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Ogilvie JM, Tzoumakis S, Thompson C, Allard T, Dennison S, Kisely S, Stewart A. Psychiatric illness and the risk of reoffending: recurrent event analysis for an Australian birth cohort. BMC Psychiatry 2023; 23:355. [PMID: 37221485 DOI: 10.1186/s12888-023-04839-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 05/03/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Psychiatric illness is a well-established risk factor for criminal justice system involvement, but less is known about the relationships between specific psychiatric illnesses and reoffending. Research typically examines reoffending as a single discrete event. We examined the relationship between different psychiatric disorders and types of reoffending while accounting for multiple reoffending events over time. METHODS Data were drawn from a population cohort of 83,039 individuals born in Queensland, Australia, in 1983 and 1984 and followed to age 29-31 years. Psychiatric diagnoses were drawn from inpatient health records and offending information was drawn from court records. Descriptive and recurrent event survival analyses were conducted to examine the association between psychiatric disorders and reoffending. RESULTS The cohort included 26,651 individuals with at least one proven offence, with 3,580 (13.4%) of these individuals also having a psychiatric disorder. Individuals with any psychiatric disorder were more likely to reoffend compared to those without a disorder (73.1% vs. 56.0%). Associations between psychiatric disorders and reoffending varied across age. Individuals with a psychiatric disorder only started to accumulate more reoffending events from ~ 27 years, which accelerated up to age 31 years. There were both specificity and common effects in the associations between different psychiatric disorders and types of reoffending. CONCLUSIONS Findings demonstrate the complexity and temporal dependency of the relationship between psychiatric illness and reoffending. These results reveal the heterogeneity present among individuals who experience psychiatric illness and contact with the justice system, with implications for intervention delivery, particularly for those with substance use disorders.
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Affiliation(s)
- James M Ogilvie
- School of Criminology and Criminal Justice, Griffith University, Mount Gravatt, QLD, Australia.
- Griffith Criminology Institute, Griffith University, Mount Gravatt, QLD, Australia.
| | - Stacy Tzoumakis
- School of Criminology and Criminal Justice, Griffith University, Mount Gravatt, QLD, Australia
- Griffith Criminology Institute, Griffith University, Mount Gravatt, QLD, Australia
| | - Carleen Thompson
- School of Criminology and Criminal Justice, Griffith University, Mount Gravatt, QLD, Australia
- Griffith Criminology Institute, Griffith University, Mount Gravatt, QLD, Australia
| | - Troy Allard
- School of Criminology and Criminal Justice, Griffith University, Mount Gravatt, QLD, Australia
- Griffith Criminology Institute, Griffith University, Mount Gravatt, QLD, Australia
| | - Susan Dennison
- School of Criminology and Criminal Justice, Griffith University, Mount Gravatt, QLD, Australia
- Griffith Criminology Institute, Griffith University, Mount Gravatt, QLD, Australia
| | - Steve Kisely
- Griffith Criminology Institute, Griffith University, Mount Gravatt, QLD, Australia
- School of Medicine, The University of Queensland, St Lucia, QLD, Australia
| | - Anna Stewart
- School of Criminology and Criminal Justice, Griffith University, Mount Gravatt, QLD, Australia
- Griffith Criminology Institute, Griffith University, Mount Gravatt, QLD, Australia
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Macdonald C, Weatherburn D, Butler T, Albalawi O, Greenberg D, Farrell M. Who gets diverted into treatment? a study of defendants with psychosis. PSYCHIATRY, PSYCHOLOGY, AND LAW : AN INTERDISCIPLINARY JOURNAL OF THE AUSTRALIAN AND NEW ZEALAND ASSOCIATION OF PSYCHIATRY, PSYCHOLOGY AND LAW 2023; 31:132-145. [PMID: 38455267 PMCID: PMC10916916 DOI: 10.1080/13218719.2023.2175070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 12/23/2022] [Indexed: 03/09/2024]
Abstract
The current study aimed to advance our understanding of the factors that influence mental health diversion in Local Courts in New South Wales, Australia. Logistic regression was used to systematically identify the factors that are correlated with diversion in a cohort of individuals (N = 7283) diagnosed with psychosis. Those with a substance-induced psychotic disorder were less likely to be diverted than those with an affective psychosis or schizophrenia, after adjusting for age, gender, Indigenous status, offence seriousness, violence and criminal history. Unexpectedly, those with psychotic disorders committing violent or serious offences were more likely to be diverted than those committing non-violent, less serious offences. Legal representation should be provided to all individuals with serious mental illnesses facing criminal charges. The State-wide Community and Court Liaison Service should be expanded to more Local Courts. Further research is required into why Aboriginal defendants with a psychotic illness are less likely to be diverted.
