Frequent Attendance to the Emergency Department after Release from Prison: a Prospective Data Linkage Study

Butler, Amanda; Love, Anthony; Young, Jesse T; Kinner, Stuart A

doi:10.1007/s11414-019-09685-1

Cited by 16 publications

(10 citation statements)

References 57 publications

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“…HCU in recently released prisoners is elevated [5,6,[11][12][13][14] and often associated with previous psychiatric conditions [15,16]. Despite these findings during prisoners' incarceration and soon after their release, knowledge of long-term HCU in people who have been in prison is scant.…”

Section: Introductionmentioning

confidence: 99%

Healthcare utilization and psychiatric morbidity in violent offenders: findings from a prospective cohort study

Tärnhäll

Björk

Wallinius

et al. 2022

Soc Psychiatry Psychiatr Epidemiol

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Purpose Although persistent offenders with histories of imprisonment and violence have disproportionate high rates of psychiatric disorders, little is known of their psychiatric healthcare utilization (HCU) and HCU-associated factors. This study aimed to explore psychiatric HCU, psychiatric morbidity, and psychotropic prescription drugs in violent offenders with a history of incarceration. Methods Male offenders aged 18–25 (n = 266) imprisoned for violent and/or physical sexual offenses were clinically assessed in 2010–2012 and prospectively followed in Swedish national registries through 2017. Register-based information regarding HCU, psychiatric morbidity, and psychotropic drugs was tracked and compared with a general population group (n = 10,000) and across offending trajectory groups. Baseline risk factors were used to explain prospective psychiatric HCU in violent offenders. Results Violent offenders used less general healthcare and psychiatric outpatient care, but more psychiatric inpatient care and were more often given psychiatric diagnoses and psychotropic drugs than the general population. Participants previously assigned to persisting offending trajectory groups had higher rates of psychiatric HCU than those assigned to a desisting trajectory. In multivariable regression models, psychiatric HCU was associated with anxiety disorders, prior psychiatric contact, placement in a foster home, psychopathic traits, low intellectual functioning, and persistent offending. Conclusions Violent offenders are burdened by extensive and serious psychiatric morbidity and typically interact with psychiatric healthcare as inpatients rather than outpatients. Knowledge about their backgrounds, criminal behaviors, and psychiatric statuses can aid the planning of psychiatric services for this troublesome group.

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Section: Introductionmentioning

confidence: 99%

Healthcare utilization and psychiatric morbidity in violent offenders: findings from a prospective cohort study

Tärnhäll

Björk

Wallinius

et al. 2022

Soc Psychiatry Psychiatr Epidemiol

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“…Around 40% of those interviewed by the research team reported that they had received therapy or counseling in the 3 months since release which reinforces that individuals are receiving mental health services independent to those provided by community mental health teams. The mental health needs of those exiting prison are clearly high; rates of emergency department attendance are elevated in this group ( 26 ), as are inpatient hospital admissions ( 27 ). However, those with mental health difficulties and criminal justice involvement commonly experience difficulties in obtaining mental health care in the community, often due to the stigma associated with their offending behavior ( 28 ).…”

Section: Discussionmentioning

confidence: 99%

Continuity of mental health care during the transition from prison to the community following brief periods of imprisonment

