Psychiatric Disorders and Repeat Incarcerations: The Revolving Prison Door
Psychiatric Disorders and Repeat Incarcerations: The Revolving Prison Door
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DOI：
10.1176/appi.ajp.2008.08030416
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发表时间：
2009-01-01
影响因子：
17.7
通讯作者：
Murray, Owen J.
中科院分区：
文献类型：
--
作者：
Baillargeon, Jacques;Binswanger, Ingrid A.;Murray, Owen J.
目的：在过去的40年里，许多法律的、社会的和政治的因素导致了目前精神疾病在美国的流行。S.监狱系统虽然许多调查报告说，与一般人口相比，监狱囚犯中精神疾病的发病率大大提高，但尚不清楚精神疾病是否是多次监禁的一个风险因素。作者在对美国最大的州立监狱系统进行的一项回顾性队列研究中检查了这种关联。方法：研究人群包括79,211名囚犯，他们在2006年9月1日至2007年8月31日期间开始服刑。从全州范围内的医疗信息系统中获得了有关精神疾病，人口统计学特征和监禁史的数据，并进行了分析。结果：患有严重精神疾病（重度抑郁症，双相情感障碍，精神分裂症和非精神分裂症精神障碍）的囚犯在6年的研究期间多次监禁的风险大幅增加。最大的风险增加，观察到双相情感障碍的囚犯，谁是3.3倍更有可能有四个或更多的以前的监禁相比，囚犯谁没有重大精神disorder.Conclusions：监狱囚犯与重大精神疾病的可能性比那些没有以前的监禁。作者建议扩大干预措施，以减少精神病囚犯的累犯。他们讨论了护理重返计划的连续性的潜在好处，以帮助精神病囚犯在释放时与社区精神健康计划联系，以及精神健康法院和其他分流策略的更大作用。
Objective: A number of legal, social, and political factors over the past 40 years have led to the current epidemic of psychiatric disorders in the U. S. prison system. Although numerous investigations have reported substantially elevated rates of psychiatric disorders among prison inmates compared with the general population, it is unclear whether mental illness is a risk factor for multiple episodes of incarceration. The authors examined this association in a retrospective cohort study of the nation's largest state prison system.Method: The study population included 79,211 inmates who began serving a sentence between September 1, 2006, and August 31, 2007. Data on psychiatric disorders, demographic characteristics, and history of incarceration for the preceding 6-year period were obtained from state-wide medical information systems and analyzed.Results: Inmates with major psychiatric disorders (major depressive disorder, bipolar disorders, schizophrenia, and non-schizophrenic psychotic disorders) had substantially increased risks of multiple incarcerations over the 6-year study period. The greatest increase in risk was observed among inmates with bipolar disorders, who were 3.3 times more likely to have had four or more previous incarcerations compared with inmates who had no major psychiatric disorder.Conclusions: Prison inmates with major psychiatric disorders are more likely than those without to have had previous incarcerations. The authors recommend expanding interventions to reduce recidivism among mentally ill inmates. They discuss the potential benefits of continuity of care reentry programs to help mentally ill inmates connect with community-based mental health programs at the time of their release, as well as a greater role for mental health courts and other diversion strategies.