and in relation to people with mental illnesses. Decision-makers across all sites experience contexts that shape how, when, and where they intervene, which are: (1) law and policy environments; (2) location of the behavior; (3) expectations of stakeholders; (4) knowledge of mental illnesses; and (5) access to community resources. Law and policy environments expand or constrain opportunities for diversion. The location of offending is relevant to who has a stake in the behavior, and what demands they have. Clinical, experiential, and system-level knowledge of mental illnesses inform a chain of decisions about what to do. The capacity to address mental health needs is contingent on access to social services, including housing. CONCLUSION People making decisions along the criminal legal continuum are critical to illuminating the dynamic, inter-related contexts that facilitate and frustrate attempts to address defendants' mental health needs while balancing considerations of public safety. Multi-sector, scenario-based or case study exercises could help identify concrete ways of improving each of the contexts that surround whole-of-system decisions.
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Affiliation(s)
- Jennifer D. Wood
- Department of Criminal Justice, Temple University, Philadelphia, PA USA
| | - Amy C. Watson
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee, WI USA
| | - Leah Pope
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
| | - Amanda Warnock
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
| | - Veronica Nelson
- Department of Criminal Justice, Temple University, Philadelphia, PA USA
| | - Nili Gesser
- Department of Psychology, University of North Dakota, Grand Forks, ND USA
| | - Adria Zern
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
| | | | | | - Michael T. Compton
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
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18
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Baker O, Wellington C, Price CR, Tracey D, Powell L, Loffredo S, Moscariello S, Meyer JP. Experience delivering an integrated service model to people with criminal justice system involvement and housing insecurity. BMC Public Health 2023; 23:222. [PMID: 36732685 PMCID: PMC9892679 DOI: 10.1186/s12889-023-15108-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/20/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND People returning to communities from prison or jail face stressors related to securing housing, including discrimination, restrictions based on prior felony convictions, and limited economic and social resources. Existing housing programs can effectively reduce housing instability but often do not fully address the needs of people involved in the criminal justice system experiencing homelessness who often have co-occurring chronic medical issues, and psychiatric and substance use disorders. METHODS Project CHANGE is an ongoing program to deliver person-centered, integrated care and services to individuals involved with the criminal justice system and experiencing homelessness. Applying a Screening, Brief Intervention, (Referral to) Treatment framework, a comprehensive needs assessment is followed by delivery of intensive housing and vocational case management; and psychiatric, substance use, and medical services in a single location by an interdisciplinary team. Participants are followed with study interviews for 12 months. The current analysis was designed to assess the baseline characteristics and needs of the sample population, and the intensity of contact required for integrated service delivery. RESULTS Between November 2019 and September 2021, 86 participants were enrolled, of whom 64% had been released from prison/jail in the past 6 months; the remainder were on parole, probation, or intensive pretrial supervision. Participants were unstably housed (64%) or residing outdoors (26.7%) or in a shelter (24.4%). Most participants had high medical need and frequent healthcare engagement through outpatient and emergency department visits. Most participants were at-risk for clinical depression, and half were diagnosed with anxiety, dissociative, stress-related, somatoform, and other non-psychotic psychiatric disorders. Over 12-month follow-up, the interdisciplinary team made over 500 contact encounters, over half of which resulted in direct services provided, including obtaining vital documents for homelessness verification, housing applications, and employment coaching. CONCLUSION Navigation of services can be particularly challenging for individuals experiencing criminal justice involvement, homelessness, and co-occurring medical, psychiatric, and substance use issues, which can be addressed holistically in an integrated service model. Integrated service delivery was time-, resource-, and staffing-intensive, and challenged by the COVID-19 pandemic, requiring innovative solutions to sustain participant engagement.
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Affiliation(s)
- Olivia Baker
- Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, USA
| | | | - Carolina R Price
- Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, USA
| | - DeShana Tracey
- Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, USA
| | - Lindsay Powell
- Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, USA
- Yale School of Nursing, New Haven, CT, USA
| | | | | | - Jaimie P Meyer
- Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, USA.
- Yale School of Public Health, Chronic Disease Epidemiology, New Haven, CT, USA.
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Murray CH, Contreras JL, Kelly CH, Padgett DK, Pollack HA. Behavioral Crisis and First Response: Qualitative Interviews with Chicago Stakeholders. Community Ment Health J 2023; 59:77-84. [PMID: 35751789 PMCID: PMC9243918 DOI: 10.1007/s10597-022-00990-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 05/18/2022] [Indexed: 01/07/2023]
Abstract
Improving interactions between first responders and individuals experiencing behavioral crisis is a critical public health challenge. To gain insight into these interactions, key informant qualitative interviews were conducted with 25 Chicago stakeholders. Stakeholders included directors and staff of community organizations and shelters that frequently engage first responders. Interviews included granular depictions related to the expectations and outcomes of 911 behavioral crisis calls, and noted areas requiring improved response. Stakeholders called 911 an average of 2 to 3 times per month, most often for assistance related to involuntary hospitalization. Engagements with first responders included unnecessary escalation or coercive tactics, or conversely, refusal of service. While stakeholders lauded the value of police trained through the city's Crisis Intervention Team program, they emphasized the need for additional response strategies that reduce the role of armed police, and underscored the need for broader social and behavioral health services for individuals at-risk of such crises.
