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Kelton K, Van Voorhees EE, Elbogen EB, Workgroup VAMAMIRECC, Dillon KH. Correlates of Incarceration History Among Military Veterans. MILITARY PSYCHOLOGY 2022; 2022:577-589. [PMID: 36712896 PMCID: PMC9881233 DOI: 10.1080/08995605.2022.2141049] [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] [Received: 02/28/2022] [Accepted: 10/25/2022] [Indexed: 11/23/2022]
Abstract
Veterans with histories of incarceration are at greater risk for poor physical and mental health outcomes, yet prior research in this population has focused on specific subsets of veterans or a narrow range of predictors. We utilized the Bronfenbrenner Socioecological Model as the framework to evaluate correlates of incarceration history in a large sample of Iraq and Afghanistan-era veterans at four levels: demographic, historical, clinical, and contextual. Participants were 2,904 veterans (76.9% male; 49.5% White and 46.5% Black; mean age 38.08, SD = 10.33), 700 of whom reported a history of incarceration. Four logistic regression models predicting history of incarceration were tested, adding demographic, historical, clinical, and contextual variables hierarchically. In the final model, younger age (OR=0.99, 95% CI=0.98-1.00), male gender (OR of being female =0.28, 95% CI=0.21-0.38), belonging to a historically marginalized group (OR of being White =0.69, 95% CI=0.56-0.84), family history of incarceration (OR=1.47, 95% CI=1.10-1.94), adult interpersonal trauma (OR=1.39, 95% CI=1.28-1.51), problematic alcohol use (OR=1.03, 95% CI=1.02-1.05), drug abuse (OR=1.15, 95% CI=1.11-1.19), and unemployment (OR for being employed=0.76, 95% CI=0.62-0.92) were significantly associated with a history of incarceration. Implications of these findings for developing interventions and supporting systems to effectively target this high-risk population of veterans are discussed.
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Affiliation(s)
- Katherine Kelton
- Research & Development, Durham VA Health Care System, Durham, North Carolina, USA
| | - Elizabeth E. Van Voorhees
- Research & Development, Durham VA Health Care System, Durham, North Carolina, USA
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
| | - Eric B. Elbogen
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
- National Center on Homelessness among Veterans, Washington, District of Columbia, USA
| | | | - Kirsten H. Dillon
- Research & Development, Durham VA Health Care System, Durham, North Carolina, USA
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
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Forkus SR, Weiss NH, Goncharenko S, Schick MR, Monteith LL, Contractor AA. Elucidating the Association Between Military Sexual Trauma Types and Different Types of Risky Behaviors. J Trauma Dissociation 2022; 23:324-338. [PMID: 34641771 PMCID: PMC9152949 DOI: 10.1080/15299732.2021.1989110] [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: 10/20/2022]
Abstract
Military sexual harassment (MSH) and assault (MSA) are associated with serious mental and physical health outcomes among military personnel and veterans. However, less is known about how these experiences relate to risky, impulsive, and health-compromising behaviors. The goal of the current study was to assess MSH and MSA in relation to a wide range of risky behaviors. Participants were 512 veterans in the community (M age = 41.36, 71.3% male, 71.3% white) who completed an online survey via Amazon's Mechanical Turk (MTurk). Compared to veterans who reported MSH only or no history of MST, veterans with a MSA history reported greater past-month risky behavior engagement, both overall and for specific behaviors, including problematic use of alcohol, drugs, gambling, technology, risky sexual behaviors, eating behaviors, illegal behaviors, reckless spending, physically aggressive behaviors, verbally aggressive behaviors, property destruction, reckless driving, non-suicidal self-injury, and suicidal behavior. Our findings emphasize the importance of differentiating between MSH and MSA when detecting and intervening with veterans at risk for engaging in risky behaviors.
