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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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Bassuk EL, Richard MK, Tsertsvadze A. The prevalence of mental illness in homeless children: a systematic review and meta-analysis. J Am Acad Child Adolesc Psychiatry 2015; 54:86-96.e2. [PMID: 25617249 DOI: 10.1016/j.jaac.2014.11.008] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 10/16/2014] [Accepted: 11/20/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The numbers of children experiencing homelessness have increased. To develop responsive interventions, we must understand their mental health/behavioral needs. The purpose of this systematic review was to update the evidence base by identifying, appraising, and summarizing studies on the prevalence of mental health issues among homeless children, comparing these individuals to low-income-housed children, and discussing research, practice, and policy implications. METHOD We searched 3 electronic databases and included empirical studies investigating the prevalence of mental illness in homeless children in the United States (1990-2014). Retrieved publications were screened, data extracted, and study quality appraised by independent reviewers. Evidence synthesis was based on qualitative and quantitative analyses. Prevalence odds ratios (OR) of individual studies were pooled using an inverse-variance random effects model. RESULTS Twelve studies were included and reviewed. Overall, 10% to 26% of homeless preschoolers had mental health problems requiring clinical evaluation. This proportion increased to 24% to 40% among homeless school-age children, a rate 2 to 4 times higher than poor children aged 6 to 11 years in the National Survey of America's Families. According to our meta-analyses, the difference in prevalence measured by Child Behavior Checklist (CBCL) Total Problems (T score ≥60-64) was not significantly different between homeless and housed preschool children (OR = 1.49; 95% CI = 0.97-2.28). School-age homeless children compared to housed children were significantly more likely to have a mental health problem as defined by the CBCL Total Problems subscale (T score ≥60; OR = 1.78; 95% CI = 1.19-2.66). CONCLUSION Evidence-based mental health interventions for children experiencing homelessness are long overdue. Universal screening, treatment plan development, and support of adaptive systems that focus on positive parenting and children's self-regulation are essential.
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Affiliation(s)
- Ellen L Bassuk
- Center for Social Innovation in Needham, MA; Harvard Medical School, Boston, MA.
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