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Lantz L, Chang Z, Virtanen S. Risk factors for dropout from psychological substance use disorder treatment programs in criminal justice settings. Drug Alcohol Depend 2024; 259:111314. [PMID: 38696932 DOI: 10.1016/j.drugalcdep.2024.111314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 04/18/2024] [Accepted: 04/21/2024] [Indexed: 05/04/2024]
Abstract
BACKGROUND Substance use disorders are highly prevalent in people within the criminal justice system. Psychological programs are the most common type of treatment available and have been shown to decrease recidivism, but dropping out of treatment is common. Risk factors associated with treatment dropout remain unclear in this setting, and whether the risk factors differ by treatment form (group-based vs. individual). METHODS Outcome (treatment dropout) was defined as not finishing the program due to client's own wish, misbehavior, no-shows, or because program leader found client to be unsuitable. Predictors of treatment dropout included a comprehensive set of individual-level clinical, socioeconomic, and crime-related pre-treatment characteristics. Multivariable regression models were used to estimate the associations between predictors and dropout. FINDINGS The study cohort included 5239 criminal justice clients who participated in a psychological treatment program (group-based or individual). Multivariable logistic regression models showed that female sex (OR=1.64, 95% CI 1.20-2.25), age (0.99, [0.97-1.00]), sentence length (0.98, [0.97-0.98]), higher education (0.54, [0.28-1.00]), number of violent offenses (1.03, [1.01-1.05]), and anxiety disorders (1.32, [1.01-1.72]) were associated with dropout from the individual treatment program. For the group-based program, age (OR=0.98, 95% CI 0.96-1.00), sentence length (OR=0.96, 95% CI 0.94-0.98), stimulant use disorder (OR=1.48, 95%, 1.00-2.19), and self-harm (OR 1.52, 95% CI 1.00-2.34) were associated with dropout. CONCLUSIONS We identified certain sociodemographic, crime-related, and clinical characteristics that were particularly important in predicting dropout from psychological treatment. Further, we find that there are similarities and differences in predictors of dropout from group-based and individual treatment forms.
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Affiliation(s)
- Lina Lantz
- Faculty of Medicine, Uppsala University, Sweden
| | - Zheng Chang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
| | - Suvi Virtanen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden; School of Educational Sciences and Psychology, University of Eastern Finland, Finland.
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Mills JM, Davidson KM. The prison-based therapeutic community: Resident recommendations for program improvement. J Subst Use Addict Treat 2024:209404. [PMID: 38768815 DOI: 10.1016/j.josat.2024.209404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 04/16/2024] [Accepted: 05/14/2024] [Indexed: 05/22/2024]
Abstract
INTRODUCTION The prison-based Therapeutic Community (TC) is widely used within correctional institutions to address substance use disorders (SUDs). While most evaluations of the prison-based TC find the program to be effective, recent mixed evidence and the continued surge of the opioid crisis call for deeper investigation into program operations, barriers to engagement, and sources of treatment effect heterogeneity. Notably lacking from prior evaluations, and critical to our understanding of variable program engagement, is first-hand experiences and perceptions from program participants. METHODS To assess prison-based TC resident perceptions of the program and their recommendations for improvement, we utilize data from the Therapeutic Community Prison Inmate Network Study (TC-PINS), a longitudinal data collection effort conducted in one prison-based TC unit within a Pennsylvania state prison. Specifically, we assess resident responses to the open-ended item "What can the TC do better?" Analyzing 470 responses to this question by 177 residents, two independent coders identified seven substantive categories of recommended changes or improvements to their TC program. RESULTS Residents provided tangible recommendations for improvement of their prison-based TC program based on their experiences and perceptions. Importantly, a number of their recommendations directly counter the intended model of the TC, which highlights imperative issues underlying the translation of the TC model within the prison environment. Resident suggestions include enhanced structure, increased individualization, expanded curriculum, stricter enforcement of rules, and improved or more experienced staff. Additionally, many question the coercive nature of TC program participation within this prison system. CONCLUSIONS Resident recommendations for program improvement unveil important sources of treatment effect heterogeneity and highlight tangible program changes that can be implemented to reduce barriers to treatment engagement. We provide suggested changes to this prison-based TC based on resident perceptions and discuss both the importance and relative ease of eliciting this critical participant feedback.
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Affiliation(s)
- Jack M Mills
- College of Criminology & Criminal Justice, Florida State University, Tallahassee, USA
| | - Kimberly M Davidson
- College of Criminology & Criminal Justice, Florida State University, Tallahassee, USA.
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Henry BF, Gray J. Access to Psychiatric and Education Services During Incarceration in the United States. Psychiatr Serv 2024:appips20230335. [PMID: 38693834 DOI: 10.1176/appi.ps.20230335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [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.
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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
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Compton MT, Tan de Bibiana J, Pope LG. Identifying Individuals With Early Psychosis in Jail: Lessons Learned for Coordinated Specialty Care Services. Psychiatr Serv 2024; 75:470-476. [PMID: 38204371 DOI: 10.1176/appi.ps.20230125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
OBJECTIVE This study sought to establish the feasibility of a two-component intervention embedded within a jail setting that would detect detainees with early psychosis and connect them to coordinated specialty care (CSC) in the community upon release. METHODS The two components of the intervention were a targeted educational campaign for correction officers and a specialized early engagement support service to facilitate jail discharge planning. Jail detainees with early psychosis were referred to the project and assessed for positive and negative symptoms, substance use, and duration of untreated psychosis (DUP). During a 24-month period, 25 individuals were referred, of whom eight were eligible and interviewed. RESULTS The sociodemographic and clinical characteristics of the jail detainees were similar to those of individuals in hospital settings. The median DUP was 36 weeks. One of the eight detainees with early psychosis was successfully referred to CSC; for the other detainees, social or criminal legal factors precluded referral. CONCLUSIONS A targeted educational campaign for correction officers and a specialized early engagement support service can be implemented in a jail setting, and referrals can be facilitated. Success of the campaign may depend on having dedicated liaisons within the jail setting (e.g., among correctional health staff) as well as liaisons in local CSC programs and leadership. Changes in the law and policy environments (e.g., criminal legal system reform) and changes in organizational practices and processes for corrections, correctional health, and local CSC programs (such as those made during the COVID-19 pandemic) require ongoing collaborations.
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Affiliation(s)
- Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Compton, Pope); Vera Institute of Justice, New York City (Tan de Bibiana)
| | - Jason Tan de Bibiana
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Compton, Pope); Vera Institute of Justice, New York City (Tan de Bibiana)
| | - Leah G Pope
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Compton, Pope); Vera Institute of Justice, New York City (Tan de Bibiana)
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Singh K, Timko C, Yu M, Taylor E, Blue-Howells J, Finlay AK. Scoping review of military veterans involved in the criminal legal system and their health and healthcare: 5-year update and map to the Veterans-Sequential Intercept Model. Health Justice 2024; 12:18. [PMID: 38639813 PMCID: PMC11027330 DOI: 10.1186/s40352-024-00274-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 04/07/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND A previous scoping review of legal-involved veterans' health and healthcare (1947-2017) identified studies and their limitations. Given the influx of literature published recently, this study aimed to update the previous review and map articles to the Veterans-Sequential Intercept Model (V-SIM) - a conceptual model used by key partners, including Veterans Health Administration, veteran advocates, criminal justice practitioners, and local governments to identify intercept points in the criminal legal system where resources and programming can be provided. Developing an updated resource of literature is essential to inform current research, discover gaps, and highlight areas for future research. METHODS A systematic search of 5 databases identified articles related to legal-involved veterans' health and healthcare published between December 2017 through December 2022. The first and senior authors conducted abstract reviews, full-text reviews, and data extraction of study characteristics. Finally, each article was sorted by the various intercept points from the V-SIM. RESULTS Of 903 potentially relevant articles, 107 peer-reviewed publications were included in this review, most related to mental health (66/107, 62%) and used an observational quantitative study design (95/107, 89%). Although most articles did not explicitly use the V-SIM to guide data collection, analyses, or interpretation, all could be mapped to this conceptual model. Half of the articles (54/107, 50%) collected data from intercept 5 (Community Corrections and Support Intercept) of the V-SIM. No articles gathered data from intercepts 0 (Community and Emergency Services Intercept), 1 (Law Enforcement Intercept), or 2 (Initial Detention and Court Hearings Intercept). CONCLUSIONS There were 107 articles published in the last five years compared to 190 articles published in 70 years covered in the last review, illustrating the growing interest in legal-involved veterans. The V-SIM is widely used by front-line providers and clinical leadership, but not by researchers to guide their work. By clearly tying their research to the V-SIM, researchers could generate results to help guide policy and practice at specific intercept points. Despite the large number of publications, research on prevention and early intervention for legal-involved veterans is lacking, indicating areas of great need for future studies.
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Affiliation(s)
- Kreeti Singh
- Center for Innovation to Implementation, VA Palo Alto Health Care System, 795 Willow Road (152-MPD), Menlo Park, CA, 94025, USA.
| | - Christine Timko
- Center for Innovation to Implementation, VA Palo Alto Health Care System, 795 Willow Road (152-MPD), Menlo Park, CA, 94025, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 291 Campus Drive, Li Ka Shing Building, Stanford, CA, 94305, USA
| | - Mengfei Yu
- Center for Innovation to Implementation, VA Palo Alto Health Care System, 795 Willow Road (152-MPD), Menlo Park, CA, 94025, USA
| | - Emmeline Taylor
- Center for Innovation to Implementation, VA Palo Alto Health Care System, 795 Willow Road (152-MPD), Menlo Park, CA, 94025, USA
- Department of Psychology, University of Colorado, Columbine Hall 4th Floor, 1420 Austin Bluffs Pkwy, Colorado Springs, CO, 80918, USA
| | - Jessica Blue-Howells
- Department of Veterans Affairs, Veterans Justice Programs, 810 Vermont Avenue, Washington DC, NW, 20420, USA
| | - Andrea K Finlay
- Center for Innovation to Implementation, VA Palo Alto Health Care System, 795 Willow Road (152-MPD), Menlo Park, CA, 94025, USA
- Department of Veterans Affairs, National Center on Homelessness Among Veterans, 795 Willow Road, Menlo Park, CA, 94025, USA
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Liddle HA, Dakof G, Rowe C, Mohamed AB, Henderson C, Foulkrod T, Lucas M, DiFrancesco M. Multidimensional Family Therapy for Justice-Involved Young Adults with Substance Use Disorders. J Behav Health Serv Res 2024; 51:250-263. [PMID: 37532966 PMCID: PMC10940488 DOI: 10.1007/s11414-023-09852-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2023] [Indexed: 08/04/2023]
Abstract
The present study explored the acceptability, feasibility, fidelity, and outcomes of a young adult adaptation of multidimensional family therapy (MDFT), an evidence-based family treatment originally developed for adolescents. Participants included 22 individuals between the ages of 19 to 25 who were enrolled in a criminal drug court program. MDFT was found to be feasible and was delivered with strong fidelity to young adults and their families. Participants reported high satisfaction with MDFT, and 95% completed treatment. Analyses revealed statistically significant decreases in substance use on all indicators from baseline to the 6-month follow-up. Significant improvements were also noted in vocational functioning, including a 73% increase in full-time employment from baseline to 6-month follow-up. Criminal justice outcomes included a significant decrease in legal risk, and 86% of study participants had no rearrests from baseline through the 18-month follow-up period. The article concludes with recommendations for implementing family-based interventions with young adults, as well as future research directions in this important area.
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Affiliation(s)
| | - Gayle Dakof
- University of Miami Miller School of Medicine, Miami, USA.
| | - Cynthia Rowe
- University of Miami Miller School of Medicine, Miami, USA
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Zarzar TR, Rosen DL, Ashkin EA. Supporting People With Serious Mental Illness After Prison Release: The FIT Wellness Model. Psychiatr Serv 2024; 75:395. [PMID: 38204367 DOI: 10.1176/appi.ps.20230513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Affiliation(s)
- Theodore R Zarzar
- Departments of Psychiatry (Zarzar), Medicine (Rosen), and Family Medicine (Ashkin), University of North Carolina School of Medicine, Chapel Hill
| | - David L Rosen
- Departments of Psychiatry (Zarzar), Medicine (Rosen), and Family Medicine (Ashkin), University of North Carolina School of Medicine, Chapel Hill
| | - Evan A Ashkin
- Departments of Psychiatry (Zarzar), Medicine (Rosen), and Family Medicine (Ashkin), University of North Carolina School of Medicine, Chapel Hill
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Peddireddy SR, Livingston MD, Young AM, Freeman PR, Ibragimov U, Komro KA, Lofwall MR, Oser CB, Staton M, Cooper HLF. Willingness to utilize a mobile treatment unit in five counties at the epicenter of the US rural opioid epidemic. J Subst Use Addict Treat 2024; 159:209262. [PMID: 38103835 PMCID: PMC10947911 DOI: 10.1016/j.josat.2023.209262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 09/26/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION US federal policies are evolving to expand the provision of mobile treatment units (MTUs) offering medications for opioid use disorder (MOUD). Mobile MOUD services are critical for rural areas with poor geographic access to fixed-site treatment providers. This study explored willingness to utilize an MTU among a sample of people who use opioids in rural Eastern Kentucky counties at the epicenter of the US opioid epidemic. METHODS The study analyzed Cross-sectional survey data from the Kentucky Communities and Researchers Engaging to Halt the Opioid Epidemic (CARE2HOPE) study covering five rural counties in the state. Logistic regression models investigated the association between willingness to utilize an MTU providing buprenorphine and naltrexone and potential correlates of willingness, identified using the Behavioral Model for Vulnerable Populations. RESULTS The analytic sample comprised 174 people who used opioids within the past six months. Willingness to utilize an MTU was high; 76.5 % of participants endorsed being willing. Those who had recently received MOUD treatment, compared to those who had not received any form of treatment or recovery support services, had six-fold higher odds of willingness to use an MTU. However, odds of being willing to utilize an MTU were 73 % lower among those who were under community supervision (e.g., parole, probation) and 81 % lower among participants who experienced an overdose within the past six months. CONCLUSIONS There was high acceptability of MTUs offering buprenorphine and naltrexone within this sample, highlighting the potential for MTUs to alleviate opioid-related harms in underserved rural areas. However, the finding that people who were recently under community supervision or had overdosed were significantly less willing to seek mobile MOUD treatment suggest barriers (e.g., stigma) to mobile MOUD at individual and systemic levels, which may prevent improving opioid-related outcomes in these rural communities given their high rates of criminal-legal involvement and overdose.
