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Balfour ME, Carson CA. Crisis Receiving and Stabilization Facilities: Designing Systems for High-Acuity Populations. Psychiatr Clin North Am 2024; 47:511-530. [PMID: 39122343 DOI: 10.1016/j.psc.2024.04.022] [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] [Indexed: 08/12/2024]
Abstract
Crisis facilities provide a safe and therapeutic alternative to emergency departments and jails for people experiencing behavioral health emergencies. Program design should center around customer needs which include individuals and families in crisis and key community stakeholders like first responders. Ideally, a crisis system should be organized into a broad continuum of services that ensures care is provided in the least restrictive setting, even for people with high acuity needs, and stakeholders should have a clear understanding of the capabilities of each component facility and the population it can safely serve. This paper provides a framework to help policymakers achieve this goal.
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Affiliation(s)
- Margaret E Balfour
- Connections Health Solutions, 2802 East District Street, Tucson, AZ 85714, USA; Department of Psychiatry, University of Arizona College of Medicine, Tucson, AZ, USA.
| | - Chris A Carson
- Connections Health Solutions, 2390 East Camelback Road Suite 400, Phoenix, AZ 85016, USA
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2
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Robles-Ramamurthy B, Bath E, Lowenhaupt EA, Tolou-Shams M. Advancing Youth Justice: The Child and Adolescent Psychiatrist's Role. Child Adolesc Psychiatr Clin N Am 2024; 33:397-409. [PMID: 38823812 DOI: 10.1016/j.chc.2024.03.006] [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] [Indexed: 06/03/2024]
Abstract
Child and adolescent psychiatrists (CAPs) play a crucial role beyond the provision of clinical care. CAPs are uniquely placed to understand and help patients navigate the fine line among psychiatric care, health and well-being, and the laws and policies supporting or impairing these processes. Focusing on vulnerable populations, such as legal system impacted youth and families, CAPs can contribute to the ongoing development of a more just and equitable world for the children of today and of tomorrow.
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Affiliation(s)
- Barbara Robles-Ramamurthy
- Department Psychiatry and Behavioral Sciences, University of Texas Health San Antonio, 10004 Wurzbach Road, 283, San Antonio, TX 78230, USA.
| | - Eraka Bath
- Division of Child and Adolescent Psychiatry, UCLA Neuropsychiatric Institute, David Geffen School of Medicine
| | - Elizabeth A Lowenhaupt
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Rhode Island Hospital, 593 Eddy Street, POB-122, Providence, RI 02903, USA
| | - Marina Tolou-Shams
- San Francisco|Weill Institute for Neurosciences, University of California, San Francisco, CA, USA; Zuckerberg San Francisco General Hospital and Trauma Center, 1001 Potrero Avenue, Building 5, Room 7M18, San Francisco, CA 94110, USA
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3
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Bonfine N, Barrenger SL, Munetz MR. Approaching Jail Diversion and Prevention of Criminal Legal System Involvement Simultaneously. Psychiatr Serv 2024; 75:489-491. [PMID: 38050441 DOI: 10.1176/appi.ps.20230218] [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] [Indexed: 12/06/2023]
Abstract
Despite prolific jail diversion initiatives, people with serious mental illness continue to be overrepresented in the criminal legal system. This continued overrepresentation has led to recent calls to address social determinants of health and criminal risk factors rather than to allocate new resources to diverting people from the criminal legal system. This shift toward prevention by addressing social factors that influence health and criminal legal outcomes should occur alongside a continued focus on diversion to understand what works and for whom. An effective, well-funded, and comprehensive community-based mental health services system could serve as the ultimate intercept for preventing criminal legal system involvement.