Browne

Korobanova²,

Chemjong³

et al. 2022

Front. Psychiatry

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PurposeThe prison-to-community transition period is one of high risk and need, particularly for those with mental illness. Some individuals cycle in and out of prison for short periods with little opportunity for mental health stabilization or service planning either in prison or the community. This study describes the socio-demographic, clinical and criminal justice characteristics of individuals with mental illness and frequent, brief periods of imprisonment, examines continuity of mental health care between prison and the community for this group, and reports on their post-release mental health and criminal justice outcomes.Design/methodology/approachThis study examined a sample of 275 men who had recently entered prison in New South Wales (NSW), Australia, who had been charged with relatively minor offenses and had been identified on reception screening as having significant mental health needs. Baseline demographic and mental health information was collected via interview and file review and contacts with the prison mental health service were recorded for the period of incarceration. Follow-up interviews were conducted 3 months post-release to determine level of health service contact and mental health symptoms. Information on criminal justice contact during the 3 month period was also collected.FindingsThe majority (85.5%) of the sample had contact with a mental health professional during their period of incarceration. Mental health discharge planning was, however, lacking, with only one in 20 receiving a referral to a community mental health team (CMHT) and one in eight being referred for any kind of mental health follow-up on release. Of those followed up 3 months post-release (n = 113), 14.2% had had contact with a CMHT. Of those released for at least 3 months (n = 255), one in three had received new charges in this period and one in five had been reincarcerated.ConclusionContinuity of mental health care for those exiting prison is poor, particularly for those with mental health needs experiencing brief periods of imprisonment, and rates of CMHT contact are low in the immediate post-release period. These findings suggest a need for early identification of individuals in this group for timely commencement of intervention and release planning, and opportunities for diversion from prison should be utilized where possible.

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“…This is especially important among people with co-occurring serious mental illness and substance use; 18 a particularly vulnerable population who experience high levels of poor health and social outcomes post release from prison. [19][20][21] Preventing imprisonment among people with co-occurring mental illness and substance use may also be achieved through diversion to appropriate mental health services at various points prior to, and when moving through the criminal justice system. 22,23 Holistically addressing pertinent social factors via mental health services, such as housing instability, 24,25 may also reduce offending and prevent entry into secure custodial settings.…”

Section: Discussionmentioning

confidence: 99%

Mental Health Contact Episodes in the Year Prior to First Adult Imprisonment Among Men Who Inject Drugs in Victoria, Australia

Stewart¹,

Cossar²,

Al³

et al. 2021

Preprint

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Background: People in prison experience higher rates of mental illness than the general community, and commonly have cooccurring histories of drug dependence. While patterns of mental health service contacts following prison release have been extensively described, limited research has explored histories of service contacts prior to adult imprisonment. We describe public mental health contacts in the 12 months prior to first adult imprisonment among a cohort of men recruited in prison in Victoria, Australia, with recent histories of injecting drug use (IDU).Methods: Retrospective data from two administrative databases — public mental health service contacts from the Victorian state-wide public mental health database and imprisonment episodes from Corrections Victoria — were linked to primary data from the Prison and Transition Health (PATH) cohort study. We describe patterns of mental health contact episodes (contact days) and contact types, including continuing community care (categorised as non-urgent care) and crisis/emergency contacts (categorised as urgent) in the 12 months prior to participants’ first adult imprisonment.Results: Among 400 participants, 60 (15%) had contact with a mental health service in the year prior to their first adult imprisonment, accounting for 861 contact episodes [median 5; interquartile range (IQR) 2–11]. The median days between last contact and imprisonment was 52 (IQR 7–116) and the median days between contacts was three (IQR 1–7). Of the total contacts, 52% (n=450/861) were for continuing community care and 27% (n=234/861) involved crisis assessment treatment; 42 (70%) participants with mental health service contacts had at least one crisis/emergency contact within one year of their first adult imprisonment. Conclusion: We found that 15% of a cohort of men with histories of IDU had mental health service contacts in the 12 months prior to their first adult imprisonment. These contacts were typically frequent and more than one in four involved crisis/emergency care. These findings highlight significant vulnerabilities and potential missed opportunities for intervention early in offending trajectories. Further research is required to understand how these vulnerabilities can be better identified and more appropriately addressed in-community to reduce pathways into prison.

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Frequent Attendance to the Emergency Department after Release from Prison: a Prospective Data Linkage Study

Cited by 16 publications

References 57 publications

Healthcare utilization and psychiatric morbidity in violent offenders: findings from a prospective cohort study

Healthcare utilization and psychiatric morbidity in violent offenders: findings from a prospective cohort study

Continuity of mental health care during the transition from prison to the community following brief periods of imprisonment

Mental Health Contact Episodes in the Year Prior to First Adult Imprisonment Among Men Who Inject Drugs in Victoria, Australia

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