Disparities in Mental Health Referral and Diagnosis in the New York City Jail Mental Health Service

Kaba, Fatos; Solimo, Angela; Graves, Jasmine; Glowa-Kollisch, Sarah; Vise, Allison; MacDonald, Ross; Waters, A. Star; Rosner, Zachary; Dickey, Nathaniel; Angell, Sonia Y.; Venters, Homer

doi:10.2105/ajph.2015.302699

Cited by 37 publications

(32 citation statements)

References 13 publications

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“…These challenges may, if unmet, increase older former inmates’ risk for repeat arrest and future incarceration. Recent research about prisoners with PTSD has found that they are 43% more likely to be rearrested in the same year compared to those without PTSD (Kaba et al, 2015), further underscoring our finding that older jail inmates with symptoms of PTSD should be considered a high-risk population in need of enhanced medical and social services. As such, coordination of correctional and community health services for this population prior to reentry could be important for improving access to care, adherence to mental and other health treatment plans, and reducing health disparities and recidivism (Binswanger, Redmond, Steiner, & Hicks, 2012).…”

Section: Discussionsupporting

confidence: 76%

Post-traumatic stress disorder symptoms and associated health and social vulnerabilities in older jail inmates

Flatt

Williams

Barnes

et al. 2016

Aging & Mental Health

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Objectives To examine post-traumatic stress disorder (PTSD) symptoms in older jail inmates, and to determine whether adverse social and health-related characteristics were associated with having PTSD symptoms. Method We performed an exploratory cross-sectional study of 238 older (age ≥55 years) jail inmates from a county jail. PTSD symptoms were determined using the Primary Care PTSD (PC-PTSD) screen. Reporting three or more PTSD symptoms was defined as a positive screen. Descriptive statistics and multiple regression analyses were used to examine the prevalence of a positive PTSD screen and associations with social and health-related characteristics. Results The mean age was 59 years, 64% were Black, and 82% reported an annual income ≤$15,000. Nearly 40% of older jail inmates had a positive PTSD screen and 10% reported a prior PTSD diagnosis by a physician. Older jail inmates with a positive PTSD screen were significantly more likely than those with a negative PTSD screen to report medication insecurity in the past year, impairment in two or more activities of daily living, traumatic brain injury, pain in the past week, and poor self-rated health. Conclusion Over one in three of the older jail inmates in this study had a positive PTSD screen, though only one in five of those with a positive screen reported a prior PTSD diagnosis. Screening for PTSD in jails may help identify older inmates who would benefit from additional mental health treatment and reentry planning to improve health in this population.

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Section: Discussionsupporting

confidence: 76%

Post-traumatic stress disorder symptoms and associated health and social vulnerabilities in older jail inmates

Flatt

Williams

Barnes

et al. 2016

Aging & Mental Health

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“…The type and severity of disorder diagnosed by a psychiatric expert witness usually plays an essential role when considering high-security hospital treatment for mentally ill offenders (27-29, 31, 43, 48). Research suggests that ethnic-minority patients are susceptible to stereotyping by physicians, psychiatrists, and judges, which implies that the complexity of their psychiatric assessment might be reduced to prejudiced assumptions about patient adherence to treatment recommendations and to associating signs of mental illness with personality traits rather than actual health disorders (19,27,43,(62)(63)(64)(65). In a UK study, Mikton and Grounds (63) searched for disparities in the diagnosing of personality disorders by forensic psychiatrists working with different ethnic groups in England and Wales.…”

Section: Discussionmentioning

confidence: 99%

“…The rising percentages of foreign nationals in the penal system has raised questions about their health conditions. Multiple sources indicate serious mental health issues among ethnic-minority and immigrant prisoners (15)(16)(17)(18)(19)(20)(21)(22)(23). Recent research suggests that the majority of factors leading to mental health vulnerability among prisoners, such as language barriers, isolation, cultural misunderstanding, and legal standing, are even more salient for foreign national prisoners (4,12,13,(24)(25)(26).…”

Section: Introductionmentioning

confidence: 99%

“…In addition, other studies indicate that missed or misinterpreted symptoms of mental disorders among ethnicminority, immigrant, and foreign national prisoners might aggravate symptoms and impact self-harmful behavior. By evaluating data from a New York City jail, Kaba et al (19) showed that Hispanic and Black prisoners with mental disorders remained undiagnosed significantly longer than White prisoners.…”

Section: Introductionmentioning

confidence: 99%

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Foreign National Patients in German Prison Psychiatry

