What works, for whom? Applying novel precision medicine methods to people with mental illness in the justice system.

什么有效，对谁有效？

• 批准号: 10723566
• 负责人: Lina Montoya
• 金额: $ 9.99万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-05 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10723566
• 关键词: Adult; Award; Behavior Therapy; Behavioral; Characteristics; Clinical; Cognitive; Cognitive Therapy; Criminal Justice; Data; Dedications; Development; Foundations; Funding; Goals; Grant; Heterogeneity; Imprisonment; Individual; Intervention; Justice; Knowledge; Learning; Machine Learning; Mediating; Mental disorders; Mentorship; Methods; National Institute of Mental Health; North Carolina; Outcome; Participant; Pathway interactions; Persons; Phase; Policies; Population; Population Heterogeneity; Populations at Risk; Positioning Attribute; Prevention; Prisons; Probability; Public Health; Randomized, Controlled Trials; Recommendation; Recording of previous events; Research; Research Personnel; Research Project Grants; Research Support; Risk Factors; Safety; Services; Statistical Methods; Symptoms; System; Talents; Techniques; Time; Training; Translating; Vulnerable Populations; Work; anti social; court; criminal behavior; demographics; experience; improved outcome; individualized medicine; intervention effect; marginalized community; novel; personalized intervention; policy recommendation; precision medicine; prevent; psychiatric symptom; recidivism; scale up; severe mental illness; skill acquisition; skills; statistics; substance use; theories; trait; treatment as usual; treatment response; treatment strategy; underserved community

PROJECT SUMMARY/ABSTRACT People with serious mental illness (SMI) are substantially overrepresented in the US criminal justice system. In an effort to reduce recidivism among this vulnerable population, average effects of administering single interventions to all have been studied in recent years. These interventions include ones that target SMI symptoms (such as mandated psychiatric services) and others that target criminogenic risk factors (such as cognitive behavioral therapy). However, justice-involved people with SMI are diverse in their characteristics, needs, and risk factors; there is no “one-size-fits-all” solution to prevent recidivism. Decreasing adverse criminal outcomes for this population requires recognizing its heterogeneity. Therefore, the broad objective of this proposal is to understand which interventions work best for which justice-involved people with SMI using state-of-the-art precision medicine methods drawn from causal inference, statistical theory, and machine learning. This is a step toward the long-term goal of identifying optimal ways to reduce criminal behavior in this population by matching interventions to those who need and benefit from them. Supported by a dedicated and talented mentorship team, the training portion of this grant will fill gaps key to achieving this goal: 1) subject-matter training and field experience on SMI in the criminal justice system, 2) development of novel technical methods in precision medicine, 3) skills in translating technical findings to high-impact recommendations for practice and policy, and 4) professional skills development. This rich training will provide a foundation for accomplishing the following research aims to reach the proposal's broad objective: 1) understand the differential pathways that situate this population at risk for re-offending, 2) identify tailored rules for administering interventions to those who benefit from them based on individual characteristics, and 3) assess whether and how the identified rules for matching interventions generalize across the US. This research will leverage randomized controlled trial data, federal data from the Administrative Office of the US Courts, and state data from the North Carolina Department of Public Safety to achieve these aims. Importantly, research from this grant will result in novel statistical precision medicine methods for transporting rules to settings different than those on which they are learned. The aims of this grant are well-aligned with NIMH's strategic goal of striving for prevention and treatments among people with SMI, including, but not limited to, the objectives of: a) advancing methods to match interventions to individuals and populations (especially marginalized and underserved communities) and b) strategies for scaling up interventions for the greatest public health impact. By learning who benefits from which interventions using the latest advances in precision medicine methods, this work has the potential to help stop the so-called “revolving prison door” for justice-involved people with SMI. Further, this research will advance the toolkit for data-supported precision medicine strategies that most efficiently and effectively increase public health and safety.

项目总结/文摘