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Affiliation(s)
- Christel Macdonald
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Don Weatherburn
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Tony Butler
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Olayan Albalawi
- Department of Statistic, Faculty of Science, University of Tabuk, Tabuk, Saudi Arabia
| | - David Greenberg
- Justice Health and Forensic Mental Health Network, Sydney, NSW, Australia
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
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Browne CC, Korobanova D, Yee N, Spencer SJ, Ma T, Butler T, Dean K. The prevalence of self-reported mental illness among those imprisoned in New South Wales across three health surveys, from 2001 to 2015. Aust N Z J Psychiatry 2023; 57:550-561. [PMID: 35694738 DOI: 10.1177/00048674221104411] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The prevalence of mental illness among those in prison is much higher than in the community; however, very few studies have examined whether rates have changed over time, in line with increasing self-reported rates in the community. METHODS This study compares the prevalence of self-reported mental illness, self-harm and suicidal thoughts/behaviours, and drug and alcohol use across three waves (2001, 2009 and 2015) of health surveys involving men and women in New South Wales prisons and compared these rates with published community-level findings. RESULTS The prevalence of those reporting any mental health diagnosis increased significantly across the three surveys, even after adjustment for socio-demographic and criminal justice variables that also changed over time. Individuals surveyed in 2015 were more likely to report a mental health diagnosis than those surveyed in 2001 (adjusted odds ratio = 2.66, 95% confidence interval = [2.16, 3.27]). The prevalence of self-harm and suicidal thoughts and behaviours remained stable across the three surveys, while self-reported regular drug use decreased over the period. Women experienced a far greater burden of mental illness than men across all three surveys and experienced more growth in the prevalence of most psychiatric disorders. CONCLUSION These findings have important implications for public and prison health systems given the poor social, health and criminal justice outcomes of those imprisoned with mental illness, both in custody and post-release.
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Affiliation(s)
- Christie C Browne
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia
- Justice Health and Forensic Mental Health Network, Matraville, NSW, Australia
| | - Daria Korobanova
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia
- Justice Health and Forensic Mental Health Network, Matraville, NSW, Australia
- Western Sydney Local Health District, North Parramatta, NSW, Australia
| | - Natalia Yee
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia
- Justice Health and Forensic Mental Health Network, Matraville, NSW, Australia
| | - Sarah-Jane Spencer
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia
- Justice Health and Forensic Mental Health Network, Matraville, NSW, Australia
| | - Trevor Ma
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia
- Justice Health and Forensic Mental Health Network, Matraville, NSW, Australia
| | - Tony Butler
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
- National Health and Medical Research Council, Centre of Research Excellence in Offender Health, Sydney, NSW, Australia
| | - Kimberlie Dean
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia
- Justice Health and Forensic Mental Health Network, Matraville, NSW, Australia
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4
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Adily A, Albalawi O, Sara G, Kariminia A, Wand H, Allnutt S, Schofield P, Greenberg D, Grant L, Butler T. Mental health service utilisation and reoffending in offenders with a diagnosis of psychosis receiving non-custodial sentences: A 14-year follow-up study. Aust N Z J Psychiatry 2023; 57:411-422. [PMID: 35575185 DOI: 10.1177/00048674221098942] [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: 11/15/2022]
Abstract
OBJECTIVE While psychosis is considered a risk factor for offending, little is reported about mental health service utilisation in offenders with psychosis and its relationship with reoffending. We examined the association between contact with mental health services and reoffending in those diagnosed with psychosis. METHODS We linked health and offending records in New South Wales (Australia) and identified all individuals with a diagnosis of psychosis and a subsequent offence resulting in a non-custodial sentence between 2001 and 2012. We examined the incidence and risk factors for reoffending, and time to reoffending between 2001 and 2015 using Cox regression and Kaplan-Meier survival methods. We specifically examined the association between clinical contact with community mental health services following the index offence and reoffending. RESULTS Of the 7393 offenders with psychosis, 70% had clinical contact and 49% reoffended. There was a linear relationship between an increased number of clinical contacts and reduced risk of reoffending: those with no clinical contact had more than a fivefold risk of reoffending compared to those with the highest number of contacts (adjusted hazard ratio = 5.78, 95% confidence interval = [5.04, 6.62]). Offenders with substance-related psychosis and those convicted of non-violent offences had fewer clinical contacts and higher rates of reoffending when compared with controls (adjusted hazard ratio = 1.29, 95% confidence interval = [1.13, 1.47] and adjusted hazard ratio = 1.26, 95% confidence interval = [1.18, 1.35], respectively). CONCLUSION This study supports an association between more frequent mental health service use and reduced risk of reoffending. Efforts to enhance mental health service utilisation in those with psychosis who are at a higher risk of reoffending should be promoted.
