Rivas-Vazquez Rafael A, Sarria Manuel, Rey Gustavo, Rivas-Vazquez Ana A, Rodriguez Julissa, Jardon Mario E
Citrus Health Network, 4175 West 20th Ave., Hialeah, FL 33012, USA.
Psychiatr Serv. 2009 Jun;60(6):766-71. doi: 10.1176/ps.2009.60.6.766.
This study assessed the effectiveness of a postbooking jail diversion program for a homeless population with mental illness in South Florida, as measured by rate of arrests after admission to the program. The program (termed relationship-based care) is structured to ensure access to psychiatric and primary health care, delivered within a theoretical framework developed for working with this population.
Data were reviewed from the Criminal Justice Information System in Miami-Dade County for 229 adults who were arrested and found to be appropriate for jail diversion. Data for 151 individuals who were consecutively diverted to the relationship-based care program were compared with data for a control group of 78 individuals who had been diverted to other programs in the community. Arrest rates for each participant during the year before diversion were compared with arrest rates for the year after diversion. In addition, for persons in the relationship-based care program, demographic data, type of homelessness (chronic or situational), and number of psychiatric contacts were analyzed to determine the impact of these variables on outcome.
A highly significant reduction in arrest rates for individuals diverted to the relationship-based care program was observed. However, the arrest rate for the control group remained nearly identical before and after diversion. For the relationship-based care group, prediversion arrest rates, duration of participation in the program, and number of psychiatric contacts accounted for a significant portion of the recidivism variance.
The relationship-based care model described here appears to be an effective strategy for reducing criminal recidivism. Length of participation in the program and involvement in psychiatric treatment were correlated with reduced arrest rates. Identifying individuals who are at risk of poor engagement in community services and subsequent premature departure remains a challenge.
本研究评估了南佛罗里达州针对患有精神疾病的无家可归者的预订后监狱分流项目的有效性,以该项目参与者入院后的逮捕率作为衡量标准。该项目(称为基于关系的护理)旨在确保在为该人群制定的理论框架内提供精神科和初级卫生保健服务。
对迈阿密-戴德县刑事司法信息系统中229名被捕且被认定适合监狱分流的成年人的数据进行了审查。将连续被分流到基于关系的护理项目的151人的数据与被分流到社区其他项目的78人对照组的数据进行了比较。比较了每个参与者分流前一年的逮捕率与分流后一年的逮捕率。此外,对于基于关系的护理项目中的人员,分析了人口统计学数据、无家可归类型(长期或临时)以及精神科接触次数,以确定这些变量对结果的影响。
观察到被分流到基于关系的护理项目的个体逮捕率显著降低。然而,对照组的逮捕率在分流前后几乎保持不变。对于基于关系的护理组,分流前的逮捕率、参与项目的时长以及精神科接触次数在再犯差异中占很大比例。
这里描述的基于关系的护理模式似乎是减少犯罪再犯的有效策略。参与项目的时长和接受精神科治疗与逮捕率降低相关。识别有社区服务参与度低和随后过早离开风险的个体仍然是一项挑战。