General medical problems of incarcerated persons with severe and persistent mental illness: a population-based study.
General medical problems of incarcerated persons with severe and persistent mental illness: a population-based study.
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DOI：
10.1176/appi.ps.61.1.45
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发表时间：
2010-01
期刊：
影响因子：
--
通讯作者：
Morrissey JP
中科院分区：
文献类型：
--
作者：
Cuddeback GS;Scheyett A;Pettus-Davis C;Morrissey JP
与普通人群相比，患有严重精神疾病的人患慢性普通内科疾病的比率更高。同样，与普通人群相比，被监禁者的慢性病患病率更高；然而，关于严重精神疾病和监禁与消费者一般医疗问题之间的协同作用的信息很少。为了解决文献中的这一差距，这项研究解决了以下问题：与没有这种病史的消费者相比，有监禁史的消费者是否有更大的一般医疗问题的风险？管理数据被用来比较3690名有监禁史的严重精神病患者和2042名无监禁史的严重精神病患者的医疗问题。有监禁史的消费者比没有监禁史的消费者更有可能患有传染病、血液和皮肤病以及受伤史。此外，当分析控制了性别、种族、年龄和物质使用障碍时，有监禁史的消费者有任何一般医疗问题的可能性增加了40%，有多种医疗问题的可能性增加了30%。这里提出的调查结果呼吁加强当地公共卫生和精神卫生服务提供者与监狱之间的沟通，以及社区精神卫生服务提供者之间初级保健和行为保健的更好整合。此外，应加快研究旨在将严重精神病患者从刑事司法系统转移到社区的循证干预措施，并便利从监狱和监狱释放的严重精神疾病患者重返社区。
Persons with severe mental illness have higher rates of chronic general medical illness compared with the general population. Similarly, compared with the general population, incarcerated persons have higher rates of chronic medical illness; however, there is little information about the synergy between severe mental illness and incarceration and the general medical problems of consumers. To address this gap in the literature this study addresses the following question: are consumers with a history of incarceration at greater risk of general medical problems compared with consumers without such a history? Administrative data were used to compare the medical problems of 3,690 persons with severe mental illness with a history of incarceration and 2,042 persons with severe mental illness with no such history. Consumers with a history of incarceration were more likely than those with no such history to have infectious, blood, and skin diseases and a history of injury. Furthermore, when analyses controlled for gender, race, age, and substance use disorders, consumers with an incarceration history were 40% more likely to have any general medical problem and 30% more likely to have multiple medical problems. The findings presented here call for better communication among local public health and mental health providers and jails and better integration of primary care and behavioral health care among community mental health providers. Also, research on evidence-based interventions designed to divert persons with severe mental illness from the criminal justice system and facilitate community reentry for persons with severe mental illness who are released from jails and prisons should be accelerated.
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