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Affiliation(s)
- Natalie Bonfine
- Department of Psychiatry, Northeast Ohio Medical University, Rootstown
| | | | - Mark R Munetz
- Department of Psychiatry, Northeast Ohio Medical University, Rootstown
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4
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Petreca VG, Barros JT, Hoblock C, Burgess AW. The Nurse-Police Assistance Crisis Team (N-PACT): A new role for nursing. J Adv Nurs 2024. [PMID: 38225816 DOI: 10.1111/jan.16056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/09/2023] [Accepted: 12/30/2023] [Indexed: 01/17/2024]
Abstract
AIM This study aimed to gain insights into forensic nurses' perspectives and approaches to behavioural crisis situations, comparing them to disciplines traditionally involved in first-line behavioural crisis response. DESIGN This study used a descriptive, qualitative exploratory design and was informed by Systems Theory. METHODS The study was carried in the United States, between 2022 and 2023. Data were gathered through four focus groups: police officers (n = 12), co-response (mental health) clinicians (n = 13), sexual assault nurse examiners (n = 6) and correctional nurses (n = 4). Thematic analysis was performed. REPORTING METHOD The Standards for Reporting Qualitative Research (SRQR) guidelines were used. RESULTS Findings revealed temporal themes in crisis response: (1) Searching for Historical Information; (2) Safety and Acting at the Present Scene; and (3) Future Strategies and Interventions. Common priorities (e.g. safety and de-escalation) were identified across groups. Notably, nurses demonstrated a comprehensive approach, addressing physical and mental health assessments, substance involvement, and physical injury evaluation. CONCLUSION This study proposes the creation of a novel nursing role within first-line multidisciplinary teams (MDTs) for crisis response-the Nurse-Police Assistance Crisis Team (N-PACT). Nurses bring expertise and comprehensive assessment skills to enhance crisis responses, particularly in cases involving mental health emergencies, medical crises, and drug-related incidents. IMPLICATIONS Forensic nurses, with their diverse competencies and comprehensive training, are highly valuable assets within MDTs. Their expertise extends to proficiently conducting mental and physical assessments, ensuring safety and adeptly navigating situations that intersect with the legal system. IMPACT The N-PACT concept can improve outcomes and streamline the allocation of resources, particularly considering the number of police calls involving behavioural crises. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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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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6
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Swanson L, Nelson V, Comartin EB, Kubiak S, Putans L, Hambrick N, Ray B, Tillander L, Washington A, Butkiewicz R, Costello M. Assessing County-Level Behavioral Health and Justice Systems with the Sequential Intercept Model Practices, Leadership, and Expertise Scorecard. Community Ment Health J 2023; 59:578-594. [PMID: 36322279 DOI: 10.1007/s10597-022-01042-5] [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] [Received: 02/18/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022]
Abstract
The Sequential Intercept Model has helped conceptualize interventions for people with serious mental illness in the criminal/legal system. This paper operationalizes the Sequential Intercept Model into a 35-item scorecard of behavioral health and legal practices. Using interviews, survey, and observational methods, the scorecard assesses an exploratory sample of 19 counties over 27 independent data collections. A series of ordinary least squares regression models assessed the predictor scores on four jail outcomes: prevalence of serious mental illness, length of stay, connections to treatment, and recidivism. Increases in pre-booking scores showed significant decreases in jail prevalence of serious mental illness at the p < 0.05 level, and post-booking scores and overall scores showed significant positive associations with connections to treatment at the p < 0.05 level, though these were non-significant after correcting for multiple comparisons. Preliminary findings suggest a combination of practices across the Sequential Intercept Model could have synergistic impacts on key jail diversion outcomes.
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Affiliation(s)
- Leonard Swanson
- Center for Behavioral Health & Justice, Wayne State University, 5447 Woodward Ave., Detroit, MI, 48202, USA.