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Affiliation(s)
- Armita Adily
- School of Population Health, UNSW Sydney, Kensington, NSW, Australia
| | - Olayan Albalawi
- Kirby Institute, UNSW Sydney, Kensington, NSW, Australia.,Department of Statistics, University of Tabuk, Tabuk, Saudi Arabia
| | - Grant Sara
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Azar Kariminia
- Kirby Institute, UNSW Sydney, Kensington, NSW, Australia
| | - Handan Wand
- Kirby Institute, UNSW Sydney, Kensington, NSW, Australia
| | - Stephen Allnutt
- Forensic Mental Health Program, UNSW Sydney, Kensington, NSW, Australia
| | - Peter Schofield
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - David Greenberg
- New South Wales Statewide Community and Court Liaison Service for Justice Health Forensic Mental Health Network and School of Psychiatry, UNSW, Sydney, NSW, Australia
| | - Luke Grant
- Department of Communities and Justice, Sydney, NSW, Australia
| | - Tony Butler
- School of Population Health, UNSW Sydney, Kensington, NSW, Australia
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5
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Ogilvie JM, Allard T, Thompson C, Dennison S, Little SB, Lockwood K, Kisely S, Putland E, Stewart A. Psychiatric disorders and offending in an Australian birth cohort: Overrepresentation in the health and criminal justice systems for Indigenous Australians. Aust N Z J Psychiatry 2022; 56:1587-1601. [PMID: 34881665 DOI: 10.1177/00048674211063814] [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: 11/17/2022]
Abstract
OBJECTIVE Most studies that examine psychiatric illness in people who offend have focused on incarcerated samples, with little known about the larger population of individuals with criminal justice system contact. We examine the overlap between proven offences and psychiatric diagnoses with an emphasis on experiences for Indigenous Australians. METHODS In a population-based birth cohort of 45,141 individuals born in Queensland, Australia, in 1990 (6.3% Indigenous), psychiatric diagnoses were identified from hospital admissions between ages 4/5 and 23/24 years and proven offences were identified from court records (spanning ages 10-24 years). Prevalence rates for offending, psychiatric diagnoses and their overlap were examined for Indigenous and non-Indigenous individuals. Associations between specific psychiatric diagnoses and types of offending were examined using logistic regressions. RESULTS There were 11,134 (24.7%) individuals with a finalised court appearance, 2937 (6.5%) with a diagnosed psychiatric disorder and 1556 (3.4%) with a proven offence and diagnosed psychiatric disorder, with Indigenous Australians significantly overrepresented across all outcomes. Compared with non-Indigenous Australians, Indigenous Australians were younger at their first court finalisation (Cohen's d = -0.62, 95% confidence interval = [-0.67, -0.57]), experienced a higher number of finalisations (d = 0.94, 95% confidence interval = [0.89, 1.00]) and offences (d = 0.64, 95% confidence interval = [0.59, 0.69]) and were more likely to receive custodial (d = 0.41, 95% confidence interval = [0.36, 0.46]) or supervised (d = 0.55, 95% confidence interval = [0.50, 0.60]) sentences. The overlap between offending and psychiatric illness was more pronounced for Indigenous Australians compared with non-Indigenous Australians (14.8% vs 2.7%). Substance use disorders were the most prevalent psychiatric diagnosis among individuals with a court finalisation (9.2%). CONCLUSIONS Indigenous Australians were significantly overrepresented in court finalisations and psychiatric diagnoses. Indigenous Australians with a psychiatric diagnosis were at highest risk of experiencing a court appearance, emphasising the importance of culturally appropriate mental health responses being embedded into the criminal justice system.
