Duke Institute for Brain Sciences, Duke University, Durham, North Carolina, USA.
Departments of Statistical Science and Political Science, Duke University, Durham, North Carolina, USA.
Crim Behav Ment Health. 2023 Jun;33(3):185-195. doi: 10.1002/cbm.2277. Epub 2023 Jan 30.
A growing body of literature demonstrates strong association between poor mental health and criminal recidivism, but research from county jails is limited.
Our aim was to examine the relationship between re-arrest and severe mental illnesses-schizophrenia, bipolar disorder and major depressive disorder-together and separately and with substance use disorders, separately and as comorbid conditions, in a mid-sized county jail cohort in the southeastern United States.
We examined the full cohort of 8097 individuals who were booked into the County Detention Facility between 31 January 2014 and 31 January 2015. Their incarceration data were merged with data from the local health system to investigate the presence of severe mental illness and substance use disorder diagnoses. Re-arrest data were tracked for 4 years after the index arrest.
Approximately 60% of the cohort was re-arrested within 4 years. People with substance use disorders, with or without severe mental illness, had higher re-arrest rates than those with severe mental illness alone or neither diagnosis. Drug-associated arrests did not explain this finding.
Using detailed mental illness diagnosis data with a complete cohort of detained arrestees, we have shown the wide range of need among such individuals. By demonstrating that drug-associated crimes per se do not drive repeated arrest, we underscore a need to examine other factors that promote the cycle of repeated arrest in this population. Each individual requires treatment tailored to their personal psychiatric and criminogenic needs.
越来越多的文献表明，心理健康状况不佳与犯罪再犯之间存在很强的关联，但县级监狱的研究有限。
我们旨在研究在美国东南部一个中等规模的县级监狱队列中，重新逮捕与严重精神疾病（精神分裂症、双相情感障碍和重度抑郁症）以及物质使用障碍（单独和作为共病情况）之间的关系，以及它们与物质使用障碍的关系。
我们检查了 8097 名在 2014 年 1 月 31 日至 2015 年 1 月 31 日期间被关押在县拘留所的所有被拘留者的完整队列。他们的监禁数据与当地卫生系统的数据合并，以调查严重精神疾病和物质使用障碍诊断的存在情况。在索引逮捕后的 4 年内追踪重新逮捕的数据。
约 60%的队列在 4 年内再次被捕。有物质使用障碍的人，无论是否有严重精神疾病，再次被捕的比率都高于仅有严重精神疾病或两种诊断都没有的人。与药物相关的逮捕并不能解释这一发现。
我们使用详细的精神疾病诊断数据和被拘留者的完整队列，展示了这些个体中广泛存在的需求。通过证明与药物相关的犯罪本身并不能导致重复逮捕，我们强调需要检查其他因素，这些因素在这一人群中促进了重复逮捕的循环。每个个体都需要根据其个人的精神科和犯罪风险因素的需要量身定制治疗方案。