| | - Victoria Nelson
- Center for Behavioral Health & Justice, Wayne State University, 5447 Woodward Ave., Detroit, MI, 48202, USA
| | - Erin B Comartin
- Center for Behavioral Health & Justice, Wayne State University, 5447 Woodward Ave., Detroit, MI, 48202, USA
| | - Sheryl Kubiak
- Center for Behavioral Health & Justice, Wayne State University, 5447 Woodward Ave., Detroit, MI, 48202, USA
| | - Laine Putans
- Center for Behavioral Health & Justice, Wayne State University, 5447 Woodward Ave., Detroit, MI, 48202, USA
| | - Nanci Hambrick
- Center for Behavioral Health & Justice, Wayne State University, 5447 Woodward Ave., Detroit, MI, 48202, USA
| | - Brad Ray
- Division for Applied Justice Research, RTI International, 3040 Cornwallis Road, Research Triangle Park, NC, 27709, USA
| | - Liz Tillander
- Center for Behavioral Health & Justice, Wayne State University, 5447 Woodward Ave., Detroit, MI, 48202, USA
| | - Aliya Washington
- Center for Behavioral Health & Justice, Wayne State University, 5447 Woodward Ave., Detroit, MI, 48202, USA
| | - Robert Butkiewicz
- Center for Behavioral Health & Justice, Wayne State University, 5447 Woodward Ave., Detroit, MI, 48202, USA
| | - Matthew Costello
- Center for Behavioral Health & Justice, Wayne State University, 5447 Woodward Ave., Detroit, MI, 48202, USA
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7
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Balfour ME, Zeller SL. Community-Based Crisis Services, Specialized Crisis Facilities, and Partnerships With Law Enforcement. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2023; 21:18-27. [PMID: 37205037 PMCID: PMC10172540 DOI: 10.1176/appi.focus.20220074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
How a community responds to behavioral health emergencies is both a public health issue and a social justice issue. Individuals experiencing a behavioral health crisis often receive inadequate care in emergency departments, boarding for hours or days while awaiting treatment. Such crises also account for a quarter of police shootings and 2 million jail bookings per year, and racism and implicit bias magnify these problems for people of color. Fortunately, the new 988 mental health emergency number compounded with police reform movements have created momentum for building behavioral health crisis response systems that deliver comparable quality and consistency of care as we expect for medical emergencies. This paper provides an overview of the rapidly evolving landscape of crisis services. The authors discuss the role of law enforcement and various approaches to lessening the impact on individuals experiencing behavioral health emergencies, especially for historically marginalized populations. The authors provide an overview of the crisis continuum, including crisis hotlines, mobile teams, observation units, crisis residential programs, and peer wraparound services that can help ensure that linkage to aftercare is successful. The authors also highlight opportunities for psychiatric leadership, advocacy, and strategies for creating a well-coordinated crisis system that meets the needs of the community.
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Affiliation(s)
- Margaret E Balfour
- Connections Health Solutions, Phoenix, Arizona, and Department of Psychiatry, University of Arizona, Tucson, Arizona (Balfour); Department of Psychiatry, Vituity, Emeryville, California, and Department of Psychiatry and Neuroscience, University of California, Riverside, Riverside, California (Zeller)
| | - Scott L Zeller
- Connections Health Solutions, Phoenix, Arizona, and Department of Psychiatry, University of Arizona, Tucson, Arizona (Balfour); Department of Psychiatry, Vituity, Emeryville, California, and Department of Psychiatry and Neuroscience, University of California, Riverside, Riverside, California (Zeller)
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8
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Wurcel AG, Kraus C, Johnson O, Zaller ND, Ray B, Spaulding AC, Flynn T, Quinn C, Day R, Akiyama MJ, Del Pozo B, Meyer F, Glenn JE. Stakeholder-engaged research is necessary across the criminal-legal spectrum. J Clin Transl Sci 2022; 7:e5. [PMID: 36755540 PMCID: PMC9879908 DOI: 10.1017/cts.2022.501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 09/23/2022] [Accepted: 11/03/2022] [Indexed: 11/16/2022] Open
Abstract
People with lived experience of incarceration have higher rates of morbidity and mortality compared to people without history of incarceration. Research conducted unethically in prisons and jails led to increased scrutiny of research to ensure the needs of those studied are protected. One consequence of increased restrictions on research with criminal-legal involved populations is reluctance to engage in research evaluations of healthcare for people who are incarcerated and people who have lived experience of incarceration. Ethical research can be done in partnership with people with lived experience of incarceration and other key stakeholders and should be encouraged. In this article, we describe how stakeholder engagement can be accomplished in this setting, and further, how such engagement leads to impactful research that can be disseminated and implemented across disciplines and communities. The goal is to build trust across the spectrum of people who work, live in, or are impacted by the criminal-legal system, with the purpose of moving toward health equity.
