Community Reentry of Persons with Severe Mental Illness Released from State Priso

从州立监狱释放的严重精神疾病患者重返社区

• 批准号: 7804475
• 负责人: LINDA K FRISMAN
• 金额: $ 36.84万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-15 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7804475
• 关键词: Address; Adopted; Adoption; Affect; Area; Collaborations; Communities; Community Integration; Connecticut; Country; Criminal Justice; Data; Deinstitutionalization; Economics; Equilibrium; Face; Freedom; Government; Health; Health Policy; Home environment; Hospitalization; Imprisonment; Individual; Inpatients; Intervention; Justice; Linear Models; Measures; Medicaid; Mental Health; Mental disorders; Mentally Ill Persons; National Institute of Mental Health; Outcome; Outpatients; Persons; Pharmaceutical Preparations; Policies; Prisoner; Prisons; Psychiatric Hospitals; Public Health; Research; Research Design; Services; Social Welfare; Substance abuse problem; Supervision; System; Testing; Time; Treatment Protocols; Washington; abstracting; authority; community based service; community living; community reentry; community reintegration; comparison group; cost effectiveness; design; disability; follow-up; frontier; knowledge base; meetings; offender; policy implication; programs; public health relevance; recidivism; research study; restoration; severe mental illness; statistics

DESCRIPTION (provided by applicant): Project Summary/Abstract Mentally ill persons involved in the criminal justice system represent the new frontier for community mental health and disability research. The scope of this problem is truly staggering with upwards of 86,000 persons with severe mental illness (SMI) released from prisons each year with high rates of recidivism. The loss of Medicaid benefits by incarcerated offenders is thought to be a major obstacle to successful community reentry. Several states have adopted expedited Medicaid restoration programs to reconnect eligible prisoners to their benefits prior to release. Early benefit restoration can avoid disruptions in medication regimens and treatments for offenders with SMI when they are released to the community. However, no rigorous research has been conducted to establish the cost-effectiveness of these policies. The proposed responds to with RFA-MH-09-050 from the NIMH with a three-year study that addresses these concerns by undertaking an assessment of Medicaid restoration policies in Connecticut and Washington State for released prisoners who have SMI with regard to three outcomes-subsequent recidivism, hospitalizations, and outpatient mental health and substance abuse service use. Two complementary study designs and analytic approaches will be implemented to address the impact (Aim 1) and cost-effectiveness (Aim 2) of these policies. The first is a difference-in-difference design comparing individuals with SMI and those without SMI centered on a policy adoption date of April 1, 2005 in Connecticut and January 1, 2006 in Washington with three years pre and two years post data in each state. The second is a quasi-experimental study design focused on the post-period only comparing individuals with SMI who received expedited Medicaid restoration (treatment group) vs. those who did not (comparison group) over a two-year follow-up period using a hierarchical linear modeling framework. Propensity score matching will be used with both designs to achieve balance between groups on all observed measures. The proposed study is well-aligned with RFA-MH-09-050 in that it addresses an important mental health policy issue for state authorities, takes advantage of a wealth of administrative data from two states, applies an array of analytical strategies from the fields of economics and statistics to address an important state mental health policy issue, and responds to the call for research about justice-involved persons with severe mental illness as put forth in the President's New Freedom Commission on Mental Health (2002). PUBLIC HEALTH RELEVANCE: All across the US mentally ill offenders are returning to their home communities. Research needs to identify their needs and how they can successfully reintegrated into community life without further criminal justice involvements. This proposal is addressed to this major public health problem.

描述(由申请人提供)：项目摘要/摘要参与刑事司法系统的精神病患者是社区精神健康和残疾研究的新前沿。这一问题的范围确实令人震惊，每年有超过86,000名严重精神疾病(SMI)患者从监狱释放，累犯率很高。被监禁的罪犯失去医疗补助福利被认为是成功重返社区的主要障碍。几个州已经通过了快速的医疗补助恢复计划，以使符合条件的囚犯在获释前重新获得他们的福利。及早恢复福利可以避免SMI患者在释放到社区时药物治疗方案和治疗的中断。然而，还没有进行严格的研究来确定这些政策的成本效益。拟议的研究回应了NIMH的RFA-MH-09-050，进行了一项为期三年的研究，通过对康涅狄格州和华盛顿州的医疗补助恢复政策进行评估，评估了康涅狄格州和华盛顿州对患有SMI的获释囚犯的三个结果-随后的累犯、住院以及门诊精神健康和药物滥用服务的使用。将实施两个互补的研究设计和分析方法，以解决这些政策的影响(目标1)和成本效益(目标2)。第一个是差异设计，比较了康涅狄格州2005年4月1日和华盛顿州2006年1月1日的政策采纳日期，每个州的三年前数据和两年后数据，比较了有SMI和没有SMI的人。第二项是一项准实验研究设计，使用分层线性建模框架，只比较接受了快速医疗补助修复的SMI患者(治疗组)和没有接受快速医疗补助修复的患者(对照组)在两年的随访期内的后期情况。倾向得分匹配将与两种设计一起使用，以在所有观察到的测量上实现组之间的平衡。拟议的研究与RFA-MH-09-050非常一致，因为它解决了州当局的一个重要的精神卫生政策问题，利用了来自两个州的丰富的行政数据，应用了来自经济学和统计学领域的一系列分析战略来解决一个重要的国家精神卫生政策问题，并响应了总统的新自由精神健康委员会(2002年)提出的关于对涉及司法的严重精神疾病患者进行研究的呼吁。 与公共健康相关：全美的精神病罪犯都在返回他们的家乡社区。研究需要确定他们的需求，以及他们如何在不进一步涉及刑事司法的情况下成功地重新融入社区生活。这项提案是针对这一重大公共卫生问题提出的。