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Affiliation(s)
- Conor H. Murray
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637 USA
- Urban Health Lab, University of Chicago, Chicago, USA
| | - Juan L. Contreras
- Urban Health Lab, University of Chicago, Chicago, USA
- Crown Family School of Social Work Policy and Practice, University of Chicago, 969 E 60th St, Chicago, IL 60637 USA
| | - Caroline H. Kelly
- Urban Health Lab, University of Chicago, Chicago, USA
- Crown Family School of Social Work Policy and Practice, University of Chicago, 969 E 60th St, Chicago, IL 60637 USA
| | - Deborah K. Padgett
- Silver School of Social Work, New York University, 1 Washington Square N, New York, NY 10003 USA
| | - Harold A. Pollack
- Urban Health Lab, University of Chicago, Chicago, USA
- Crown Family School of Social Work Policy and Practice, University of Chicago, 969 E 60th St, Chicago, IL 60637 USA
- Department of Public Health Sciences, University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637 USA
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20
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Compton MT, Zern A, Pope LG, Gesser N, Stagoff-Belfort A, Tan de Bibiana J, Watson AC, Wood J, Smith TE. Misdemeanor Charges Among Individuals With Serious Mental Illnesses: A Statewide Analysis of More Than Two Million Arrests. Psychiatr Serv 2023; 74:31-37. [PMID: 35795979 DOI: 10.1176/appi.ps.202000936] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Reducing the overrepresentation of individuals with serious mental illnesses in the criminal legal system requires a better understanding of the charges for which they are most commonly arrested. This study aimed to compare violent offenses, penal code classifications, Uniform Crime Reporting (UCR) codes, and specific charges in arrests among individuals with and individuals without serious mental illnesses. METHODS The authors analyzed all arrests (N=2,224,847) in New York State during 2010-2013. Medicaid data and the state mental health authority's records were used to create an indicator of serious mental illness for each arrest. RESULTS Among arrests involving individuals with the serious mental illness indicator (N=91,363), 7.3% were for violent offenses, compared with 7.6% of arrests involving individuals without the indicator. Among 10 penal code classifications, class B felonies and class A misdemeanors were more likely in arrests among those with the indicator than among those without it. Of the 14 UCR codes examined, seven were more common in arrests with the serious mental illness indicator. Criminal trespass was among the most common charges in arrests involving individuals with the indicator. CONCLUSIONS Most arrests involving people with serious mental illnesses were for misdemeanors, specifically class A misdemeanors, and this class comprised a larger proportion of arrests for those with the indicator than of arrests for those without it. New approaches are needed to address the situations-usually related to socioeconomic disadvantage-that result in individuals with mental illnesses receiving misdemeanor charges and cycling through the criminal legal system.
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Affiliation(s)
- Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope, Smith); New York State Psychiatric Institute, New York City (Compton, Pope); Department of Psychology, University of North Dakota, Grand Forks (Gesser); Vera Institute of Justice, New York City (Stagoff-Belfort, Tan de Bibiana); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood); New York State Office of Mental Health, Albany (Smith)
| | - Adria Zern
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope, Smith); New York State Psychiatric Institute, New York City (Compton, Pope); Department of Psychology, University of North Dakota, Grand Forks (Gesser); Vera Institute of Justice, New York City (Stagoff-Belfort, Tan de Bibiana); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood); New York State Office of Mental Health, Albany (Smith)
| | - Leah G Pope
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope, Smith); New York State Psychiatric Institute, New York City (Compton, Pope); Department of Psychology, University of North Dakota, Grand Forks (Gesser); Vera Institute of Justice, New York City (Stagoff-Belfort, Tan de Bibiana); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood); New York State Office of Mental Health, Albany (Smith)
| | - Nili Gesser
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope, Smith); New York State Psychiatric Institute, New York City (Compton, Pope); Department of Psychology, University of North Dakota, Grand Forks (Gesser); Vera Institute of Justice, New York City (Stagoff-Belfort, Tan de Bibiana); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood); New York State Office of Mental Health, Albany (Smith)
| | - Aaron Stagoff-Belfort
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope, Smith); New York State Psychiatric Institute, New York City (Compton, Pope); Department of Psychology, University of North Dakota, Grand Forks (Gesser); Vera Institute of Justice, New York City (Stagoff-Belfort, Tan de Bibiana); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood); New York State Office of Mental Health, Albany (Smith)
| | - Jason Tan de Bibiana
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope, Smith); New York State Psychiatric Institute, New York City (Compton, Pope); Department of Psychology, University of North Dakota, Grand Forks (Gesser); Vera Institute of Justice, New York City (Stagoff-Belfort, Tan de Bibiana); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood); New York State Office of Mental Health, Albany (Smith)
| | - Amy C Watson
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope, Smith); New York State Psychiatric Institute, New York City (Compton, Pope); Department of Psychology, University of North Dakota, Grand Forks (Gesser); Vera Institute of Justice, New York City (Stagoff-Belfort, Tan de Bibiana); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood); New York State Office of Mental Health, Albany (Smith)
| | - Jennifer Wood
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope, Smith); New York State Psychiatric Institute, New York City (Compton, Pope); Department of Psychology, University of North Dakota, Grand Forks (Gesser); Vera Institute of Justice, New York City (Stagoff-Belfort, Tan de Bibiana); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood); New York State Office of Mental Health, Albany (Smith)