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Affiliation(s)
- Snigdha R Peddireddy
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, USA.
| | - Melvin D Livingston
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, USA
| | - April M Young
- Department of Epidemiology and Environmental Health, University of Kentucky College of Public Health, Lexington, KY, USA
| | - Patricia R Freeman
- Department of Pharmacy Practice & Science, University of Kentucky College of Pharmacy, Lexington, KY, USA
| | - Umedjon Ibragimov
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, USA
| | - Kelli A Komro
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, USA
| | - Michelle R Lofwall
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Carrie B Oser
- Department of Sociology, University of Kentucky College of Arts & Sciences, Lexington, KY, USA
| | - Michele Staton
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Hannah L F Cooper
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, USA
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Wei LC, Chan CH. Integrating Virtual and In-Person Judicial Processes: Lessons From Taiwan's Experience During and After the COVID-19 Pandemic. Psychiatr Serv 2024; 75:398-399. [PMID: 38557132 DOI: 10.1176/appi.ps.20240042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Affiliation(s)
- Lien-Chung Wei
- Department of Addiction Psychiatry (Wei) and Department of General Psychiatry (Chan), Republic of China Ministry of Health and Welfare, Taiwan
| | - Chia-Hsiang Chan
- Department of Addiction Psychiatry (Wei) and Department of General Psychiatry (Chan), Republic of China Ministry of Health and Welfare, Taiwan
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Manthey J, Klinger S, Rosenkranz M, Schwarzkopf L. Cannabis use, health problems, and criminal offences in Germany: national and state-level trends between 2009 and 2021. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01778-z. [PMID: 38502205 DOI: 10.1007/s00406-024-01778-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 02/16/2024] [Indexed: 03/21/2024]
Abstract
The German federal government plans to decriminalise cannabis. The impact of this policy on use prevalence, cannabis-related health and legal problems cannot be fully anticipated and should be viewed in context with current trends. We used routine data on (a) cannabis use (population-based surveys), (b) cannabis-related diagnoses (ICD-10 code F12) in outpatient medical settings and (c) minor law offences (registered violations against the narcotics law for possessing small amounts) to analyse age and sex-specific trends by federal state between 2009 and 2021. To enable comparisons across time and federal state besides crude prevalence rates, age-standardised rates were calculated. Between 2009 and 2021, the age-standardised prevalence of cannabis use (5.7-10.6%), rate of diagnoses (1.1-3.7 per 1,000), and legal offences (1.8-3.1 per 1,000) increased, with the largest increase noted for cannabis-related diagnoses. Relatively, increases were most pronounced for older users (40-to-59-year-olds: use and offences; 35-to-44-year-olds: cannabis-related diagnoses) and rather stagnant for minors. Cannabis use and health problems appear to be more pronounced in Northern and city states, while no clear geographic trend was observed for law offences. Cannabis-related outpatient treatment demand has risen more steeply than use prevalence suggesting an increasing challenge for the health care system. Despite rising rates for documented offences, the long-term implications of law violations on social and occupational life are poorly understood but may be considered for evaluations of the proposed law changes.
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Affiliation(s)
- Jakob Manthey
- Centre of Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany.
- Institute for Interdisciplinary Addiction and Drug Research, Lokstedter Weg 24, 20251, Hamburg, Germany.
- Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, 04103, Leipzig, Germany.
| | - Sinja Klinger
- Institute for Interdisciplinary Addiction and Drug Research, Lokstedter Weg 24, 20251, Hamburg, Germany
| | - Moritz Rosenkranz
- Centre of Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
- Institute for Interdisciplinary Addiction and Drug Research, Lokstedter Weg 24, 20251, Hamburg, Germany
| | - Larissa Schwarzkopf
- IFT Institut Für Therapieforschung, Mental Health and Addiction Research, Leopoldstrasse 175, 80804, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Clinic of the Ludwig Maximilians University Munich, Ziemssenstrasse 5, 80336, Munich, Germany
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Tsutsumi S, Takano A, Usami T, Kumakura Y, Kanazawa Y, Takebayashi T, Sugiyama D, Matsumoto T. Risk and protective factors for early dropout from telephone monitoring for individuals with drug convictions in community mental health centers in Japan. J Subst Use Addict Treat 2024; 162:209347. [PMID: 38494050 DOI: 10.1016/j.josat.2024.209347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/27/2024] [Accepted: 02/21/2024] [Indexed: 03/19/2024]
Abstract
INTRODUCTION Individuals involved with the criminal justice system face challenges in receiving and maintaining substance use disorder (SUD) treatment and support. Although telephone monitoring (TM) could reduce these barriers, data on TM for community-dwelling individuals involved with the criminal justice system and research on individuals who drop out of TM are scarce. We examined the factors associated with dropping out early from the Voice Bridges Project, which provides TM for individuals on probation for drug-related convictions through community mental health centers in Japan. METHODS Participants (n = 546) were individuals aged ≥20 years with methamphetamine-related convictions who were on probation. Univariate analyses examine the associations between one-year follow-up status and baseline variables, and multivariate Cox proportional hazards regression analyses identify the risk and protective factors associated with dropping out. Stratified analyses report results based on sex and halfway-house residency. RESULTS The one-year dropout rate was 43.6 % (n = 238). Multivariate analysis identified two risk factors for dropping out-halfway-house residency and suicide attempts in the past year, and two protective factors-higher education and the current use of SUD services. Sex-stratified analyses showed that halfway-house residency was a risk factor for both men and women. Attempted suicide was a risk factor for women. Conversely, higher education and current use of SUD services were protective factors for men. CONCLUSIONS Our results identify unique risk factors for women, such as a recent history of suicide attempts, and distinctive protective factors for men, including higher education and current use of SUD services, emphasizing the importance of sex-specific approaches. Furthermore, the study reveals that irrespective of sex, vulnerable individuals, such as halfway-house residents, are at a higher risk of dropping out from TM.
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Affiliation(s)
- Shiori Tsutsumi
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira-shi, Tokyo, Japan; Graduate School of Health Management, Keio University, 4411 Endo, Fujisawa-shi, Kanagawa, Japan.
| | - Ayumi Takano
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira-shi, Tokyo, Japan.
| | - Takashi Usami
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira-shi, Tokyo, Japan; Kitakyushu Municipal Mental Health and Welfare Center, 1-7-1 Bashaku, Kokurakita Ward, Kitakyushu, Fukuoka, Japan
| | - Yousuke Kumakura
- Department of Neuropsychiatry, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Yuka Kanazawa
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo, Japan
| | - Toru Takebayashi
- Graduate School of Health Management, Keio University, 4411 Endo, Fujisawa-shi, Kanagawa, Japan; Department of Preventive Medicine and Public Health, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo, Japan.
| | - Daisuke Sugiyama
- Graduate School of Health Management, Keio University, 4411 Endo, Fujisawa-shi, Kanagawa, Japan; Department of Preventive Medicine and Public Health, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo, Japan; Faculty of Nursing and Medical Care, Keio University, 4411 Endo, Fujisawa-shi, Kanagawa, Japan.
| | - Toshihiko Matsumoto
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira-shi, Tokyo, Japan.
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Graves BD, Fendrich M. Community-based substance use treatment programs for reentering justice-involved adults: A scoping review. Drug Alcohol Depend Rep 2024; 10:100221. [PMID: 38425420 PMCID: PMC10901914 DOI: 10.1016/j.dadr.2024.100221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/25/2024] [Accepted: 02/13/2024] [Indexed: 03/02/2024]
Abstract
Introduction For adults involved with the criminal justice system who are reentering their communities post-incarceration, there is a large need for community-based substance use treatment. Little is known, however, about the types, availability, and benefits of programs targeting the reentry population in community settings that operate independently from the criminal justice system. Methods We conducted a scoping review of community-based treatment programs for substance use among reentering justice-involved adults to examine the contemporary state of literature and identify research gaps. We searched four databases for peer-reviewed articles conducted in the United States and published between 2017 and 2021. Results The final sample included 58 articles. Interventions varied, but the two most prominent were medications for opioid use disorder (35%) and peer support or social support interventions (22.4%). Studies were more likely to show positive impact on substance use outcomes than criminal justice outcomes. Themes were identified around participant characteristics, treatment delivery, and treatment benefits. Conclusions Findings from this scoping review suggest that the range of evidence-based strategies for substance use treatment targeting the reentry population is growing, but there is a need for additional research that examines implementation, cost effectiveness, and racial/ethnic disparities.
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Rhodes Fortino B, Carda-Auten J, DiRosa EA, Rosen DL. Provision of health care services related to substance use disorder in southern U.S. jails. J Subst Use Addict Treat 2024; 158:209234. [PMID: 38061634 PMCID: PMC10947909 DOI: 10.1016/j.josat.2023.209234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 08/09/2023] [Accepted: 11/20/2023] [Indexed: 03/18/2024]
Abstract
INTRODUCTION The U.S. jail population has more than tripled since the 1980s, and today, one out of every three incarcerated individuals is being held in a county or city jail. Substance use disorders (SUD) are overrepresented in incarcerated populations; however, little recent research has examined the availability and quality of SUD-related health care services in jail settings. Incarcerated individuals may engage with a variety of SUD-related health care services, including: screening and withdrawal management at entry, SUD treatment or other brief health care interventions while they are being held, and overdose prevention education and reentry planning at release. METHODS We conducted a thematic analysis of qualitative data from 34 interviews conducted with 38 personnel from a purposive sample of jails that varied in size and rurality within a five-state study area. The goals of the analyses were to: 1) describe jail health care services for SUD and barriers to service provision, 2) compare current practices to best practice recommendations, and 3) provide context by describing factors at the jail and community level that influence service provision, such as access to resources. RESULTS Interviewees described wide variability in both availability and comprehensiveness of SUD-related health care services. Most adhered to federal guidance for supervising withdrawal from alcohol and benzodiazepines, but not opioids. Medication for addiction treatment was most widely available for pregnant women and rarely for other individuals. Roughly one third of the jails in our sample provided behavioral group or individual therapy with a licensed counselor and roughly one quarter offered self-help groups. Very few jails provided comprehensive re-entry planning and support. Jail staff reported specific barriers to providing each type of service, as well as limiting contextual factors. Despite observed increases in case volume, jail health care staff did not necessarily receive any additional funding or staff members. Overall, lack of investment in mental and behavioral health care contributed to recidivism and feelings of hopelessness among staff. CONCLUSIONS This study identified several areas where jails could improve SUD-related health care services. Many of the barriers to improvement-organizational buy-in, cost/budgeting, staffing, logistics-were not under the control of health care staff. Implementing changes will require support from local governments, jails administrators, private health care companies, and other local health care providers.
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Affiliation(s)
- Blythe Rhodes Fortino
- UNC Chapel Hill Gillings School of Global Public Health, United States of America; Duke University School of Medicine, United States of America.
| | | | - Elena A DiRosa
- UNC Chapel Hill School of Medicine, United States of America
| | - David L Rosen
- UNC Chapel Hill School of Medicine, United States of America
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Shah H, Hawks L, Walker RJ, Egede LE. Substance Use Disorders, Mental Illness, and Health Care Utilization Among Adults With Recent Criminal Legal Involvement. Psychiatr Serv 2024; 75:221-227. [PMID: 37674397 DOI: 10.1176/appi.ps.20220491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
OBJECTIVE Individuals involved with the criminal legal system have higher rates of mental illness, addiction, and health care utilization. The authors examined whether substance use disorders and mental illness alone or in combination drive health care utilization among those with recent criminal legal involvement. METHODS This cross-sectional analysis used nationally representative data from U.S. adults with past-year criminal legal involvement (N=9,039) recorded in the National Survey on Drug Use and Health (2015-2019). Using adjusted negative binomial regression models, the authors estimated relative risks for health care utilization. Primary independent variable categories included neither substance use disorder nor mental illness, substance use disorder only, mental illness only, and both conditions. Health care utilization included emergency department (ED) visits and nights spent in inpatient care. RESULTS Relative to neither mental illness nor substance use disorder, mental illness alone was associated with significantly increased acute health care services use: for ED visits, incidence risk ratio (IRR)=1.43 (95% CI=1.18-1.75) and for inpatient stays, IRR=2.14 (95% CI=1.47-3.11). Having both conditions was associated with increased ED visits (IRR=1.62, 95% CI=1.38-1.91) and inpatient stays (IRR=4.16, 95% CI=2.98-5.82). Substance use disorder alone was associated only with higher risk for ED visits compared with neither condition (IRR=1.23, 95% CI=1.01-1.50). CONCLUSIONS Mental illness with or without co-occurring substance use disorder is a strong driver of acute health care utilization after interaction with the criminal legal system. Interventions tailored to the unique needs of individuals with mental illness or substance use disorder are needed for those with recent criminal legal involvement.
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Affiliation(s)
- Harini Shah
- School of Medicine (Shah), Department of Medicine, Division of General Internal Medicine (Hawks, Walker, Egede), and Center for Advancing Population Science (Hawks, Walker, Egede), Medical College of Wisconsin, Milwaukee
| | - Laura Hawks
- School of Medicine (Shah), Department of Medicine, Division of General Internal Medicine (Hawks, Walker, Egede), and Center for Advancing Population Science (Hawks, Walker, Egede), Medical College of Wisconsin, Milwaukee
| | - Rebekah J Walker
- School of Medicine (Shah), Department of Medicine, Division of General Internal Medicine (Hawks, Walker, Egede), and Center for Advancing Population Science (Hawks, Walker, Egede), Medical College of Wisconsin, Milwaukee
| | - Leonard E Egede
- School of Medicine (Shah), Department of Medicine, Division of General Internal Medicine (Hawks, Walker, Egede), and Center for Advancing Population Science (Hawks, Walker, Egede), Medical College of Wisconsin, Milwaukee
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Johnson JE, Ramezani N, Viglione J, Hailemariam M, Taxman FS. Recommended Mental Health Practices for Individuals Interacting With U.S. Police, Court, Jail, Probation, and Parole Systems. Psychiatr Serv 2024; 75:246-257. [PMID: 37933131 DOI: 10.1176/appi.ps.20230029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
OBJECTIVE Tens of millions of individuals with mental health problems interact with the U.S. criminal legal system (including 911, police, jail detention and sentences, courts, and probation and parole) each year. The authors sought to identify recommended mental health practices for criminal legal system-involved individuals and report the percentages of U.S. counties and of the U.S. population living in counties in which each recommended practice is present. METHODS Recommended practices for criminal legal-involved individuals with mental health problems were identified from meta-analyses, reviews, and best practice recommendations. Up to four respondents per county (i.e., jail, probation, community mental health, and community substance use treatment administrators) from 950 counties were asked whether each recommended practice was present for criminal legal-involved individuals. Weighted percentages of U.S. counties using recommended practices and of the U.S. population living in counties with each recommended practice are reported. RESULTS Fifty-nine recommended practices, including general mental health approaches (e.g., permanent supportive housing, Medicaid continuity) and diagnosis-specific mental health treatments (including medications and psychotherapies), were identified. Weighted data from respondents (N=791 from 519 counties) indicated that each recommended practice was present for criminal legal-involved individuals in only 21.9%-43.0% of U.S. counties. CONCLUSIONS These results inform implementation efforts by indicating the presence of recommended care practices for criminal legal-involved individuals with mental health problems in counties nationwide. Because supportive housing, access to Medicaid reactivation in jails, and psychosocial interventions for physical pain have low presence but high importance for recovery, implementation efforts might first target these approaches.
