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Arias SA, Sperber K, Jones R, Taxman FS, Miller TR, Zylberfuden S, Weinstock LM, Brown GK, Ahmedani B, Johnson JE. Managed care updates of subscriber jail release to prompt community suicide prevention: clinical trial protocol. BMC Health Serv Res 2023; 23:1265. [PMID: 37974126 PMCID: PMC10655488 DOI: 10.1186/s12913-023-10249-5] [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: 09/13/2023] [Accepted: 10/30/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Recent jail detention is a marker for trait and state suicide risk in community-based populations. However, healthcare providers are typically unaware that their client was in jail and few post-release suicide prevention efforts exist. This protocol paper describes an effectiveness-implementation trial evaluating community suicide prevention practices triggered by advances in informatics that alert CareSource, a large managed care organization (MCO), when a subscriber is released from jail. METHODS This randomized controlled trial investigates two evidence-based suicide prevention practices triggered by CareSource's jail detention/release notifications, in a partial factorial design. The first phase randomizes ~ 43,000 CareSource subscribers who pass through any Ohio jail to receive Caring Contact letters sent by CareSource or to Usual Care after jail release. The second phase (running simultaneously) involves a subset of ~ 6,000 of the 43,000 subscribers passing through jail who have been seen in one of 12 contracted behavioral health agencies in the 6 months prior to incarceration in a stepped-wedge design. Agencies will receive: (a) notifications of the client's jail detention/release, (b) instructions for re-engaging these clients, and (c) training in suicide risk assessment and the Safety Planning Intervention for use at re-engagement. We will track suicide-related and service linkage outcomes 6 months following jail release using claims data. CONCLUSIONS This design allows us to rigorously test two intervention main effects and their interaction. It also provides valuable information on the effects of system-level change and the scalability of interventions using big data from a MCO to flag jail release and suicide risk. TRIAL REGISTRATION The trial is registered at clinicaltrials.gov (NCT05579600). Registered 27 June, 2023.
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Affiliation(s)
- Sarah A Arias
- Butler Hospital, Providence, RI, USA.
- Department of Psychiatry and Human Behavior, Brown University, Butler Hospital, 345 Blackstone Blvd., Providence, RI, 02906, USA.
| | | | - Richard Jones
- Department of Psychiatry and Human Behavior, Brown University, Butler Hospital, 345 Blackstone Blvd., Providence, RI, 02906, USA
| | - Faye S Taxman
- Center for Advancing Correctional Excellence!, George Mason University, Arlington, VA, USA
| | - Ted R Miller
- Pacific Institute for Research & Evaluation, Beltsville, MI, USA
- Curtin University School of Public Health, Perth, Australia
| | | | - Lauren M Weinstock
- Department of Psychiatry and Human Behavior, Brown University, Butler Hospital, 345 Blackstone Blvd., Providence, RI, 02906, USA
| | - Gregory K Brown
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Brian Ahmedani
- Department of Psychiatry, Henry Ford Health System, Detroit, MI, USA
| | - Jennifer E Johnson
- Charles Stewart Mott Department of Public Health, Michigan State University, Flint, MI, USA
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Arias SA, Sperber K, Jones R, Taxman FS, Miller TR, Zylberfuden S, Weinstock LM, Brown GK, Ahmedani B, Johnson JE. Managed Care Updates of Subscriber Jail Release to Prompt Community Suicide Prevention: Clinical Trial Protocol. RESEARCH SQUARE 2023:rs.3.rs-3350204. [PMID: 37841869 PMCID: PMC10571633 DOI: 10.21203/rs.3.rs-3350204/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Background Recent jail detention is a marker for trait and state suicide risk in community-based populations. However, healthcare providers are typically unaware that their client was in jail and few post-release suicide prevention efforts exist. This protocol paper describes an effectiveness-implementation trial evaluating community suicide prevention practices triggered by advances in informatics that alert CareSource, a large managed care organization (MCO), when a subscriber is released from jail. Methods This randomized controlled trial investigates two evidence-based suicide prevention practices triggered by CareSource's jail detention/release notifications, in a partial factorial design. The first phase randomizes ~43,000 CareSource subscribers who pass through any Ohio jail to receive Caring Contact letters sent by CareSource or to Usual Care after jail release. The second phase (running simultaneously) involves a subset of ~6,000 of the 43,000 subscribers passing through jail who have been seen in one of 12 contracted behavioral health agencies in the 6 months prior to incarceration in a stepped-wedge design. Agencies will receive: (a) notifications of the client's jail detention/release, (b) instructions for re-engaging these clients, and (c) training in suicide risk assessment and the Safety Planning Intervention for use at re-engagement. We will track suicide-related and service linkage outcomes 6 months following jail release using claims data. Conclusions This design allows us to rigorously test two intervention main effects and their interaction. It also provides valuable information on the effects of system-level change and the scalability of interventions using big data from a MCO to flag jail release and suicide risk. Trial Registration The trial is registered at clinicaltrials.gov (NCT05579600). Registered 27 June, 2023, https://beta.clinicaltrials.gov/study/NCT05579600?cond=Suicide&term=Managed%20Care&rank=1.