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Affiliation(s)
- Shannon R Forkus
- Department of Psychology, Univeristy of Rhode Island, Kingston, RI, USA
| | - Nicole H Weiss
- Department of Psychology, Univeristy of Rhode Island, Kingston, RI, USA
| | | | - Melissa R Schick
- Department of Psychology, Univeristy of Rhode Island, Kingston, RI, USA
| | - Lindsey L Monteith
- Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Aurora, Colorado, USA.,Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Taylor EN, Timko C, Nash A, Owens MD, Harris AH, Finlay AK. Posttraumatic Stress Disorder and Justice Involvement Among Military Veterans: A Systematic Review and Meta-Analysis. J Trauma Stress 2020; 33:804-812. [PMID: 32516492 PMCID: PMC8288507 DOI: 10.1002/jts.22526] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 12/05/2019] [Accepted: 12/15/2019] [Indexed: 12/25/2022]
Abstract
There is evidence of an association between posttraumatic stress disorder (PTSD) and criminal justice involvement among military veterans. For this study, we systematically reviewed the literature to examine the association between PTSD and criminal justice involvement among military veterans, assess the magnitude of this association, and identify strengths and limitations of the underlying evidence. Five databases were searched for a larger scoping review, and observational studies that assessed PTSD and criminal justice involvement were selected from the scoping review database (N = 191). Meta-analyses were conducted, pooling odds ratios (ORs) via restricted maximum likelihood random-effects models. The main outcomes were criminal justice involvement (i.e., documentation of arrest) and PTSD (i.e., PTSD assessment score indicating probable PTSD). Of 143 unique articles identified, 10 studies were eligible for the meta-analysis. Veterans with PTSD had higher odds of criminal justice involvement (OR = 1.61, 95% CI [1.16, 2.23], p = .002) and arrest for violent offenses (OR = 1.59, 95% CI [1.15, 2.19], p = .002) compared to veterans without PTSD. The odds ratio of criminal justice involvement among military veterans with PTSD assessed using the PTSD Checklist was 1.98, 95% CI [1.08, 3.63], p = .014. Considerable heterogeneity was identified, but no evidence of publication bias was found. Criminal justice involvement and PTSD are linked among military veterans, highlighting an important need for clinicians and healthcare systems working with this population to prioritize PTSD treatment to reduce veterans' new and recurring risk of criminal justice involvement.
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Affiliation(s)
- Emmeline N. Taylor
- Center for Innovation to Implementation, U.S. Department of Veterans Affairs, Palo Alto, California, USA,Department of Psychology, University of Colorado, Colorado Springs, Colorado, USA
| | - Christine Timko
- Center for Innovation to Implementation, U.S. Department of Veterans Affairs, Palo Alto, California, USA,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Amia Nash
- Center for Innovation to Implementation, U.S. Department of Veterans Affairs, Palo Alto, California, USA
| | - Mandy D. Owens
- Alcohol and Drug Abuse Institute, University of Washington, Seattle, Washington, USA
| | - Alex H.S. Harris
- Center for Innovation to Implementation, U.S. Department of Veterans Affairs, Palo Alto, California, USA,Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Andrea K. Finlay
- Center for Innovation to Implementation, U.S. Department of Veterans Affairs, Palo Alto, California, USA,U.S. Department of Veterans Affairs, National Center on Homelessness Among Veterans, Palo Alto, California, USA
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Kim B, Bolton RE, Hyde J, Fincke BG, Drainoni ML, Petrakis BA, Simmons MM, McInnes DK. Coordinating across correctional, community, and VA systems: applying the Collaborative Chronic Care Model to post-incarceration healthcare and reentry support for veterans with mental health and substance use disorders. HEALTH & JUSTICE 2019; 7:18. [PMID: 31832790 PMCID: PMC6909453 DOI: 10.1186/s40352-019-0099-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 11/20/2019] [Indexed: 05/05/2023]
Abstract
BACKGROUND Between 12,000 and 16,000 veterans leave incarceration annually. As is known to be the case for justice-involved populations in general, mental health disorders (MHDs) and substance use disorders (SUDs) are highly prevalent among incarcerated veterans, and individuals with MHDs and SUDs reentering the community are at increased risk of deteriorating health and recidivism. We sought to identify opportunities to better coordinate care/services across correctional, community, and VA systems for reentry veterans with MHDs and SUDs. METHODS We interviewed 16 veterans post-incarceration and 22 stakeholders from reentry-involved federal/state/community organizations. We performed a grounded thematic analysis, and recognizing consistencies