Center for Behavioral Health and Justice, School of Social Work, Wayne State University, Detroit, MI, USA.
Am J Community Psychol. 2021 Mar;67(1-2):7-20. doi: 10.1002/ajcp.12466. Epub 2020 Oct 3.
The overrepresentation of individuals with mental illness in the criminal/legal system is well documented. While professional associations urge diversion towards treatment, little is known about the practices these institutions use to identify this population. One understudied space in the criminal/legal continuum is jails. This exploratory study compares two types of mental health identification at jail booking to assess jail- and community-based service outcomes by identification type (N = 2956): (a) staff observation and (b) a standardized screening instrument. Individuals identified through staff observation were significantly more likely to receive jail- and community-based services, even though current symptomology and substance misuse were both significantly higher for individuals identified only by the screening instrument. These findings point to the importance of jails in providing stabilizing services during incarceration, but further, show the impact that identification practices have on individuals as they transition to the community. Community context showed varied rates of jail staff observations of mental illness, showing greater risks for individuals in rural communities. Implications include a need for system-level changes by instituting evidence-based identification practices in jails, and improving professional collaboration practices between mental health and criminal/legal practitioners as individuals enter and exit jails.
精神疾病患者在刑事/法律系统中过度出现的现象已被充分记录。尽管专业协会敦促将其分流至治疗,但对于这些机构用于识别此类人群的做法却知之甚少。在刑事/法律连续体中,一个研究不足的领域是监狱。这项探索性研究比较了监狱登记时使用的两种心理健康识别方法,以评估按识别类型(N=2956)获得的监狱和社区服务结果:(a) 工作人员观察和 (b) 标准化筛选工具。通过工作人员观察识别出的个体更有可能获得监狱和社区服务,尽管仅通过筛选工具识别出的个体的当前症状和物质滥用情况都明显更高。这些发现表明监狱在提供监禁期间稳定服务方面的重要性,但更进一步表明识别实践对个体在向社区过渡时的影响。社区环境显示出监狱工作人员对精神疾病观察的不同比率,农村社区的个体风险更大。这意味着需要在监狱中实施基于证据的识别实践,以及改善精神卫生和刑事/法律从业人员之间的专业合作实践,以提高系统水平,因为个体进出监狱。