| | - Thomas E Smith
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope, Smith); New York State Psychiatric Institute, New York City (Compton, Pope); Department of Psychology, University of North Dakota, Grand Forks (Gesser); Vera Institute of Justice, New York City (Stagoff-Belfort, Tan de Bibiana); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, Temple University, Philadelphia (Wood); New York State Office of Mental Health, Albany (Smith)
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21
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Ehntholt A, Frimpong EY, Compton MT, Rowan GA, Ferdousi W, Swetnam H, Chaudhry S, Radigan M, Smith TE, Rotter M. Prevalence and Correlates of Four Social Determinants in a Statewide Survey of Licensed Mental Health Services. Psychiatr Serv 2022; 73:1282-1285. [PMID: 35538747 DOI: 10.1176/appi.ps.202100380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This analysis examined the distribution of four social determinants of health among recipients of state-licensed mental health services and analyzed relationships between determinants and individuals' clinical and demographic characteristics. METHODS With data from the New York State Office of Mental Health 2017 Patient Characteristics Survey (N=103,416), prevalences of four social determinants (education, employment, housing, and criminal legal involvement) among mental health service recipients were described. Results were stratified to explore differences by diagnosis, gender, race and ethnicity, and region of residence. RESULTS High proportions had low education (20.9%), unemployment (79.1%), homelessness (8.2%), and criminal legal involvement (12.2%), surpassing statistics for the general state population. Prevalences of alcohol-related, drug-related, and psychotic disorders were higher among these groups than were prevalences of other diagnoses. People of color and male recipients were overrepresented among those with adverse social determinants. CONCLUSIONS Results highlight the magnitude of social adversity among those receiving mental health services, as well as potential inequities.
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Affiliation(s)
- Amy Ehntholt
- New York State Office of Mental Health, Albany (Ehntholt, Frimpong, Rowan, Ferdousi, Swetnam, Chaudhry, Radigan, Smith, Rotter); New York State Psychiatric Institute, New York City (Ehntholt, Compton, Smith); Vagelos College of Physicians and Surgeons, Columbia University, New York City (Compton); Albert Einstein College of Medicine, New York City (Rotter)
| | - Eric Y Frimpong
- New York State Office of Mental Health, Albany (Ehntholt, Frimpong, Rowan, Ferdousi, Swetnam, Chaudhry, Radigan, Smith, Rotter); New York State Psychiatric Institute, New York City (Ehntholt, Compton, Smith); Vagelos College of Physicians and Surgeons, Columbia University, New York City (Compton); Albert Einstein College of Medicine, New York City (Rotter)
| | - Michael T Compton
- New York State Office of Mental Health, Albany (Ehntholt, Frimpong, Rowan, Ferdousi, Swetnam, Chaudhry, Radigan, Smith, Rotter); New York State Psychiatric Institute, New York City (Ehntholt, Compton, Smith); Vagelos College of Physicians and Surgeons, Columbia University, New York City (Compton); Albert Einstein College of Medicine, New York City (Rotter)
| | - Grace A Rowan
- New York State Office of Mental Health, Albany (Ehntholt, Frimpong, Rowan, Ferdousi, Swetnam, Chaudhry, Radigan, Smith, Rotter); New York State Psychiatric Institute, New York City (Ehntholt, Compton, Smith); Vagelos College of Physicians and Surgeons, Columbia University, New York City (Compton); Albert Einstein College of Medicine, New York City (Rotter)
| | - Wahida Ferdousi
- New York State Office of Mental Health, Albany (Ehntholt, Frimpong, Rowan, Ferdousi, Swetnam, Chaudhry, Radigan, Smith, Rotter); New York State Psychiatric Institute, New York City (Ehntholt, Compton, Smith); Vagelos College of Physicians and Surgeons, Columbia University, New York City (Compton); Albert Einstein College of Medicine, New York City (Rotter)
| | - Hannah Swetnam
- New York State Office of Mental Health, Albany (Ehntholt, Frimpong, Rowan, Ferdousi, Swetnam, Chaudhry, Radigan, Smith, Rotter); New York State Psychiatric Institute, New York City (Ehntholt, Compton, Smith); Vagelos College of Physicians and Surgeons, Columbia University, New York City (Compton); Albert Einstein College of Medicine, New York City (Rotter)
| | - Sahil Chaudhry
- New York State Office of Mental Health, Albany (Ehntholt, Frimpong, Rowan, Ferdousi, Swetnam, Chaudhry, Radigan, Smith, Rotter); New York State Psychiatric Institute, New York City (Ehntholt, Compton, Smith); Vagelos College of Physicians and Surgeons, Columbia University, New York City (Compton); Albert Einstein College of Medicine, New York City (Rotter)
| | - Marleen Radigan
- New York State Office of Mental Health, Albany (Ehntholt, Frimpong, Rowan, Ferdousi, Swetnam, Chaudhry, Radigan, Smith, Rotter); New York State Psychiatric Institute, New York City (Ehntholt, Compton, Smith); Vagelos College of Physicians and Surgeons, Columbia University, New York City (Compton); Albert Einstein College of Medicine, New York City (Rotter)
| | - Thomas E Smith
- New York State Office of Mental Health, Albany (Ehntholt, Frimpong, Rowan, Ferdousi, Swetnam, Chaudhry, Radigan, Smith, Rotter); New York State Psychiatric Institute, New York City (Ehntholt, Compton, Smith); Vagelos College of Physicians and Surgeons, Columbia University, New York City (Compton); Albert Einstein College of Medicine, New York City (Rotter)
| | - Merrill Rotter
- New York State Office of Mental Health, Albany (Ehntholt, Frimpong, Rowan, Ferdousi, Swetnam, Chaudhry, Radigan, Smith, Rotter); New York State Psychiatric Institute, New York City (Ehntholt, Compton, Smith); Vagelos College of Physicians and Surgeons, Columbia University, New York City (Compton); Albert Einstein College of Medicine, New York City (Rotter)
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22
