1
|
Henry BF, Gray J. Access to Psychiatric and Education Services During Incarceration in the United States. Psychiatr Serv 2024; 75:847-853. [PMID: 38693834 DOI: 10.1176/appi.ps.20230335] [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: 05/03/2024]
Abstract
OBJECTIVE Individuals with psychiatric disorders are incarcerated at disproportionately high rates and often have low educational attainment. Access to psychiatric and education services within prisons has been described as inadequate, but recent data are lacking. The authors sought to assess the association of psychiatric disorders with both educational attainment before incarceration and access to psychiatric and education services during incarceration. METHODS Data were from the 2016 Survey of Prison Inmates, a national survey of adults incarcerated in U.S. state and federal prisons (N=24,848). Multinomial regression was used to identify associations of educational attainment before incarceration with psychiatric disorders and sociodemographic factors. Multivariable logistic regression models were used to assess associations of psychiatric disorders with access to psychiatric and education services during incarceration and with sociodemographic factors. RESULTS Before incarceration, 57.3% of survey respondents had less than a high school diploma. Across four education and psychiatric services, only 8.4%-44.8% of respondents reported participating in these services during incarceration, despite 57.3% reporting a psychiatric or learning disorder. Psychiatric disorders were associated with lower educational attainment before incarceration and lower access to education services during incarceration. Psychiatric disorders were associated with higher odds of access to psychiatric services during incarceration. Men had lower educational attainment before incarceration and lower odds of accessing psychiatric and education services during incarceration. CONCLUSIONS Incarcerated people had a high need for psychiatric and education services. Individuals with psychiatric disorders had lower odds of participating in education services during incarceration, highlighting the need for policies and services that increase participation.
Collapse
Affiliation(s)
- Brandy F Henry
- Department of Educational Psychology, Counseling, and Special Education, College of Education (Henry, Gray), and Consortium on Substance Use and Addiction, Social Science Research Institute (Henry), Pennsylvania State University, University Park
| | - Joy Gray
- Department of Educational Psychology, Counseling, and Special Education, College of Education (Henry, Gray), and Consortium on Substance Use and Addiction, Social Science Research Institute (Henry), Pennsylvania State University, University Park
| |
Collapse
|
2
|
Hailemariam M, Bustos TE, Montgomery BW, Brown G, Tefera G, Adaji R, Taylor B, Eshetu H, Barajas C, Barajas R, Najjar V, Dennis D, Hudson J, Felton JW, Johnson JE. Mental health interventions for individuals with serious mental illness in the criminal legal system: a systematic review. BMC Psychiatry 2024; 24:199. [PMID: 38475800 PMCID: PMC10935949 DOI: 10.1186/s12888-024-05612-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 02/14/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Globally, individuals with mental illness get in contact with the law at a greater rate than the general population. The goal of this review was to identify and describe: (1) effectiveness of mental health interventions for individuals with serious mental illness (SMI) who have criminal legal involvement; (2) additional outcomes targeted by these interventions; (3) settings/contexts where interventions were delivered; and (4) barriers and facilitating factors for implementing these interventions. METHODS A systematic review was conducted to summarize the mental health treatment literature for individuals with serious mental illness with criminal legal involvement (i.e., bipolar disorder, schizophrenia, major depressive disorder). Searches were conducted using PsychINFO, Embase, ProQuest, PubMed, and Web of Science. Articles were eligible if they were intervention studies among criminal legal involved populations with a mental health primary outcome and provided description of the intervention. RESULTS A total of 13 eligible studies were identified. Tested interventions were categorized as cognitive/behavioral, community-based, interpersonal (IPT), psychoeducational, or court-based. Studies that used IPT-based interventions reported clinically significant improvements in mental health symptoms and were also feasible and acceptable. Other interventions demonstrated positive trends favoring the mental health outcomes but did not show statistically and clinically significant changes. All studies reported treatment outcomes, with only 8 studies reporting both treatment and implementation outcomes. CONCLUSION Our findings highlight a need for more mental health research in this population. Studies with randomized design, larger sample size and studies that utilize non-clinicians are needed.
