Sodhi-Berry Nita, Preen David B, Alan Janine, Knuiman Matthew, Morgan Vera A
Centre for Health Services Research, School of Population Health, The University of Western Australia, Crawley, Australia.
Crim Behav Ment Health. 2014 Jul;24(3):204-21. doi: 10.1002/cbm.1901. Epub 2014 Feb 17.
Little is known about community mental health service use prior to offending.
This study aimed to investigate the 1-year community mental health service use by adult offenders (18-44 years) prior to their first ever criminal sentence in Western Australia.
Administrative mental health service data were compared between all offenders (n = 23,755) commencing their first ever criminal sentence in Western Australia during 1985-1994 and a matched community group of 21,977 non-offenders.
Just over 8% of offenders had used mental health services prior to sentence compared with 1% of non-offenders. After adjusting for age, offenders were more likely to have used these services than non-offenders in all gender-race groups, but the effect was strongest for non-Indigenous women, who were over 12 times more likely to have used such services, and weakest among Indigenous men, who were about twice as likely to have used them as their non-offending peers. Service use for substance use disorder, the most common diagnosis, was about one and a half times more prevalent among Indigenous than non-Indigenous offenders, regardless of gender. For non-Indigenous offenders, prevalence of any mental health service contact was higher for violent than non-violent offenders, irrespective of gender. Service use was no different between offenders receiving custodial or non-custodial sentences in all gender-race groups.
The higher likelihood of mental health service use by offenders in the year prior to their first ever sentence than by non-offenders suggests that, insofar as the disorder was relevant to offending, there were some opportunities for preventive measures during that time. Differential service use according to gender and Indigenous/non-Indigenous status is of concern. It would be important to understand more about this apparently unequal service access, not least because Indigenous populations tend to be over-represented in prison.
关于犯罪前社区心理健康服务的使用情况，人们了解甚少。
本研究旨在调查西澳大利亚州成年罪犯（18 - 44岁）在首次被刑事判决前一年的社区心理健康服务使用情况。
对1985 - 1994年期间在西澳大利亚州开始首次刑事判决的所有罪犯（n = 23,755）与21,977名匹配的非罪犯社区群体的心理健康服务管理数据进行比较。
略多于8%的罪犯在判决前使用过心理健康服务，而非罪犯的这一比例为1%。在对年龄进行调整后，所有性别 - 种族群体中，罪犯比非罪犯更有可能使用这些服务，但这种影响在非土著女性中最为明显，她们使用此类服务的可能性是常人的12倍多，而在土著男性中最弱，他们使用这些服务的可能性约为非犯罪同龄人中的两倍。物质使用障碍是最常见的诊断，无论性别，土著罪犯中该障碍的服务使用率比非土著罪犯高约1.5倍。对于非土著罪犯，无论性别，暴力罪犯的任何心理健康服务接触率都高于非暴力罪犯。在所有性别 - 种族群体中，被判处监禁或非监禁刑罚的罪犯之间的服务使用情况没有差异。
罪犯在首次被判刑前一年使用心理健康服务的可能性高于非罪犯，这表明，就该疾病与犯罪相关而言，在此期间存在一些预防措施的机会。按性别和土著/非土著身份划分的服务使用差异令人担忧。更深入了解这种明显不平等服务获取情况非常重要，尤其是因为土著人口在监狱中的比例往往过高。