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Frequency and Duration of Incarceration and Mortality Among US Veterans With and Without HIV. J Acquir Immune Defic Syndr 2021; 84:220-227. [PMID: 32049771 DOI: 10.1097/qai.0000000000002325] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Exposure to incarceration is associated with increased risk of mortality, and HIV is cited as a leading cause of death. Yet, few studies have examined the association between incarceration and mortality among people with HIV (PWH), specifically whether and how increasing exposure to incarceration increases risk of mortality. We compared mortality by different incarceration exposures and HIV status. METHODS We conducted a prospective cohort study of participants in the Veterans Aging Cohort Study from January 2011 to August 2017 (N = 5367). The primary exposure was incarceration by 3 measures: (1) any (ever/never); (2) frequency; and (3) cumulative duration. Stratifying by HIV status and controlling for age, race, and sex, we used Cox Proportional Hazard models to estimate adjusted hazard ratios (AHRs) and 95% confidence intervals (CIs). RESULTS Incarceration was associated with increased risk of mortality compared with those never incarcerated for PWH (AHR 1.37; 95% CI: 1.13 to 1.66) and those uninfected (AHR 1.24; 95% CI: 0.99 to 1.54), but the association was only statistically significant among PWH. Increasing frequency of incarceration was associated with higher risk of mortality in both groups: for PWH, AHRs 1.13, 1.45, and 1.64 for 1, 2-5; 6+ times, respectively, for uninfected, AHRs 0.98, 1.35, and 1.70 for 1, 2-5, and 6+ times, respectively. CONCLUSIONS PWH were at increased risk of mortality after incarceration, and repeated exposure to incarceration was associated with mortality in both groups in a dose-response fashion. This increased risk of mortality may be mitigated by improving transitional health care, especially HIV care, and reducing incarceration.
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Erlyana E, Reynolds GL, Fisher DG, Pedersen WC, Van Otterloo L. Arrest and Trait Aggression Correlates of Emergency Department Use. JOURNAL OF CORRECTIONAL HEALTH CARE 2019; 25:253-264. [PMID: 31179818 DOI: 10.1177/1078345819854373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examined the associations between arrest and incarceration, trait aggression, and emergency department (ED) use. Data were collected from 525 clients who visited the Center for Behavioral Research and Services in Long Beach, CA, using the following instruments: Risk Behavior Assessment, Risk Behavior Follow-Up Assessment, the Aggression Questionnaire (AQ), the Displaced AQ, and the parole and Legal Status section of the Addiction Severity Index. The bivariate analysis suggested that ED use was significantly associated with trait aggression and trait-displaced aggression among those with a history of incarceration. In the logistic regression, weapons offenses, manslaughter/homicide, being male, and being Black were significantly associated with ED use. Identification and management of aggressive trait personality are important in improving the management of postrelease care in transition to clinical networks and community-based health care settings.