Collapse
Affiliation(s)
- Maji Hailemariam
- Charles Stewart Mott Department of Public Health, College of Human Medicine, Michigan State University, Flint, MI, USA.
| | | | | | - Garrett Brown
- Charles Stewart Mott Department of Public Health, College of Human Medicine, Michigan State University, Flint, MI, USA
| | - Gashaye Tefera
- College of Social Work, Florida State University, Tallahassee, USA
| | - Rosemary Adaji
- Department of Epidemiology and Biostatistics, Michigan State University, Flint, MI, USA
| | - Brandon Taylor
- Charles Stewart Mott Department of Public Health, College of Human Medicine, Michigan State University, Flint, MI, USA
| | - Hiywote Eshetu
- Charles Stewart Mott Department of Public Health, College of Human Medicine, Michigan State University, Flint, MI, USA
| | - Clara Barajas
- Dornsife School of Public Health, Health Management and Policy Department, Drexel University, Philadelphia, USA
| | - Rolando Barajas
- Georgetown University School of Medicine, Washington, DC, USA
| | - Vanessa Najjar
- College of Osteopathic Medicine, Michigan State University, Flint, MI, USA
| | - Donovan Dennis
- College of Human Medicine, Michigan State University, Flint, MI, USA
| | - Jasmiyne Hudson
- College of Human Medicine, Michigan State University, Flint, MI, USA
| | - Julia W Felton
- Center for Health Policy & Health Services Research, Henry Ford Health, Detroit, MI, USA
| | - Jennifer E Johnson
- Charles Stewart Mott Department of Public Health, College of Human Medicine, Michigan State University, Flint, MI, USA
| |
Collapse
|
3
|
Cohen TR, Fronk GE, Kiehl KA, Curtin JJ, Koenigs M. Clarifying the relationship between mental illness and recidivism using machine learning: A retrospective study. PLoS One 2024; 19:e0297448. [PMID: 38394314 PMCID: PMC10890739 DOI: 10.1371/journal.pone.0297448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 01/04/2024] [Indexed: 02/25/2024] Open
Abstract
OBJECTIVE There is currently inconclusive evidence regarding the relationship between recidivism and mental illness. This retrospective study aimed to use rigorous machine learning methods to understand the unique predictive utility of mental illness for recidivism in a general population (i.e.; not only those with mental illness) prison sample in the United States. METHOD Participants were adult men (n = 322) and women (n = 72) who were recruited from three prisons in the Midwest region of the United States. Three model comparisons using Bayesian correlated t-tests were conducted to understand the incremental predictive utility of mental illness, substance use, and crime and demographic variables for recidivism prediction. Three classification statistical algorithms were considered while evaluating model configurations for the t-tests: elastic net logistic regression (GLMnet), k-nearest neighbors (KNN), and random forests (RF). RESULTS Rates of substance use disorders were particularly high in our sample (86.29%). Mental illness variables and substance use variables did not add predictive utility for recidivism prediction over and above crime and demographic variables. Exploratory analyses comparing the crime and demographic, substance use, and mental illness feature sets to null models found that only the crime and demographics model had an increased likelihood of improving recidivism prediction accuracy. CONCLUSIONS Despite not finding a direct relationship between mental illness and recidivism, treatment of mental illness in incarcerated populations is still essential due to the high rates of mental illnesses, the legal imperative, the possibility of decreasing institutional disciplinary burden, the opportunity to increase the effectiveness of rehabilitation programs in prison, and the potential to improve meaningful outcomes beyond recidivism following release.
Collapse
Affiliation(s)
- Talia R. Cohen
- Department of Psychology, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- Department of Psychiatry, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Gaylen E. Fronk
- Department of Psychology, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Kent A. Kiehl
- Departments of Psychology, The Mind Research Network, Neuroscience and Law, University of New Mexico, Albuquerque, New Mexico, United States of America
| | - John J. Curtin
- Department of Psychology, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Michael Koenigs
- Department of Psychiatry, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| |
Collapse
|
4
|
Hood BJ, Komoski MC. Treating Trauma in Criminal Justice-Involved with SMI: "Trauma Is a Huge Part of It". Community Ment Health J 2023; 59:1537-1548. [PMID: 37268846 DOI: 10.1007/s10597-023-01141-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 05/17/2023] [Indexed: 06/04/2023]
Abstract
Individuals with serious mental illness are both disproportionately represented in the criminal justice system and more likely to experience correlates with offending (e.g., trauma, substance abuse, and homelessness). Moreover, research using the Adverse Childhood Experiences has found strong correlation between childhood trauma and later negative outcomes, including criminal justice involvement. Despite this, research has yet to examine how trauma can influence treatment decisions for criminal justice-involved individuals with SMI. Using a qualitative approach and in-depth semi-structured interviews with 61 community mental health service providers, the current study addresses this gap in the literature. Findings confirm the high prevalence of trauma in this population as well as suggests a number of key findings for this population including (1) how trauma affects treatment decisions, (2) the existing barriers related to the treatment of trauma, and (3) what service providers need to effectively treat trauma. Implications for policy and practice are extensive.