between the emergent themes and the evidence-based Collaborative Chronic Care Model (CCM), we mapped findings to the CCM's elements - work role redesign (WRR), patient self-management support (PSS), provider decision support (PDS), clinical information systems (CIS), linkages to community resources (LCR), and organizational/leadership support (OLS). RESULTS Emergent themes included (i) WRR - coordination challenges among organizations involved in veterans' reentry; (ii) PSS - veterans' fear of reentering society; (iii) PDS - uneven knowledge by reentry support providers regarding available services when deciding which services to connect a reentry veteran to and whether he/she is ready and/or willing to receive services; (iv) CIS - lapses in MHD/SUD medications between release and a first scheduled health care appointment, as well as challenges in transfer of medical records; (v) LCR - inconsistent awareness of existing services and resources available across a disparate reentry system; and (vi) OLS - reentry plans designed to address only immediate transitional needs upon release, which do not always prioritize MHD/SUD needs. CONCLUSIONS Applying the CCM to coordinating cross-system health care and reentry support may contribute to reductions in mental health crises and overdoses in the precarious first weeks of the reentry period.
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Affiliation(s)
- Bo Kim
- VA Center for Healthcare Organization and Implementation Research, Bedford/Boston, MA USA
- Harvard Medical School, Boston, MA USA
| | - Rendelle E. Bolton
- VA Center for Healthcare Organization and Implementation Research, Bedford/Boston, MA USA
- Brandeis University The Heller School for Social Policy and Management, Waltham, MA USA
| | - Justeen Hyde
- VA Center for Healthcare Organization and Implementation Research, Bedford/Boston, MA USA
- Boston University School of Medicine, Boston, MA USA
| | - B. Graeme Fincke
- VA Center for Healthcare Organization and Implementation Research, Bedford/Boston, MA USA
- Boston University School of Public Health, Boston, MA USA
| | - Mari-Lynn Drainoni
- VA Center for Healthcare Organization and Implementation Research, Bedford/Boston, MA USA
- Boston University School of Medicine, Boston, MA USA
- Boston University School of Public Health, Boston, MA USA
| | - Beth Ann Petrakis
- VA Center for Healthcare Organization and Implementation Research, Bedford/Boston, MA USA
| | | | - D. Keith McInnes
- VA Center for Healthcare Organization and Implementation Research, Bedford/Boston, MA USA
- Boston University School of Public Health, Boston, MA USA
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Finlay AK, Owens MD, Taylor E, Nash A, Capdarest-Arest N, Rosenthal J, Blue-Howells J, Clark S, Timko C. A scoping review of military veterans involved in the criminal justice system and their health and healthcare. HEALTH & JUSTICE 2019; 7:6. [PMID: 30963311 PMCID: PMC6718001 DOI: 10.1186/s40352-019-0086-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 03/18/2019] [Indexed: 05/08/2023]
Abstract
BACKGROUND In the criminal justice system, special populations, such as older adults or patients with infectious diseases, have been identified as particularly vulnerable to poor health outcomes. Military veterans involved in the criminal justice system are also a vulnerable population warranting attention because of their unique healthcare needs. This review aims to provide an overview of existing literature on justice-involved veterans' health and healthcare to identify research gaps and inform policy and practice. METHODS A systematic search was conducted to identify research articles related to justice-involved veterans' health and healthcare that were published prior to December 2017. Study characteristics including healthcare category, study design, sample size, and funding source were extracted and summarized with the aim of providing an overview of extant literature. RESULTS The search strategy initially identified 1830 unique abstracts with 1387 abstracts then excluded. Full-text review of 443 articles was conducted with 252 excluded. There were 191 articles included, most related to veterans' mental health (130/191, 68%) or homelessness (24/191, 13%). Most studies used an observational design (173/191, 91%). CONCLUSIONS Knowledge gaps identified from the review provide guidance on future areas of research. Studies on different sociodemographic groups, medical conditions, and the management of multiple conditions and psychosocial challenges are needed. Developing and testing interventions, especially randomized trials, to address justice-involved veterans care needs will help to improve their health and healthcare. Finally, an integrated conceptual framework that draws from diverse disciplines, such as criminology, health services, psychology, and implementation science is needed to inform research, policy and practice focused on justice-involved veterans.