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Affiliation(s)
- James M Ogilvie
- Griffith Criminology Institute, Griffith University, Mount Gravatt, QLD, Australia
| | - Troy Allard
- Griffith Criminology Institute, Griffith University, Mount Gravatt, QLD, Australia.,School of Criminology and Criminal Justice, Griffith University, Mount Gravatt, QLD, Australia
| | - Carleen Thompson
- Griffith Criminology Institute, Griffith University, Mount Gravatt, QLD, Australia.,School of Criminology and Criminal Justice, Griffith University, Mount Gravatt, QLD, Australia
| | - Susan Dennison
- Griffith Criminology Institute, Griffith University, Mount Gravatt, QLD, Australia.,School of Criminology and Criminal Justice, Griffith University, Mount Gravatt, QLD, Australia
| | - Simon B Little
- Griffith Criminology Institute, Griffith University, Mount Gravatt, QLD, Australia
| | - Krystal Lockwood
- Griffith Criminology Institute, Griffith University, Mount Gravatt, QLD, Australia.,School of Criminology and Criminal Justice, Griffith University, Mount Gravatt, QLD, Australia
| | - Steve Kisely
- Griffith Criminology Institute, Griffith University, Mount Gravatt, QLD, Australia.,School of Medicine, The University of Queensland, Woolloongabba, QLD, Australia
| | - Ellie Putland
- School of Applied Psychology, Griffith University, Mount Gravatt, QLD, Australia
| | - Anna Stewart
- Griffith Criminology Institute, Griffith University, Mount Gravatt, QLD, Australia.,School of Criminology and Criminal Justice, Griffith University, Mount Gravatt, QLD, Australia
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Tong K, Smith D, Mohan C, Hickey P, Taylor E, McLoughlin L, Kennedy HG, O'Neill C. Psychiatric court reports and diversion outcomes in a remand prison over three years. Ir J Psychol Med 2021:1-11. [PMID: 34629124 DOI: 10.1017/ipm.2021.64] [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: 11/06/2022]
Abstract
OBJECTIVES There has been a notable increase in requests for psychiatric reports from District Courts for persons remanded to Ireland's main remand prison, Cloverhill. We aimed to identify if reports were prepared for persons with severe mental illness and if they led to therapeutic benefits such as diversion to healthcare. Measures of equitability between Cloverhill and other District Courts were explored. METHODS For District Court-requested reports completed by the Prison Inreach and Court Liaison Service (PICLS) at Cloverhill Prison from 2015 to 2017, we recorded clinical variables and therapeutic outcomes such as diversion to inpatient psychiatric settings. RESULTS Of 236 cases, over half were diverted to inpatient or outpatient psychiatric care. One-third of remand episodes were admitted to a psychiatric hospital, mainly in non-forensic settings. Nearly two-thirds had major mental illness, mainly schizophrenia and related conditions. Almost half had active psychosis. Cases in Cloverhill District Court and other District Courts were similarly likely to have active psychosis (47% overall) and hospital admission (33% overall). Voluntary reports were more likely to identify active psychosis, with over 90% diverted to inpatient or outpatient community treatment settings. CONCLUSIONS This is the first large scale study of diversion outcomes following requests for psychiatric advice from District Courts in Ireland. Requests were mainly appropriate. Over half led to diversion from the criminal justice system to healthcare settings. There is a need for a complementary network of diversion initiatives at every stage of the criminal justice system to effectively divert mentally ill individuals to appropriate settings at the earliest possible stage.
