Assessment of Strengths in Criminal Justice System-Impacted Youth: A Retrospective Validation Study of the SAPROF-YV
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PROVIDER: S-EPMC10265291 | biostudies-literature | 2023 Apr
REPOSITORIES: biostudies-literature
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Project description:Lay abstractThere has been growing interest in offending and contact with the criminal justice system (CJS) by people with autism spectrum disorder (ASD). However, it is not clear whether people with ASD offend more than those without ASD. Studies have started to look at whether there are particular offences people with ASD are more likely to commit and whether there are any factors that can affect whether someone comes into contact with the CJS as a potential suspect. This study looked at the patients who attended an ASD diagnostic service over a 17-year period to see the rate of contact with the CJS of those who were diagnosed with ASD and whether there were any particular factors that might increase the risk of CJS contact. Nearly a quarter of the ASD group had some contact with the CJS as a potential suspect. Factors that seemed to increase whether someone with ASD was more likely to have contact with the CJS were being male, being diagnosed with ADHD, and being diagnosed with psychosis. This study is one of the largest studies to investigate the rate of CJS contact as a potential suspect in a sample of adults with ASD in an attempt to give a clearer picture of what might influence someone with ASD to engage in offending behaviour in order to try to see what mental health services can offer to reduce the likelihood of someone with ASD coming into contact with the CJS, for example, treatment for another condition or support.
| S-EPMC9596951 | biostudies-literature
Project description:ImportanceHealth disparities between African Americans and Whites have persisted in the United States. Researchers have recently hypothesized that the relatively poor health of African Americans may be caused, in part, by African American overrepresentation in the criminal justice system.ObjectivesTo test the hypothesis that criminal justice system involvement is associated with poor health and greater health risk when controlling for unobserved family factors through a discordant sibling design.MethodsSubjects were drawn from the Carolina African American Twin Study of Aging (CAATSA). Criminal conviction records were extracted from North Carolina's Department of Public Safety. Six measures of health and one measure of health risk were analyzed. The health of convicted respondents was compared to that of unrelated non-convicted respondents matched on childhood and demographic factors ("matched sample"). Convicted respondents were also compared to non-convicted siblings ("discordant sibling sample").ResultsThe matched sample included 134 CAATSA respondents. On average, convicted CAATSA respondents, compared to matched non-convicted respondents, were in worse health. Convicted respondents had worse mean self-reported health, worse lung function, more depressive symptoms, and smoked more. The discordant sibling sample included 74 respondents. Convicted siblings and non-convicted siblings had similar self-reported health, depressive symptoms, and smoking. In general, non-convicted siblings were in worse health than non-convicted respondents from the matched sample, implying that poor health runs in families.ConclusionsThis study provided preliminary evidence that some of the association between a criminal record and poor health is confounded by family factors. Though more research is needed to support these results, the study suggests that criminal involvement may not be associated with the surfeit of health problems observed among African Americans. The criminal justice system, nonetheless, could be used to decrease the health disparity.
| S-EPMC6369245 | biostudies-literature
Project description:We investigate whether autistic people's vulnerability is taken into account at each stage of the criminal justice system (CJS). Defense lawyers from 12 nations were included in the study although the sample was predominantly from the UK. Lawyers completed an online survey regarding one case in which they had defended an autistic client between January 2015 and January 2020; and on one case in which they had defended a nonautistic client charged with a similar offense, to provide a comparison group. Ninety-three lawyers (85% in the UK) reported on one autistic case, and 53 also reported on one nonautistic case. 75% of autistic clients were not given reasonable adjustments during the process. Only 43% were offered an appropriate adult during police investigations, even though they had an existing diagnosis of autism. 59% of prosecution barristers and 46% of judges said or did something during the trial that made the lawyers concerned that they did not have an adequate understanding of autism. Lawyers were 7.58 times more likely to be concerned about their autistic client's effective participation in court and were 3.83 times more likely to be concerned that their autistic clients would engage in self-harm, compared with their nonautistic clients. There is a failure to identify and address autistic peoples' disability within the CJS. There is a need for mandatory autism training for police officers and the judiciary, with a focus on identifying autism and understanding the needs of autistic people so that reasonable adjustments are offered in all cases. LAY SUMMARY: This study sought to investigate if the needs of autistic people are being overlooked by the police and other professionals within the CJS. Results show that autistic people are not always given the support they need during police questioning or in court. The experience of being involved with the police may also have a more negative impact on autistic peoples' mental health than that of nonautistic people.