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Affiliation(s)
- Alysse G. Wurcel
- Department of Medicine, Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA, USA
| | - Christina Kraus
- Tufts University Medical Student, JCOIN LEAP Scholar, Boston, MA, USA
| | - O’Dell Johnson
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Bradley Ray
- RTI International, Division for Applied Justice Research, 3040 Cornwallis Road, Research Triangle Park, NC27709, USA
| | - Anne C. Spaulding
- Associate Professor of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Tara Flynn
- Assistant Deputy Superintendent Health Services, Norfolk County Sheriff’s Office, Dedham, MA, USA
| | | | - Ronald Day
- The Fortune Society, Vice President of Programs and Research, Long Island City, New York, USA
| | - Matthew J. Akiyama
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Fred Meyer
- Deputy Chief (Retired), Las Vegas Metropolitan Police Department, Las Vegas, NV, USA
| | - Jason E. Glenn
- Department of History and Philosophy of Medicine, University of Kansas Medical Center, Kansas, USA
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Stakeholder Perspectives on Implementing a Police-Mental Health Collaborative to Improve Pathways to Treatment. J Behav Health Serv Res 2022; 49:299-314. [PMID: 35000102 PMCID: PMC8742697 DOI: 10.1007/s11414-021-09782-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2021] [Indexed: 11/16/2022]
Abstract
High rates of criminal justice involvement among individuals with mental illness have led to collaborative efforts between law enforcement agencies and mental health providers to improve crisis responses and pathways to treatment. The development and implementation of these police-mental health collaborations (PMHCs) have received little attention in the literature, but these processes are crucial in understanding feasibility and sustainability. The PMHC discussed here is an interagency effort to identify individuals involved with law enforcement who have unmet behavioral health needs and engage them in services. Perspectives from leaders, service providers, and clients highlight the importance of developing PMHCs that support individuals with serious mental illness at multiple points, from initial crisis to independent management of treatment. In an environment where police responses to individuals with mental health and substance use disorders are increasingly scrutinized, it is critical to highlight and evaluate ways that behavioral health and law enforcement agencies work together to collaboratively address these problems.
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10
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Diriba K, Whitlock E. Deflection to Harm Reduction: Public Health and Public Safety Collaborative Responses to the Overdose Epidemic in the United States. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:321-323. [PMID: 35334488 DOI: 10.1097/phh.0000000000001531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Kabaye Diriba
- National Association of County and City Health Officials, Washington, District of Columbia
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11
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Kamin D, Weisman RL, Lamberti JS. Promoting Mental Health and Criminal Justice Collaboration Through System-Level Partnerships. Front Psychiatry 2022; 13:805649. [PMID: 35178003 PMCID: PMC8844546 DOI: 10.3389/fpsyt.2022.805649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 01/11/2022] [Indexed: 11/22/2022] Open
Abstract
Recent high-profile deaths of unarmed individuals in police custody have raised concerns about the role of police officers in responding to people who are experiencing mental health crises. Of further concern, people with serious mental illness are highly over-represented throughout the entire criminal justice system including within jail, prison and community corrections populations. It is widely accepted that promoting mental health and criminal justice collaboration is a key to addressing these concerns. Promoting effective collaboration is challenging, however, due to fundamental differences in cultures and methods that exist between mental health and criminal justice service providers. To promote effective collaboration between service providers, a conceptual framework was recently published that divides the collaborative process into separate steps and outlines respective responsibilities at each step. Yet optimal collaboration between mental health and criminal justice service providers requires the support of their respective supervisors and agency heads. This paper extends previous work at the service provider level by applying the conceptual framework to promote effective collaboration at the systems level (i.e., between agencies). Barriers to inter-agency collaboration are discussed, and strategies for facilitating collaboration at each step of the collaborative process are presented.