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Affiliation(s)
- Jennifer E Johnson
- Charles Stewart Mott Department of Public Health, Michigan State University, Flint (Johnson, Hailemariam); Department of Biostatistics, Virginia Commonwealth University, Richmond (Ramezani); Department of Criminal Justice, University of Central Florida, Orlando (Viglione); Schar School of Policy and Government, Center for Advancing Correctional Excellence, George Mason University, Fairfax, Virginia (Taxman)
| | - Niloofar Ramezani
- Charles Stewart Mott Department of Public Health, Michigan State University, Flint (Johnson, Hailemariam); Department of Biostatistics, Virginia Commonwealth University, Richmond (Ramezani); Department of Criminal Justice, University of Central Florida, Orlando (Viglione); Schar School of Policy and Government, Center for Advancing Correctional Excellence, George Mason University, Fairfax, Virginia (Taxman)
| | - Jill Viglione
- Charles Stewart Mott Department of Public Health, Michigan State University, Flint (Johnson, Hailemariam); Department of Biostatistics, Virginia Commonwealth University, Richmond (Ramezani); Department of Criminal Justice, University of Central Florida, Orlando (Viglione); Schar School of Policy and Government, Center for Advancing Correctional Excellence, George Mason University, Fairfax, Virginia (Taxman)
| | - Maji Hailemariam
- Charles Stewart Mott Department of Public Health, Michigan State University, Flint (Johnson, Hailemariam); Department of Biostatistics, Virginia Commonwealth University, Richmond (Ramezani); Department of Criminal Justice, University of Central Florida, Orlando (Viglione); Schar School of Policy and Government, Center for Advancing Correctional Excellence, George Mason University, Fairfax, Virginia (Taxman)
| | - Faye S Taxman
- Charles Stewart Mott Department of Public Health, Michigan State University, Flint (Johnson, Hailemariam); Department of Biostatistics, Virginia Commonwealth University, Richmond (Ramezani); Department of Criminal Justice, University of Central Florida, Orlando (Viglione); Schar School of Policy and Government, Center for Advancing Correctional Excellence, George Mason University, Fairfax, Virginia (Taxman)
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Bukten A, Virtanen S, Hesse M, Chang Z, Kvamme TL, Thylstrup B, Tverborgvik T, Skjærvø I, Stavseth MR. The prevalence and comorbidity of mental health and substance use disorders in Scandinavian prisons 2010-2019: a multi-national register study. BMC Psychiatry 2024; 24:95. [PMID: 38317111 PMCID: PMC10840271 DOI: 10.1186/s12888-024-05540-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 01/19/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Mental health disorders are common among people in prison, but their prevalence in the Scandinavian prison population remain unclear. In this multinational register study, we examined the prevalence of mental health disorders and the comorbidity of substance use disorders (SUDs) with other mental health disorders in this population. Further, we investigated how the prevalence of mental disorders at prison entry had changed in Norway, Denmark, and Sweden over the study period. METHODS The three study cohorts included all individuals, aged 19 or older, whom had been imprisoned in Norway (2010-2019), Denmark (2011-2018), and Sweden (2010-2013). Mental disorders were defined as ICD-10 diagnoses (F-codes) registered in the national patient registers. The study prevalence was estimated based on recorded diagnoses during the entire study follow-up period in each respective country. The one-year prevalence of mental disorders was estimated for each calendar year for individuals entering prison during that year. RESULTS The Scandinavian prison cohorts included 119 507 individuals released 191 549 times during the study period. Across all three countries a high proportion of both women (61.3%-74.4%) and men (49.6%-57.9%) had at least one mental health disorder during the observation period. The most prevalent disorders were SUDs (39.1%-44.0%), depressive disorder (8.1%-17.5%), and stress related disorder (8.8%-17.1%). Women (31.8%-41.1%) had higher levels of mental health and substance use comorbidities compared to men (20.8%-27.6%). The one-year prevalence of any mental health disorder increased over time with a 33% relative increase in Norway, 8% in Denmark, and 10% in Sweden. The proportion of individuals entering prison with a comorbid SUD and other mental disorder had also increased. CONCLUSIONS While the incarceration rate has been decreasing during the past decade in the Scandinavian countries, an increasing proportion of people entering prison have a diagnosed mental health disorder. Our results suggest that prisons should provide adequate treatment and scale up services to accommodate the increasing proportion of people with complex health needs among incarcerated people.
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Affiliation(s)
- Anne Bukten
- Norwegian Centre for Addiction Research, University of Oslo, Kirkeveien 166, Oslo, N-0407, Norway.
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
| | - Suvi Virtanen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Morten Hesse
- Center for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Zheng Chang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | | | - Birgitte Thylstrup
- Center for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Torill Tverborgvik
- Norwegian Centre for Addiction Research, University of Oslo, Kirkeveien 166, Oslo, N-0407, Norway
| | - Ingeborg Skjærvø
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Marianne R Stavseth
- Norwegian Centre for Addiction Research, University of Oslo, Kirkeveien 166, Oslo, N-0407, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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O'Grady MA, Elkington KS, Robson G, Achebe IY, Williams AR, Cohall AT, Cohall R, Christofferson M, Garcia A, Ramsey KS, Lincourt P, Tross S. Referral to and engagement in substance use disorder treatment within opioid intervention courts in New York: a qualitative study of implementation barriers and facilitators. Subst Abuse Treat Prev Policy 2024; 19:12. [PMID: 38287329 PMCID: PMC10826099 DOI: 10.1186/s13011-024-00593-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 01/09/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND People with opioid use disorder (OUD) are frequently in contact with the court system and have markedly higher rates of fatal opioid overdose. Opioid intervention courts (OIC) were developed to address increasing rates of opioid overdose among court defendants by engaging court staff in identification of treatment need and referral for opioid-related services and building collaborations between the court and OUD treatment systems. The study goal was to understand implementation barriers and facilitators in referring and engaging OIC clients in OUD treatment. METHODS Semi-structured interviews were conducted with OIC stakeholders (n = 46) in 10 New York counties in the United States, including court coordinators, court case managers, and substance use disorder treatment clinic counselors, administrators, and peers. Interviews were recorded and transcribed and thematic analysis was conducted, guided by the Exploration, Preparation, Implementation, Sustainment (EPIS) framework, employing both inductive and deductive coding. RESULTS Results were conceptualized using EPIS inner (i.e., courts) and outer (i.e., OUD treatment providers) implementation contexts and bridging factors that impacted referral and engagement to OUD treatment from the OIC. Inner factors that facilitated OIC implementation included OIC philosophy (e.g., non-punitive, access-oriented), court organizational structure (e.g., strong court staff connectedness), and OIC court staff and client characteristics (e.g., positive medications for OUD [MOUD] attitudes). The latter two also served as barriers (e.g., lack of formalized procedures; stigma toward MOUD). Two outer context entities impacted OIC implementation as both barriers and facilitators: substance use disorder treatment programs (e.g., attitudes toward the OIC and MOUD; operational characteristics) and community environments (e.g., attitudes toward the opioid epidemic). The COVID-19 pandemic and bail reform were macro-outer context factors that negatively impacted OIC implementation. Facilitating bridging factors included staffing practices that bridged court and treatment systems (e.g., peers); barriers included communication and cultural differences between systems (e.g., differing expectations about OIC client success). CONCLUSIONS This study identified key barriers and facilitators that OICs may consider as this model expands in the United States. Referral to and engagement in OUD treatment within the OIC context requires ongoing efforts to bridge the treatment and court systems, and reduce stigma around MOUD.
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Affiliation(s)
- Megan A O'Grady
- Department of Public Health Sciences, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT, 06030, USA.
| | - Katherine S Elkington
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, NY, USA
- Center for Behavioral Health and Youth Justice, Columbia University, New York Psychiatric Institute, New York, NY, USA
| | - Gail Robson
- Callen-Lorde Community Health Center, New York, NY, USA
| | - Ikenna Y Achebe
- Center for Behavioral Health and Youth Justice, Columbia University, New York Psychiatric Institute, New York, NY, USA
| | - Arthur Robin Williams
- Division on Substance Use Disorders, New York State Psychiatric Institute, New York, NY, USA
| | - Alwyn T Cohall
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Renee Cohall
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | | | - Kelly S Ramsey
- New York State Office of Addiction Services and Supports, Albany, NY, USA
| | - Pat Lincourt
- New York State Office of Addiction Services and Supports, Albany, NY, USA
| | - Susan Tross
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, NY, USA
- Division on Substance Use Disorders, New York State Psychiatric Institute, New York, NY, USA
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Baser O, Rodchenko K, Zeng Y, Endrizal A. Mental health disparities in young adults with arrest history: a survey-based, cross-sectional analysis. Health Justice 2024; 12:1. [PMID: 38165523 PMCID: PMC10759331 DOI: 10.1186/s40352-023-00257-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 12/13/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Over 4.53 million arrests were made in 2021 in the United States. People under 26 years of age were more likely to be arrested than older people. Although mental health disparities are prominent in the incarcerated population, the subject has not been closely examined among young adults specifically. OBJECTIVES This study examines how criminal justice involvement, specifically arrests, affects the mental health of adults between 18 and 25 years of age. METHODS We analyzed secondary data using the 2021 National Survey on Drug Use and Health (NSDUH). The study used a subsample of 13,494 people aged 18 to 25 years, including 7,330 women and 6,164 men. History of arrest was the key independent variable. Depression, serious mental illness (SMI), substance use, suicidal ideation, and suicide attempt were the outcome variables. We performed five multivariate logistic regression models for each outcome variable, controlling for race/ethnicity, income, and education level for men and women separately. RESULTS Of 13,494 respondents, 6.63% had a history of arrest. Among young women, a history of arrest was associated with significantly higher adjusted odds ratios for all mental health concerns. Most notably, a history of arrest increased the likelihood of substance use by a factor of 15.19, suicide attempts by 2.27, SMI by 1.79, suicidal ideation by 1.75, and depression by 1.52. Among young men, a history of arrest was associated with increased adjusted odds ratios (AORs) for substance use (AOR, 13.37; p < .001), suicidal ideation (AOR, 1.45; p = .011), and suicide attempt (AOR, 1.82; p = .044). CONCLUSIONS We found a strong relationship between young people having an arrest history and mental health concerns. More specifically, a history of arrest was associated with all mental health concerns among young women, while it was associated with only substance use and suicide among young men. Providing arrestees with appropriate mental health care would benefit them and the criminal justice system by decreasing the odds of recidivism.
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Affiliation(s)
- Onur Baser
- Department of Economics, Bogazici University, Istanbul, Türkiye.
- Graduate School of Public Health, City University of New York, New York, NY, USA.
- University of Michigan Medical School, Ann Arbor, MI, USA.
| | | | - Yixuan Zeng
- Columbia Data Analytics, New York, NY, USA
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
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Kois LE, Murrie DC, Gowensmith WN, Packer IK. A Public Health Perspective to Reform the Competence to Stand Trial System. Psychiatr Serv 2023; 74:1289-1290. [PMID: 37070263 DOI: 10.1176/appi.ps.20230079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Affiliation(s)
- Lauren E Kois
- Department of Psychology, University of Alabama, Tuscaloosa (Kois); Department of Psychiatry and Neurobehavioral Sciences, Institute of Law, Psychiatry, and Public Policy, University of Virginia School of Medicine, Charlottesville (Murrie); Graduate School of Professional Psychology, University of Denver, Denver (Gowensmith); Department of Psychiatry, UMass Chan Medical School, Worcester, Massachusetts (Packer)
| | - Daniel C Murrie
- Department of Psychology, University of Alabama, Tuscaloosa (Kois); Department of Psychiatry and Neurobehavioral Sciences, Institute of Law, Psychiatry, and Public Policy, University of Virginia School of Medicine, Charlottesville (Murrie); Graduate School of Professional Psychology, University of Denver, Denver (Gowensmith); Department of Psychiatry, UMass Chan Medical School, Worcester, Massachusetts (Packer)
| | - W Neil Gowensmith
- Department of Psychology, University of Alabama, Tuscaloosa (Kois); Department of Psychiatry and Neurobehavioral Sciences, Institute of Law, Psychiatry, and Public Policy, University of Virginia School of Medicine, Charlottesville (Murrie); Graduate School of Professional Psychology, University of Denver, Denver (Gowensmith); Department of Psychiatry, UMass Chan Medical School, Worcester, Massachusetts (Packer)
| | - Ira K Packer
- Department of Psychology, University of Alabama, Tuscaloosa (Kois); Department of Psychiatry and Neurobehavioral Sciences, Institute of Law, Psychiatry, and Public Policy, University of Virginia School of Medicine, Charlottesville (Murrie); Graduate School of Professional Psychology, University of Denver, Denver (Gowensmith); Department of Psychiatry, UMass Chan Medical School, Worcester, Massachusetts (Packer)
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Savinkina A, Jurecka C, Gonsalves G, Barocas JA. Mortality, incarceration and cost implications of fentanyl felonization laws: A modeling study. Int J Drug Policy 2023; 121:104175. [PMID: 37729682 PMCID: PMC10840895 DOI: 10.1016/j.drugpo.2023.104175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 08/16/2023] [Accepted: 08/22/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND Opioid overdose continues to be a major cause of death in the United States. One effort to control opioid use has been to implement policies that enhance criminalization of opioid possession. Laws to further criminalize possession of fentanyl have been enacted or are under consideration across the country, including at the national level. OBJECTIVE Estimate the long-term effects on opioid death and incarceration resulting from increasingly strict fentanyl possession laws . DESIGN We built a Markov simulation model to explore the potential outcomes of a 2022 Colorado law which made possession of >1 g of drug with any amount of fentanyl a Level 4 drug felony (and escalation of the previous law, where >4 g of any drug with any amount of fentanyl in possession was considered a felony). The model simulates a cohort of people with fentanyl possession moving through the criminal justice system, exploring the probability of overdose and incarceration under different scenarios, including various fentanyl possession policies and potential interventions. SETTING Colorado PARTICIPANTS: A simulated cohort of people in possession of fentanyl. MEASUREMENTS Number of opioid overdose deaths, people incarcerated, and associated costs over 5 years. RESULTS When >4 g of a drug containing any amount of fentanyl is considered a felony in Colorado, the model predicts 5460 overdose deaths (95% CrI 410-9260) and 2,740 incarcerations for fentanyl possession (95% CrI: 230-10,500) over 5 years. When the policy changes so that >1 g possession of drug with fentanyl is considered a felony, opioid overdose deaths increase by 19% (95% CRI: 16-38%) and incarcerations for possession increase by 98% (CrI: 85-98%). Diversion programs and MOUD in prison help alleviate some of the increases in death and incarceration, but do not completely offset them. LIMITATIONS The mathematical model is meant to offer broad assessment of the impact of these policies, not forecast specific and exact numerical outcomes. CONCLUSIONS Our model shows that lowering thresholds for felony possession of fentanyl containing drugs can lead to more opioid overdose deaths and incarceration.
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Affiliation(s)
- Alexandra Savinkina
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, United States; Public Health Modeling Unit, Yale School of Public Health, New Haven, CT, United States.
| | - Cole Jurecka
- Divisions of General Internal Medicine and Infectious Diseases, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Gregg Gonsalves
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, United States; Public Health Modeling Unit, Yale School of Public Health, New Haven, CT, United States
| | - Joshua A Barocas
- Divisions of General Internal Medicine and Infectious Diseases, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.
