Magee Lauren A, Fortenberry J Dennis, Rosenman Marc, Aalsma Matthew C, Gharbi Sami, Wiehe Sarah E
O'Neill School of Public and Environmental Affairs, Indiana University Purdue University Indianapolis, 801 W. Michigan St, Indianapolis, IN, 46202, USA.
Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.
Health Justice. 2021 Jan 7;9(1):2. doi: 10.1186/s40352-020-00126-2.
Individuals with mental illness and co-occurring substance use disorders often rapidly cycle through the justice system with multiple arrests. Therefore, is it imperative to examine the prevalence of mental health and substance use diagnoses among arrestees and repeat arrestees to identify opportunities for intervention.
We linked police arrest and clinical care data at the individual level to conduct a retrospective cohort study of all individuals arrested in 2016 in Indianapolis, Indiana. We classified arrestees into three levels: 1 arrest, 2 arrests, or 3 or more arrests. We included data on clinical diagnoses between January 1, 2014 and December 31, 2015 and classified mental health diagnoses and substance use disorder (SUD) based on DSM categories using ICD9/10 diagnoses codes.
Of those arrested in 2016, 18,236 (79.5%) were arrested once, 3167 (13.8%) were arrested twice, and 1536 (6.7%) were arrested three or more times. In the 2 years before the arrest, nearly one-third (31.3%) of arrestees had a mental health diagnosis, and over a quarter (27.7%) of arrestees had an SUD diagnosis. Most of those with a mental health or SUD diagnosis had both (22.5% of all arrestees). Arrestees with multiple mental health (OR 2.68, 95% CI 2.23, 3.23), SUD diagnoses (OR 1.59, 95% CI 1.38, 1,82), or co-occurring conditions (1.72, 95% CI 1.48, 2.01) in the preceding 2 years had higher odds of repeat arrest.
Our findings show that linked clinical and criminal justice data systems identify individuals at risk of repeat arrest and inform opportunities for interventions aimed at low-level offenders with behavioral health needs.
患有精神疾病且同时存在物质使用障碍的个体常常迅速在司法系统中循环,多次被捕。因此,必须检查被捕者和再次被捕者中精神健康和物质使用诊断的患病率,以确定干预机会。
我们在个体层面将警方逮捕数据与临床护理数据相链接,对2016年在印第安纳州印第安纳波利斯被捕的所有个体进行回顾性队列研究。我们将被捕者分为三个级别:1次被捕、2次被捕或3次及以上被捕。我们纳入了2014年1月1日至2015年12月31日期间的临床诊断数据,并使用ICD9/10诊断代码根据《精神疾病诊断与统计手册》类别对精神健康诊断和物质使用障碍(SUD)进行分类。
在2016年被捕的人中,18236人(79.5%)被捕一次,3167人(13.8%)被捕两次,1536人(6.7%)被捕三次及以上。在被捕前的两年里,近三分之一(31.3%)的被捕者有精神健康诊断,超过四分之一(27.7%)的被捕者有物质使用障碍诊断。大多数有精神健康或物质使用障碍诊断的人两者都有(占所有被捕者的22.5%)。在之前两年中有多种精神健康(比值比2.68,95%置信区间2.23,3.23)、物质使用障碍诊断(比值比1.59,95%置信区间1.38,1.82)或并发疾病(1.72,95%置信区间1.48,2.01)的被捕者再次被捕的几率更高。
我们的研究结果表明,相链接的临床和刑事司法数据系统能够识别有再次被捕风险的个体,并为针对有行为健康需求的低级别罪犯的干预机会提供信息。