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Affiliation(s)
- Kezanne Tong
- Senior Registrar, National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, Ireland
- Prison Inreach and Court Liaison Service, Cloverhill Prison, Dublin, Ireland
| | - Damian Smith
- Consultant Forensic Psychiatrist, National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, Ireland
- Prison Inreach and Court Liaison Service, Cloverhill Prison, Dublin, Ireland
| | - Christopher Mohan
- Registrar, National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, Ireland
| | - Philip Hickey
- Forensic Community Mental Health Nurse, National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, Ireland
- Prison Inreach and Court Liaison Service, Cloverhill Prison, Dublin, Ireland
| | - Enda Taylor
- Forensic Community Mental Health Nurse, National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, Ireland
- Prison Inreach and Court Liaison Service, Cloverhill Prison, Dublin, Ireland
| | - Lisa McLoughlin
- Consultant Forensic Psychiatrist, National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, Ireland
| | - Harry G Kennedy
- Consultant Forensic Psychiatrist and Executive Clinical Director, National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, Ireland
- Clinical Professor in Forensic Psychiatry, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - Conor O'Neill
- Consultant Forensic Psychiatrist, National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, Ireland
- Clinical Senior Lecturer, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
- Prison Inreach and Court Liaison Service, Cloverhill Prison, Dublin, Ireland
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Simpson PL, Settumba S, Adily A, Ton B, Butler T. Defining Optimal Post-prison Care for Those With Psychosis: A Delphi Study. Front Psychiatry 2021; 12:760904. [PMID: 34744842 PMCID: PMC8569300 DOI: 10.3389/fpsyt.2021.760904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 09/20/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Early treatment (considered as early contact with community mental health services) and treatment retention are associated with reduced reoffending among those with a previous diagnosis of psychosis, yet the attributes of care required to best achieve this is largely unexplored for people with psychosis leaving prison. This study sought consensus from a sample of experts and consumers regarding the attributes of an "optimal model of care" for those with a prior episode of psychosis leaving prison in New South Wales, Australia. Methods: A Delphi method was used, which involved establishing a consensus from a panel of 25 experts and consumers. Following three meetings, 34 model of care attributes and 168 attribute levels were generated for two rounds of online scoring. All attributes and levels were included in the final model if they scored "very important" or "extremely important;" or if the attribute was agreed on by 70% or more of participants. The participant retention rate across scoring rounds was 96% for Round 1 and 84% for Round 2, where consensus was reached. Two "member checking" procedures were undertaken to enhance the integrity of findings: a model "stress test" and an online consumer poll. Results: Thirty-two attributes and 72 attribute levels were included in the final model across four components: pre-release care planning and coordination; treatments in community; diversion from prison; and evaluation. Member checking endorsed a person-centered approach with carers and peer-support central to care. Conclusions: Participants agreed that an optimal model of care should involve a specialized team who works independent of community health service teams to directly deliver certain treatments and services while helping consumers to access external social an economic supports and services.
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Affiliation(s)
- Paul L Simpson
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Stella Settumba
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Armita Adily
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Bianca Ton
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Tony Butler
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
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Hwang YIJ, Albalawi O, Adily A, Hudson M, Wand H, Kariminia A, O'Driscoll C, Allnutt S, Grant L, Sara G, Ogloff J, Greenberg DM, Butler T. Disengagement from mental health treatment and re-offending in those with psychosis: a multi-state model of linked data. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1639-1648. [PMID: 32390094 DOI: 10.1007/s00127-020-01873-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 05/02/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIMS Individuals with psychosis are over-represented in the criminal justice system and, as a group, are at elevated risk of re-offending. Recent studies have observed an association between increased contacts with mental health services and reduced re-offending, as well as reduced risk of re-offending in those who are ordered to mental health treatment rather than punitive sanctions. In furthering this work, this study examines the effect of disengagement from mental health treatment on probability of re-offence in offenders with psychosis over time. METHODS Data linkage was conducted with judicial, health and mortality datasets from New South Wales, Australia (2001-2015). The study population included 4960 offenders with psychosis who received non-custodial sentences and engaged with community-based mental health treatment. Risk factors for leaving treatment and/or reconviction were examined using multivariate cox regression. Further, a multi-state model was used to observe the probabilities associated with individuals moving between three states: conviction, disengagement from mental health treatment and subsequent re-conviction. RESULTS A threefold increase was observed in the risk of re-offending for those who disengaged from treatment compared to those who did not (aHR = 2.76, 95% CI 1.65-4.62, p < 0.001). The median time until re-offence was 195 days, with the majority (67%) being convicted within one year of leaving treatment. A higher risk of leaving treatment was found for those born outside of Australia, with substance-related psychosis, and a history of violent offence. CONCLUSIONS The findings argue for an emphasis on continued engagement with mental health services following release for offenders with psychosis and identify subgroups within this population for whom concentrated efforts regarding treatment retention should be targeted.