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Klemperer EM, Evans EA, Rawson R. A call to action: Contingency management to improve post-release treatment engagement among people with opioid use disorder who are incarcerated. Prev Med 2023; 176:107647. [PMID: 37499918 PMCID: PMC10808263 DOI: 10.1016/j.ypmed.2023.107647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 07/21/2023] [Accepted: 07/24/2023] [Indexed: 07/29/2023]
Abstract
People with opioid use disorder (OUD) are overrepresented in US correctional facilities and experience disproportionately high risk for illicit opioid use and overdose after release. A growing number of correctional facilities offer medication for OUD (MOUD), which is effective in reducing these risks. However, a recent evaluation found that <50% of those prescribed MOUD during incarceration continued MOUD within 30 days after release, demonstrating a need to improve post-release continuity of care. We describe available evidence on contingency management (CM), an intervention wherein patients receive incentives contingent on behavior change, to achieve this goal. A prior systematic review reported strong evidence in support of CM for increasing treatment adherence in MOUD programs, but the trials reviewed did not include incarcerated participants. Research on CM to increase treatment adherence among participants in the criminal justice system is limited with mixed findings. However, in comparison to the trials that supported CM's efficacy in the community, CM trials in the criminal justice system provided smaller rewards with greater delays in the delivery of rewards to patients, which likely contributed to null findings. Indeed, a prior meta-analysis demonstrates a dose-response relationship between the magnitude and immediacy of reward and CM effectiveness. Thus, CM involving larger and more immediately delivered rewards are likely necessary to improve MOUD adherence during the critical period following release from incarceration. Future research on the effectiveness and implementation of CM to improve MOUD retention after release from incarceration is warranted.
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Affiliation(s)
- Elias M Klemperer
- University of Vermont, College of Medicine, Department of Psychiatry, United States of America.
| | - Elizabeth A Evans
- University of Massachusetts Amherst, School of Public Health & Health Sciences, United States of America
| | - Richard Rawson
- University of Vermont, College of Medicine, Department of Psychiatry, United States of America
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Snowden LR, Cordell K, Bui J. Racial and Ethnic Disparities in Health Status and Community Functioning Among Persons with Untreated Mental Illness. J Racial Ethn Health Disparities 2023; 10:2175-2184. [PMID: 36068480 PMCID: PMC10482760 DOI: 10.1007/s40615-022-01397-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 11/30/2022]
Abstract
Using 6 years of data from the National Survey of Drug Use and Health, the present study investigated ethnic minority-White disparities in self-rated health and community functioning for persons with untreated mental illness. Comparing minority and White persons with untreated severe mental illness (SMI) and mild and moderate mental illness (MMMI), the study sought evidence of "double jeopardy": that minority persons with mental illness suffer an added burden from being members of ethnic minority groups. For African Americans with SMI and MMMI, results indicated that the odds were greater of living in poverty, being unemployed, and being arrested in the past year, and for African Americans with SMI, the odds were greater of reporting fair/poor health. For Native Americans/Alaska Native persons with MMMI, the odds were greater of living in poverty and being arrested in the past year. For Latinx persons with SMI and MMMI, the odds were greater of living in poverty and for Latinx persons with SMI the odds were greater of reporting fair/poor health. Results indicate that African Americans with mental illness suffer pervasive adversity relative to Whites and Native Americans/Alaska Natives and Latinx persons do so selectively.
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Affiliation(s)
- Lonnie R. Snowden
- School of Public Health, University of California, Berkeley, Berkeley, CA 94720 USA
| | - Katharan Cordell
- Center for Innovation and Population Health, University of Kentucky, Lexington, KY 40506 USA
| | - Juliet Bui
- Office of Minority Health, U S Department of Health and Human Services, Rockville, MD USA
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23
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Yukhnenko D, Blackwood N, Lichtenstein P, Fazel S. Association of substance use and other psychiatric disorders with all-cause and external-cause mortality in individuals given community sentences in Sweden: a national cohort study. Lancet Reg Health Eur 2023; 33:100703. [PMID: 37954004 PMCID: PMC10636268 DOI: 10.1016/j.lanepe.2023.100703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 11/14/2023]
Abstract
Background Consistently high rates of premature mortality have been reported in individuals who receive community sentences. However, few studies have explored potential modifiable risk factors for these rates, particularly mental health. We examined the association of substance use and other psychiatric disorders with all-cause and external-cause mortality in individuals convicted of a criminal offence and given a community sentence. Methods We did a longitudinal cohort study of 109,751 individuals given community sentences in Sweden using population-based registers. We calculated mortality rates for all-cause and external-cause mortality, hazard ratios for the association between psychiatric disorders and mortality, and population attributable fractions to quantify the contribution of psychiatric disorders to mortality risk. Findings During the follow-up, 5749 (5.2%) individuals died, including 2709 (2.5%) from external causes. Individuals with pre-existing substance use and other psychiatric disorders had an increased mortality risk from any cause (aHR = 2.28 [95% CI 2.15-2.42]) and from external causes (3.11 [2.85-3.40]) compared to individuals without known psychiatric or substance use disorders. Suicide was the most common cause of death in younger persons. Interpretation In individuals given community sentences, substance use and other psychiatric disorders were associated with an increased risk of premature death with suicide being the leading cause of death. Community supervision represents an opportunity to provide sentenced individuals with access to evidence-based treatment targeting substance misuse and psychiatric disorders to prevent potentially preventable deaths. Funding Wellcome Trust.
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Affiliation(s)
| | - Nigel Blackwood
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
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24
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Prins SJ, Shefner RT, Kajeepeta S, Levy N, Esie P, Mauro PM. Longitudinal relationships among exclusionary school discipline, adolescent substance use, and adult arrest: Public health implications of the school-to-prison pipeline. Drug Alcohol Depend 2023; 251:110949. [PMID: 37699288 PMCID: PMC10868664 DOI: 10.1016/j.drugalcdep.2023.110949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 08/01/2023] [Accepted: 08/06/2023] [Indexed: 09/14/2023]
Abstract
PURPOSE Exclusionary school discipline is an initiating component of the school-to-prison pipeline that is racialized and may lead to short- and long-term negative substance use and criminal legal outcomes. However, these impacts, and racial disparities therein, have not been well explored empirically at the individual-level. PROCEDURES We analyzed data from the National Longitudinal Study of Adolescent to Adult Health (1995-2009). We fit survey-weighted multivariable logistic regression models to estimate reciprocal relationships between exclusionary discipline and adolescent substance use, between these factors and subsequent exposure to the adult criminal legal system, and whether these relationships were modified by race or ethnicity. RESULTS We found that students reporting substance use had 2.07 (95% CI 1.57, 2.75) times greater odds of reporting subsequent school discipline, and students exposed to school discipline had 1.59 (95% CI 1.26, 2.02) times greater odds of reporting subsequent substance use. Substance use and school discipline were associated with 2.69 (95% CI 2.25, 3.22) and 2.98 (95% CI 2.46, 3.60) times the odds of reporting subsequent adult criminal legal system exposure, respectively. There was little evidence of effect modification by race/ethnicity. CONCLUSIONS Findings indicate that school discipline and substance use are reciprocally associated and have direct implications for adolescent health and future criminal legal system exposure.
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Affiliation(s)
- Seth J Prins
- Columbia University Mailman School of Public Health, Department of Epidemiology, 722 W 168th Street, New York, NY, United States; Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, 722 W 168th Street, New York, NY, United States.
| | - Ruth T Shefner
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, 722 W 168th Street, New York, NY, United States.
| | - Sandhya Kajeepeta
- Columbia University Mailman School of Public Health, Department of Epidemiology, 722 W 168th Street, New York, NY, United States; Thurgood Marshall Institute, NAACP Legal Defense and Educational Fund, Inc., New York, NY, USA.
| | - Natalie Levy
- Columbia University Mailman School of Public Health, Department of Epidemiology, 722 W 168th Street, New York, NY, United States.
| | - Precious Esie
- Columbia University Mailman School of Public Health, Department of Epidemiology, 722 W 168th Street, New York, NY, United States.
| | - Pia M Mauro
- Columbia University Mailman School of Public Health, Department of Epidemiology, 722 W 168th Street, New York, NY, United States.
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25
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Howell BA, Hawks LC, Balasuriya L, Chang VW, Wang EA, Winkelman TNA. Health Insurance and Mental Health Treatment Use Among Adults With Criminal Legal Involvement After Medicaid Expansion. Psychiatr Serv 2023; 74:1019-1026. [PMID: 37016823 PMCID: PMC10939137 DOI: 10.1176/appi.ps.20220171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
OBJECTIVE Individuals with criminal legal involvement have high rates of substance use and other mental disorders. Before implementation of the Affordable Care Act's Medicaid expansion, they also had low health insurance coverage. The objective of this study was to assess the impact of Medicaid expansion on health insurance coverage and use of treatment for substance use or other mental disorders in this population. METHODS The authors used restricted data (2010-2017) from the National Survey on Drug Use and Health (NSDUH). Using a difference-in-differences approach, the authors estimated the impact of Medicaid expansion on health insurance coverage and treatment for substance use or other mental disorders among individuals with recent criminal legal involvement. RESULTS The sample consisted of 9,910 NSDUH respondents who were ages 18-64 years, had a household income ≤138% of the federal poverty level, and reported past-year criminal legal involvement. Medicaid expansion was associated with an 18 percentage-point increase in insurance coverage but no change in receipt of substance use treatment among individuals with substance use disorder. Individuals with any other mental illness had a 16 percentage-point increase in insurance coverage but no change in receipt of mental health treatment. CONCLUSIONS Despite a large increase in health insurance coverage among individuals with criminal legal involvement and substance use or other mental disorders, Medicaid expansion was not associated with a significant change in treatment use for these conditions. Insurance access alone appears to be insufficient to increase treatment for substance use or other mental disorders in this population.
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Affiliation(s)
- Benjamin A Howell
- SEICHE Center for Health and Justice and Section of General Internal Medicine (Howell, Wang) and National Clinician Scholars Program (Balasuriya), Yale School of Medicine, New Haven; Division of General Internal Medicine and Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee (Hawks); Department of Social and Behavioral Sciences, School of Global Public Health, and Department of Population Health, Grossman School of Medicine, New York University, New York City (Chang); Health, Homelessness, and Criminal Justice Lab, Hennepin Healthcare Research Institute, and Division of General Internal Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis (Winkelman)
| | - Laura C Hawks
- SEICHE Center for Health and Justice and Section of General Internal Medicine (Howell, Wang) and National Clinician Scholars Program (Balasuriya), Yale School of Medicine, New Haven; Division of General Internal Medicine and Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee (Hawks); Department of Social and Behavioral Sciences, School of Global Public Health, and Department of Population Health, Grossman School of Medicine, New York University, New York City (Chang); Health, Homelessness, and Criminal Justice Lab, Hennepin Healthcare Research Institute, and Division of General Internal Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis (Winkelman)
| | - Lilanthi Balasuriya
- SEICHE Center for Health and Justice and Section of General Internal Medicine (Howell, Wang) and National Clinician Scholars Program (Balasuriya), Yale School of Medicine, New Haven; Division of General Internal Medicine and Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee (Hawks); Department of Social and Behavioral Sciences, School of Global Public Health, and Department of Population Health, Grossman School of Medicine, New York University, New York City (Chang); Health, Homelessness, and Criminal Justice Lab, Hennepin Healthcare Research Institute, and Division of General Internal Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis (Winkelman)
| | - Virginia W Chang
- SEICHE Center for Health and Justice and Section of General Internal Medicine (Howell, Wang) and National Clinician Scholars Program (Balasuriya), Yale School of Medicine, New Haven; Division of General Internal Medicine and Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee (Hawks); Department of Social and Behavioral Sciences, School of Global Public Health, and Department of Population Health, Grossman School of Medicine, New York University, New York City (Chang); Health, Homelessness, and Criminal Justice Lab, Hennepin Healthcare Research Institute, and Division of General Internal Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis (Winkelman)
| | - Emily A Wang
- SEICHE Center for Health and Justice and Section of General Internal Medicine (Howell, Wang) and National Clinician Scholars Program (Balasuriya), Yale School of Medicine, New Haven; Division of General Internal Medicine and Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee (Hawks); Department of Social and Behavioral Sciences, School of Global Public Health, and Department of Population Health, Grossman School of Medicine, New York University, New York City (Chang); Health, Homelessness, and Criminal Justice Lab, Hennepin Healthcare Research Institute, and Division of General Internal Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis (Winkelman)
| | - Tyler N A Winkelman
- SEICHE Center for Health and Justice and Section of General Internal Medicine (Howell, Wang) and National Clinician Scholars Program (Balasuriya), Yale School of Medicine, New Haven; Division of General Internal Medicine and Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee (Hawks); Department of Social and Behavioral Sciences, School of Global Public Health, and Department of Population Health, Grossman School of Medicine, New York University, New York City (Chang); Health, Homelessness, and Criminal Justice Lab, Hennepin Healthcare Research Institute, and Division of General Internal Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis (Winkelman)
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26
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Piros HI, Bauman A, Clark CB. An exploration of the link between narcissism, masochism, and crime in a post-incarcerated sample. J Natl Med Assoc 2023; 115:488-495. [PMID: 37541903 DOI: 10.1016/j.jnma.2023.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 04/20/2023] [Accepted: 07/25/2023] [Indexed: 08/06/2023]
Abstract
This study examined the relationship between narcissism, masochism, and violent criminal justice involvement. Current interventions used with offender populations target traits such as antisocial personality but typically ignore narcissism and masochism. Understanding the connection between violent crime, narcissism, and masochism can help us develop a more indepth understanding of which personality features contribute to an increased proclivity towards criminal action. The participants (N = 494) were post-incarcerated individuals. To assess individuals' degree of narcissistic and masochistic thinking, the Narcissistic Personality Inventory and the underserving self-image subscale of the Self-Defeating Interpersonal Style Scale were administered via a Qualtrics survey. Basic demographic information, psychopathy, intelligence, and personality were also measured and controlled for in the analyses. A logistic regression indicated that high levels masochistic thinking were associated with violent criminal justice involvement, even when relevant covariates were controlled for. High levels of narcissism were not found to exhibit a statically significant relationship with violent criminal justice involvement when psychopathy was controlled for. These findings suggest that masochistic characteristics may be a potential target for treatment in rehabilitating offenders.
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Affiliation(s)
- Hannah I Piros
- Department of Psychology, Wichita State University, 1845 Fairmount St, Wichita, KS 67260, United States
| | - Amy Bauman
- Department of Psychology, Wichita State University, 1845 Fairmount St, Wichita, KS 67260, United States
| | - C Brendan Clark
- Department of Psychology, Wichita State University, 1845 Fairmount St, Wichita, KS 67260, United States.
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Matheson FI, McLuhan A, Croxford R, Hahmann T, Ferguson M, Mejia-Lancheros C. Health status and health-care utilization among men recently released from a superjail: a matched prospective cohort study. Int J Prison Health 2023; ahead-of-print. [PMID: 37658480 DOI: 10.1108/ijph-01-2023-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
PURPOSE Continuity of care and access to primary care have been identified as important contributors to improved health outcomes and reduced reincarceration among people who are justice-involved. While the disproportionate burden of health concerns among incarcerated populations is well documented, less is known about their health service utilization, limiting the potential for effective improvements to current policy and practice. This study aims to examine health status and health care utilization among men recently released from a superjail in a large metropolitan area to better understand patterns of use, risk factors and facilitators. DESIGN/METHODOLOGY/APPROACH Participants included adult men (n = 106) matched to a general population group (n = 530) in Ontario, Canada, linked to medical records (88.5% linkage) to examine baseline health status and health utilization three-months post-release. The authors compared differences between the groups in baseline health conditions and estimated the risk of emergency department, primary care, inpatient hospitalization and specialist ambulatory care visits. FINDINGS Superjail participants had a significantly higher prevalence of respiratory conditions, mental illness, substance use and injuries. Substance use was a significant risk factor for all types of visits and emergency department visits were over three times higher among superjail participants. ORIGINALITY/VALUE This empirical case is illustrative of an emerging phenomenon in some regions of the world where emergency departments serve as de facto "walk-in clinics" for those with criminal justice involvement. Strategic approaches to health services are required to meet the complex social and health needs and disparities in access to care experienced by men released from custody.
