Solomon P, Draine J, Meyerson A
Department of Psychiatry, Hahnemann University, Philadelphia, PA 19102.
Hosp Community Psychiatry. 1994 Aug;45(8):793-7. doi: 10.1176/ps.45.8.793.
The authors' aim was to test the relationship between receipt of desired community mental health services by homeless mentally ill forensic clients and whether the clients returned to jail within six months.
Mentally ill homeless clients leaving jail were randomly assigned to three service conditions: intensive case management provided by an assertive community treatment team, intensive case management provided by individual case managers, and referral to a community mental health center. Data on whether clients' service needs were met were analyzed using discriminant function and chi square analyses.
Thirty-two percent of the 105 clients interviewed at six months were reincarcerated during the six-month study period. Jail recidivism was related to receipt of fewer services that clients reported they needed, specifically to receipt of fewer services for developing independent living skills. Service condition was not significantly related to return to jail.
Case management, a flexible community-based service that does not lend itself to clearly prescribed procedures, may easily deteriorate into providing monitoring rather than rehabilitative services for forensic clients and thus may facilitate reincarceration.
作者旨在测试患有精神疾病的无家可归的法医鉴定客户接受所需社区心理健康服务与客户在六个月内是否再次入狱之间的关系。
刚出狱的患有精神疾病的无家可归客户被随机分配到三种服务条件下:由积极社区治疗团队提供的强化个案管理、由个案经理个人提供的强化个案管理,以及转介到社区心理健康中心。使用判别函数和卡方分析对客户服务需求是否得到满足的数据进行分析。
在六个月的研究期间,接受访谈的105名客户中有32%在六个月内再次入狱。再次入狱与客户报告所需服务的较少接受有关,特别是与发展独立生活技能的服务接受较少有关。服务条件与再次入狱没有显著关系。
个案管理是一种灵活的基于社区的服务,不太适合明确规定的程序,可能很容易退化为对法医鉴定客户提供监督而不是康复服务,从而可能促使再次入狱。