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Affiliation(s)
- Ye In Jane Hwang
- Kirby Institute, University of New South Wales, Sydney, Australia.
| | - Olayan Albalawi
- Kirby Institute, University of New South Wales, Sydney, Australia.,Department of Statistics, Science Faculty, Tabuk University, Tabuk, Saudi Arabia
| | - Armita Adily
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Malcolm Hudson
- Department of Mathematics and Statistics, Macquarie University, Sydney, Australia
| | - Handan Wand
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Azar Kariminia
- Kirby Institute, University of New South Wales, Sydney, Australia
| | | | - Stephen Allnutt
- Community and Forensic Mental Health Services, New South Wales, Australia
| | - Luke Grant
- Corrective Services New South Wales, Haymarket, Australia
| | - Grant Sara
- Northern Clinical School, University of Sydney, Sydney, Australia
| | - James Ogloff
- Centre for Forensic Behavioural Science, Swinburne University of Technology, Melbourne, Australia
| | - David Mace Greenberg
- Justice Health and Forensic Mental Health Network New South Wales, Matraville, Australia
| | - Tony Butler
- Kirby Institute, University of New South Wales, Sydney, Australia
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9
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Adily A, Albalawi O, Kariminia A, Wand H, Chowdhury NZ, Allnutt S, Schofield P, Sara G, Ogloff JRP, O’Driscoll C, Greenberg DM, Grant L, Butler T. Association Between Early Contact With Mental Health Services After an Offense and Reoffending in Individuals Diagnosed With Psychosis. JAMA Psychiatry 2020; 77:1137-1146. [PMID: 32667664 PMCID: PMC7364339 DOI: 10.1001/jamapsychiatry.2020.1255] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Psychosis is a known risk factor for offending behavior, but little is known about the association between clinical contact with mental health services after an offense and reoffending. OBJECTIVE To examine the association between early contact with mental health services and reoffending after an index offense in individuals with psychosis. DESIGN, SETTING, AND PARTICIPANTS In this cohort study, individuals diagnosed with psychosis before their index offense from July 1, 2001, to December 31, 2012, and who received a noncustodial sentence were identified by linking health and offending databases in New South Wales, Australia. The incidence of and risk factors for reoffending and time to reoffending within 2 years from the index offense were examined using Cox proportional hazards regression and Kaplan-Meier survival estimates. Specifically, the association between contact with mental health services within 30 days after an offense and reoffending was examined. Data were analyzed from July 1, 2019, to March 5, 2020. EXPOSURES Hospital admission, emergency department presentation, and contact with community mental health services associated with psychosis. MAIN OUTCOMES AND MEASURES Reoffending within 2 years of the index offense was compared in individuals with and without clinical contact with mental health services within 30 days after an offense, with adjustment for potential confounders. RESULTS Of the 7030 offenders with psychosis (4933 male [70.2%]; median age at the index offense, 34 [interquartile range, 26-42] years), 2605 (37.1%) had clinical contact with mental health services within 30 days after the index offense. The risk of reoffending was significantly lower in those with vs without clinical contact (adjusted hazard ratio [AHR], 0.83; 95% CI, 0.76-0.91). The risk of reoffending was 30% less in male offenders with 5 or more clinical contacts compared with male offenders with no clinical contact (AHR, 0.71; 95% CI, 0.59-0.84). Reoffending in both male and female offenders was associated with younger age (eg, AHR for male offenders aged <18 years, 3.31 [95% CI, 2.39-4.59]; AHR for female offenders aged <18 years, 2.60 [95% CI, 1.69-3.99]) and offending history (eg, AHR for male offenders with ≥4 prior offenses, 2.28 [95% CI, 1.98-2.64]; AHR for female offenders with ≥4 prior offenses, 2.22 [95% CI, 1.67-2.96]). CONCLUSIONS AND RELEVANCE In this cohort, early and frequent clinical contact with mental health services after an offense in individuals with psychosis was associated with reduced risk of reoffending in this group. More support may be needed for early treatment of those with serious mental illness who are at risk of reoffending.
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Affiliation(s)
- Armita Adily
- Justice Health Research Program, Kirby Institute, University of New South Wales, Sydney, Australia,Kirby Institute, University of New South Wales, Sydney, Australia
| | - Olayan Albalawi
- Kirby Institute, University of New South Wales, Sydney, Australia,Department of Statistics, Science Faculty, Tabuk University, Tabuk, Saudi Arabia
| | - Azar Kariminia
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Handan Wand
- Kirby Institute, University of New South Wales, Sydney, Australia
| | | | - Stephen Allnutt
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Peter Schofield
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | - Grant Sara
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - James R. P. Ogloff
- Centre for Forensic Behavioural Science, Swinburne University of Technology, Alphington, Australia
| | | | - David M. Greenberg
- New South Wales Statewide Community and Court Liaison Service, Justice Health Forensic Mental Health Network, University of New South Wales, Sydney, Australia,School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Luke Grant
- Corrective Services New South Wales, Sydney, Australia
| | - Tony Butler
- Kirby Institute, University of New South Wales, Sydney, Australia
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Abstract
This article reviews the development of forensic psychiatry and mental health services in Australia for the international reader. It covers the legacy of a series of colonial systems that have contributed to a modern health service that interacts with justice systems. The development of relevant legislation, hospitals, prison services, community, and courts services is reviewed. The training and academic development of professionals is covered. Gaps in service delivery and future directions are considered.
