Michael Lebenbaum, Fiona Kouyoumdjian, Anjie Huang, Paul Kurdyak
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We use Cox-proportional hazards models to examine the association between prior MHA service use and each outcome adjusting for prior correctional involvement and demographic characteristics.</p><p><strong>Results: </strong>Among a sample consisting of 45,890 individuals, we found that prior MHA service use was moderately associated with recidivism (hazard ratio (HR): 1.20-1.50, all <i>P</i> < 0.001), with secondary analyses finding larger associations for addiction service use (HR range: 1.34-1.54, all <i>P</i> < 0.001) than for mental health service use (HR range: 1.09-1.18, all <i>P</i> < 0.001). 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引用次数: 0
摘要
背景:关于心理健康和成瘾(MHA)病史与累犯之间的联系,证据不一。很少有研究对刑满释放后的心理健康和戒毒护理进行调查。我们的目标是研究之前(入狱前)使用心理健康和成瘾服务与释放后再犯罪和服务使用之间的联系:我们开展了一项基于人口的队列研究,将 2010 年省级教养机构的在押人员与卫生行政数据库联系起来。按照住院、急诊就诊和门诊就诊的顺序,对之前使用的MHA服务进行了分级。我们对刑满释放人员进行了长达 5 年的跟踪调查,以了解他们是否首次出现累犯、MHA 住院、急诊就诊和门诊就诊情况。我们使用 Cox 比例危险模型来检验之前使用 MHA 服务与每种结果之间的关联,并对之前的管教参与和人口特征进行调整:结果:在由 45,890 人组成的样本中,我们发现之前使用 MHA 服务与累犯之间存在中度关联(危险比 (HR):1.20-1.50,均为 P P P 讨论):尽管再犯的风险很高,并且在释放后也会急性使用 MHA 服务,但我们发现获得 MHA 门诊护理的机会很少,这突出表明有必要加大力度,促进有心理健康需求的人在惩教机构中获得护理和护理整合。
The Association Between Prior Mental Health Service Utilization and Risk of Recidivism among Incarcerated Ontario Residents.
Background: There is mixed evidence on the link between mental health and addiction (MHA) history and recidivism. Few studies have examined post-release MHA care. Our objective was to examine the association between prior (pre-incarceration) MHA service use and post-release recidivism and service use.
Methods: We conducted a population-based cohort study linking individuals held in provincial correctional institutions in 2010 to health administrative databases. Prior MHA service use was assigned hierarchically in order of hospitalization, emergency department visit and outpatient visit. We followed up individuals post-release for up to 5 years for the first occurrence of recidivism and MHA hospitalization, emergency department visit and outpatient visit. We use Cox-proportional hazards models to examine the association between prior MHA service use and each outcome adjusting for prior correctional involvement and demographic characteristics.
Results: Among a sample consisting of 45,890 individuals, we found that prior MHA service use was moderately associated with recidivism (hazard ratio (HR): 1.20-1.50, all P < 0.001), with secondary analyses finding larger associations for addiction service use (HR range: 1.34-1.54, all P < 0.001) than for mental health service use (HR range: 1.09-1.18, all P < 0.001). We found high levels of post-release MHA hospitalization and low levels of outpatient MHA care relative to need even among individuals with prior MHA hospitalization.
Discussion: Despite a high risk of recidivism and acute MHA utilization post-release, we found low access to MHA outpatient care, highlighting the necessity for greater efforts to facilitate access to care and care integration for individuals with mental health needs in correctional facilities.
期刊介绍:
Established in 1956, The Canadian Journal of Psychiatry (The CJP) has been keeping psychiatrists up-to-date on the latest research for nearly 60 years. The CJP provides a forum for psychiatry and mental health professionals to share their findings with researchers and clinicians. The CJP includes peer-reviewed scientific articles analyzing ongoing developments in Canadian and international psychiatry.