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Affiliation(s)
- Erlyana Erlyana
- 1 Department of Health Care Administration, Center for Behavioral Research and Services, California State University, Long Beach, CA, USA
| | - Grace L Reynolds
- 1 Department of Health Care Administration, Center for Behavioral Research and Services, California State University, Long Beach, CA, USA
| | - Dennis G Fisher
- 2 Department of Psychology, Center for Behavioral Research and Services, California State University, Long Beach, CA, USA
| | - William C Pedersen
- 3 Department of Psychology, California State University, Long Beach, CA, USA
| | - Lucy Van Otterloo
- 4 School of Nursing, California State University, Long Beach, CA, USA
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Binswanger IA, Blatchford PJ, Forsyth SJ, Stern MF, Kinner SA. Epidemiology of Infectious Disease-Related Death After Release from Prison, Washington State, United States, and Queensland, Australia: A Cohort Study. Public Health Rep 2017; 131:574-82. [PMID: 27453602 DOI: 10.1177/0033354916662216] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES People in prison may be at high risk for infectious diseases and have an elevated risk of death immediately after release compared with later; their risk of death is elevated for at least a decade after release. We compared rates, characteristics, and prison-related risk factors for infectious disease-related mortality among people released from prisons in Queensland, Australia, and Washington State, United States, regions with analogous available data. METHODS We analyzed data from retrospective cohort studies of people released from prison in Queensland (1997-2007, n=37,180) and Washington State (1999-2009, n=76,208) and linked identifiers from each cohort to its respective national death index. We estimated infectious disease-related mortality rates (deaths per person-years in community) and examined associations using Cox proportional hazard models. RESULTS The most frequent infectious disease-related underlying cause of death after release from prison was pneumonia (43%, 23/54 deaths) in the Australian cohort and viral hepatitis (40%, 69/171 deaths) in the U.S. cohort. The infectious disease-related mortality rate was significantly higher in the U.S. cohort than in the Australian cohort (51.2 vs. 26.5 deaths per 100,000 person-years; incidence rate ratio = 1.93, 95% confidence interval 1.42, 2.62). In both cohorts, increasing age was strongly associated with mortality from infectious diseases. CONCLUSION Differences in the epidemiology of infectious disease-related mortality among people released from prison may reflect differences in patterns of community health service delivery in each region. These findings highlight the importance of preventing and treating hepatitis C and other infectious diseases during the transition from prison to the community.
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Affiliation(s)
- Ingrid A Binswanger
- Kaiser Permanente Colorado, Institute for Health Research, Denver, CO; University of Colorado Denver, School of Medicine, Department of Psychiatry, Division of General Internal Medicine, Aurora, CO
| | - Patrick J Blatchford
- University of Colorado Denver, Colorado School of Public Health, Department of Biostatistics and Informatics, Denver, CO
| | - Simon J Forsyth
- University of Queensland, School of Public Health, Brisbane, Australia
| | - Marc F Stern
- University of Washington School of Public Health, Department of Health Services, Seattle, WA
| | - Stuart A Kinner
- University of Melbourne, Melbourne School of Population and Global Health, Melbourne, Australia; University of Queensland, Mater Research Institute, Brisbane, Australia; Monash University School of Public Health and Preventive Medicine, Melbourne, Australia; Griffith University, Griffith Criminology Institute & Menzies Health Institute Queensland, Brisbane, Australia
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Bechelli MJ, Caudy M, Gardner TM, Huber A, Mancuso D, Samuels P, Shah T, Venters HD. Case studies from three states: breaking down silos between health care and criminal justice. Health Aff (Millwood) 2016; 33:474-81. [PMID: 24590948 DOI: 10.1377/hlthaff.2013.1190] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The jail-involved population-people with a history of arrest in the previous year-has high rates of illness, which leads to high costs for society. A significant percentage of jail-involved people are estimated to become newly eligible for coverage through the Affordable Care Act's expansion of Medicaid, including coverage of substance abuse treatment and mental health care. In this article we explore the need to break down the current policy silos between health care and criminal justice, to benefit both sectors and reduce unnecessary costs resulting from lack of coordination. To draw attention to the hidden costs of the current system, we review three case studies, from Washington State, Los Angeles County in California, and New York City. Each case study addresses different aspects of care needed by or provided to the jail-involved population, including mental health and substance abuse, emergency care, and coordination of care transitions. Ultimately, bending the cost curve for health care and criminal justice will require greater integration of the two systems.
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Cropsey KL, Binswanger IA, Clark CB, Taxman FS. The unmet medical needs of correctional populations in the United States. J Natl Med Assoc 2013; 104:487-92. [PMID: 23560350 DOI: 10.1016/s0027-9684(15)30214-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The goal of this study was to document the health needs of members in the criminal justice system and the capacity of the system to meet those needs. Using data from the National Criminal Justice Treatment Practices survey, we estimated the number of adults under correctional control who need medical care and the capacity of the correctional system to provide needed care. A mailed survey of 431 adult correctional agencies and administrators was used to define the capacity and techniques of the correctional system to meet the medical needs of the offender population. Most offenders in jail and prison received tuberculosis screening, physical health services, and mental health screening and treatment. Screening for sexually transmitted diseases (STDs) and provision of detoxification or methadone maintenance were universally absent, regardless of criminal justice setting. Community corrections settings were lacking in most health care areas. Prisons and jails are constitutionally mandated to provide health care; however, community corrections agencies are not federally required to provide health services. While community correction settings have the lowest provision of health care services, prisons and jails also demonstrate a deficiency in most services, but particularly for STD screening, substance abuse detoxification, and opioid maintenance therapies.