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Chowdhury NZ, Albalawi O, Wand H, Adily A, Kariminia A, Allnutt S, Sara G, Dean K, Lappin J, O'Driscoll C, Grant L, Schofield PW, Greenberg D, Butler T. First diagnosis of psychosis in the prison: results from a data-linkage study. BJPsych Open 2019; 5:e89. [PMID: 31608850 PMCID: PMC6854362 DOI: 10.1192/bjo.2019.74] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Psychosis is more prevalent among people in prison compared with the community. Early detection is important to optimise health and justice outcomes; for some, this may be the first time they have been clinically assessed. AIMS Determine factors associated with a first diagnosis of psychosis in prison and describe time to diagnosis from entry into prison. METHOD This retrospective cohort study describes individuals identified for the first time with psychosis in New South Wales (NSW) prisons (2006-2012). Logistic regression was used to identify factors associated with a first diagnosis of psychosis. Cox regression was used to describe time to diagnosis from entry into prison. RESULTS Of the 38 489 diagnosed with psychosis for the first time, 1.7% (n = 659) occurred in prison. Factors associated with an increased likelihood of being diagnosed in prison (versus community) were: male gender (odds ratio (OR) = 2.27, 95% CI 1.79-2.89), Aboriginality (OR = 1.81, 95% CI 1.49-2.19), older age (OR = 1.70, 95% CI 1.37-2.11 for 25-34 years and OR = 1.63, 95% CI 1.29-2.06 for 35-44 years) and disadvantaged socioeconomic area (OR = 4.41, 95% CI 3.42-5.69). Eight out of ten were diagnosed within 3 months of reception. CONCLUSIONS Among those diagnosed with psychosis for the first time, only a small number were identified during incarceration with most identified in the first 3 months following imprisonment. This suggests good screening processes are in place in NSW prisons for detecting those with serious mental illness. It is important these individuals receive appropriate care in prison, have the opportunity to have matters reheard and possibly diverted into treatment, and are subsequently connected to community mental health services on release. DECLARATION OF INTEREST None.
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Affiliation(s)
| | - Olayan Albalawi
- PhD student, Kirby Institute, University of New South Wales, Australia.,Tabuk University, Department of Statistics, Science Faculty, Saudi Arabia
| | - Handan Wand
- Associate Professor, Kirby Institute, University of New South Wales, Australia
| | - Armita Adily
- Research Fellow, Kirby Institute, University of New South Wales, Australia
| | - Azar Kariminia
- Senior Lecturer, Kirby Institute, University of New South Wales, Australia
| | - Stephen Allnutt
- Forensic Psychiatrist and Conjoint Senior Lecturer, University of New South Wales, Australia
| | - Grant Sara
- Director, InforMH, NSW Ministry of Health; and Clinical Associate Professor, University of Sydney Northern Clinical School, Australia
| | - Kimberlie Dean
- Associate Professor, Forensic Mental Health, School of Psychiatry, University of New South Wales, Australia
| | - Julia Lappin
- Psychiatrist, School of Psychiatry, University of New South Wales, Australia
| | - Colman O'Driscoll
- Executive Director, Lifeline Australia; and Conjoint Lecturer, University of New South Wales, Australia
| | - Luke Grant
- Assistant Commissioner, Corrections Strategy & Policy, Corrective Services NSW, Australia
| | - Peter W Schofield
- FRACP Clinical Director, Neuropsychiatry Service, Hunter New England Local Health District; and Conjoint Professor, University of Newcastle, Australia
| | - David Greenberg
- Director, New South Wales State-Wide Clinical Court Liaison Service, New South Wales Justice and Forensic Mental Health Network; and Conjoint Lecturer, University of New South Wales, Australia
| | - Tony Butler
- Program Head, Justice Health Research Program, Kirby Institute, University of New South Wales, Australia
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