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美国基于监狱的能力恢复服务:需求、争议、新冠疫情的影响以及对未来治疗提供的启示

Jail-Based Competency Restoration Services in the United States: The Need, the Controversy, the Impact of COVID-19, and Implications for Future Treatment Delivery.

作者信息

Lewis Douglas E, Ash Peter, Roberts Victoria C, Schwenke Tomina J, Pagán-González Melvin, Egan Glenn J

机构信息

Georgia Diagnostic and Classification Prison.

Emory University School of Medicine.

出版信息

Crim Justice Behav. 2023 Feb;50(2):216-234. doi: 10.1177/00938548221120280.

Abstract

Jail-based competency restoration largely emerged as a method to address the backlog at forensic hospitals around the United States, as the number of justice-involved persons in need of restoration outgrew available beds. Jail-based competency restoration units (JBCRUs) appear to be highly effective and cost-saving. However, after the COVID-19 outbreak, services at some JBCRUs were stalled, as providers were forced to either quickly initiate or ramp up technology use to maintain services. The present study describes the course of programming for a JBCRU in Fulton County, Georgia, prior to and after the onset of COVID-19, during which time all treatment shifted to telehealth. A matched comparison group of prepandemic defendants was used to compare in-person versus telehealth services and findings indicated that while defendants' length of stay remained effectively the same, the restoration rate for telehealth increased remarkably over prepandemic levels (χ = 10.1, = .001). Such findings suggest that telehealth services are an effective mode of delivery for competency restoration.

摘要

基于监狱的能力恢复措施主要是作为一种解决美国各地法医医院积压问题的方法而出现的,因为需要恢复能力的涉司法人员数量超过了可用床位数量。基于监狱的能力恢复单元(JBCRUs)似乎非常有效且节省成本。然而,在COVID-19疫情爆发后,一些JBCRUs的服务陷入停滞,因为提供者被迫要么迅速启动要么加大技术使用力度以维持服务。本研究描述了佐治亚州富尔顿县一个JBCRU在COVID-19疫情爆发之前和之后的项目开展过程,在此期间所有治疗都转向了远程医疗。使用一组疫情前被告作为匹配对照组来比较面对面服务和远程医疗服务,结果表明,虽然被告的住院时间基本保持不变,但远程医疗的恢复率比疫情前水平显著提高(χ = 10.1, = .001)。这些发现表明,远程医疗服务是能力恢复的一种有效提供方式。

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