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Affiliation(s)
- Karen L Cropsey
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL 35209, USA.
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Merrall ELC, Kariminia A, Binswanger IA, Hobbs MS, Farrell M, Marsden J, Hutchinson SJ, Bird SM. Meta-analysis of drug-related deaths soon after release from prison. Addiction 2010; 105:1545-54. [PMID: 20579009 PMCID: PMC2955973 DOI: 10.1111/j.1360-0443.2010.02990.x] [Citation(s) in RCA: 448] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS The transition from prison back into the community is particularly hazardous for drug-using offenders whose tolerance for heroin has been reduced by imprisonment. Studies have indicated an increased risk of drug-related death soon after release from prison, particularly in the first 2 weeks. For precise, up-to-date understanding of these risks, a meta-analysis was conducted on the risk of drug-related death in weeks 1 + 2 and 3 + 4 compared with later 2-week periods in the first 12 weeks after release from prison. METHODS English-language studies were identified that followed up adult prisoners for mortality from time of index release for at least 12 weeks. Six studies from six prison systems met the inclusion criteria and relevant data were extracted independently. RESULTS These studies contributed a total of 69 093 person-years and 1033 deaths in the first 12 weeks after release, of which 612 were drug-related. A three- to eightfold increased risk of drug-related death was found when comparing weeks 1 + 2 with weeks 3-12, with notable heterogeneity between countries: United Kingdom, 7.5 (95% CI: 5.7-9.9); Australia, 4.0 (95% CI: 3.4-4.8); Washington State, USA, 8.4 (95% CI: 5.0-14.2) and New Mexico State, USA, 3.1 (95% CI: 1.3-7.1). Comparing weeks 3 + 4 with weeks 5-12, the pooled relative risk was: 1.7 (95% CI: 1.3-2.2). CONCLUSIONS These findings confirm that there is an increased risk of drug-related death during the first 2 weeks after release from prison and that the risk remains elevated up to at least the fourth week.
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Affiliation(s)
| | - Azar Kariminia
- National Centre in HIV Epidemiology and Clinical ResearchSydney, NSW, Australia
| | - Ingrid A Binswanger
- Division of General Internal Medicine, University of Colorado at Denver School of MedicineDenver, CO, USA,Denver Health Medical CenterDenver, CO, USA
| | - Michael S Hobbs
- School of Population Health, The University of Western AustraliaCrawley, WA, Australia
| | - Michael Farrell
- National Addiction Centre, Division of Psychological Medicine and Psychiatry, Institute of Psychiatry, King's College LondonLondon, UK
| | - John Marsden
- National Addiction Centre, Division of Psychological Medicine and Psychiatry, Institute of Psychiatry, King's College LondonLondon, UK
| | - Sharon J Hutchinson
- Health Protection ScotlandGlasgow, UK,Department of Statistics and Modelling Science, Strathclyde UniversityGlasgow, UK
| | - Sheila M Bird
- MRC Biostatistics UnitCambridge, UK,Department of Statistics and Modelling Science, Strathclyde UniversityGlasgow, UK
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Abstract
PURPOSE OF REVIEW Health problems related to substance use are investigated and monitored throughout the world by both international organizations and governments. It is well recognized that prison inmates are a vulnerable group of the population. Research on this group is minimal compared with the general population. The problem of drug use and health consequences among this subpopulation is significant and needs to be explored. RECENT FINDINGS A higher prevalence of drug use is found among prison inmates than among the general population. The health status of prison inmates seems to be lower because of both the inmates' behavior and the prison environment. Various communicable diseases are commonly found such as hepatitis C virus, HIV, and syphilis. SUMMARY The health of prison inmates tended to be worse than in the general population, particularly for those who use drugs. Based on the principle of human rights and equity of access, healthcare services provided to prison inmates should be equivalent to those provided to the general population.
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