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Affiliation(s)
- Flora I Matheson
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada; ICES, Toronto, Canada and Dalla Lana School of Public Health and Centre for Criminology and Socio-Legal Studies, University of Toronto, Toronto, Canada
| | - Arthur McLuhan
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada
| | | | - Tara Hahmann
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada
| | - Max Ferguson
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada
| | - Cilia Mejia-Lancheros
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada
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28
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Hoff E, Hansen L, Pulitzer Z, Campalans N, Salyards M, Muquith M, Shavit S, Nguyen H, Crain C, Walker R, Nijhawan AE. A randomized control trial of a combined community health worker and re-entry intervention for people with HIV recently released from jail who use substances. J Subst Use Addict Treat 2023; 152:209118. [PMID: 37454733 DOI: 10.1016/j.josat.2023.209118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/21/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION People with human immunodeficiency virus (HIV; PWH) who use substances are disproportionately involved in the criminal justice system. While HIV viral suppression typically improves during incarceration, these gains are frequently lost after release. We evaluated the impact of a combined intervention (formerly incarcerated community health workers [CHW] plus a re-entry organization; CHW+) on postrelease HIV- and substance use-related outcomes. METHODS We conducted a pilot randomized controlled trial of a CHW+ for PWH who use substances, within 30 days of release from a large southern, urban jail. Between February 2019 and August 2021, participants were recruited, enrolled, and randomized to treatment as usual (TAU; passive referral to care) or CHW+. Follow up study visits occurred at 3, 6, and 12 months. The primary outcome was HIV VL at 6 months; secondary outcomes included 6-month urinary toxicology and high-risk substance use at 12 months. RESULTS A total of 31 participants were enrolled who were primarily male (n = 24; 77 %), Black (n = 22; 71 %), unemployed (n = 23; 74.2 %), had unstable housing (n = 18; 58 %), had food insecurity (n = 14; 45 %), and reported their drug of choice was stimulants (n = 24; 77 %). The study identified no significant difference in HIV VL suppression at 6 months (20 % v. 37 %; [CHW+ v. TAU], p = 0.61). We observed improved substance use outcomes in CHW+ v. TAU, including fewer positive urinary toxicology screens for stimulants (40 % v. 100 %; p = 0.01) and a trend toward less high-risk substance use (30 % v. 43 %). The CHW+ group met more basic needs, such as food security [+32 % v. +11 %], housing security [+52 % v. -7 %] and full-time employment [+20 % v. +5 %] compared to TAU. CONCLUSIONS PWH who use substances assigned to a combined intervention of CHW+ after jail release did not achieve higher rates of HIV VL suppression than TAU; however, they had improved substance use outcomes and met more basic subsistence needs. Results highlight the potential of culturally informed interventions to address the competing needs of PWH who use substances after release from jail and call for further development of innovative solutions to successfully bridge to HIV care in the community.
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Affiliation(s)
- Emily Hoff
- Department of Internal Medicine, University of Texas-Southwestern, Dallas, TX, United States
| | - Laura Hansen
- Division of Infectious Diseases and Geographic Medicine, University of Texas-Southwestern, Dallas, TX, United States
| | - Zoe Pulitzer
- Division of Infectious Diseases and Geographic Medicine, University of Texas-Southwestern, Dallas, TX, United States
| | - Nicholas Campalans
- Department of Internal Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Maverick Salyards
- Division of Infectious Diseases and Geographic Medicine, University of Texas-Southwestern, Dallas, TX, United States; Department of Public Health, Texas Christian University, United States
| | - Maishara Muquith
- Department of Internal Medicine, University of Texas-Southwestern, Dallas, TX, United States
| | - Shira Shavit
- Department of Family and Community Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Hue Nguyen
- Unlocking DOORS®, Dallas, TX, United States
| | | | - Robrina Walker
- Division of Infectious Diseases and Geographic Medicine, University of Texas-Southwestern, Dallas, TX, United States; The Emmes Company, Rockville, MD, United States
| | - Ank E Nijhawan
- Department of Internal Medicine, University of Texas-Southwestern, Dallas, TX, United States; Division of Infectious Diseases and Geographic Medicine, University of Texas-Southwestern, Dallas, TX, United States.
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Nteziryayo D, Xinshe L. Development of forensic medicine in Rwanda- past, present, and future perspectives. J Forensic Leg Med 2023; 98:102573. [PMID: 37557006 DOI: 10.1016/j.jflm.2023.102573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/26/2023] [Accepted: 07/31/2023] [Indexed: 08/11/2023]
Abstract
The Republic of Rwanda is a landlocked country with more than 12.6 million people. Similar to other nations in Africa, Rwanda is still developing its forensic medicine capabilities. This paper attempts to provide a concise history of forensic medicine in Rwanda, as well as a critique of the current state of affairs and recommendations for reform. The Rwanda Investigation Bureau (RIB) investigates any suspicious or unexplained deaths in the country, after which the body is sent to the nearest public hospital for medico-legal autopsy. Except for the Rwanda Forensic Laboratory, which has forensic practitioners with minimal training in forensic medicine, the majority of medical practitioners engaged in medicolegal activities in Rwanda lack forensic medicine training. To standardize medico-legal practices and forensic medicine education in the country, a competent medico-legal authority must be established to host frequent seminars, conferences, and various training programs for both forensic and non-forensic medicine experts.
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Affiliation(s)
- Damascene Nteziryayo
- Department of Forensic Pathology, College of Forensic Medicine, Xi'an Jiaotong University Health Science Center, Institute of Forensic Injury, Institute of Forensic Bioevidence, Western China Science and Technology Innovation Harbor, Shaanxi, Xi'an, 710061, PR China.
| | - Liu Xinshe
- College of Forensic Medicine, Xi'an Jiaotong University Health Science Center, Institute of Forensic Injury, Institute of Forensic Bioevidence, Western China Science and Technology Innovation Harbor, Shaanxi, Xi'an, 710061, PR China.
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30
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Rogers BG, Murphy M, Zanowick-Marr A, Chambers L, Maynard M, Galipeau D, Toma E, Almonte A, Napoleon S, Chan PA. Characterizing HIV Syndemics and the Role of Incarceration Among Men Who have Sex with Men Presenting for Care at a Sexually Transmitted Infections Clinic. AIDS Behav 2023; 27:2513-2522. [PMID: 36633764 PMCID: PMC10336172 DOI: 10.1007/s10461-023-03978-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2023] [Indexed: 01/13/2023]
Abstract
Men who have sex with men (MSM) with a history of incarceration experience unique risk factors for HIV acquisition. The current study examined unique risk factors for HIV among MSM with a history of incarceration presenting to a sexually transmitted infections (STI) clinic. We analyzed self-reported behavioral data from clinical encounters among patients attending the clinic between January 2012 and April 2021. There were 17,221 unique visits, of which 5988 were MSM. Of these, 4.34% (N = 206) were MSM with a history of incarceration. MSM with a history of incarceration were significantly more likely to report a range of behavioral risk factors for HIV, yet also were significantly less likely to perceive themselves at risk for HIV. Future research and practice should develop culturally tailored biobehavioral HIV prevention services and consider embedding these programs within criminal justice settings to better reach this at-risk group.
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Affiliation(s)
- Brooke G Rogers
- Division of Infectious Diseases, Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI, 02903, USA.
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, 02903, USA.
| | - Matthew Murphy
- Division of Infectious Diseases, Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI, 02903, USA
- The Rhode Island Public Health Institute, Providence, RI, USA
| | - Alexandra Zanowick-Marr
- Division of Infectious Diseases, Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI, 02903, USA
| | - Laura Chambers
- Division of Infectious Diseases, Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI, 02903, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, 02903, USA
| | - Michaela Maynard
- Division of Infectious Diseases, Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI, 02903, USA
| | - Drew Galipeau
- Division of Infectious Diseases, Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI, 02903, USA
| | - Emily Toma
- Division of Infectious Diseases, Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI, 02903, USA
| | - Alexi Almonte
- Division of Infectious Diseases, Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI, 02903, USA
| | - Siena Napoleon
- Division of Infectious Diseases, Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI, 02903, USA
| | - Philip A Chan
- Division of Infectious Diseases, Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI, 02903, USA
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31
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Flores MW, Sharp A, Moyer M, Fung V, Rotter MR, Cook BL. Criminal Legal Involvement Among U.S. Adults With Serious Psychological Distress and Differences by Race-Ethnicity. Psychiatr Serv 2023; 74:702-708. [PMID: 36625137 PMCID: PMC10329978 DOI: 10.1176/appi.ps.202200048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The authors examined associations between criminal legal involvement (CLI) and serious psychological distress and how these associations differed by racial-ethnic group. METHODS The authors conducted a retrospective analysis of multiple cross-sections of data from the National Survey on Drug Use and Health (2015-2019) and used multivariable linear probability regression models to assess lifetime CLI and past-year probation, parole, supervised release, or other conditional release in a nationally representative sample of noninstitutionalized U.S. adults, ages ≥18 years (N=214,505), with and without serious psychological distress. RESULTS Adults with serious psychological distress had higher rates of CLI than adults without such distress (difference of 4.1 percentage points, 95% CI=3.3-4.8, p<0.001). The rate of CLI increased as distress severity increased, from mild (3.2 percentage-point difference, 95% CI=2.6-3.8, p<0.001) to high (7.2 percentage-point difference, 95% CI=6.4-8.0, p<0.001). The risk for CLI among those with serious psychological distress was even greater for Black and Latinx adults than for White adults (1.8 percentage-point difference, 95% CI=0.1-3.5, p<0.05, and 3.2 percentage-point difference, 95% CI=1.3-5.2, p<0.01, respectively). CONCLUSIONS Rates of CLI were higher for adults with serious psychological distress. Efforts are needed to equitably triage individuals with acute mental health needs to timely psychiatric care instead of carceral settings. Collaborative models of care that commingle resources from mental health and law enforcement organizations are needed to prevent unnecessary incarceration of individuals experiencing mental health crises and to increase access to community-based treatment.
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Affiliation(s)
- Michael William Flores
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, Massachusetts (Flores, Sharp, Moyer, Cook); Departments of Psychiatry (Flores, Cook) and Medicine (Fung), Harvard Medical School, Boston; Mongan Institute, Massachusetts General Hospital, Boston (Fung); Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York City (Rotter)
| | - Amanda Sharp
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, Massachusetts (Flores, Sharp, Moyer, Cook); Departments of Psychiatry (Flores, Cook) and Medicine (Fung), Harvard Medical School, Boston; Mongan Institute, Massachusetts General Hospital, Boston (Fung); Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York City (Rotter)
| | - Margo Moyer
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, Massachusetts (Flores, Sharp, Moyer, Cook); Departments of Psychiatry (Flores, Cook) and Medicine (Fung), Harvard Medical School, Boston; Mongan Institute, Massachusetts General Hospital, Boston (Fung); Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York City (Rotter)
| | - Vicki Fung
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, Massachusetts (Flores, Sharp, Moyer, Cook); Departments of Psychiatry (Flores, Cook) and Medicine (Fung), Harvard Medical School, Boston; Mongan Institute, Massachusetts General Hospital, Boston (Fung); Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York City (Rotter)
| | - Merrill R Rotter
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, Massachusetts (Flores, Sharp, Moyer, Cook); Departments of Psychiatry (Flores, Cook) and Medicine (Fung), Harvard Medical School, Boston; Mongan Institute, Massachusetts General Hospital, Boston (Fung); Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York City (Rotter)
| | - Benjamin Lê Cook
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, Massachusetts (Flores, Sharp, Moyer, Cook); Departments of Psychiatry (Flores, Cook) and Medicine (Fung), Harvard Medical School, Boston; Mongan Institute, Massachusetts General Hospital, Boston (Fung); Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York City (Rotter)
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Sorokowska A, Trzciński M, Cieśla R, Skubisz-Ślusarczyk SA, Zieniewicz I, Hummel T, Sorokowski P. Odor exposure and recall of a virtual reality crime scene: A preliminary study. Sci Justice 2023; 63:537-541. [PMID: 37453786 DOI: 10.1016/j.scijus.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 06/05/2023] [Accepted: 06/14/2023] [Indexed: 07/18/2023]
Abstract
Environmental context reinstatement has a particular value for recall of information in forensic interviews. Since odors are valuable memory cues and can act as memory triggers, in our preliminary study we explored whether odor exposure can help people recall details of a crime scene. The study comprised 58 women and 15 men aged 22-35 who immersed in a carefully controlled environment closely resembling an actual crime setting, i.e., a virtual reality crime. Participants were exposed to an odor at encoding, recall, both or neither of these instances, yielding a total of 4 experimental groups that further completed a memory recall task. The crime scene content recall was tested in a free recall and a forced-response test immediately after seeing the crime scene and one month later. We found no significant effects of odor exposure on the free or the cued recall of the crime scene. The memory scores correlated neither with the self-assessed olfactory/visual sensitivity of the subjects, nor with the perceived odor pleasantness. These preliminary findings suggest that introduction of a vanilla odor while encoding and recalling a crime scene does not aid witness recall accuracy.
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Affiliation(s)
- Agnieszka Sorokowska
- Institute of Psychology, University of Wroclaw, ul. Dawida 1, 50-527 Wroclaw, Poland.
| | - Maciej Trzciński
- Department of Forensic Sciences, Faculty of Law, Administration and Economics, University of Wroclaw, ul. Uniwersytecka 22/26, 50-145 Wrocław, Poland.
| | - Rafał Cieśla
- Department of Forensic Sciences, Faculty of Law, Administration and Economics, University of Wroclaw, ul. Uniwersytecka 22/26, 50-145 Wrocław, Poland.
| | - Sylwia Adrianna Skubisz-Ślusarczyk
- Department of Forensic Sciences, Faculty of Law, Administration and Economics, University of Wroclaw, ul. Uniwersytecka 22/26, 50-145 Wrocław, Poland.
| | - Iwona Zieniewicz
- Department of Forensic Sciences, Faculty of Law, Administration and Economics, University of Wroclaw, ul. Uniwersytecka 22/26, 50-145 Wrocław, Poland.
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngolory, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Piotr Sorokowski
- Institute of Psychology, University of Wroclaw, ul. Dawida 1, 50-527 Wroclaw, Poland.