| S-EPMC9314022 | biostudies-literature
Project description:ImportanceIndividuals who are incarcerated represent a vulnerable group due to concerns about their ability to provide voluntary and informed consent, and there are considerable legal protections regarding their participation in medical research. Little is known about the quality of surgical care received by this population.ObjectiveTo evaluate perioperative surgical care provided to patients who are incarcerated within the Texas Department of Criminal Justice (TDCJ) and compare their outcomes with that of the general nonincarcerated population.Design, setting, and participantsThis cohort study analyzed data from patients who were incarcerated within the TDCJ and underwent general or vascular surgery at the University of Texas Medical Branch (UTMB) from 2012 to 2021. Case-specific outcomes for a subset of these patients and for patients in the general academic medical center population were obtained from the American College of Surgeons National Quality Improvement Program (ACS-NSQIP) and compared. Additional quality metrics (mortality index, length of stay index, and excess hospital days) from the Vizient Clinical Data Base were analyzed for patients in the incarcerated and nonincarcerated groups who underwent surgery at UTMB in 2020 and 2021 to provide additional recent data. Patient-specific demographics, including age, sex, and comorbidities were not available for analysis within this data set.Main outcome and measuresPerioperative outcomes (30-day morbidity, mortality, and readmission rates) were compared between the incarcerated and nonincarcerated groups using the Fisher exact test.ResultsThe sample included data from 6675 patients who were incarcerated and underwent general or vascular surgery at UTMB from 2012 to 2021. The ACS-NSQIP included data (2012-2021) for 2304 patients who were incarcerated and 602 patients who were not and showed that outcomes were comparable between the TDCJ population and that of the general population treated at the academic medical center with regard to 30-day readmission (6.60% vs 5.65%) and mortality (0.91% vs 1.16%). However, 30-day morbidity was significantly higher in the TDCJ population (8.25% vs 5.48%, P = .01). The 2020 and 2021 data from the Vizient Clinical Data Base included 629 patients who were incarcerated and 2614 who were not and showed that the incarcerated and nonincarcerated populations did not differ with regard to 30-day readmission (12.52% vs 11.30%) or morbidity (1.91% vs 2.60%). Although the unadjusted mortality rate was significantly lower in the TDCJ population (1.27% vs 2.68%, P = .04), mortality indexes, which account for case mix index, were similar between the 2 populations (1.17 vs 1.12).Conclusions and relevanceFindings of this cohort study suggest that patients who are incarcerated have equivalent rates of mortality and readmission compared with a general academic medical center population. Future studies that focus on elucidating the potential factors associated with perioperative morbidity and exploring long-term surgical outcomes in the incarcerated population are warranted.
| S-EPMC10701659 | biostudies-literature
Project description:Risk assessment instruments (RAIs) are widely used to aid high-stakes decision-making in criminal justice settings and other areas such as health care and child welfare. These tools, whether using machine learning or simpler algorithms, typically assume a time-invariant relationship between predictors and outcome. Because societies are themselves changing and not just individuals, this assumption may be violated in many behavioral settings, generating what we call cohort bias. Analyzing criminal histories in a cohort-sequential longitudinal study of children, we demonstrate that regardless of model type or predictor sets, a tool trained to predict the likelihood of arrest between the ages of 17 and 24 y on older birth cohorts systematically overpredicts the likelihood of arrest for younger birth cohorts over the period 1995 to 2020. Cohort bias is found for both relative and absolute risks, and it persists for all racial groups and within groups at highest risk for arrest. The results imply that cohort bias is an underappreciated mechanism generating inequality in contacts with the criminal legal system that is distinct from racial bias. Cohort bias is a challenge not only for predictive instruments with respect to crime and justice, but also for RAIs more broadly.
| S-EPMC10265989 | biostudies-literature
Project description:The treatment of people diagnosed with mental disorders who committed crimes differ greatly in countries around the world because of the long histories of criminal justice and psychiatry specific to each country. As a result, it is often difficult to grasp the specificities of each system. The main objective of this paper is to provide a narrative review of the interactions between the French mental health and judicial systems. Subsequently, we will discuss how the concept of forensic psychiatry does not yet exist in France and how it can be applied.