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Affiliation(s)
- Don Kamin
- Institute for Police, Mental Health & Community Collaboration, Rochester, NY, United States
- Monroe County Office of Mental Health, Rochester, NY, United States
| | - Robert L. Weisman
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States
| | - J. Steven Lamberti
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States
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12
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Vaughan AD, Hewitt AN, Verdun-Jones SN, Brink J. A retrospective records study of patterns in mental health and criminal justice service use by people found not criminally responsible on account of mental disorder. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2021; 31:331-342. [PMID: 34525231 DOI: 10.1002/cbm.2216] [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: 11/09/2020] [Accepted: 09/01/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND While the presence or absence of previous healthcare and criminal justice system (CJS) contacts in the histories of mentally ill offenders has been well-studied, the frequency of these contacts and when they occur in the period leading up to an index criminal event has received less research attention. AIMS To explore patterns of healthcare and CJS use in the year prior to a criminal act leading to a Not Criminally Responsible on Account of Mental Disorder (NCRMD) finding in Canada. METHODS In this 3-year retrospective records study, the case files of all patients newly admitted to the British Columbia forensic psychiatric system after a finding of NCRMD between 1st July 2012 and 31st July 2015 were reviewed. Data were extracted on healthcare and CJS use for the 12 months before the act leading to the NCRMD finding. Time-based descriptive statistics and two-step cluster analysis were used to investigate service use patterns. RESULTS Among 94 eligible patients, only four had no service contacts in the year leading up to the index event, leaving 90 in the cohort for further analysis. On average, these 90 patients had seven contacts with health or criminal justice services in the year prior to the index offence. Cluster analysis revealed a high healthcare pathway group who had had many healthcare and few CJS contacts; a limited service user group who had had few contacts of any kind and a heavy service user group who had had a high volume of contacts with both types of service providers. CONCLUSIONS The different patterns of patient contact prior to the index event imply that each practitioner-type has distinct and temporally relevant opportunities to provide preventative interventions to their patients or user groups.
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Affiliation(s)
- Adam D Vaughan
- School of Criminal Justice and Criminology, Texas State University, San Marcos, Texas, USA
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Ashley N Hewitt
- School of Criminal Justice and Criminology, Texas State University, San Marcos, Texas, USA
| | - Simon N Verdun-Jones
- School of Criminology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Johann Brink
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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13
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Folk JB, Kemp K, Yurasek A, Barr-Walker J, Tolou-Shams M. Adverse childhood experiences among justice-involved youth: Data-driven recommendations for action using the sequential intercept model. AMERICAN PSYCHOLOGIST 2021; 76:268-283. [PMID: 33734794 PMCID: PMC8281579 DOI: 10.1037/amp0000769] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Justice-involved youth experience high rates of adverse childhood experiences (ACEs), placing them in great need of behavioral health treatment and risk for continued justice involvement. Policymakers, government agencies, and professionals working with justice-involved youth have called for trauma-informed juvenile justice reform. Yet, there is currently no available review of the literature on ACEs and their impact on justice-involved youths' psychological, legal, and related (e.g., academic) outcomes to rigorously guide such reform efforts. The current systematic scoping review synthesizes existing literature related to the impact of ACEs on justice-involved youth and offers recommendations for data-driven intervention along the Sequential Intercept Model, which describes five different points of justice system contact (i.e., first arrest, court diversion, detention, and community supervision) in which there is opportunity to intervene and improve youth behavioral health, legal, and associated outcomes. Eight unique studies were included in 40 articles examining ACEs among justice-involved youth; 38% were longitudinal or prospective analyses and none were intervention studies. Studies included delinquency (e.g., recidivism; n = 5), psychiatric (n = 4), substance use (n = 3), and other (n = 2; e.g., academic, pregnancy) outcomes, documenting high prevalence of ACEs and significant associations between ACEs and a variety of outcomes. Implications for clinical services (e.g., targeting youth dysregulation and aggression), agency context (e.g., training police officers in trauma-responsive practices), and system-level changes (e.g., intervening at the time of first ACE documentation such as parent's arrest) are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Johanna B Folk