2020

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Introduction: Over the past few years, the share of foreign national prisoners in the European and American justice systems has increased at a disproportionately high rate, yet studies on mental health issues among this diverse group are rare. Recent research suggests a range of factors leading to mental health vulnerability in foreign national prisoners, including language barriers, isolation, cultural misunderstanding, and legal standing. Relevant findings of topic-related studies indicate that under-referral to mental health services due to missed or misinterpreted symptoms is a major risk for foreign national prisoners. Aims: We aimed to investigate the disparities regarding the percentage of foreign national patients who were treated in high-security hospitals compared to the psychiatric ward of prison hospitals-after adjusting for diagnosis, age, marital status, and substance abuse. We hypothesized that foreign national patients were underrepresented in compulsory, high-security mental health care. We also aimed to explore citizenship-related institutional disparities concerning diagnoses and self-harmful behavior. Method: From 2010 to 2015, data collected from high-security hospitals in the federal state of Baden-Wurttemberg and the psychiatric ward of a Berlin prison hospital was evaluated by comparing nationality, diagnosis, and self-harm using Fisher's exact test and c²-test. The odds ratios for citizenship-related differences in diagnosis and institution of treatment were evaluated by using logistic regression. Results: Mentally ill foreign national patients were significantly less likely to be treated in high-security hospitals rather than prison hospital psychiatry (adjusted for diagnosis, age at admission, marital status, and substance abuse; adjusted OR = 0.5). Foreign nationals and Germans in prison hospital psychiatry showed no significant disparities in diagnosis; however, in high-security hospitals, foreign nationals were more likely to have been diagnosed with schizophrenia/psychotic or neurotic/stress-related disorders and were less likely to have been diagnosed with personality disorders than German patients. Additionally, foreign nationals were more likely to commit self-harm than Germans in

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“…In cross-sectional studies undertaken on community dwelling samples, PTSD has been consistently found to be associated with grater rates of self-reported contacts with the criminal justice system (Collins & Bailey, 1990;Donley et al, 2012). More recent research on released prisoners with PTSD showed that a majority of those justice-involved persons with PTSD were more likely to be rearrested within the same year for a new felony charge relative to prisoners without PTSD (Kaba et al, 2015;Peller, Najavits, Nelson, LaBrie, & Shaffer, 2010;Sadeh & McNiel, 2015), indicating that jail inmates with severe PSTD symptoms should be conceived as high risk population requiring more attention.…”

Section: Original Articlementioning

confidence: 99%

Associations between circadian preferences, sleep quality, dissociation, post-traumatic cognitions, and post-traumatic stress disorder (PTSD) among incarcerated offenders

Acar¹,

Öğülmüş²,

Boysan³

2018

Sleep Hypn

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The aim of this study was to explore whether DSM-5 posttraumatic stress disorder (PTSD) dissociative subtype could be differentiated from non-dissociative PTSD caseness in sleep disturbances, circadian preferences, and posttraumatic cognitions. We also investigated associations of dissociation, sleep quality, insomnia, circadian preferences, and traumarelated negative cognitions with DSM-5 PTSD caseness among prisoners. Data from 399 volunteers (mean age: 34.54±9.93 years) were collected. Using the symptoms clusters measured by the PTSD Checklist for DSM-5 (PCL-5) and Dissociative Experiences Scale (DES), the participants were classified into four subgroups: no dissociation or PTSD, pure dissociative, pure PTSD, and dissociative PTSD. Differences in scale scores across four groups were evaluated using one-way analysis of variance. Logistic regression analysis was utilized to determine predictors of DSM-5 PTSD caseness. Participants with dissociative PTSD reported significantly greater posttraumatic stress reactions in terms of PTSD and dissociative symptomatology, greater number of prior trauma exposure, greater scores on posttraumatic negative cognitions, and a tendency to have eveningness diurnal preferences in comparison to those prisoners classified into other three subgroups (no dissociation or PTSD, pure dissociative, and pure PTSD). However, sleep disturbances in terms of insomnia and poor sleep quality were found to be pronounced among prisoners with PTSD irrespective of levels of dissociation. Dissociative symptomatology, insomnia and poor sleep quality significantly contributed to probable PTSD caseness. Dissociation and sleep disturbances appear to be hallmark for PTSD among prisoners.

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Disparities in Mental Health Referral and Diagnosis in the New York City Jail Mental Health Service

Cited by 37 publications

References 13 publications

Post-traumatic stress disorder symptoms and associated health and social vulnerabilities in older jail inmates

Post-traumatic stress disorder symptoms and associated health and social vulnerabilities in older jail inmates

Foreign National Patients in German Prison Psychiatry

Associations between circadian preferences, sleep quality, dissociation, post-traumatic cognitions, and post-traumatic stress disorder (PTSD) among incarcerated offenders

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