Collapse
Affiliation(s)
- Brittany J Hood
- Texas A&M International University, 5201 University Boulevard, Academic Innovation Center (AIC) 314, Laredo, TX, 78041, USA.
| | | |
Collapse
|
5
|
Cameron J, Thurlin M, Hilton NZ, Ball LC, Marshall L, Kolla NJ. Privacy and safety: Issues of dual compliance in high-secure and other forensic psychiatric hospitals. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2022; 82:101780. [PMID: 35279456 DOI: 10.1016/j.ijlp.2022.101780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 01/30/2022] [Accepted: 02/11/2022] [Indexed: 06/14/2023]
Abstract
Health care organizations are obligated to provide safe and effective treatment to their patients and also protect the safety of their workers. This paper analyzes the tensions arising from legislative regimes that, respectively, protect privacy and workplace safety, using a large, tertiary high-secure forensic psychiatric hospital in Ontario, Canada, as an example. In Ontario, the Personal Health Information Protection Act (PHIPA) prohibits personal health information (PHI) from being disclosed to individuals who fall outside the "circle of care," including nonclinical employees who have direct involvement with patients and may be at risk of violence. PHIPA permits the disclosure of information where there is a risk of violence, but the statute's scheme for privacy protection was not designed to address, and may not be compatible with, the operations and requirements of high-secure forensic and other psychiatric hospitals. At the same time, the Occupational Health and Safety Act (OHSA) creates a regulatory framework that sets health and safety standards, including an employer's duty to disclose the risk of violence. OHSA prosecutions and proceedings demonstrate how these duties have been enforced against psychiatric hospitals. We examine this regulatory backdrop, explaining that PHIPA provides little guidance to psychiatric hospitals, where the risk of violence is elevated. We also discuss issues of dual compliance that arise from a hospital's legal obligations under PHIPA and OHSA. Finally, we turn to the ongoing clinical and operational challenges, suggesting strategies for increasing staff safety. These include strengthening the therapeutic alliance and providing patients with the option of consenting to disclosure of PHI to those outside the circle of care.
Collapse
Affiliation(s)
- Jamie Cameron
- Professor Emerita, Osgoode Hall Law School, York University, Toronto, Ontario, Canada
| | - Matti Thurlin
- Osgoode Hall Law School, York University, Toronto, Ontario, Canada
| | - N Zoe Hilton
- Waypoint Centre for Mental Health Care, Penetaguishene, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Laura C Ball
- Waypoint Centre for Mental Health Care, Penetaguishene, Ontario, Canada
| | - Liam Marshall
- Waypoint Centre for Mental Health Care, Penetaguishene, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Nathan J Kolla
- Waypoint Centre for Mental Health Care, Penetaguishene, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Waypoint/University of Toronto Research Chair in Forensic Mental Health Science, Penetanguishene, Ontario, Canada.
| |
Collapse
|
6
|
Maguire T, Carroll A, McKenna B, Dunn C, Daffern M. The Model for Understanding Inpatient Aggression: A Version for Mental Health Nurses Working in Prisons. Issues Ment Health Nurs 2021; 42:827-835. [PMID: 33480815 DOI: 10.1080/01612840.2020.1871134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Preventing and managing aggression remains an important and challenging task for mental health nurses. Despite the concern, there is a dearth of frameworks to assist practice and inform assessment and intervention related to aggression, for forensic mental health nurses working in prisons. This paper presents a model for understanding aggression within prison mental health units. The model elucidates various personal and situational determinants of aggression. It offers a systematic framework for mental health nurses to investigate and understand aggression, to ultimately assist nurses to provide care in an informed and effective manner, and for services to consider structural factors that contribute to the risk of aggression.
Collapse
Affiliation(s)
- Tessa Maguire
- Faculty of Health Arts and Design, Centre for Forensic Behavioural Science Swinburne University of Technology and Forensicare, Alphington, Australia.,Forensicare, Fairfield, Australia
| | - Andrew Carroll
- Faculty of Health Arts and Design, Centre for Forensic Behavioural Science Swinburne University of Technology and Forensicare, Alphington, Australia.,Forensicare, Fairfield, Australia.,cCurious Minds Pty Ltd, Melbourne, Australia
| | - Brian McKenna
- Faculty of Health Arts and Design, Centre for Forensic Behavioural Science Swinburne University of Technology and Forensicare, Alphington, Australia.,Forensic Mental Health, Auckland University of Technology, Auckland, New Zealand.,Auckland Regional Forensic Psychiatry Services, Auckland, New Zealand
| | | | - Michael Daffern
- Faculty of Health Arts and Design, Centre for Forensic Behavioural Science Swinburne University of Technology and Forensicare, Alphington, Australia.,Forensicare, Fairfield, Australia
| |
Collapse
|