Mental health treatment among older adults with mental illness on parole or probation

Abstract

Background The number of older adults on parole and probation is growing at an unprecedented rate, yet little is known about the mental health needs and treatment utilization patterns among this group. The objective of this study is to compare the prevalence of serious or moderate mental illness (SMMI), and the proportion of those with SMMI who receive mental health treatment, among community-dwelling older adults on correctional supervision (parole or probation) vs. not on correctional supervision. Methods Design: Cross-sectional analysis of data from the 2008–2014 National Surveys for Drug Use and Health (NSDUH). Setting: Population-based national survey data. Participants: Older adults (age ≥ 50) who participated in the NSDUH between 2008 and 2014 ( n = 44,624). Participants were categorized according to whether they were on parole or probation during the 12 months prior to survey completion ( n = 379) vs. not ( n = 44,245). Measurements: Probable SMMI was defined using a validated measure in the NSDUH. Mental health treatment included any outpatient mental health services or prescriptions over the 12 months prior to survey completion. We compared the prevalence of SMMI, and the proportion of those with SMMI who received any treatment, by correctional status. Results Overall, 7% ( N = 3266) of participants had SMMI; the prevalence was disproportionately higher among those on parole or probation (21% vs. 7%, p < 0.001). Sixty-two percent of those with SMMI received any mental health treatment, including 81% of those on parole or probation and 61% of those who were not ( p < 0.001). This result remained statistically significant after logistic regression accounted for differences in sociodemographics and health. Conclusions SMMI is disproportionally prevalent among older adults on parole or probation, and community correctional supervision programs may be facilitating linkages to needed community-based mental health treatment.

Medical Multimorbidity, Mental Illness, and Substance Use Disorder among Middle-Aged and Older Justice-Involved Adults in the USA, 2015–2018

“…Several interventions have been developed or proposed to address either mental illness, SUD, or chronic medical diseases in this population, especially for those transitioning back to the community. 24,25,[32][33][34] Our results highlight the need to address these problems simultaneously. Existing multimorbidity models of geriatric-based care are best suited to accomplish this but must incorporate treatment for SUD and mental illness with traditional models that address medical multimorbidity, functional health, and geriatric conditions.…”

Coordinating across correctional, community, and VA systems: applying the Collaborative Chronic Care Model to post-incarceration healthcare and reentry support for veterans with mental health and substance use disorders

“…For individuals with opioid use disorders in particular, Reichert and Gleicher’s study (2019) indicates the need for more up-to-date training of probation department staff to enable interagency collaboration that can help link the individuals to evidence-based treatment, which can then lead to their better probation requirement adherence and importantly positive outcomes such as reduced recidivism. Furthermore, support for individuals with MHDs in the justice context overall, from transitional housing (Heard et al 2019) to needs during parole and probation (Bryson et al 2019), are receiving increased attention in the field.…”

Applying the Stress Process Theory to Assess Correlates of Suicide Ideation-to-Action Among Persons on Parole in the United States

“…Persons on parole are growing at an unprecedented rate, resulting in a higher need for physical health, mental health, and substance use treatment (Bryson et al, 2019;Houser et al, 2019;Pinedo, 2020;Sheppard & Ricciardelli, 2020). There is also a growing recognition that being imprisoned expands or intensifies healthcare disparities (Massoglia, 2008;Wang et al, 2014).…”

“…In terms of mental health, acute stress has been associated with higher rates of suicidality, but was not the sole variable impacting the likelihood of suicide attempts (López-Díaz et al, 2018). In addition to the gap in physical health services, studies show that individuals on parole often lack mental health services aimed at addressing suicide-related behaviors, non-suicidal self-injury, and a multitude of behavioral health concerns (Bryson et al, 2019;Houser et al, 2019;Shaffer et al, 2018;Timmer & Nowotny, 2021;Van Deinse et al, 2019). For example, some estimates suggest that as many as 29% of persons on parole experience risk factors associated with suicide, such as depression, psychological distress, and episodes of major depression (Bryson et al, 2019;Visher & Courtney, 2007;Yu et al, 2014).…”