加拿大安大略省省级监狱监禁前后心理健康和成瘾服务使用的流行率：一项回顾性队列研究。
Prevalence of Mental Health and Addiction Service use Prior to and During Incarceration in Provincial Jails in Ontario, Canada: A Retrospective Cohort Study.
机构信息
7978Centre for Addiction and Mental Health, Toronto, ON, Canada.
ICES, Toronto, ON, Canada.
出版信息
Can J Psychiatry. 2022 Sep;67(9):690-700. doi: 10.1177/07067437211055414. Epub 2021 Nov 18.
OBJECTIVE
Individuals with mental illness and addiction are overrepresented in prisons. Few studies have assessed mental health and addiction (MHA)-related service use among individuals experiencing incarceration using health administrative data and most focus on service use after prison release. The objective of this study was to determine the prevalence of MHA-related service use in the 5 years prior to and during incarceration.
METHODS
We used linked correctional and administrative health data for people released from Ontario provincial jails in 2010. MHA-related service use in the 5 years prior to the index incarceration was categorized hierarchically into four mutually exclusive categories based on the type of service use: psychiatric hospitalization, MHA-related emergency department (ED) visit, MHA-related outpatient visit (from psychiatrist or primary care physician), and no MHA-related service use. Demographic, diagnostic, and incarceration characteristics were compared across the four service use categories. MHA-related service use during the index incarceration was assessed by category and length of incarceration.
RESULTS
A total of 48,917 individuals were included. Prior to incarceration, 6,116 (12.5%) had a psychiatric hospitalization, 8,837 (18.1%) had an MHA-related ED visit, and 15,866 (32.4%) had an MHA-related outpatient visit. Of the individuals with any MHA-related service prior to incarceration, 60.4% did not receive outpatient care from a psychiatrist prior to incarceration and 65.6% did not receive MHA-related care during incarceration.
CONCLUSION
Despite a high prevalence of mental illness and addiction among people experiencing incarceration, access to and use of MHA-related care prior to and during incarceration is poor. Increasing the accessibility and use of MHA-related services throughout the criminal justice pathway is warranted.
目的
患有精神疾病和成瘾问题的个体在监狱中人数过多。很少有研究使用健康管理数据评估监禁期间的个体的心理健康和成瘾（MHA）相关服务使用情况，而且大多数研究都集中在监禁后服务的使用上。本研究的目的是确定在监禁前和监禁期间与 MHA 相关的服务使用的流行率。
方法
我们使用了 2010 年从安大略省监狱获释人员的链接矫正和行政健康数据。在索引监禁前的 5 年内，根据服务使用类型，将 MHA 相关服务使用分为四个互斥类别：精神科住院治疗、MHA 相关急诊就诊、MHA 相关门诊就诊（来自精神科医生或初级保健医生）和没有 MHA 相关服务使用。在四个服务使用类别中比较了人口统计学、诊断和监禁特征。通过类别和监禁长度评估索引监禁期间的 MHA 相关服务使用情况。
结果
共纳入 48917 人。在监禁前，有 6116 人（12.5%）接受过精神科住院治疗，8837 人（18.1%）接受过 MHA 相关急诊就诊，15866 人（32.4%）接受过 MHA 相关门诊就诊。在监禁前有任何 MHA 相关服务的个体中，60.4%在监禁前未接受过精神科医生的门诊治疗，65.6%在监禁期间未接受 MHA 相关治疗。
结论
尽管监禁中的个体患有精神疾病和成瘾问题的比例很高，但在监禁前和监禁期间获得和使用 MHA 相关护理的情况很差。需要提高整个刑事司法途径中 MHA 相关服务的可及性和使用情况。
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