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Inpatient early intervention for serious mental illnesses and post-discharge criminal involvement in a high-volume psychiatric hospital setting
Journal of Psychiatric Research ( IF 4.8 ) Pub Date : 2021-09-11 , DOI: 10.1016/j.jpsychires.2021.09.020
Alia R Warner 1 , Stephen Glazier 1 , Luca Lavagnino 1 , Ana Ruiz 1 , Sarah Hernandez 1 , Scott D Lane 1
Affiliation  

Individuals with serious mental illness (SMI) are at increased risk for arrest and incarceration relative to the same-community population without SMI. Publicly-funded inpatient psychiatric hospitals usually feature short lengths of stay and limited opportunities for extended services that might impact criminal justice involvement after discharge. This study examined the influence of an early intervention program for SMI at a high-volume public psychiatric hospital on involvement in the criminal justice system post-discharge. The Early Onset Treatment Program (EOTP) is an extended service intervention program for uninsured patients who are within 5 years of SMI onset. Criminal justice records (number of arrests with conviction, days of incarceration) were obtained for EOTP participants (n = 164) and comparison patients (n = 164) matched on demographics, diagnosis, and discharge date via propensity score matching. Data were zero-inflated and analyzed using hurdle models, controlling for prior arrests. The EOTP group was less likely to be convicted of at least one crime post-discharge (0 arrests vs. > 0, p < .001), and spent fewer days incarcerated (if incarcerated ≥1 day, p < .03). Participation in the EOTP service was linked to reduced likelihood of post-discharge arrest and days incarcerated. Several alternative variables may contribute to this preliminary observation, including length of stay, medication adherence, longer environmental stability, and individual patient characteristics.



中文翻译:

对严重精神疾病的住院早期干预和出院后在高容量精神病院环境中的犯罪活动

与没有 SMI 的同一社区人群相比,患有严重精神疾病 (SMI) 的个人被捕和监禁的风险更高。公共资助的住院精神病医院通常住院时间短,延长服务的机会有限,可能会影响出院后的刑事司法参与。本研究调查了大型公立精神病院的 SMI 早期干预计划对出院后参与刑事司法系统的影响。早期发病治疗计划 (EOTP) 是一项针对 SMI 发病 5 年内未投保患者的扩展服务干预计划。刑事司法记录(被定罪的逮捕人数,EOTP 参与者 (n = 164) 和比较患者 (n = 164) 通过倾向评分匹配在人口统计学、诊断和出院日期上匹配。数据为零膨胀并使用障碍模型进行分析,控制先前的逮捕。EOTP 组在出院后被判犯有至少一项罪行的可能性较小(0 次逮捕 vs. > 0,p < .001),并且被监禁的天数更少(如果监禁 ≥ 1 天,p < .03)。参与 EOTP 服务与减少出院后逮捕和监禁天数的可能性有关。几个替代变量可能有助于这一初步观察,包括住院时间、药物依从性、更长的环境稳定性和个体患者特征。数据为零膨胀并使用障碍模型进行分析,控制先前的逮捕。EOTP 组在出院后被判犯有至少一项罪行的可能性较小(0 次逮捕 vs. > 0,p < .001),并且被监禁的天数更少(如果监禁 ≥ 1 天,p < .03)。参与 EOTP 服务与减少出院后逮捕和监禁天数的可能性有关。几个替代变量可能有助于这一初步观察,包括住院时间、药物依从性、更长的环境稳定性和个体患者特征。数据为零膨胀并使用障碍模型进行分析,控制先前的逮捕。EOTP 组在出院后被判犯有至少一项罪行的可能性较小(0 次逮捕 vs. > 0,p < .001),并且被监禁的天数更少(如果监禁 ≥ 1 天,p < .03)。参与 EOTP 服务与减少出院后逮捕和监禁天数的可能性有关。几个替代变量可能有助于这一初步观察,包括住院时间、药物依从性、更长的环境稳定性和个体患者特征。p < .03)。参与 EOTP 服务与减少出院后逮捕和监禁天数的可能性有关。几个替代变量可能有助于这一初步观察,包括住院时间、药物依从性、更长的环境稳定性和个体患者特征。p < .03)。参与 EOTP 服务与减少出院后逮捕和监禁天数的可能性有关。几个替代变量可能有助于这一初步观察,包括住院时间、药物依从性、更长的环境稳定性和个体患者特征。

更新日期:2021-09-14
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