Incarceration Associated With Homelessness, Mental Disorder, and Co-occurring Substance Abuse
ABSTRACT This study assessed relationships between homelessness, mental disorder, and incarceration.
Using archival databases that included all 12,934 individuals who entered the San Francisco County Jail system during the first six months of 2000, the authors assessed clinical and behavioral characteristics associated with homelessness and incarceration.
In 16 percent of the episodes of incarceration, the inmates were homeless, and in 18 percent of the episodes, the inmates had a diagnosis of a mental disorder; 30 percent of the inmates who were homeless had a diagnosis of a mental disorder during one or more episodes. Seventy-eight percent of the homeless inmates with a severe mental disorder had co-occurring substance-related disorders. Inmates with dual diagnoses were more likely to be homeless and to be charged with violent crimes than other inmates. Multiple regression analyses showed that inmates who were homeless and had co-occurring severe mental disorders and substance-related disorders were held in jail longer than other inmates who had been charged with similar crimes.
People who were homeless and who were identified as having mental disorders, although representing only a small proportion of the total population, accounted for a substantial proportion of persons who were incarcerated in the criminal justice system in this study's urban setting. The increased duration of incarceration associated with homelessness and co-occurring severe mental disorders and substance-related disorders suggests that jails are de facto assuming responsibility for a population whose needs span multiple service delivery systems.
- SourceAvailable from: Saddichha Sahoo
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- "Unfortunately, accompanying these substances' high rates of use are their associations with criminal involvement and social marginalization (Greenberg & Rosenheck, 2010; Grinman et al., 2010; Hadland, Marshall, Kerr, Qi, Montaner, & Wood, 2011; McNiel, Binder, & Robinson, 2005). In addition, stimulants and cannabis have been linked to severe mental disorders (Fiorentini et al., 2011; Grant et al., 2012; Marshall & Werb, 2010; Moore et al., 2007; Saddichha, Sur, Sinha, & Khess, 2010; Smart, 1991). "
ABSTRACT: High rates of substance use, especially cannabis and stimulant use, have been associated with homelessness, exposure to trauma, and involvement with the criminal justice system. This study explored differences in substance use (cannabis vs. stimulants) and associations with trauma and incarceration among a homeless population. Data were derived from the BC Health of the Homeless Study (BCHOHS), carried out in three cities in British Columbia, Canada. Measures included sociodemographic information, the Maudsley Addiction Profile (MAP), the Childhood Trauma Questionnaire (CTQ), and the Mini International Neuropsychiatric Interview (MINI) Plus. Stimulant users were more likely to be female (43%), using multiple substances (3.2), and engaging in survival sex (14%). Cannabis users had higher rates of lifetime psychotic disorders (32%). Among the incarcerated, cannabis users had been subjected to greater emotional neglect (p < .05) and one in two cannabis users had a history of lifetime depressive disorders (p < .05). Childhood physical abuse and Caucasian ethnicity were also associated with greater crack cocaine use. One explanation for the results is that a history of childhood abuse may lead to a developmental cascade of depressive symptoms and other psychopathology, increasing the chances of cannabis dependence and the development of psychosis.International Journal of Offender Therapy and Comparative Criminology 07/2014; DOI:10.1177/0306624X14541661 · 0.84 Impact Factor
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- "For such individuals, successful re-integration into the community is often impeded by lack of access to or disqualification from adequate mental and physical health care, housing, and employment (Baillargeon et al. 2010; Draine et al. 2005; Hoge 2007; Roman and Travis 2004). In addition, persons with mental illness and criminal justice histories have high rates of coexisting substance abuse disorders (McNeil et al. 2005) and experiences of trauma including childhood traumas and traumas associated with arrests and incarcerations (Osher and Steadman 2007), which can further challenge their efforts to achieve personal stability and community integration. While a few evidence-based practices—Forensic Assertive Community Treatment, Illness Management and Recovery, and Supported Employment— have been developed or adapted to help meet the specific challenges these individuals face, few interventions that address the multiple day-to-day struggles that individuals with mental illness and criminal justice histories experience have been implemented and evaluated. "
ABSTRACT: This study assessed the effectiveness of an intervention based on a theoretical framework of citizenship on reducing psychiatric symptoms, alcohol use, and drug use, and increasing quality of life for persons with serious mental illness (SMI) and criminal justice involvement. One-hundred fourteen adults with SMI and a history of criminal justice involvement participated in a 2 × 3 longitudinal randomized controlled trial of a four-month citizenship intervention versus usual services. Linear mixed model analyses were used to assess the intervention's impact on quality of life, symptoms, and substance use. After controlling for baseline covariates, participants in the experimental condition reported significantly increased quality of life, greater satisfaction with and amount of activity, higher satisfaction with work, and reduced alcohol and drug use over time. However, individuals in the experimental condition also reported increased anxiety/depression and agitation at 6 months (but not 12 months) and significantly increased negative symptoms at 12 months. Findings suggest that community-oriented, citizenship interventions for persons with SMI and criminal justice histories may facilitate improved clinical and community outcomes in some domains, but some negative clinical findings suggest the need for post-intervention support for intervention participants. Implications for practice and future research are discussed.American Journal of Community Psychology 08/2012; DOI:10.1007/s10464-012-9549-z · 1.74 Impact Factor
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- "People with COD face greater difficulties managing day-to-day situations than those with one condition. They are at higher risk for becoming homeless or incarcerated than their single-diagnosis peers (Marshall 1998; McNiel et al., 2005) and for acquiring additional illnesses and disabilities (Geppert & Minckoff 2004; Klinkenberg & Sacks 2004; Comtois et al. 2005). They have difficulty gaining and holding jobs, and may not interact well enough with assistance agencies to maintain housing and food security (Gamm et al., 2003). "
ABSTRACT: Family help provision for adults diagnosed with co-occurring severe mental illness and substance dependence is understudied. This article draws on verbally-administered structured and semi-structured interviews with one group of 122 behavioral health care clients and one group of 54 client-nominated family members. In New Mexico, USA, these were collected as part of a larger, long-term study. We examine the latter's concerns and fears, relative desire to be involved with treatment, and difficulties connecting with professionals, as well as forms of assistance they gave to clients and intra-family communication. We found that family members' actions and communications often support client recovery through resource provision and other, intangible forms of help. However, their misunderstandings of and lack of knowledge about client experiences can also impede recovery. We also compare the two groups of interviewees' perspectives on assistance given to clients by family members. We give examples of family attempts to deliver help and their consequences. Last, we offer suggestions for providers and policymakers to better help family members achieve their goal of caring for clients in recovery.Social Science [?] Medicine 07/2011; 73(8):1222-9. DOI:10.1016/j.socscimed.2011.07.006 · 2.56 Impact Factor