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Myers N, Hutnyan M, Wright G, Lee G, Woodward P, Wilkey J, Young W, Bromley E. Lessons in "Slow" Engagement From Staff and Administrators at a Prebooking Jail Diversion Program. Psychiatr Serv 2022; 73:1117-1122. [PMID: 35414189 DOI: 10.1176/appi.ps.202100317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE In this study, the authors elicited the perspectives of criminal justice and mental health stakeholders about a prebooking jail diversion program, the Judge Ed Emmett Mental Health Diversion Center, serving primarily individuals experiencing chronic homelessness and diagnosed as having a serious mental illness. METHODS The authors analyzed semistructured interviews with 19 participants and observational fieldnotes from 60 hours of ethnographic fieldwork, conducted from January to July 2020 and including five administrative-level meetings. They used qualitative coding to develop themes. Administrative data were also reviewed. RESULTS Engagement of clients in the program was a major theme. Barriers to engagement included clients’ fear of police involvement and strict rules around smoking. Facilitators to engagement included “slow” engagement, or gradual, gentle microengagements over time and across multiple visits, ideally with peer counselors. CONCLUSIONS To promote client use of services at this critical point of care, jail diversion programs might consider ongoing negotiations with clients to balance expectations between the criminal justice and mental health systems of care by using “slow” client engagement, limiting police involvement, and adopting trauma-informed and harm-reduction approaches.
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Affiliation(s)
- Neely Myers
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Wilkey); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); University of Texas Galveston Medical Branch, Galveston (Wright); Los Angeles County Department of Mental Health, Los Angeles (Lee, Woodward); The Harris Center, Houston (Young); Departments of Anthropology and Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (Bromley); U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles (Bromley)
| | - Matthew Hutnyan
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Wilkey); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); University of Texas Galveston Medical Branch, Galveston (Wright); Los Angeles County Department of Mental Health, Los Angeles (Lee, Woodward); The Harris Center, Houston (Young); Departments of Anthropology and Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (Bromley); U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles (Bromley)
| | - Gillian Wright
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Wilkey); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); University of Texas Galveston Medical Branch, Galveston (Wright); Los Angeles County Department of Mental Health, Los Angeles (Lee, Woodward); The Harris Center, Houston (Young); Departments of Anthropology and Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (Bromley); U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles (Bromley)
| | - Garrett Lee
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Wilkey); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); University of Texas Galveston Medical Branch, Galveston (Wright); Los Angeles County Department of Mental Health, Los Angeles (Lee, Woodward); The Harris Center, Houston (Young); Departments of Anthropology and Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (Bromley); U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles (Bromley)
| | - Paula Woodward
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Wilkey); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); University of Texas Galveston Medical Branch, Galveston (Wright); Los Angeles County Department of Mental Health, Los Angeles (Lee, Woodward); The Harris Center, Houston (Young); Departments of Anthropology and Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (Bromley); U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles (Bromley)
| | - Justin Wilkey
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Wilkey); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); University of Texas Galveston Medical Branch, Galveston (Wright); Los Angeles County Department of Mental Health, Los Angeles (Lee, Woodward); The Harris Center, Houston (Young); Departments of Anthropology and Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (Bromley); U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles (Bromley)
| | - Wayne Young
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Wilkey); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); University of Texas Galveston Medical Branch, Galveston (Wright); Los Angeles County Department of Mental Health, Los Angeles (Lee, Woodward); The Harris Center, Houston (Young); Departments of Anthropology and Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (Bromley); U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles (Bromley)
| | - Elizabeth Bromley
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Wilkey); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); University of Texas Galveston Medical Branch, Galveston (Wright); Los Angeles County Department of Mental Health, Los Angeles (Lee, Woodward); The Harris Center, Houston (Young); Departments of Anthropology and Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (Bromley); U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles (Bromley)
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23
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Smith JL, Khatri UG, Olubiyi O, Hadley T, Lim S, Mandell D, Kang-Yi C. Behavioral health service use post-jail release and reduced risk of return to jail. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:3044-3053. [PMID: 35132631 DOI: 10.1002/jcop.22813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 11/05/2021] [Accepted: 01/26/2022] [Indexed: 06/14/2023]
Abstract
This study examined whether behavioral health service use post-jail release was associated with reduced risk of jail reincarceration. The study sample included 20,615 individuals who had behavioral health diagnoses and were released from the Philadelphia County jail. Using administrative records of the county jail and state-, county-, and Medicaid-funded behavioral health service use from 2010 to 2018, we conducted Cox proportional hazard analyses to estimate the association between behavioral health service use post-jail release and the risk of return to jail within 3 years. Nearly 50% of the sample returned to jail within 3 years. Individuals who used behavioral health services were 26%-38% less likely to return to jail within 3 years than were individuals who did not. The study results suggest that connecting individuals with behavioral health services upon release from jail can reduce the risk of repeated jail incarceration.