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
| | - Kathleen Kemp
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University
| | - Allison Yurasek
- Department of Health Education and Behavior, University of Florida
| | - Jill Barr-Walker
- Zuckerberg San Francisco General Library, Zuckerberg San Francisco General Hospital
| | - Marina Tolou-Shams
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
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14
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Pinals DA, Callahan L. Evaluation and Restoration of Competence to Stand Trial: Intercepting the Forensic System Using the Sequential Intercept Model. Psychiatr Serv 2020; 71:698-705. [PMID: 32237983 DOI: 10.1176/appi.ps.201900484] [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] [Indexed: 12/01/2022]
Abstract
The sequential intercept model (SIM) is used to reduce the penetration of persons with mental illness and substance use disorders in the criminal legal system. Its framework recommends identifying individuals with mental illness at various decision points of criminal case processing, from arrest to return from incarceration, so that they can be diverted toward treatment rather than permeate deeper into the criminal justice system. Communities frequently use the model to augment and inform jail diversion services. Despite the model's widespread adoption, individuals with serious mental illness, intellectual and developmental disabilities, and disorders affecting neurocognition and behavior are often found ineligible for such diversion because their competence to stand trial (CST) warrants evaluation, which effectively pauses their criminal case processes. If found incompetent to stand trial, these people can be ordered for competence restoration treatment, creating a pathway that is different from jail diversion options. Traditional community mental health services and courts await resolution by the "forensic system" before linking these individuals to needed services, and often these linkages are lacking. This review aims to describe and demystify these forensic processes and to highlight the potential use of the SIM to decrease jail stays and maximize community service connections for individuals with some of the most impairing mental health conditions who are involved in the justice system and for whom diversion is a safe option. The authors offer specific examples of intercept opportunities at each step involved in evaluations of CST and in the competence restoration processes.
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Affiliation(s)
- Debra A Pinals
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor (Pinals); Policy Research Associates, Delmar, New York (Callahan)
| | - Lisa Callahan
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor (Pinals); Policy Research Associates, Delmar, New York (Callahan)
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15
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Bonfine N, Wilson AB, Munetz MR. Meeting the Needs of Justice-Involved People With Serious Mental Illness Within Community Behavioral Health Systems. Psychiatr Serv 2020; 71:355-363. [PMID: 31795858 DOI: 10.1176/appi.ps.201900453] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The overrepresentation of people with serious mental illness in the criminal justice system is a complex problem. A long-standing explanation for this phenomenon, the criminalization hypothesis, posits that policy changes that shifted the care of people with serious mental illness from psychiatric hospitals to an underfunded community treatment setting resulted in their overrepresentation within the criminal justice system. This framework has driven the development of interventions to connect people with serious mental illness to needed mental health and substance use treatment, a critical component for people in need. However, the criminalization hypothesis is a limited explanation of the overrepresentation of people with serious mental illness in the criminal justice system because it downplays the social and economic forces that have contributed to justice system involvement in general and minimizes the complex clinical, criminogenic, substance use, and social services needs of people with serious mental illness. A new approach is needed that focuses on addressing the multiple factors that contribute to justice involvement for this population. Although the authors' proposed approach may be viewed as aspirational, they suggest that an integrated community-based behavioral health system-i.e., intercept 0-serve as the focal point for coordinating and integrating services for justice-involved people with serious mental illness.
