Harris V, Koepsell T D
Department of Psychiatry, University of Washington, Seattle, USA.
J Am Acad Psychiatry Law. 1998;26(3):393-402.
The importance of criminal recidivism among mentally ill offenders lies in resource allocation and community services for the mentally ill. It has been suggested that jails are used, in part, simply to house the mentally ill. The objective of this study is to determine whether mentally ill criminal offenders have higher rates of rearrest than non-mentally ill offenders. A sample of mentally ill offenders (n = 127) was drawn at random from all admissions to the psychiatric unit at the King County Jail in Seattle, Washington, in 1990. They were compared with a sample (n = 127) of non-mentally ill offenders also jailed in King County during 1990; the two groups were frequency matched on age, gender, and crime at index arrest. Both groups were followed for up to four years to until the next arrest. After 12 months, 54.3 percent of the mentally ill group and 51.2 percent of the non-mentally ill group were rearrested. Using the log rank test in Kaplan-Meier survival analysis, no statistical difference in the relative risk of rearrest occurred for the mentally ill group (relative risk = .84; 95% CI = .84-1.34). Adjustment for housing, marital status, and previous criminal history had little effect on this finding. The presence of substance abuse or psychosis at the index arrest did not affect rearrest significantly. Mentally ill offenders, as a whole, may not be at increased risk for rearrest. However, there may be specific high-risk subgroups that can benefit from early intervention.
患有精神疾病的罪犯再次犯罪的重要性体现在为精神疾病患者的资源分配和社区服务方面。有人提出,监狱部分只是被用来关押精神疾病患者。本研究的目的是确定患有精神疾病的罪犯再次被捕的比率是否高于未患精神疾病的罪犯。1990年,从华盛顿州西雅图市金县监狱精神科病房的所有入院患者中随机抽取了127名患有精神疾病的罪犯作为样本。将他们与1990年也被关押在金县的127名未患精神疾病的罪犯样本进行比较;两组在年龄、性别和初次被捕时的罪行方面进行了频率匹配。对两组进行了长达四年的跟踪,直到再次被捕。12个月后,患有精神疾病的组中有54.3%再次被捕,未患精神疾病的组中有51.2%再次被捕。在Kaplan-Meier生存分析中使用对数秩检验,患有精神疾病的组在再次被捕的相对风险方面没有统计学差异(相对风险=0.84;95%置信区间=0.84 - 1.34)。对住房、婚姻状况和既往犯罪史进行调整对这一结果影响不大。初次被捕时存在药物滥用或精神病症状对再次被捕没有显著影响。总体而言,患有精神疾病的罪犯再次被捕的风险可能不会增加。然而,可能存在一些特定的高风险亚组,它们可以从早期干预中受益。