Adily Armita, Albalawi Olayan, Sara Grant, Kariminia Azar, Wand Handan, Allnutt Stephen, Schofield Peter, Greenberg David, Grant Luke, Butler Tony
School of Population Health, UNSW Sydney, Kensington, NSW, Australia.
Kirby Institute, UNSW Sydney, Kensington, NSW, Australia.
Aust N Z J Psychiatry. 2023 Mar;57(3):411-422. doi: 10.1177/00048674221098942. Epub 2022 May 14.
While psychosis is considered a risk factor for offending, little is reported about mental health service utilisation in offenders with psychosis and its relationship with reoffending. We examined the association between contact with mental health services and reoffending in those diagnosed with psychosis.
We linked health and offending records in New South Wales (Australia) and identified all individuals with a diagnosis of psychosis and a subsequent offence resulting in a non-custodial sentence between 2001 and 2012. We examined the incidence and risk factors for reoffending, and time to reoffending between 2001 and 2015 using Cox regression and Kaplan-Meier survival methods. We specifically examined the association between clinical contact with community mental health services following the index offence and reoffending.
Of the 7393 offenders with psychosis, 70% had clinical contact and 49% reoffended. There was a linear relationship between an increased number of clinical contacts and reduced risk of reoffending: those with no clinical contact had more than a fivefold risk of reoffending compared to those with the highest number of contacts (adjusted hazard ratio = 5.78, 95% confidence interval = [5.04, 6.62]). Offenders with substance-related psychosis and those convicted of non-violent offences had fewer clinical contacts and higher rates of reoffending when compared with controls (adjusted hazard ratio = 1.29, 95% confidence interval = [1.13, 1.47] and adjusted hazard ratio = 1.26, 95% confidence interval = [1.18, 1.35], respectively).
This study supports an association between more frequent mental health service use and reduced risk of reoffending. Efforts to enhance mental health service utilisation in those with psychosis who are at a higher risk of reoffending should be promoted.
虽然精神病被认为是犯罪的一个风险因素，但关于患有精神病的罪犯对心理健康服务的利用情况及其与再次犯罪的关系，报道较少。我们研究了被诊断患有精神病的人与心理健康服务机构接触和再次犯罪之间的关联。
我们将澳大利亚新南威尔士州的健康和犯罪记录相链接，识别出所有在2001年至2012年期间被诊断患有精神病且随后因犯罪被判处非监禁刑罚的个体。我们使用Cox回归和Kaplan-Meier生存方法研究了再次犯罪的发生率和风险因素，以及2001年至2015年期间再次犯罪的时间。我们特别研究了初次犯罪后与社区心理健康服务机构的临床接触和再次犯罪之间的关联。
在7393名患有精神病的罪犯中，70%有临床接触，49%再次犯罪。临床接触次数增加与再次犯罪风险降低之间存在线性关系：与接触次数最多的人相比，没有临床接触的人再次犯罪的风险高出五倍多（调整后的风险比=5.78，95%置信区间=[5.04, 6.62]）。与对照组相比，患有物质相关精神病的罪犯和被判非暴力犯罪的罪犯临床接触较少，再次犯罪率较高（调整后的风险比分别为1.29，95%置信区间=[1.13, 1.47]；调整后的风险比为1.26，95%置信区间=[1.18, 1.35]）。
本研究支持更频繁使用心理健康服务与降低再次犯罪风险之间存在关联。应推动在再次犯罪风险较高的精神病患者中提高心理健康服务利用率的努力。
