Intensive Use of Forensic Inpatient Services by People with Intellectual and Developmental Disabilities in Ontario, Canada: Prevalence and Associated Characteristics

Lin, Elizabeth; Whittingham, Lisa; Busch, Louis; Calzavara, Andrew; Kouyoumdjian, Fiona G.; Durbin, Anna; Matheson, Flora I.; Dastoori, Parisa; Volpe, Tiziana; Lunsky, Yona

doi:10.1080/14999013.2022.2027047

Cited by 4 publications

(8 citation statements)

References 28 publications

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“…• Ontario Mental Health Reporting System (OMHRS) dataset: Included persons accessing forensic inpatient care between 1 April 2006 and 31 March 2016. Forensic inpatients were individuals who had an inpatient episode identified as 'forensic' upon admission or as having a 'forensic assessment' (Lin et al, 2022).…”

Section: Data Sourcesmentioning

confidence: 99%

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Intellectual and developmental disabilities in Ontario's criminal justice and forensic mental health systems: Using data to tell the story

Lunsky,

Matheson,

Kouyoumdjian

et al. 2024

Criminal Behav Ment Health

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BackgroundInternational studies show that adults with intellectual and developmental disabilities (IDD) are disproportionately represented in the criminal justice and forensic mental health systems; however, it is difficult to capture their involvement across systems in any one jurisdiction.AimsThe current study aimed to estimate the prevalence of IDD across different parts of the criminal justice and forensic mental health systems in Ontario and to describe the demographic and clinical profiles of these individuals relative to their counterparts without IDD.MethodsThis project utilised administrative data to identify and describe the demographic and clinical characteristics of adults with IDD and criminal justice or forensic involvement across four sectors: federal correctional facilities, provincial correctional facilities, forensic inpatient mental health care and community mental health programmes. Questions were driven by and results were contextualised by a project advisory group and people with lived experience from the different sectors studied, resulting in a series of recommendations.ResultsAdults with IDD were over‐represented in each of the four settings, ranging from 2.1% in federal corrections to 16.7% in forensic inpatient care. Between 20% (forensic inpatient) and 38.4% (provincial corrections) were under the age of 25 and between 34.5% (forensic inpatient) and 41.8% (provincial corrections) resided in the lowest income neighbourhoods. Medical complexity and rates of co‐occurring mental health conditions were higher for people with IDD than those without IDD in federal and provincial corrections.ConclusionsEstablishing a population‐based understanding of people with IDD within these sectors is an essential first step towards understanding and addressing service and care needs. Building on the perspectives of people who work in and use these systems, this paper concludes with intervention recommendations before, during and after justice involvement.

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Section: Data Sourcesmentioning

confidence: 99%

“…For those in community mental health, demographic and clinical information was collected within OCAN. (For additional information about data linkage processes and variable definitions, and results including comparisons to other individuals, see Matheson et al (2022), Whittingham et al (2020) and Lin et al (2022)).…”

Section: Demographic and Clinical Variablesmentioning

confidence: 99%

Intellectual and developmental disabilities in Ontario's criminal justice and forensic mental health systems: Using data to tell the story

Lunsky,

Matheson,

Kouyoumdjian

et al. 2024

Criminal Behav Ment Health

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“…People with mild intellectual disabilities or borderline intellectual functioning (IQ 50–85) are overrepresented in forensic treatment settings (Kaal et al, 2017; Lin et al, 2022). In such settings, instruments that measure dynamic risk factors can be used to monitor the progress of treatment.…”

Section: Introductionmentioning

confidence: 99%

Reliability and validity of the dynamic risk outcome scales—short version for clients with mild intellectual disabilities or borderline intellectual functioning

Delforterie,

Turhan,

Driessen

et al. 2024

Research Intellect Disabil

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IntroductionThis study investigated the reliability and validity of the dynamic risk outcome scales—short version (DROS‐SV). This instrument is developed to monitor treatment progress using dynamic risk factors in clients with mild intellectual disabilities or borderline intellectual functioning and behavioural and/or mental health problems.MethodData were collected from 264 clients who received Flexible Assertive Community Treatment (FACT), a form of intensive outpatient treatment.ResultsA principal component analysis showed that there were six components explaining 73.9% of the variance. Furthermore, the DROS‐SV showed good internal consistency of its subscales and total score (α > 0.78). Correlating the DROS‐SV with the Historical and Clinical subscales of the Historical, Clinical and Future—30 indicated convergent and divergent validity.DiscussionThe DROS‐SV has good psychometric properties for measuring dynamic risk factors in clients with mild intellectual disabilities or borderline intellectual functioning in FACT teams.

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“…While the disproportionate burden of health concerns among incarcerated populations is well documented, less is known about their health service utilization (Plugge et al , 2014). Some evidence suggests that, relative to the general population, people who have experienced incarceration have higher rates of ambulatory care and emergency department (ED) visits as well as medical-surgical and psychiatric hospitalizations (Baquero et al , 2020; Kouyoumdjian et al , 2018a, 2018b, Kouyoumdjian et al , 2020; Tuinema et al , 2020; Mackenzie et al , 2006; Lin et al , 2022; Matheson et al , 2022; Whittingham et al , 2020). In a study comparing people on and not on probation, the authors found that those on probation were less likely to have an outpatient visit (past year) but more likely to have an emergency department visit and inpatient hospitalization (Hawks et al , 2020).…”

Section: Introductionmentioning

confidence: 99%

Health status and health-care utilization among men recently released from a superjail: a matched prospective cohort study

Matheson,

McLuhan,

Croxford

et al. 2023

IJPH

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Purpose Continuity of care and access to primary care have been identified as important contributors to improved health outcomes and reduced reincarceration among people who are justice-involved. While the disproportionate burden of health concerns among incarcerated populations is well documented, less is known about their health service utilization, limiting the potential for effective improvements to current policy and practice. This study aims to examine health status and health care utilization among men recently released from a superjail in a large metropolitan area to better understand patterns of use, risk factors and facilitators. Design/methodology/approach Participants included adult men (n = 106) matched to a general population group (n = 530) in Ontario, Canada, linked to medical records (88.5% linkage) to examine baseline health status and health utilization three-months post-release. The authors compared differences between the groups in baseline health conditions and estimated the risk of emergency department, primary care, inpatient hospitalization and specialist ambulatory care visits. Findings Superjail participants had a significantly higher prevalence of respiratory conditions, mental illness, substance use and injuries. Substance use was a significant risk factor for all types of visits and emergency department visits were over three times higher among superjail participants. Originality/value This empirical case is illustrative of an emerging phenomenon in some regions of the world where emergency departments serve as de facto “walk-in clinics” for those with criminal justice involvement. Strategic approaches to health services are required to meet the complex social and health needs and disparities in access to care experienced by men released from custody.

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Intensive Use of Forensic Inpatient Services by People with Intellectual and Developmental Disabilities in Ontario, Canada: Prevalence and Associated Characteristics

Cited by 4 publications

References 28 publications

Intellectual and developmental disabilities in Ontario's criminal justice and forensic mental health systems: Using data to tell the story

Intellectual and developmental disabilities in Ontario's criminal justice and forensic mental health systems: Using data to tell the story

Reliability and validity of the dynamic risk outcome scales—short version for clients with mild intellectual disabilities or borderline intellectual functioning

Health status and health-care utilization among men recently released from a superjail: a matched prospective cohort study

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