Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
ICES, Toronto, Ontario, Canada.
Crim Behav Ment Health. 2024 Apr;34(2):197-207. doi: 10.1002/cbm.2331. Epub 2024 Jan 24.
International studies show that adults with intellectual and developmental disabilities (IDD) are disproportionately represented in the criminal justice and forensic mental health systems; however, it is difficult to capture their involvement across systems in any one jurisdiction.
The current study aimed to estimate the prevalence of IDD across different parts of the criminal justice and forensic mental health systems in Ontario and to describe the demographic and clinical profiles of these individuals relative to their counterparts without IDD.
This project utilised administrative data to identify and describe the demographic and clinical characteristics of adults with IDD and criminal justice or forensic involvement across four sectors: federal correctional facilities, provincial correctional facilities, forensic inpatient mental health care and community mental health programmes. Questions were driven by and results were contextualised by a project advisory group and people with lived experience from the different sectors studied, resulting in a series of recommendations.
Adults with IDD were over-represented in each of the four settings, ranging from 2.1% in federal corrections to 16.7% in forensic inpatient care. Between 20% (forensic inpatient) and 38.4% (provincial corrections) were under the age of 25 and between 34.5% (forensic inpatient) and 41.8% (provincial corrections) resided in the lowest income neighbourhoods. Medical complexity and rates of co-occurring mental health conditions were higher for people with IDD than those without IDD in federal and provincial corrections.
Establishing a population-based understanding of people with IDD within these sectors is an essential first step towards understanding and addressing service and care needs. Building on the perspectives of people who work in and use these systems, this paper concludes with intervention recommendations before, during and after justice involvement.
国际研究表明,智障和发育障碍(IDD)成年人在刑事司法和法医心理健康系统中的比例不成比例;然而,在任何一个司法管辖区内,都很难捕捉到他们在整个系统中的参与情况。
本研究旨在估计安大略省刑事司法和法医心理健康系统不同部分的 IDD 患病率,并描述这些人与无 IDD 者相比的人口统计学和临床特征。
本项目利用行政数据,在四个部门(联邦惩教机构、省级惩教机构、法医住院心理健康护理和社区心理健康计划)中确定和描述具有 IDD 且涉及刑事司法或法医问题的成年人的人口统计学和临床特征。问题由项目咨询小组和来自不同研究部门的有生活经验的人驱动,并根据项目咨询小组和有生活经验的人提出了一系列建议。
在四个环境中,IDDD 成年人的比例都过高,从联邦惩教机构的 2.1%到法医住院护理的 16.7%不等。年龄在 25 岁以下的人在 20%(法医住院)和 38.4%(省级监狱)之间,而收入最低的社区中居住的人在 34.5%(法医住院)和 41.8%(省级监狱)之间。联邦和省级监狱中,患有 IDD 的人与没有 IDD 的人相比,医疗复杂性和同时存在的心理健康状况的比例更高。
在这些部门中,建立对 IDD 人群的基于人群的理解是了解和满足服务和护理需求的必要的第一步。在与在这些系统中工作和使用这些系统的人的观点的基础上,本文在司法介入之前、期间和之后提出了干预建议。