Characteristics of Arrestees at Risk for Co-Existing Substance Abuse and Mental Disorder

Abstract

Recent research indicates that persons with co-existing mental illness and substance abuse are disproportionately represented in local jails. Those with co-existing disorder are reported to be at higher risk for arrest and to be arrested for less serious offenses. Although studies have been conducted to determine prevalence rates of co-existing disorder amongst arrestees, few studies have examined in any detail the discriminating characteristics of this group. In particular, little is known about how those presenting with dual symptoms differ from those who display only mental health symptoms or substance disorder symptoms. This study was conducted as a supplemental study to the Cleveland/Cuyahoga County ADAM (Arrestee Drug Abuse Monitoring) program in order to determine the characteristics of adult arrestees with mental health and/or substance disorders. In a sample of 311 adult arrestees, one-third (29%) scored at no risk for either mental health or substance disorders based on a screening instrument. Seventeen percent (17%) scored at risk for substance disorder with no symptoms of active mental disorder. Eighteen percent (18%) scored at risk for active mental disorder without substance abuse risks. Thirty five percent (35%) scored at risk for both mental disorder and substance disorder. Using multinomial logistic regression, those in the dual risk group were more likely to lack stable housing, to lack insurance, to have a history of substance abuse treatment and to test positive for cocaine use. Classification into the mental disorder risk only group was predicted by a personal and family history of mental illness. Members of the substance disorder risk only group were less likely to have health insurance and more likely to have a personal history of substance abuse treatment. This study supports the need for the development of an efficient means for identifying arrestees with dual risk and linking these clients to case management services, particularly to housing.

A Hero’s Welcome? Exploring the Prevalence and Problems of Military Veterans in the Arrestee Population

“…These questions, which were derived from the Dual Diagnosis addendum developed and used for ADAM (Alemagno, Shaffer-King, Tonkin, & Hammel, 2004), focus on whether the respondent has received professional help for an emotional, psychiatric, or mental health problem, if they have been told they have a problem, or have been treated, prescribed 7. Interviews are also conducted at juvenile detention facilities but those data are not used in this paper.…”

The potential for violence in arrests of persons with mental illness

“…Within 30 years, the number of persons in mental institutions had decreased by 80 percent to just over 100,000 (Mechanic and Rochefort, 1990), and by 2005, that number had dropped to 52,000 (Lurigio et al, 2008). Although deinstitutionalization successfully emptied psychiatric asylums, the movement's second component fell far short, as tax dollars for the development of community mental health treatment never materialized (Bachrach, 1978;Gilligan, 2001). The movement of so many PMIs from psychiatric institutions to the community without proper treatment or care inevitably led to increased contact with the police (Bonovitz and Bonovitz, 1981;Torrey, 1997).…”

“…The variables used to assess mental health warrant some discussion. These questions, which were derived from the Dual Diagnosis addendum developed and used for ADAM (Alemagno et al, 2004), focus on whether the respondent has received professional help for an emotional, psychiatric, or mental health problem, if they have been told they have a problem by a professional, or if they have been treated, prescribed medication, or hospitalized for a mental health condition [4]. Importantly, prior research has shown that brief, self-reported screening for mental health problems is a valid proxy for clinical assessments (Berwick et al, 1991).…”