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Satcher MF, Bruce ML, Goodman DJ, Lord SE. Biopsychosocial contexts of timely and adequate prenatal care utilization among women with criminal legal involvement and opioid use disorder. BMC Public Health 2023; 23:729. [PMID: 37085842 PMCID: PMC10119004 DOI: 10.1186/s12889-023-15627-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 04/07/2023] [Indexed: 04/23/2023] Open
Abstract
OBJECTIVE Pregnant women with criminal legal involvement and opioid use disorder (CL-OUD) living in non-urban regions may be at risk for complex biomedical, psychological, and social barriers to prenatal care and healthy pregnancy. Yet, limited research has explored prenatal care utilization patterns among this subpopulation. This study describes the biopsychosocial factors of pregnant women with a history of criminal legal involvement and opioid use disorder (CL-OUD) associated with timely prenatal care initiation and adequate prenatal care utilization (APNCU). METHODS Analyses were conducted on a subsample of medical record data from an observational comparative effectiveness study of medication treatment models for pregnant women with diagnosed opioid use disorder (OUD) who received prenatal care in Northern New England between 2015 and 2022. The subsample included women aged ≥ 16 years with documented criminal legal involvement. Analyses included χ2, Fisher exact tests, and multiple logistic regression to assess differences in timely prenatal care and APNCU associated with biopsychosocial factors selected by backwards stepwise regression. RESULTS Among 317 women with CL-OUD, 203 (64.0%) received timely prenatal care and 174 (54.9%) received adequate care. Timely prenatal care was associated with having two or three prior pregnancies (aOR 2.37, 95% CI 1.07-5.20), receiving buprenorphine at care initiation (aOR 1.85, 95% CI 1.01-3.41), having stable housing (aOR 2.49, 95% CI 1.41-4.41), and being mandated to court diversion (aOR 4.06, 95% CI 1.54-10.7) or community supervision (aOR 2.05, 95% CI 1.16-3.63). APNCU was associated with having a pregnancy-related medical condition (aOR 2.17, 95% CI 1.27-3.71), receiving MOUD throughout the entire prenatal care period (aOR 3.40, 95% CI 1.45-7.94), having a higher number of psychiatric diagnoses (aOR 1.35, 95% CI 1.07-1.70), attending a rurally-located prenatal care practice (aOR 2.14, 95% CI 1.22-3.76), having stable housing (aOR 1.94, 95% CI 1.06-3.54), and being mandated to court diversion (aOR 3.11, 95% CI 1.19-8.15). CONCLUSION While not causal, results suggest that timely and adequate prenatal care among women with CL-OUD may be supported by OUD treatment, comorbid indications for care, stable access to social resources, and maintained residence in the community (i.e., community-based alternatives to incarceration).
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Affiliation(s)
- Milan F Satcher
- Department of Community and Family Medicine, Dartmouth Health, Lebanon, NH, USA.
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA.
| | - Martha L Bruce
- Department of Community and Family Medicine, Dartmouth Health, Lebanon, NH, USA
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
- Department of Psychiatry, Dartmouth Health, Lebanon, NH, USA
- The Dartmouth Institute, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
| | - Daisy J Goodman
- Department of Community and Family Medicine, Dartmouth Health, Lebanon, NH, USA
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
- Department of Obstetrics-Gynecology, Dartmouth Health, Lebanon, NH, USA
| | - Sarah E Lord
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
- Department of Psychiatry, Dartmouth Health, Lebanon, NH, USA
- Department of Pediatrics, Dartmouth Health, Lebanon, NH, USA
- Department of Biomedical Data Sciences, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
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Hartung DM, McCracken CM, Nguyen T, Kempany K, Waddell EN. Fatal and nonfatal opioid overdose risk following release from prison: A retrospective cohort study using linked administrative data. J Subst Use Addict Treat 2023; 147:208971. [PMID: 36821990 DOI: 10.1016/j.josat.2023.208971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 11/08/2022] [Accepted: 01/31/2023] [Indexed: 02/12/2023]
Abstract
INTRODUCTION Among individuals who are released from prison, opioid overdose is a leading cause of death with a risk more than ten-fold the general population. Although the epidemiology of opioid-related fatalities has been described, few studies have characterized both fatal and nonfatal opioid-related poisonings. The objective of this study was to estimate risk of fatal and nonfatal opioid overdose among adults released from prison. METHODS The study estimated fatal and nonfatal opioid overdose rates using linked corrections, Medicaid, hospital discharge, and vital statistics from the state of Oregon from 2014 to 2018. Multivariable proportional hazards models identified demographic and prison-related factors associated with overdose. RESULTS Between 2014 and 2017, 18,258 individuals were released from prison. A majority of individuals were male (87 %) and ages 26 to 64 (83 %). Two-thirds had a documented substance use disorder treatment need and 20 % demonstrated mental health treatment need. Following prison release, 579 opioid overdose events occurred; 65 (11 %) were fatal. The rate of opioid overdose was 1085.7 per 100,000 person-years (PY). Rates were highest in the first two weeks (2286.7 per 100,000 PY), among women (1582.9 per 100,000 PY), and those with mental health (1624.3 per 100,000 PY) or substance use disorder treatment needs (1382.6 per 100,100 PY). Only mental health (adjusted hazard ratio [aHR] 1.54, 95 % CI 1.24 to 1.90) and substance use need (aHR 2.59; 95 % CI 2.01 to 3.34) remained significant in multivariable models. CONCLUSIONS The rate of opioid overdose is markedly elevated after prison release, particularly in the first two weeks. In women, the higher rate of opioid overdose is mediated by a greater mental health burden.
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Affiliation(s)
- Daniel M Hartung
- College of Pharmacy, Oregon State University, Portland, OR, United States of America.
| | - Caitlin M McCracken
- College of Pharmacy, Oregon State University, Portland, OR, United States of America
| | - Thuan Nguyen
- OHSU-Portland State University School Public Health, Oregon Health & Science University, Portland, OR, United States of America
| | - Katherine Kempany
- Oregon Department of Corrections, Salem, OR, United States of America
| | - Elizabeth Needham Waddell
- OHSU-Portland State University School Public Health, Oregon Health & Science University, Portland, OR, United States of America
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Maeng D, Tsun ZY, Lesch E, Jacobowitz DB, Strawderman RL, Harrington DK, Li Y, Weisman RL, Lamberti JS. Affordability of Forensic Assertive Community Treatment Programs: A Return-on-Investment Analysis. Psychiatr Serv 2023; 74:358-364. [PMID: 36065582 DOI: 10.1176/appi.ps.20220186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE In this study, the authors assessed return on investment (ROI) associated with a forensic assertive community treatment (FACT) program. METHODS A retrospective secondary data analysis of a randomized controlled trial comprising 70 legal-involved patients with severe mental illness was conducted in Rochester, New York. Patients were randomly assigned to receive either FACT or outpatient psychiatric treatment including intensive case management. Unit of service costs associated with psychiatric emergency department visits, psychiatric inpatient days, and days in jail were obtained from records of New York State Medicaid and the Department of Corrections. The total dollar value difference between the two trial arms calculated on a per-patient-per-year (PPPY) basis constituted the return from the FACT intervention. The FACT investment cost was defined by the total additional PPPY cost associated with FACT implementation relative to the control group. ROI was calculated by dividing the return by the investment cost. RESULTS The estimated return from FACT was $27,588 PPPY (in 2019 dollars; 95% confidence interval [CI]=$3,262-$51,913), which was driven largely by reductions in psychiatric inpatient days, and the estimated investment cost was $18,440 PPPY (95% CI=$15,215-$21,665), implying an ROI of 1.50 (95% CI=0.35-2.97) for FACT. CONCLUSIONS The Rochester FACT program was associated with approximately $1.50 return for every $1 spent on its implementation, even without considering potential returns from other sources, including reductions in acute medical care, crime-related damages, and public safety costs. ROI estimates were highly dependent on context-specific factors, particularly Medicaid reimbursement rates for assertive community treatment and hospital stays.
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Affiliation(s)
- Daniel Maeng
- Departments of Psychiatry (Maeng, Tsun, Lesch, Jacobowitz, Weisman, Lamberti), Biostatistics and Computational Biology (Strawderman, Harrington), and Public Health Sciences (Li), University of Rochester Medical Center, Rochester, New York
| | - Zhi-Yang Tsun
- Departments of Psychiatry (Maeng, Tsun, Lesch, Jacobowitz, Weisman, Lamberti), Biostatistics and Computational Biology (Strawderman, Harrington), and Public Health Sciences (Li), University of Rochester Medical Center, Rochester, New York
| | - Eric Lesch
- Departments of Psychiatry (Maeng, Tsun, Lesch, Jacobowitz, Weisman, Lamberti), Biostatistics and Computational Biology (Strawderman, Harrington), and Public Health Sciences (Li), University of Rochester Medical Center, Rochester, New York
| | - David B Jacobowitz
- Departments of Psychiatry (Maeng, Tsun, Lesch, Jacobowitz, Weisman, Lamberti), Biostatistics and Computational Biology (Strawderman, Harrington), and Public Health Sciences (Li), University of Rochester Medical Center, Rochester, New York
| | - Robert L Strawderman
- Departments of Psychiatry (Maeng, Tsun, Lesch, Jacobowitz, Weisman, Lamberti), Biostatistics and Computational Biology (Strawderman, Harrington), and Public Health Sciences (Li), University of Rochester Medical Center, Rochester, New York
| | - Donald K Harrington
- Departments of Psychiatry (Maeng, Tsun, Lesch, Jacobowitz, Weisman, Lamberti), Biostatistics and Computational Biology (Strawderman, Harrington), and Public Health Sciences (Li), University of Rochester Medical Center, Rochester, New York
| | - Yue Li
- Departments of Psychiatry (Maeng, Tsun, Lesch, Jacobowitz, Weisman, Lamberti), Biostatistics and Computational Biology (Strawderman, Harrington), and Public Health Sciences (Li), University of Rochester Medical Center, Rochester, New York
| | - Robert L Weisman
- Departments of Psychiatry (Maeng, Tsun, Lesch, Jacobowitz, Weisman, Lamberti), Biostatistics and Computational Biology (Strawderman, Harrington), and Public Health Sciences (Li), University of Rochester Medical Center, Rochester, New York
| | - J Steven Lamberti
- Departments of Psychiatry (Maeng, Tsun, Lesch, Jacobowitz, Weisman, Lamberti), Biostatistics and Computational Biology (Strawderman, Harrington), and Public Health Sciences (Li), University of Rochester Medical Center, Rochester, New York
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Ramakrishnan A, Gonzales G. Sexual Orientation, Mental Illness, and Substance Use Disorders Among Criminal Legal System-Involved Individuals. Psychiatr Serv 2023; 74:257-264. [PMID: 36039551 DOI: 10.1176/appi.ps.202100596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the prevalence of mental illness, substance use disorders, and access to treatment among individuals from sexual minority groups who have been involved with the criminal legal system. METHODS This study used data from 195,239 heterosexual adults and 14,995 sexual minority adults ages ≥18 years surveyed in the 2015-2019 National Survey on Drug Use and Health. The authors compared mental illness, substance use disorders, and access to treatment between sexual minority and heterosexual adults by using multivariable logistic regression models and controlling for sociodemographic characteristics. RESULTS Approximately 9% of legal system-involved adults identified as belonging to a sexual minority group. Among legally involved individuals, sexual minority individuals were more likely than heterosexual individuals to have a serious mental illness, suicidal ideation, or depressive thoughts and to use inhalants, hallucinogens, alcohol, marijuana, or cocaine. Legally involved sexual minority individuals were also more likely than their heterosexual counterparts to receive treatment for mental illness or substance use disorders. The increased probability of receiving treatment for mental illness and substance use among sexual minority individuals was also observed when comparing sexual minority and heterosexual adults not involved with the criminal legal system. CONCLUSIONS This study adds new population-based research to a limited body of evidence on the health disparities and mental health needs of legally involved sexual minority populations. More research and programmatic and policy interventions are needed to better support legally involved sexual minority groups in order to achieve mental health equity for this vulnerable population.
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Affiliation(s)
- Abinaya Ramakrishnan
- Department of Medicine, Health, and Society (Ramakrishnan, Gonzales) and Department of Health Policy (Gonzales), Vanderbilt University, Nashville, Tennessee
| | - Gilbert Gonzales
- Department of Medicine, Health, and Society (Ramakrishnan, Gonzales) and Department of Health Policy (Gonzales), Vanderbilt University, Nashville, Tennessee
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Wakefield T, Bialous S, Apollonio DE. Clearing cannabis criminal records: A survey of criminal record expungement availability and accessibility among US States and Washington DC that decriminalized or legalized cannabis. Int J Drug Policy 2023; 114:103983. [PMID: 36863286 DOI: 10.1016/j.drugpo.2023.103983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 03/04/2023]
Abstract
BACKGROUND In 2022, despite expanding state-level legalization, cannabis remained illegal at the federal level, driving drug offenses, and contact with the justice system. Cannabis criminalization disproportionately impacts minorities, and criminal records carry negative economic, health, and social consequences. Legalization prevents future criminalization but fails to assist existing record-holders. We surveyed 39 states and Washington DC where cannabis was decriminalized or legalized to determine record expungement availability and accessibility for cannabis offenders. METHODS We performed a retrospective, qualitative survey of state expungement laws allowing record sealing or record destruction where cannabis use was decriminalized or legalized. Statutes were collected between February 25, 2021, and August 25, 2022, from state websites or NexisUni. We collected pardon information for two states from online state government resources. Materials were coded in Atlas.ti to determine if states had general, cannabis, and other drug conviction expungement regimes, petitions, or automated systems, waiting periods, and financial requirements. Codes were developed via inductive and iterative coding of materials. RESULTS Among places surveyed, 36 provided any conviction expungement, 34 provided general relief, 21 offered cannabis-specific relief, and 11 offered general drug relief, nonexclusively. Most states used petitions. Thirty-three general and 7 cannabis-specific programs required waiting periods. Nineteen general and 4 cannabis programs imposed administrative fees, and 16 general and one cannabis-specific program required legal financial obligations to be paid. CONCLUSION Among the 39 states and Washington DC that decriminalized or legalized cannabis and offered expungement, more states relied on general rather than cannabis-specific systems, and the majority of these required record holders to petition for relief and imposed waiting periods and financial requirements. Research is needed to determine if automating expungement, reducing or eliminating waiting periods, and eliminating financial requirements may expand record relief for former cannabis offenders.
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Affiliation(s)
- Tanner Wakefield
- Center for Tobacco Control Research and Education, School of Pharmacy, University of California, San Francisco, 530 Parnassus Avenue, Suite 366 Library, San Francisco, CA 94143, USA.
| | - Stella Bialous
- School of Nursing, University of California, San Francisco, 530 Parnassus Avenue, Suite 366 Library, San Francisco, CA 94143, USA
| | - Dorie E Apollonio
- Department of Clinical Pharmacy, University of California, San Francisco, 530 Parnassus Avenue, Suite 366 Library, San Francisco, CA 94143, USA
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Enich M, Treitler P, Swarbrick M, Belsky L, Hillis M, Crystal S. Peer Health Navigation Experiences Before and After Prison Release Among People With Opioid Use Disorder. Psychiatr Serv 2023:appips20220310. [PMID: 36820527 DOI: 10.1176/appi.ps.20220310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
OBJECTIVE Recently incarcerated people with opioid use disorder are at high risk of overdose and adverse outcomes as a result of biopsychosocial risk factors. Peer support models aiming to improve these outcomes have expanded in recent years. This qualitative study aimed to document participants' experiences with peer health navigation before and after prison release, examine participants' perspectives on the role of peer health navigators, and understand participants' views on service improvements. METHODS The authors conducted in-depth, semistructured interviews with 39 recipients of peer health navigation at release, 30 of whom also completed a follow-up interview 3 months later. Interviews were analyzed via cross-case analysis. RESULTS Interviewees differently valued the various types of support they received. Participants appreciated working with someone with shared lived experience with whom they could establish a trusting relationship. Nevertheless, structural and policy barriers meant that certain key needs-such as housing and employment-could not always be met. CONCLUSIONS Peer health navigators can connect participants to evidence-based treatment and help them address their psychosocial needs and develop skills to support long-term wellness. Further research is needed to assess the impact of peer health navigation on participant outcomes, such as overdose reduction, treatment engagement, and sustained recovery.