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Affiliation(s)
- Joseph L Smith
- HealthCore, Inc., Wilmington, Delaware, USA
- College of Population Health, Jefferson University, Philadelphia, Pennsylvania, USA
| | - Utsha G Khatri
- Emergency Medicine, Population Health Science and Policy, Global Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Oluwatoyin Olubiyi
- Philadelphia Department of Public Health, Philadelphia, Pennsylvania, USA
| | - Trevor Hadley
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Suet Lim
- Philadelphia Department of Behavioral Health and Intellectual disAbility Services, Philadelphia, Pennsylvania, USA
| | - David Mandell
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Christina Kang-Yi
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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24
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Parisi A, Wilson AB, Villodas M, Phillips J, Dohler E. A Systematic Review of Interventions Targeting Criminogenic Risk Factors Among Persons With Serious Mental Illness. Psychiatr Serv 2022; 73:897-909. [PMID: 34911352 DOI: 10.1176/appi.ps.202000928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Individuals with serious mental illness are overrepresented in the criminal justice system. Research has found that interventions targeting risk factors for recidivism (i.e., criminogenic risks) reduce justice involvement in the general correctional population. However, more needs to be learned regarding use of these interventions among individuals with serious mental illness. To this end, this systematic review synthesized research on interventions that target criminogenic risk factors and are delivered to justice-involved individuals with serious mental illness. METHODS A systematic search of six computerized bibliographic databases from inception to 2021 yielded 8,360 potentially relevant studies. Title and abstract screening, full-text reviews, and data extraction were performed independently, and discrepancies were resolved through discussion. To identify additional articles meeting inclusion criteria, experts in the field were contacted, and reference-harvesting techniques were used. Study quality was assessed with the Mixed Methods Appraisal Tool. RESULTS Twenty-one studies were identified that evaluated nine interventions delivered to justice-involved individuals with serious mental illness. All identified programs targeted criminogenic risk factors, were group based, and used cognitive-behavioral strategies. Study quality was moderate to high. Interventions were associated with improvements in recidivism, violence, and criminogenic risk factors. CONCLUSIONS This review is the first to evaluate interventions targeting criminogenic risks among justice-involved individuals with serious mental illness. Findings suggest that outcomes associated with these interventions are promising. Given the overrepresentation of persons with serious mental illness in the criminal justice system, these findings provide an important step toward identifying services that curb justice involvement in this population.
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Affiliation(s)
- Anna Parisi
- Center on Mindfulness and Integrative Health Intervention Development, College of Social Work, University of Utah, Salt Lake City (Parisi); School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill (Wilson, Villodas, Phillips, Dohler)
| | - Amy Blank Wilson
- Center on Mindfulness and Integrative Health Intervention Development, College of Social Work, University of Utah, Salt Lake City (Parisi); School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill (Wilson, Villodas, Phillips, Dohler)
| | - Melissa Villodas
- Center on Mindfulness and Integrative Health Intervention Development, College of Social Work, University of Utah, Salt Lake City (Parisi); School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill (Wilson, Villodas, Phillips, Dohler)
| | - Jon Phillips
- Center on Mindfulness and Integrative Health Intervention Development, College of Social Work, University of Utah, Salt Lake City (Parisi); School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill (Wilson, Villodas, Phillips, Dohler)
| | - Ehren Dohler
- Center on Mindfulness and Integrative Health Intervention Development, College of Social Work, University of Utah, Salt Lake City (Parisi); School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill (Wilson, Villodas, Phillips, Dohler)
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25
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Cooper DS, Uppal D, Railey KS, Blank Wilson A, Maras K, Zimmerman E, Bornman J, Shea LL. Policy gaps and opportunities: A systematic review of autism spectrum disorder and criminal justice intersections. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:1014-1031. [DOI: 10.1177/13623613211070341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Autism spectrum disorder prevalence is rising, and as this population enters adulthood, preliminary research has identified high rates of contact with the criminal justice system. Policy and programmatic reform are crucial given reported negative and violent outcomes for autistic individuals when encountering the criminal justice system. Given the size and scope of the entire criminal justice system, identifying priorities and opportunities for change is critical, and must be rooted in evidence-based findings to maximize impact and scalability. This article provides a systematic review of the literature on autism spectrum disorder and criminal justice system intersections, analyzed through a convergent qualitative synthesis. As the extant literature is diverse and employs a variety of study methods, this review allows for an analysis across study types. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis structure was utilized and captured 89 total articles from six databases. Studies are grouped by the Sequential Intercept Model, which offers a framework for analyzing criminal justice system dimensions, and informs where research at the intersection of autism spectrum disorder and the criminal justice system is most prevalent. Themes were identified at each intercept and described through key study findings to articulate implications and guidance for policy, practice, and future research to promote equitable justice for autistic individuals. Lay abstract The number of people with autism spectrum disorder has increased, and as this population ages, research is showing high rates of contact with the criminal justice system among this group. Social and communication differences that autistic individuals experience can act as a risk factor during these interactions, as shown by public reports of negative and violent encounters between autistic individuals and the law enforcement. There is a clear need for evidence-based strategies to reduce high rates of contact and to improve outcomes when an interaction occurs. This article provides a systematic review of research on autism spectrum disorder and criminal justice system to compile this evidence base. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis structure was used to identify 89 articles after searching six databases. The Sequential Intercept Model describes the criminal justice system as different stages, or intercepts, that are connected, and the Sequential Intercept Model serves as an overall framework to organize the included articles. Articles were analyzed to identify research themes at each intercept, which offer guidance for policy and program changes that support equitable justice for autistic individuals.
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Affiliation(s)
| | - Disha Uppal
- A.J. Drexel Autism Institute, Drexel University, USA
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26
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Supporting Mental Health Recovery, Citizenship, and Social Justice. Community Ment Health J 2022; 58:11-19. [PMID: 34716831 DOI: 10.1007/s10597-021-00900-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 09/25/2021] [Indexed: 10/19/2022]
Abstract
Individuals with serious mental illness (SMI) have historically experienced stigma and marginalization. Mental health providers are well positioned to engage in social justice agendas geared at supporting the civil rights of those with SMI, and ultimately helping open doors to the full rights of participation in the community. By engaging and partnering in a mental health recovery and strengths-based orientation, leaders in these settings have the capacity to influence micro-, meso, and macro-systems. This can shed light on mechanisms to build on the strengths, capabilities, and hopes of individuals to live lives of meaning as they so define, with equal access to resources and rights, within communities of their choice. The article articulates an integrated application of these concepts for embracing and utilizing the concepts of mental health recovery, citizenship, and social justice in public mental health. Additionally, specific examples and practical applications are offered within the context of an inpatient setting and a community setting.
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27
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Abstract
The overrepresentation of people of color and individuals with serious mental illnesses across all levels of the criminal legal system results from the effects of social and economic forces, including social determinants of health and behavioral health, as well as systemic racism. Conversely, criminal legal contact creates and exacerbates these social stresses, with associated consequences to general medical and behavioral health. In this column, the authors explore the relationship between social determinants of health and criminal legal contact through the lens of recent literature on criminal recidivism and describe the ways in which criminal legal contact is itself a social determinant that drives mental health outcomes.
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Affiliation(s)
- Merrill Rotter
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York City (Rotter); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton). Ruth S. Shim, M.D., M.P.H., and Michael T. Compton, M.D., M.P.H., are editors of this column
| | - Michael Compton
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York City (Rotter); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton). Ruth S. Shim, M.D., M.P.H., and Michael T. Compton, M.D., M.P.H., are editors of this column
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Vinson SY, Dennis AL. Systemic, Racial Justice-Informed Solutions to Shift "Care" From the Criminal Legal System to the Mental Health Care System. Psychiatr Serv 2021; 72:1428-1433. [PMID: 33979203 DOI: 10.1176/appi.ps.202000735] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The current configuration and function of U.S. societal structures drives the overrepresentation of people with serious mental illness in the criminal legal system. Although the causes are multifactorial, the mental health system poorly serves those at highest risk of criminal legal system involvement. The growth of the mental health evidence base regarding the social determinants of mental health has ushered in greater understanding of their central role in the promotion and maintenance of mental illness and health. These academic strides, however, have failed to translate into widespread care and payment policy changes. Additionally, as is the case in the criminal legal system, structural racism shapes people's experiences in the mental health care system, contributing to inequitable mental health outcomes for persons with severe mental illness from racial and ethnic minority groups. This is a critical consideration for the population involved in the criminal legal system: Black and Brown people make up more than half of those incarcerated in the United States (despite comprising just 32% of the total population). In the absence of an intersectional, antiracist, structurally informed approach, any attempt by the mental health care system to stem the overrepresentation of people with serious mental illness in the criminal legal system will fail. This article provides an overview of the current mental health care system's shortcomings in serving this population. It proposes concrete steps to address these shortcomings, with a special focus on race and social determinants of health.
