Psychiatric Illness Among Drug Court Probationers
The purpose of this study was to identify the level of psychiatric symptoms reported by probationers involved with a drug court in Hennepin County, Minnesota. Sixty probationers completed a brief demographic interview, the Beck Depression and Anxiety Inventories (BDI and BAI) and a measure of medical quality of life. Fifteen participants completed a structured interview for psychiatric diagnosis (SCID-I). The sample was predominantly male, African American, and unemployed. Over 40% had received treatment for psychiatric problems, including 20% who reported a history of inpatient psychiatric admission and 15% currently taking a psychotropic medication. More than 1/3 of BDI and BAI scores were moderate to severe. The mean Short Form (SF)-36 scores were significantly lower than in the general population. Trends suggested more distress associated with: Caucasian race, female gender, less education, unemployment, and less previous legal involvement. Of 15 participants that completed a SCID-I, 13 participants met lifetime diagnostic criteria for at least one psychiatric disorder. The most common diagnoses were major depressive disorder and posttraumatic stress disorder (PTSD). Three participants met diagnostic criteria for current psychotic disorder. Half of participants who currently met criteria for a disorder reported that they had never received psychiatric treatment. Results indicate participants currently were experiencing high rates of emotional symptoms. Serious mental illness was common. Many of these individuals had not been identified previously as needing psychiatric treatment. More frequent and thorough screening for psychiatric illness in drug court settings is necessary to identify serious psychiatric illnesses.
Available from: Elizabeth A Evans
- "Pretreatment employment experiences have been found to vary by drug type, with fewer methamphetamine users having any employment experience prior to entering care.11 Individuals without a job at treatment entry may have greater needs for services to address medical or mental health problems.12,13 Drug abusers who reenter the community directly from prison or who live in the community with a criminal record or history of public assistance, homelessness, or mental illness face added personal and system barriers to gaining or maintaining employment,14–18 which further compromise their ability to successfully integrate into society. "
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ABSTRACT: California drug treatment programs may use funds to address barriers to work faced by Proposition 36 offenders, most of whom are not working at treatment entry, but employment services utilization and related behavioral outcomes have never been studied. This study examined primary data collected on 1,453 offenders by 30 programs during 2004 to explore the characteristics, employment services utilization, and outcomes of those who did and did not receive employment services while in drug treatment. One-year outcomes were mostly similar across groups, however, increases in the proportion of offenders employed, receiving income from employment and family or friends, and being paid for work were significantly greater among the received-employment-services group, and a greater proportion of this group also completed drug treatment. Employment services utilization was less likely for persons recruited from outpatient settings and more likely with greater severity of family/social problems and desire for services. Odds of employment one-year post-treatment entry were higher for those of Hispanic race/ethnicity (vs. White) and for those with treatment completion/longer retention but lower for those who were older, lived in specific counties, had greater employment problem severity at intake, and received other income-related services. Strategies for improving employment services utilization and outcomes among Proposition 36 offenders are discussed.
Available from: Laura L Symonds
- "Keywords: 5-HTTLPR, abuse, depressive symptoms, gender, gene–environment interaction, pregnancy, stressful life events, women Received 28 June 2006, revised 2 August 2006, accepted for publication 3 August 2006 Depressive disorders (major depression, dysthymic disorder, postpartum depression) are a leading cause of lost productivity (WHO 2004), inpatient psychiatric admissions (Hudson 2004; Thompson et al. 2004) and suicide (Bertolote et al. 2004; Conwell et al. 1996) and commonly co-occur with substance use disorders (Hagedorn & Willenbring 2003). Depression in pregnancy poses additional concerns because of potential risks to the developing fetus, either directly through altered hormonal milieu (Heim et al. 2002; Rajewska & Rybakowski 2003) or indirectly through maternal behaviors such as substance use and diet (Fulkerson et al. 2004; Zuckerman et al. 1989). "
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ABSTRACT: Few studies of gene-environment interactions for the serotonin transporter promoter polymorphism (5-HTTLPR), life stressors and depression have considered women separately or examined specific types of stressful life events. None have looked at depression during pregnancy. In the Pregnancy Outcomes and Community Health (POUCH) Study, women were queried about history of stressful life events and depressive symptoms at the time of enrollment (15-27 weeks gestation). Stressful life events were grouped a priori into "subconstructs" (e.g. economic, legal, abuse, loss) and evaluated by subconstruct, total subconstruct score and total stressful life event score. The effect of genotype on the association between stressful life events and elevated depressive symptoms was assessed in 568 white non-Hispanic participants. The relationship between exposure to abuse and elevated depressive symptoms was more pronounced in the s/s group (OR = 24.5) than in the s/l group (OR = 3.0) and the l/l group (OR = 7.7), but this significant interaction was detected only after excluding 73 (13%) women with recent use of psychotropic medications. There was no evidence of gene-environment interaction in analytic models with other stressful life events subconstructs, total subconstruct score or total stressful life events score. These data offer modest support to other reports of gene-environment interaction and highlight the importance of considering specific stressful life events.
Available from: Christine A. Saum
- "In a study examining psychiatric illness among drug court participants (n=60), Hagedorn and Willenbring (2003) found that over 40% of the sample reported moderate to severe depression and 35% reported being moderately to severely anxious. The study also found that many offenders had been previously diagnosed with depression (31.7%), had received treatment for psychiatric problems, (41.7%), had taken psychiatric medications (35%) or antidepressants (30%), and had received inpatient (20%) or outpatient (35%) psychiatric care. "
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ABSTRACT: Drug-involved offenders report high rates of mental health problems that can negatively impact criminal justice outcomes.
Yet, relatively little attention has been given to the mental health issues of drug court offenders. Therefore, this study
examined 449 participants in a Delaware drug court and investigated relationships between mental health, gender, and program
completion. Bivariate results indicated that gender was related to both mental health status and completion status. Multivariate
findings revealed that two indicators of mental health, depression and being prescribed drugs for a psychological or emotional
problem, were significant predictors of drug court completion. Policy implications include assessing the mental health status
of all drug court participants at program entry so that services can be provided which aim to improve offender health and
increase the likelihood of successful program outcomes. Drug courts must better meet the needs of participants with co-occurring
disorders if they are to remain an effective and viable criminal justice intervention.
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