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Affiliation(s)
- Natalie Bonfine
- Department of Psychiatry, Northeast Ohio Medical University, Rootstown (Bonfine, Munetz); School of Social Work, University of North Carolina-Chapel Hill, Chapel Hill (Wilson)
| | - Amy Blank Wilson
- Department of Psychiatry, Northeast Ohio Medical University, Rootstown (Bonfine, Munetz); School of Social Work, University of North Carolina-Chapel Hill, Chapel Hill (Wilson)
| | - Mark R Munetz
- Department of Psychiatry, Northeast Ohio Medical University, Rootstown (Bonfine, Munetz); School of Social Work, University of North Carolina-Chapel Hill, Chapel Hill (Wilson)
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16
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Gicquelais RE, Mezuk B, Foxman B, Thomas L, Bohnert ASB. Justice involvement patterns, overdose experiences, and naloxone knowledge among men and women in criminal justice diversion addiction treatment. Harm Reduct J 2019; 16:46. [PMID: 31311572 PMCID: PMC6636104 DOI: 10.1186/s12954-019-0317-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 07/05/2019] [Indexed: 12/17/2022] Open
Abstract
Background Persons in addiction treatment are likely to experience and/or witness drug overdoses following treatment and thus could benefit from overdose education and naloxone distribution (OEND) programs. Diverting individuals from the criminal justice system to addiction treatment represents one treatment engagement pathway, yet OEND needs among these individuals have not been fully described. Methods We characterized justice involvement patterns among 514 people who use opioids (PWUO) participating in a criminal justice diversion addiction treatment program during 2014–2016 using a gender-stratified latent class analysis. We described prevalence and correlates of naloxone knowledge using quasi-Poisson regression models with robust standard errors. Results Only 56% of participants correctly identified naloxone as an opioid overdose treatment despite that 68% had experienced an overdose and 79% had witnessed another person overdose. We identified two latent justice involvement classes: low involvement (20.3% of men, 46.5% of women), characterized by older age at first arrest, more past-year arrests, and less time incarcerated; and high involvement (79.7% of men, 53.5% of women), characterized by younger age at first arrest and more lifetime arrests and time incarcerated. Justice involvement was not associated with naloxone knowledge. Male participants who had personally overdosed more commonly identified naloxone as an overdose treatment after adjustment for age, race, education level, housing status, heroin use, and injection drug use (prevalence ratio [95% confidence interval]: men 1.5 [1.1–2.0]). Conclusions All PWUO in criminal justice diversion programs could benefit from OEND given the high propensity to experience and witness overdoses and low naloxone knowledge across justice involvement backgrounds and genders. Electronic supplementary material The online version of this article (10.1186/s12954-019-0317-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rachel E Gicquelais
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA. .,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA. .,Department of Psychiatry, University of Michigan, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA. .,Current Address: Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, E7133A, Baltimore, MD, 21205, USA.
| | - Briana Mezuk
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Betsy Foxman
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Laura Thomas
- Department of Psychiatry, University of Michigan, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA.,Veterans Affairs Center for Clinical Management Research, 2215 Fuller Road, Ann Arbor, MI, 48105, USA
| | - Amy S B Bohnert
- Department of Psychiatry, University of Michigan, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA.,Veterans Affairs Center for Clinical Management Research, 2215 Fuller Road, Ann Arbor, MI, 48105, USA
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17
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Bonfine N, Nadler N. The Perceived Impact of Sequential Intercept Mapping on Communities Collaborating to Address Adults with Mental Illness in the Criminal Justice System. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2019; 46:569-579. [PMID: 30969391 DOI: 10.1007/s10488-019-00936-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Sequential intercept mapping is an approach to address the overrepresentation of adults with mental illness in the criminal justice system. This approach follows the sequential intercept model, a nationally recognized framework conceptualizing the linear movement of people with mental illness through the criminal justice system. During the sequential intercept mapping process, community stakeholders identify service and policy gaps and opportunities to address the needs of this target population. This qualitative study describes the perceived impact of sequential intercept mapping among community stakeholders. Sequential intercept mapping appears to be well-received, with the potential to improve collaboration and enhance community policy and practices.
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Affiliation(s)
- Natalie Bonfine
- Department of Psychiatry, Northeast Ohio Medical University, PO Box 95, Rootstown, OH, 44272, USA.
| | - Nikhil Nadler
- College of Medicine, Northeast Ohio Medical University, Rootstown, USA
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18
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Pinals DA, Felthous AR. Introduction to this double issue: Jail diversion and collaboration across the justice continuum. BEHAVIORAL SCIENCES & THE LAW 2017; 35:375-379. [PMID: 29271027 DOI: 10.1002/bsl.2322] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 09/06/2017] [Accepted: 09/06/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Debra A Pinals
- Clinical Professor of Psychiatry, Director, Program in Psychiatry, Law, and Ethics, Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI, 48109, USA
| | - Alan R Felthous
- Professor & Director, Forensic Psychiatry Division Department of Psychiatry Behavioral Neuroscience, Saint Louis University School of Medicine
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