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Affiliation(s)
- Michael Enich
- Center for Health Services Research, Institute for Health, Health Care Policy and Aging Research, and School of Social Work, Rutgers, the State University of New Jersey, New Brunswick (Enich, Treitler, Belsky, Crystal); Center of Alcohol and Substance Use Studies, Graduate School of Allied and Professional Psychology, Rutgers University, Piscataway, New Jersey, and Collaborative Support Programs of New Jersey, Freehold (Swarbrick); University Behavioral Health Care, Rutgers Health, Piscataway, New Jersey (Hillis); School of Public Health, Rutgers University, New Brunswick, New Jersey (Crystal)
| | - Peter Treitler
- Center for Health Services Research, Institute for Health, Health Care Policy and Aging Research, and School of Social Work, Rutgers, the State University of New Jersey, New Brunswick (Enich, Treitler, Belsky, Crystal); Center of Alcohol and Substance Use Studies, Graduate School of Allied and Professional Psychology, Rutgers University, Piscataway, New Jersey, and Collaborative Support Programs of New Jersey, Freehold (Swarbrick); University Behavioral Health Care, Rutgers Health, Piscataway, New Jersey (Hillis); School of Public Health, Rutgers University, New Brunswick, New Jersey (Crystal)
| | - Margaret Swarbrick
- Center for Health Services Research, Institute for Health, Health Care Policy and Aging Research, and School of Social Work, Rutgers, the State University of New Jersey, New Brunswick (Enich, Treitler, Belsky, Crystal); Center of Alcohol and Substance Use Studies, Graduate School of Allied and Professional Psychology, Rutgers University, Piscataway, New Jersey, and Collaborative Support Programs of New Jersey, Freehold (Swarbrick); University Behavioral Health Care, Rutgers Health, Piscataway, New Jersey (Hillis); School of Public Health, Rutgers University, New Brunswick, New Jersey (Crystal)
| | - Leigh Belsky
- Center for Health Services Research, Institute for Health, Health Care Policy and Aging Research, and School of Social Work, Rutgers, the State University of New Jersey, New Brunswick (Enich, Treitler, Belsky, Crystal); Center of Alcohol and Substance Use Studies, Graduate School of Allied and Professional Psychology, Rutgers University, Piscataway, New Jersey, and Collaborative Support Programs of New Jersey, Freehold (Swarbrick); University Behavioral Health Care, Rutgers Health, Piscataway, New Jersey (Hillis); School of Public Health, Rutgers University, New Brunswick, New Jersey (Crystal)
| | - Micah Hillis
- Center for Health Services Research, Institute for Health, Health Care Policy and Aging Research, and School of Social Work, Rutgers, the State University of New Jersey, New Brunswick (Enich, Treitler, Belsky, Crystal); Center of Alcohol and Substance Use Studies, Graduate School of Allied and Professional Psychology, Rutgers University, Piscataway, New Jersey, and Collaborative Support Programs of New Jersey, Freehold (Swarbrick); University Behavioral Health Care, Rutgers Health, Piscataway, New Jersey (Hillis); School of Public Health, Rutgers University, New Brunswick, New Jersey (Crystal)
| | - Stephen Crystal
- Center for Health Services Research, Institute for Health, Health Care Policy and Aging Research, and School of Social Work, Rutgers, the State University of New Jersey, New Brunswick (Enich, Treitler, Belsky, Crystal); Center of Alcohol and Substance Use Studies, Graduate School of Allied and Professional Psychology, Rutgers University, Piscataway, New Jersey, and Collaborative Support Programs of New Jersey, Freehold (Swarbrick); University Behavioral Health Care, Rutgers Health, Piscataway, New Jersey (Hillis); School of Public Health, Rutgers University, New Brunswick, New Jersey (Crystal)
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Baker O, Wellington C, Price CR, Tracey D, Powell L, Loffredo S, Moscariello S, Meyer JP. Experience delivering an integrated service model to people with criminal justice system involvement and housing insecurity. BMC Public Health 2023; 23:222. [PMID: 36732685 PMCID: PMC9892679 DOI: 10.1186/s12889-023-15108-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/20/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND People returning to communities from prison or jail face stressors related to securing housing, including discrimination, restrictions based on prior felony convictions, and limited economic and social resources. Existing housing programs can effectively reduce housing instability but often do not fully address the needs of people involved in the criminal justice system experiencing homelessness who often have co-occurring chronic medical issues, and psychiatric and substance use disorders. METHODS Project CHANGE is an ongoing program to deliver person-centered, integrated care and services to individuals involved with the criminal justice system and experiencing homelessness. Applying a Screening, Brief Intervention, (Referral to) Treatment framework, a comprehensive needs assessment is followed by delivery of intensive housing and vocational case management; and psychiatric, substance use, and medical services in a single location by an interdisciplinary team. Participants are followed with study interviews for 12 months. The current analysis was designed to assess the baseline characteristics and needs of the sample population, and the intensity of contact required for integrated service delivery. RESULTS Between November 2019 and September 2021, 86 participants were enrolled, of whom 64% had been released from prison/jail in the past 6 months; the remainder were on parole, probation, or intensive pretrial supervision. Participants were unstably housed (64%) or residing outdoors (26.7%) or in a shelter (24.4%). Most participants had high medical need and frequent healthcare engagement through outpatient and emergency department visits. Most participants were at-risk for clinical depression, and half were diagnosed with anxiety, dissociative, stress-related, somatoform, and other non-psychotic psychiatric disorders. Over 12-month follow-up, the interdisciplinary team made over 500 contact encounters, over half of which resulted in direct services provided, including obtaining vital documents for homelessness verification, housing applications, and employment coaching. CONCLUSION Navigation of services can be particularly challenging for individuals experiencing criminal justice involvement, homelessness, and co-occurring medical, psychiatric, and substance use issues, which can be addressed holistically in an integrated service model. Integrated service delivery was time-, resource-, and staffing-intensive, and challenged by the COVID-19 pandemic, requiring innovative solutions to sustain participant engagement.
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Affiliation(s)
- Olivia Baker
- Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, USA
| | | | - Carolina R Price
- Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, USA
| | - DeShana Tracey
- Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, USA
| | - Lindsay Powell
- Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, USA
- Yale School of Nursing, New Haven, CT, USA
| | | | | | - Jaimie P Meyer
- Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, USA.
- Yale School of Public Health, Chronic Disease Epidemiology, New Haven, CT, USA.
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Balio CP, Norwood C, McFarlane T, Rusyniak D, Blackburn J. Health Care and Behavioral Service Use by Medicaid-Enrolled Adults After Release From Incarceration. Psychiatr Serv 2023; 74:192-196. [PMID: 35855622 DOI: 10.1176/appi.ps.202200035] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study explored the characteristics and health care utilization of adults released from state prisons and enrolled in Medicaid in Indiana, which has policies to facilitate timely enrollment. METHODS Medicaid claims and Department of Corrections data were used to examine demographic and incarceration characteristics and health care utilization patterns of adults (N=15,929) released from state prisons and enrolled in Medicaid within 120 days of release, between 2015 and 2018. RESULTS More than 80% of participants had at least one health encounter within 120 days of initiating coverage, and nearly 50% used the emergency department. Those enrolled in Medicaid within 30 days of release were more likely to have behavioral health needs and to utilize subacute behavioral health care than those who enrolled later. CONCLUSIONS Understanding these patterns of health care utilization is essential to operationalizing procedures and interventions to support the health care needs of adults involved in the criminal legal system.
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Affiliation(s)
- Casey P Balio
- Center for Rural Health Research and Department of Health Services Management and Policy, East Tennessee State University, Johnson City (Balio); Indiana Family and Social Services Administration, Indianapolis (Norwood, McFarlane, Rusyniak); Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis (Blackburn)
| | - Connor Norwood
- Center for Rural Health Research and Department of Health Services Management and Policy, East Tennessee State University, Johnson City (Balio); Indiana Family and Social Services Administration, Indianapolis (Norwood, McFarlane, Rusyniak); Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis (Blackburn)
| | - Tim McFarlane
- Center for Rural Health Research and Department of Health Services Management and Policy, East Tennessee State University, Johnson City (Balio); Indiana Family and Social Services Administration, Indianapolis (Norwood, McFarlane, Rusyniak); Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis (Blackburn)
| | - Dan Rusyniak
- Center for Rural Health Research and Department of Health Services Management and Policy, East Tennessee State University, Johnson City (Balio); Indiana Family and Social Services Administration, Indianapolis (Norwood, McFarlane, Rusyniak); Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis (Blackburn)
| | - Justin Blackburn
- Center for Rural Health Research and Department of Health Services Management and Policy, East Tennessee State University, Johnson City (Balio); Indiana Family and Social Services Administration, Indianapolis (Norwood, McFarlane, Rusyniak); Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis (Blackburn)
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Miller CM. A survey of prosecutors and investigators using digital evidence: A starting point. Forensic Sci Int Synerg 2022; 6:100296. [PMID: 37398922 PMCID: PMC10311201 DOI: 10.1016/j.fsisyn.2022.100296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 11/06/2022] [Accepted: 12/04/2022] [Indexed: 07/04/2023]
Abstract
Digital evidence is essential to criminal investigations and prosecutions, but its use is fraught with challenges: rapid changes in technology, the need to communicate those changes to stakeholders, and a sociopolitical landscape that leaves little room for error, particularly regarding electronic data privacy. In the criminal justice system, these challenges can affect the admissibility of evidence and its proper introduction at trial, as well as how cases are charged and resolved. A survey of 50 United States (U.S.)-based prosecutors, contextualized by data from a second survey of 51 U.S.-based investigators, explores these issues for the present and future, finding that crucial factors include training, prosecutors who specialize in digital evidence issues, and strong relationships between prosecutors and investigators.
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Zaller ND, Gorvine MM, Ross J, Mitchell SG, Taxman FS, Farabee D. Providing substance use disorder treatment in correctional settings: knowledge gaps and proposed research priorities-overview and commentary. Addict Sci Clin Pract 2022; 17:69. [PMID: 36482490 PMCID: PMC9733039 DOI: 10.1186/s13722-022-00351-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 11/18/2022] [Indexed: 12/13/2022] Open
Abstract
This manuscript is the product of the authors' discussions, literature overview, and consultation with experts in the field, and identifies important gaps in the evidence base for substance use disorder (SUD) treatment effectiveness within criminal justice (CJ) settings. Lacking from the extant literature are longitudinal investigations of treatment related outcomes during and after incarceration. Such studies could provide rich contextual data about treatment delivery and effectiveness across the CJ continuum, and would provide important insight into individual characteristics (e.g., motivation, treatment modality preferences, treatment completion rates, etc.) as well as institutional and environmental factors (e.g., appropriate staffing, space limitations for individual treatment sessions, distribution of medications, etc.). We also identified the importance of reproducibility within CJ research, and the unfortunate reality of too many single studies conducted in single (or relatively few) correctional facilities. Some of this has been because the studies designed to produce that evidence are not prioritized for funding, which has continually placed researchers in a position where we cannot make firm conclusions or recommendations based on available evidence. The importance of replicating the foundational studies in this field cannot be overstated. We hope this article spurs other researchers to join in the healthy process of questioning the existing state of the CJ-based SUD treatment research, what should be re-examined, and how we can lay a stronger foundation for the future.
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Affiliation(s)
- Nickolas D Zaller
- University of Arkansas for Medical Sciences, College of Public Health, Little Rock, AR, USA.
| | - Margaret M Gorvine
- University of Arkansas for Medical Sciences, College of Public Health, Little Rock, AR, USA
| | - Jon Ross
- TASC, Inc. (Treatment Alternatives for Safe Communities), Chicago, IL, USA
| | | | - Faye S Taxman
- George Mason University, Schar School of Policy and Government, Fairfax, VA, USA
| | - David Farabee
- New York University, School of Medicine, New York, NY, USA
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Jacobs LA, Branson Z, Greeno CG, Skeem JL, Labrum T. Community Behavioral Health Service Use and Criminal Recidivism of People With Mental, Substance Use, and Co-occurring Disorders. Psychiatr Serv 2022; 73:1397-1400. [PMID: 35578804 PMCID: PMC9669267 DOI: 10.1176/appi.ps.202100530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study assessed the relationship between community behavioral health service (CBHS) use and criminal recidivism in a broad sample of potential beneficiaries and by diagnostic group. METHODS Among a cohort of people on probation with any mental and/or substance use disorder (N=772), the study estimated the effect of CBHS use on rearrest with Cox proportional hazards models. RESULTS Service use significantly predicted reduced recidivism among people with any mental disorder (hazard rate=0.36, p=0.008), but not among those with any substance use disorder or co-occurring disorders. CONCLUSIONS CBHS use in a given week predicted a 64% reduced recidivism risk during the following week among people with any mental disorder. However, CBHS use had no clear relationship with recidivism among people with co-occurring disorders or any substance use disorder. CBHS use may reduce recidivism, depending on recipient and service characteristics.
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Affiliation(s)
- Leah A Jacobs
- School of Social Work, University of Pittsburgh, Pittsburgh (Jacobs, Greeno, Labrum); Department of Statistics and Data Science, Carnegie Mellon University, Pittsburgh (Branson); School of Social Work and Goldman School of Public Policy, University of California, Berkeley, Berkeley (Skeem)
| | - Zach Branson
- School of Social Work, University of Pittsburgh, Pittsburgh (Jacobs, Greeno, Labrum); Department of Statistics and Data Science, Carnegie Mellon University, Pittsburgh (Branson); School of Social Work and Goldman School of Public Policy, University of California, Berkeley, Berkeley (Skeem)
| | - Catherine G Greeno
- School of Social Work, University of Pittsburgh, Pittsburgh (Jacobs, Greeno, Labrum); Department of Statistics and Data Science, Carnegie Mellon University, Pittsburgh (Branson); School of Social Work and Goldman School of Public Policy, University of California, Berkeley, Berkeley (Skeem)
| | - Jennifer L Skeem
- School of Social Work, University of Pittsburgh, Pittsburgh (Jacobs, Greeno, Labrum); Department of Statistics and Data Science, Carnegie Mellon University, Pittsburgh (Branson); School of Social Work and Goldman School of Public Policy, University of California, Berkeley, Berkeley (Skeem)
| | - Travis Labrum
- School of Social Work, University of Pittsburgh, Pittsburgh (Jacobs, Greeno, Labrum); Department of Statistics and Data Science, Carnegie Mellon University, Pittsburgh (Branson); School of Social Work and Goldman School of Public Policy, University of California, Berkeley, Berkeley (Skeem)
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O'Grady MA, Tross S, Cohall A, Wilson P, Cohall R, Campos S, Lee S, Dolezal C, Elkington KS. Readiness to change among justice-involved young adults in an alternative sentencing program who screened positive for alcohol or drug risk. Addict Behav Rep 2022; 16:100456. [PMID: 36147454 PMCID: PMC9485898 DOI: 10.1016/j.abrep.2022.100456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 08/05/2022] [Accepted: 08/28/2022] [Indexed: 11/26/2022] Open
Abstract
Justice-involved young adults are in need of tailored substance use interventions. Readiness to change is a key component of substance use behavioral change. Many justice-involved young adults were ready to change their substance use. Personal reasons to quit using drugs are a potential intervention target.