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Affiliation(s)
- Sarah Y Vinson
- Department of Psychiatry and Behavioral Sciences, Morehouse School of Medicine, and Lorio Forensics, Atlanta (Vinson); University of Georgia School of Law, Athens (Dennis)
| | - Andrea L Dennis
- Department of Psychiatry and Behavioral Sciences, Morehouse School of Medicine, and Lorio Forensics, Atlanta (Vinson); University of Georgia School of Law, Athens (Dennis)
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29
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Watson AC, Pope LG, Compton MT. Police Reform From the Perspective of Mental Health Services and Professionals: Our Role in Social Change. Psychiatr Serv 2021; 72:1085-1087. [PMID: 33887954 DOI: 10.1176/appi.ps.202000572] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Calls to defund and reform police agencies have been emphasized in recent public discourse. Demands range from shuttering police agencies to shifting resources and responsibility for responding to noncriminal social and behavioral health vulnerabilities to the health and social services sector. This Open Forum discusses how police officers became primary responders to behavioral health concerns, how this arrangement disproportionately and negatively affects communities of color, and several solutions to these circumstances. The mental health field must advocate for the policies and resources needed to address urgent mental health needs and crisis response. Several conditions for successful outcomes that do not further compound racial inequities are discussed.
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Affiliation(s)
- Amy C Watson
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Research Foundation for Mental Hygiene (Pope), New York State Psychiatric Institute (Compton), and Columbia University Vagelos College of Physicians and Surgeons (Pope, Compton), New York City
| | - Leah G Pope
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Research Foundation for Mental Hygiene (Pope), New York State Psychiatric Institute (Compton), and Columbia University Vagelos College of Physicians and Surgeons (Pope, Compton), New York City
| | - Michael T Compton
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Research Foundation for Mental Hygiene (Pope), New York State Psychiatric Institute (Compton), and Columbia University Vagelos College of Physicians and Surgeons (Pope, Compton), New York City
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30
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Shea LL, Cooper D, Wilson AB. Preventing and improving interactions between autistic individuals and the criminal justice system: A roadmap for research. Autism Res 2021; 14:2053-2060. [PMID: 34402601 DOI: 10.1002/aur.2594] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 11/06/2022]
Abstract
Researchers have identified that autistic individuals are encountering the criminal justice system as victims, offenders, and witnesses at high rates. The prevalence of autism spectrum disorder (ASD) is increasing and generating a comprehensive approach to addressing criminal justice system involvement among autistic individuals is a timely and urgent need. Revisions to an established framework generated for use among individuals with mental health diagnoses, the sequential Intercept Model (SIM), were produced by an international consortium of interdisciplinary stakeholders presenting a new opportunity to identify gaps in ASD research and generate preventive solutions across the criminal justice system. The revised SIM maps each criminal justice system component, or Intercept, and includes paths for the experiences of autistic individuals as victims or witnesses to crimes as well as offenders to catalyze new and interdisciplinary research, policy, and practice efforts. As the field of ASD research continues to grow, the revised SIM is a promising pathway to avoiding siloed research approaches, including diverse autistic voices, and contributing to international dialogue about criminal justice reform at a critical juncture. LAY SUMMARY: Autistic individuals are encountering the criminal justice system as victims, offenders, and witnesses at high rates. A revised version of the SIM generated by an international consortium provides a cohesive framework to ensure research focused on this topic extends across the criminal justice system. Preventing and improving interactions between autistic individuals and the criminal justice system is an urgent research, policy, and practice need.
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Affiliation(s)
- Lindsay Lawer Shea
- Policy and Analytics Center, A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | - Dylan Cooper
- Policy and Analytics Center, A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | - Amy Blank Wilson
- School of Social Work, University of North Carolina Chapel Hill, Chapel Hill, North Carolina, USA
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Hoge SK, Bonnie RJ. A New Commitment Pathway for Offenders With Serious Mental Illness: Expedited Diversion to Court-Ordered Treatment. Psychiatr Serv 2021; 72:969-971. [PMID: 33334155 DOI: 10.1176/appi.ps.202000436] [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: 11/30/2022]
Abstract
The authors propose a new form of civil commitment that would benefit individuals with serious mental illness involved with the criminal justice system. This population has complex needs rooted in comorbid conditions, alienation from treatment and support systems, and poor access to care. Although many dollars are spent on costly assessments and hospitalization of jail detainees with serious mental illness to ensure that they are competent to stand trial, these detainees typically do not receive adequate services during incarceration or after release and recidivate at high rates. The proposed commitment pathway would expeditiously divert offenders with serious mental illness into treatment, providing services under court supervision while avoiding unnecessary and often fruitless interactions with the criminal justice system.
