Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA.
Adult Correction and Juvenile Justice, NC Department of Public Safety, Raleigh, NC, USA.
Prev Med. 2022 Nov;164:107318. doi: 10.1016/j.ypmed.2022.107318. Epub 2022 Oct 22.
Therapeutic Diversion Units (TDUs) in North Carolina prisons are intended to reduce cycling of individuals with mental health conditions through restrictive housing (i.e., solitary confinement). This paper investigates if previously identified benefits of TDU are sustained when individuals return to the general prison population. Using administrative data on 3170 people, we compare individuals placed in TDUs to TDU-eligible individuals (i.e., individuals with mental health needs) placed in restrictive housing. We use survival analysis methods to estimate hazard ratios (HRs) with confidence intervals (CIs), controlling for confounders. Compared to restrictive housing placement, TDU placement reduced the hazard of infractions (HR: 0.66; 95% CI: 0.52, 0.84) and subsequent restrictive housing placement (HR: 0.64; 95% CI: 0.55, 0.73) but increased the hazard of self-harm (HR: 2.67; 95% CI: 1.66, 4.29) upon program release to the general prison population. These findings suggest a need for additional investments and research on restrictive housing diversion programming, including post-diversion program supports.
北卡罗来纳州监狱的治疗性转移单位（TDU）旨在通过限制居住（即单独监禁）减少有心理健康问题的个人的循环。本文研究了当个人返回普通监狱人口时，TDU 先前确定的益处是否仍然存在。使用 3170 人的行政数据，我们将被安置在 TDU 的个人与 TDU 有资格的个人（即有心理健康需求的个人）进行比较，这些人被安置在限制居住中。我们使用生存分析方法来估计风险比（HR）及其置信区间（CI），同时控制混杂因素。与限制居住安置相比，TDU 安置降低了违规（HR：0.66；95%CI：0.52，0.84）和随后的限制居住安置（HR：0.64；95%CI：0.55，0.73）的风险，但增加了自我伤害的风险（HR：2.67；95%CI：1.66，4.29），当该方案被释放到普通监狱人口时。这些发现表明，需要对限制居住转移方案进行额外的投资和研究，包括转移后方案支持。