Introduction Readiness to change is a key component of substance use behavioral change; yet little is known about readiness to change among justice-involved young adults. This study 1) describes readiness to change alcohol and drug use and 2) examines predictors of readiness to change alcohol and drug use among justice-involved young adults. Method Justice-involved young adults (18–24 years; n = 137) who were positive on a validated alcohol and/or drug screening tool completed an interview assessing substance use, readiness to change, and reasons to quit. A multivariable linear regression model examined whether reasons to change and substance use severity, and interactions between these, predicted readiness. Results More than half of participants were contemplating or had decided to quit/cut down substance use. Personal reasons to quit were positively related to readiness to change; interpersonal reasons were negatively associated. Conclusions This study contributes information needed to design motivational interventions for substance use among justice-involved young adults. Personal reasons to quit using drugs are a potential intervention target.
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Affiliation(s)
- Megan A O'Grady
- Department of Public Health Sciences, University of Connecticut, School of Medicine, USA
| | - Susan Tross
- Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, USA
| | - Alwyn Cohall
- Mailman School of Public Health, Columbia University, USA.,New York Presbyterian Hospital, USA
| | - Patrick Wilson
- Mailman School of Public Health, Columbia University, USA
| | - Renee Cohall
- Mailman School of Public Health, Columbia University, USA.,New York Presbyterian Hospital, USA
| | - Stephanie Campos
- Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, USA
| | - Sin Lee
- Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, USA
| | - Curtis Dolezal
- Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, USA.,HIV Center of Clinical and Behavioral Studies, USA
| | - Katherine S Elkington
- Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, USA.,HIV Center of Clinical and Behavioral Studies, USA
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46
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Crepelle A, Fegley T, Murtazashvili I. Military societies: self-governance and criminal justice in Indian country. Public Choice 2022:1-19. [PMID: 36311038 PMCID: PMC9589843 DOI: 10.1007/s11127-022-01004-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 09/10/2022] [Indexed: 06/16/2023]
Abstract
We argue that criminal justice institutions must be accessible to citizens, legitimate and have capacity to enforce law. Such was the case with the military societies of the Plains Indians: a system of criminal justice that predated the time of European contact and which remained a significant source of law and order in Indian country until the Indian Wars concluded at the end of the nineteenth century. Nonetheless, the federal government attempted to replace military societies with federal police starting circa 1850. Despite such attempts, we show that military societies remain an important institution for criminal justice on the contemporary Northern Cheyenne Reservation. When the federal government shirked on policing during the coronavirus pandemic, military societies took over important policing functions. This does not mean that traditional military societies should replace federal enforcement; rather, it shows that until the quality of federal policing improves, traditional institutions of criminal justice remain an important source of public safety in Indian country.
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Jalali A, Jeng PJ, Polsky D, Poole S, Ku YC, Woody GE, Murphy SM. Cost-effectiveness of extended-release injectable naltrexone among incarcerated persons with opioid use disorder before release from prison versus after release. J Subst Abuse Treat 2022; 141:108835. [PMID: 35933942 PMCID: PMC9508988 DOI: 10.1016/j.jsat.2022.108835] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/06/2022] [Accepted: 06/23/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Opioid use disorder (OUD) is highly prevalent among incarcerated populations, and the risk of fatal overdose following release from prison is substantial. Despite efficacy, few correctional facilities provide evidence-based addiction treatment. Extended-release injectable naltrexone (XR-NTX) administered prior to release from incarceration may improve health and economic outcomes. METHODS We conducted an economic evaluation alongside a randomized controlled trial testing the effectiveness of XR-NTX before release from prison (n = 38) vs. XR-NTX referral after release (n = 48) of incarcerated participants with OUD, both groups continuing treatment at a community addiction treatment center. The incremental cost-effectiveness ratio (ICER) assessed the cost-effectiveness of XR-NTX before release compared to referral after release for three stakeholder perspectives at 12- and 24-week periods: state policymaker, health care sector, and societal. Effectiveness measures included quality-adjusted life-years (QALYs) and abstinent years from opioids. In addition, we categorized resources as OUD-related and non-OUD-related medical care, state transfer payments, and other societal costs (productivity, criminal justice resources, etc.). RESULTS Results showed an association between XR-NTX and greater OUD-related costs and total costs from the state policymaker perspective. QALYs gained were positive but statistically insignificant between arms; however, results showed XR-NTX had an estimated 15.5 more days of opioid abstinence over 24 weeks and statistically significant at a 95 % confidence level based on the distribution of bootstrapped samples. We found that estimated ICERs to be > $500,000 per QALY for all stakeholder perspectives. For the abstinent-year effectiveness measure, we found XR-NTX before release to be cost-effective at a 95 % confidence level for willingness-to-pay values >$49,000 per abstinent-year, across all perspectives. CONCLUSIONS XR-NTX administered to persons who are incarcerated with OUD before release may provide value for stakeholders and bridge a well-known treatment gap for this vulnerable population. Lower than expected participant engagement and missing data limit our results, and study outcomes may be sensitive to methods that address missing data if replicated.
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Affiliation(s)
- Ali Jalali
- Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA.
| | - Philip J Jeng
- Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA
| | - Daniel Polsky
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Sabrina Poole
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Yi-Chien Ku
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Academy for the Judiciary, Ministry of Justice, Taiwan
| | - George E Woody
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sean M Murphy
- Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA
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Compton MT, Graves J, Zern A, Pauselli L, Anderson S, Ashekun O, Ellis S, Langlois S, Pope L, Watson AC, Wood J. Characterizing Arrests and Charges Among Individuals With Serious Mental Illnesses in Public-Sector Treatment Settings. Psychiatr Serv 2022; 73:1102-1108. [PMID: 35378991 DOI: 10.1176/appi.ps.202000581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Individuals with serious mental illnesses are overrepresented in all facets of the legal system. State-level criminal histories of patients with serious mental illnesses were analyzed to determine the proportion who had been arrested and number of lifetime arrests and charges, associations of six variables with number of arrests, and the most common charges from individuals’ first two arrests and most recent two arrests. METHODS A total of 240 patients were recruited at three inpatient psychiatric facilities and gave consent to access their criminal history. Information was extracted from Record of Arrest and Prosecution (RAP) sheets for lifetime arrests in Georgia. RESULTS A total of 171 (71%) had been arrested. Their mean±SD lifetime arrests were 8.6±10.1, and mean lifetime charges were 12.6±14.6. In a Poisson regression, number of arrests was associated with lower educational attainment, Black or African American race, the presence of a substance use disorder, the presence of a mood disorder, and female sex. Common early charges included marijuana possession, driving under the influence of alcohol, and burglary and shoplifting. Common recent charges included probation violations, failure to appear in court, officer obstruction–related charges, and disorderly conduct. CONCLUSIONS Findings point to a need for policy and program development in the legal system (e.g., pertaining to charges such as willful obstruction of an officer), the mental health community (e.g., to ensure that professionals know about clients’ legal involvement and can partner in strategies to reduce arrests), and social services sectors (to address charges, such as shoplifting, often related to material disadvantage).
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Affiliation(s)
- Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope); Gateway Behavioral Health Services, Savannah, Georgia (Graves, Anderson, Ellis); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, and St. Luke's/West Hospital Center, New York City (Pauselli); DeKalb Community Service Board, Atlanta (Ashekun, Langlois); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, College of Liberal Arts, Temple University, Philadelphia (Wood)
| | - JaShala Graves
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope); Gateway Behavioral Health Services, Savannah, Georgia (Graves, Anderson, Ellis); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, and St. Luke's/West Hospital Center, New York City (Pauselli); DeKalb Community Service Board, Atlanta (Ashekun, Langlois); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, College of Liberal Arts, Temple University, Philadelphia (Wood)
| | - Adria Zern
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope); Gateway Behavioral Health Services, Savannah, Georgia (Graves, Anderson, Ellis); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, and St. Luke's/West Hospital Center, New York City (Pauselli); DeKalb Community Service Board, Atlanta (Ashekun, Langlois); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, College of Liberal Arts, Temple University, Philadelphia (Wood)
| | - Luca Pauselli
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope); Gateway Behavioral Health Services, Savannah, Georgia (Graves, Anderson, Ellis); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, and St. Luke's/West Hospital Center, New York City (Pauselli); DeKalb Community Service Board, Atlanta (Ashekun, Langlois); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, College of Liberal Arts, Temple University, Philadelphia (Wood)
| | - Simone Anderson
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope); Gateway Behavioral Health Services, Savannah, Georgia (Graves, Anderson, Ellis); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, and St. Luke's/West Hospital Center, New York City (Pauselli); DeKalb Community Service Board, Atlanta (Ashekun, Langlois); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, College of Liberal Arts, Temple University, Philadelphia (Wood)
| | - Oluwatoyin Ashekun
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope); Gateway Behavioral Health Services, Savannah, Georgia (Graves, Anderson, Ellis); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, and St. Luke's/West Hospital Center, New York City (Pauselli); DeKalb Community Service Board, Atlanta (Ashekun, Langlois); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, College of Liberal Arts, Temple University, Philadelphia (Wood)
| | - Samantha Ellis
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope); Gateway Behavioral Health Services, Savannah, Georgia (Graves, Anderson, Ellis); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, and St. Luke's/West Hospital Center, New York City (Pauselli); DeKalb Community Service Board, Atlanta (Ashekun, Langlois); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, College of Liberal Arts, Temple University, Philadelphia (Wood)
| | - Stephanie Langlois
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope); Gateway Behavioral Health Services, Savannah, Georgia (Graves, Anderson, Ellis); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, and St. Luke's/West Hospital Center, New York City (Pauselli); DeKalb Community Service Board, Atlanta (Ashekun, Langlois); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, College of Liberal Arts, Temple University, Philadelphia (Wood)
| | - Leah Pope
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope); Gateway Behavioral Health Services, Savannah, Georgia (Graves, Anderson, Ellis); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, and St. Luke's/West Hospital Center, New York City (Pauselli); DeKalb Community Service Board, Atlanta (Ashekun, Langlois); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, College of Liberal Arts, Temple University, Philadelphia (Wood)
| | - Amy C Watson
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope); Gateway Behavioral Health Services, Savannah, Georgia (Graves, Anderson, Ellis); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, and St. Luke's/West Hospital Center, New York City (Pauselli); DeKalb Community Service Board, Atlanta (Ashekun, Langlois); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, College of Liberal Arts, Temple University, Philadelphia (Wood)
| | - Jennifer Wood
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Compton, Zern, Pope); Gateway Behavioral Health Services, Savannah, Georgia (Graves, Anderson, Ellis); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, and St. Luke's/West Hospital Center, New York City (Pauselli); DeKalb Community Service Board, Atlanta (Ashekun, Langlois); Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee (Watson); Department of Criminal Justice, College of Liberal Arts, Temple University, Philadelphia (Wood)
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Myers N, Hutnyan M, Wright G, Lee G, Woodward P, Wilkey J, Young W, Bromley E. Lessons in "Slow" Engagement From Staff and Administrators at a Prebooking Jail Diversion Program. Psychiatr Serv 2022; 73:1117-1122. [PMID: 35414189 DOI: 10.1176/appi.ps.202100317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE In this study, the authors elicited the perspectives of criminal justice and mental health stakeholders about a prebooking jail diversion program, the Judge Ed Emmett Mental Health Diversion Center, serving primarily individuals experiencing chronic homelessness and diagnosed as having a serious mental illness. METHODS The authors analyzed semistructured interviews with 19 participants and observational fieldnotes from 60 hours of ethnographic fieldwork, conducted from January to July 2020 and including five administrative-level meetings. They used qualitative coding to develop themes. Administrative data were also reviewed. RESULTS Engagement of clients in the program was a major theme. Barriers to engagement included clients’ fear of police involvement and strict rules around smoking. Facilitators to engagement included “slow” engagement, or gradual, gentle microengagements over time and across multiple visits, ideally with peer counselors. CONCLUSIONS To promote client use of services at this critical point of care, jail diversion programs might consider ongoing negotiations with clients to balance expectations between the criminal justice and mental health systems of care by using “slow” client engagement, limiting police involvement, and adopting trauma-informed and harm-reduction approaches.
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Affiliation(s)
- Neely Myers
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Wilkey); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); University of Texas Galveston Medical Branch, Galveston (Wright); Los Angeles County Department of Mental Health, Los Angeles (Lee, Woodward); The Harris Center, Houston (Young); Departments of Anthropology and Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (Bromley); U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles (Bromley)
| | - Matthew Hutnyan
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Wilkey); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); University of Texas Galveston Medical Branch, Galveston (Wright); Los Angeles County Department of Mental Health, Los Angeles (Lee, Woodward); The Harris Center, Houston (Young); Departments of Anthropology and Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (Bromley); U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles (Bromley)
| | - Gillian Wright
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Wilkey); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); University of Texas Galveston Medical Branch, Galveston (Wright); Los Angeles County Department of Mental Health, Los Angeles (Lee, Woodward); The Harris Center, Houston (Young); Departments of Anthropology and Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (Bromley); U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles (Bromley)
| | - Garrett Lee
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Wilkey); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); University of Texas Galveston Medical Branch, Galveston (Wright); Los Angeles County Department of Mental Health, Los Angeles (Lee, Woodward); The Harris Center, Houston (Young); Departments of Anthropology and Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (Bromley); U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles (Bromley)
| | - Paula Woodward
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Wilkey); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); University of Texas Galveston Medical Branch, Galveston (Wright); Los Angeles County Department of Mental Health, Los Angeles (Lee, Woodward); The Harris Center, Houston (Young); Departments of Anthropology and Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (Bromley); U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles (Bromley)
| | - Justin Wilkey
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Wilkey); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); University of Texas Galveston Medical Branch, Galveston (Wright); Los Angeles County Department of Mental Health, Los Angeles (Lee, Woodward); The Harris Center, Houston (Young); Departments of Anthropology and Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (Bromley); U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles (Bromley)
| | - Wayne Young
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Wilkey); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); University of Texas Galveston Medical Branch, Galveston (Wright); Los Angeles County Department of Mental Health, Los Angeles (Lee, Woodward); The Harris Center, Houston (Young); Departments of Anthropology and Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (Bromley); U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles (Bromley)
| | - Elizabeth Bromley
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Wilkey); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); University of Texas Galveston Medical Branch, Galveston (Wright); Los Angeles County Department of Mental Health, Los Angeles (Lee, Woodward); The Harris Center, Houston (Young); Departments of Anthropology and Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (Bromley); U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles (Bromley)
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Pope LG, Compton MT. "If This Is an Emergency, Hang up and Dial 911" in the Era of 988. Psychiatr Serv 2022; 73:1179-1181. [PMID: 35895843 DOI: 10.1176/appi.ps.20220261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The recent implementation of 988 as a behavioral crisis hotline is a critical opportunity for improving crisis care across the United States. The bold vision for 988 is to offer individuals experiencing a mental health crisis a rapid entry into a coordinated crisis system and reduce reliance on 911 (and prevent a police response when it is not warranted). In this Open Forum, the authors suggest that mental health professionals have a role to play in educating their clients about when to use 988. Promoting 988 will also depend on answering key questions about what constitutes a crisis and how 988 is being implemented at a local level.
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Affiliation(s)
- Leah G Pope
- New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City
| | - Michael T Compton
- New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City
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