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Affiliation(s)
- Steven K Hoge
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York City (Hoge); Institute of Law, Psychiatry and Public Policy, University of Virginia, Charlottesville (Bonnie)
| | - Richard J Bonnie
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York City (Hoge); Institute of Law, Psychiatry and Public Policy, University of Virginia, Charlottesville (Bonnie)
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Abstract
LEARNING OBJECTIVE After participating in this activity, learners should be better able to:• Assess characteristics of forensic assertive community treatment programs. ABSTRACT Forensic assertive community treatment (FACT) has emerged internationally as an intervention strategy for people with serious mental disorders who are involved with the criminal justice system. Studies to date have shown marked variability, however, in FACT program design and operation. Based upon a literature review and relevant experience, the authors present their perspective on the essential elements of FACT. Given that FACT is an adaptation of the evidence-based assertive community treatment (ACT) model, it is recommended that FACT programs maintain a high-fidelity ACT component. FACT programs should also have both mental health and criminal justice admission criteria because service recipients are involved in both service systems. For optimal effectiveness, FACT team clinicians must partner with criminal justice agencies that provide community-based supervision to their patients. Prospective FACT enrollees should receive a clear explanation of the program, including how their respective mental health and criminal justice service providers will work collaboratively with them to prevent incarceration. FACT programs should also use risk/need assessment to inform treatment planning, evidence-based mental health and community correctional practices to promote both wellness and public safety, and shared training to promote effective collaboration. Additional elements to consider include housing, medical care, and transitional services. These elements are presented and discussed, including a rationale and evidence to support each component. The article concludes with introduction of a FACT fidelity scale, the Rochester Forensic Assertive Community Treatment Scale (R-FACTS). By operationalizing essential FACT elements, the R-FACTS is designed to support FACT program development, implementation, and dissemination in a more consistent and measurable manner.
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Mote J, Fulford D. Now Is the Time to Support Black Individuals in the US Living With Serious Mental Illness-A Call to Action. JAMA Psychiatry 2021; 78:129-130. [PMID: 32678421 DOI: 10.1001/jamapsychiatry.2020.2656] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Jasmine Mote
- Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, Massachusetts
| | - Daniel Fulford
- Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, Massachusetts.,Department of Psychological & Brain Sciences, Boston University, Boston, Massachusetts
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Wilson AB, Ishler KJ, Morgan R, Phillips J, Draine J, Farkas KJ. Examining Criminogenic Risk Levels Among People with Mental Illness Incarcerated in US Jails and Prisons. J Behav Health Serv Res 2020:10.1007/s11414-020-09737-x. [PMID: 33155072 PMCID: PMC10016026 DOI: 10.1007/s11414-020-09737-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2020] [Indexed: 11/24/2022]
Abstract
This study examines criminogenic risk levels of individuals with serious mental illness (SMI) involved in the justice system compared to justice-involved individuals without mental illness. The sample (N = 436) consisted of ninety-three individuals with SMI incarcerated in a county jail in a mid-size Midwest city, 217 individuals with SMI incarcerated in a state prison in the US Northeast, and 126 individuals without mental illness incarcerated in a state prison in the US Southwest. Results indicated that people with SMI incarcerated in jail and prison had higher overall criminal risk levels than prison inmates without mental illness. Results further demonstrated that, on average, higher percentages of persons with SMI had high/very high criminogenic risk scores. Finally, we noted that persons with SMI scored higher on most of the eight criminogenic risk domains measured by the Level of Service Inventory. These findings are possibly the most compelling to date in the growing body of literature demonstrating that justice-involved people with SMI have elevated criminogenic risk comparable to or greater than their non-mentally ill peers involved in the justice system. Consequently, treatment programs and interventions for justice-involved individuals with SMI need to explicitly target criminogenic needs into treatment efforts.
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Affiliation(s)
- Amy Blank Wilson
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro St., Campus Box 3550, Chapel Hill, NC, 27599-3550, USA.
| | - Karen J Ishler
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH, 44106, USA
| | - Robert Morgan
- Department of Psychological Sciences, Texas Tech University, PO Box 42051, Lubbock, TX, 79409, USA
| | - Jonathan Phillips
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro St., Campus Box 3550, Chapel Hill, NC, 27599-3550, USA
| | - Jeff Draine
- School of Social Work, College of Public Health Sciences, Temple University, 1301 Cecil B. Moore Ave., Philadelphia, PA, 19122, USA
| | - Kathleen J Farkas
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH, 44106, USA
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The Cal-DSH diversion guidelines. CNS Spectr 2020; 25:701-713. [PMID: 33111661 DOI: 10.1017/s1092852920001819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The Cal-DSH Diversion Guidelines provide 10 general guidelines that jurisdictions should consider when developing diversion programs for individuals with a serious mental illness (SMI) who become involved in the criminal justice system. Screening for SMI in a jail setting is reviewed. In addition, important treatment interventions for SMI and substance use disorders are highlighted with the need to address criminogenic risk factors highlighted.
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Bonfine N, Wilson AB, Munetz MR. Meeting the Needs of Justice-Involved People With Serious Mental Illness: In Reply. Psychiatr Serv 2020; 71:876-877. [PMID: 32741334 DOI: 10.1176/appi.ps.71802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lamberti JS, Weisman RL. Meeting the Needs of Justice-Involved People With Serious Mental Illness. Psychiatr Serv 2020; 71:875-876. [PMID: 32741333 DOI: 10.1176/appi.ps.71801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- J Steven Lamberti
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York
| | - Robert L Weisman
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York
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