Bethany Joy Hedden is with the School of Social Work, the Center for Behavioral Health and Justice, and the Department of Anthropology, Wayne State University, Detroit, MI. Erin Comartin and Sheryl Kubiak are with the School of Social Work and the Center for Behavioral Health and Justice, Wayne State University. Nanci Hambrick is with the Center for Behavioral Health and Justice, Wayne State University.
Am J Public Health. 2021 Feb;111(2):277-285. doi: 10.2105/AJPH.2020.305992. Epub 2020 Dec 22.
To examine the dual disproportionality that individuals with serious mental illness and people of color (PoC) occupy in the criminal-legal system. This study follows a cohort of 623 individuals who screened positive for mental health issues at booking in 8 Midwestern jails in 2017. We followed individuals through the jails' practices of jail-based mental health treatment, and we used Medicaid billing data to assess community-based behavioral health treatment engagement in the postyear period after jail release. The aim was to examine if an individual's race/ethnicity was associated with their access to jail- and community-based mental health treatment. We did not find any racial disparities in jail-based treatment, although 3 community-based outcomes significantly differed. Compared with PoC, White people had 1.9 times greater odds of receiving community-based mental health and substance use treatment and 4.5 times greater odds of receiving co-occurring disorder treatment. Barriers that individuals released from jail face adversely affect PoC, resulting in reduced access to treatment. Critical race theory can expose the assumptions and functions of systems of care and the possible reproduction of implicit bias in potential solutions.
探讨严重精神疾病患者和有色人种（PoC）在刑事法律系统中双重不成比例的现象。本研究跟踪了 2017 年在中西部 8 个监狱中登记入住时筛查出心理健康问题的 623 名个人。我们跟踪了这些个人在监狱中接受基于监狱的心理健康治疗的情况，并使用医疗补助账单数据评估了他们在监狱释放后的一年中接受社区为基础的行为健康治疗的情况。目的是研究个体的种族/族裔是否与其获得监狱和社区心理健康治疗有关。我们没有发现监狱治疗方面存在任何种族差异，尽管有 3 项社区治疗结果存在显著差异。与 PoC 相比，白人获得社区心理健康和药物使用治疗的可能性高 1.9 倍，同时获得共病治疗的可能性高 4.5 倍。从监狱获释的个人面临的障碍对 PoC 不利，导致治疗机会减少。批判种族理论可以揭示护理系统的假设和功能，以及潜在解决方案中隐含偏见的可能再现。