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Affiliation(s)
- Andrea K. Finlay
- Center for Innovation to Implementation, VA Palo Alto Health Care System, 795 Willow Road, Menlo Park, CA 94025 USA
- Department of Veterans Affairs, National Center on Homelessness Among Veterans, 795 Willow Road, Menlo Park, CA 94025 USA
| | - Mandy D. Owens
- Department of Veterans Affairs Health Care System, Center of Innovation for Veteran-Centered and Value-Driven Care, 1660 S. Columbian Way, Seattle, WA 98108 USA
- Department of Health Services, University of Washington, 1959 NE Pacific St, Magnuson Health Sciences Center, Room H-680, Box 357660, Seattle, WA 98195-7660 USA
| | - Emmeline Taylor
- Center for Innovation to Implementation, VA Palo Alto Health Care System, 795 Willow Road, Menlo Park, CA 94025 USA
| | - Amia Nash
- Center for Innovation to Implementation, VA Palo Alto Health Care System, 795 Willow Road, Menlo Park, CA 94025 USA
| | - Nicole Capdarest-Arest
- Blaisdell Medical Library, University of California, Davis, 4610 X St, Sacramento, CA 95817 USA
| | - Joel Rosenthal
- Veterans Justice Programs, Department of Veterans Affairs, 795 Willow Road, Menlo Park, CA 94025 USA
| | - Jessica Blue-Howells
- Veterans Justice Programs, Department of Veterans Affairs, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA
| | - Sean Clark
- Veterans Justice Programs, Department of Veterans Affairs, 2250 Leestown Road, Lexington, KY 40511 USA
| | - Christine Timko
- Center for Innovation to Implementation, VA Palo Alto Health Care System, 795 Willow Road, Menlo Park, CA 94025 USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305-5717 USA
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Hourani LL, Williams J, Lattimore PK, Trudeau JV, Van Dorn RA. Psychological Model of Military Aggressive Behavior: Findings From Population-Based Surveys. MILITARY PSYCHOLOGY 2017. [DOI: 10.1037/mil0000172] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Laurel L. Hourani
- Social Policy, Health & Economics Research, RTI International, Durham, North Carolina
| | - Jason Williams
- Social Policy, Health & Economics Research, RTI International, Durham, North Carolina
| | - Pamela K. Lattimore
- Social Policy, Health & Economics Research, RTI International, Durham, North Carolina
| | - James V. Trudeau
- Social Policy, Health & Economics Research, RTI International, Durham, North Carolina
| | - Richard A. Van Dorn
- Social Policy, Health & Economics Research, RTI International, Durham, North Carolina
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Young G. Psychiatric/Psychological Injury and Law: Introduction. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2016; 49:161-162. [PMID: 27914507 DOI: 10.1016/j.ijlp.2016.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This special issue on psychiatric/psychological injury and law covers major developments in the field, and illustrates the complexities for mental health professionals in dealing with psychiatric/psychological injuries in court. The articles vary in the range of topics covered, and include ones on posttraumatic stress disorder, other trauma reactions, dissociation, disability, pain, and traumatic brain injury, in particular but also new areas, such as the effects of early penile injury. Work in the area of psychiatric/psychological injury and law needs to be scientifically-informed, comprehensive, and impartial, and the series of articles to follow will help workers in the area meet this standard.
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