| S-EPMC9387428 | biostudies-literature
Project description:BackgroundLegal-involved veterans with opioid use disorder (OUD) have lower receipt of medications for opioid use disorder (MOUD) than other veterans served at the Veterans Health Administration (VHA). This qualitative study examined the influence of the criminal justice system on access to MOUD for legal-involved veterans in the U.S.MethodsVHA facilities (n = 14) that varied in their provision of MOUD to legal-involved veterans were selected for qualitative interviews. Interviewees included legal-involved veterans (n = 18), VHA Veterans Justice Programs Specialists (n = 15), substance use disorder treatment providers (n = 5), and criminal justice staff (n = 12). Team members applied codes to meaningful units of analysis (quotations) in the transcribed interviews. Using a matrix approach, team members created a spreadsheet matrix with codes, facility rate of MOUD, and relevant quotations summarized for each participant. Themes and connections between individual participants and cross-interview concepts were explored. Participants were not asked to provide feedback on the findings.ResultsThemes identified were as follows: (1) Veterans Treatment Court policies both enhanced and limited MOUD treatment access and utilization among participants; (2) cross-system collaboration strengths and challenges existed; and (3) criminal justice system treatment preferences and policies both enhanced and limited MOUD in jails and prisons.ConclusionsThe influence of the criminal justice system on MOUD has led to variable access to MOUD for legal-involved veterans. Our findings can help inform recommendations to enhance access to MOUD for veterans within the criminal justice system, including the development of a national database of MOUD education materials for Veterans Treatment Courts, strengthening community-court relationships, allowing individuals to use their own healthcare coverage within jails and prisons and extend Medicaid coverage into criminal justice settings, and applying national quality measures for MOUD to criminal justice settings and develop a national system for tracking these quality measures.
| S-EPMC11622969 | biostudies-literature
Project description:BackgroundIn 2016, over 11 million individuals were admitted to prisons and jails in the United States. Because the majority of these individuals will return to the community, addressing their health needs requires coordination between community and correctional health care providers. However, few systems exist to facilitate this process and little is known about how physicians perceive and manage these transitions.ObjectiveThe goal of this study was to characterize physicians' views on transitions both into and out of incarceration and describe how knowledge of a patient's criminal justice involvement impacts patient care plans.MethodsSemi-structured interviews were conducted between October 2018 and May 2019 with physicians from three community clinics in Hennepin County, Minnesota. Team members used a hybrid approach of deductive and inductive coding, in which a priori codes were defined based on the interview guide while also allowing for data-driven codes to emerge.ResultsFour themes emerged related to physicians' perceptions on continuity of care for patients with criminal justice involvement. Physicians identified disruptions in patient-physician relationships, barriers to accessing prescription medications, disruptions in insurance coverage, and problems with sharing medical records, as factors contributing to discontinuity of care for patients entering and exiting incarceration. These factors impacted patients differently depending on the direction of the transition.ConclusionsOur findings identified four disruptions to continuity of care that physicians viewed as key barriers to successful transitions into and out of incarceration. These disruptions are unlikely to be effectively addressed at the provider level and will require system-level changes, which Medicaid and managed care organizations could play a leading role in developing.
| S-EPMC8279398 | biostudies-literature
Project description:BackgroundEvidence on the effectiveness of opioid agonist treatment (OAT) in reducing crime is mixed. We aimed to assess the effect of OAT on crime in terms of delaying time to first charge and reducing overall charge rates, as well as the relationship between OAT retention and overall charge rates.MethodsWe did a retrospective cohort study of opioid-dependent people who entered OAT for the first time between Jan 1, 2004, and Dec 30, 2010, in New South Wales (NSW), Australia. We used three linked NSW and national administrative datasets. Data on OAT were obtained from the Pharmaceutical Drugs of Addiction System, data on charges were obtained from the Reoffending Database, and data on mortality were obtained from the National Death Index. The cohort was followed up until Dec 31, 2011. Time-dependent OAT exposure was modelled using Cox proportional hazards models (time to first charge) and Andersen-Gill intensity models (total charge-days). Retention in OAT was modelled using two features of treatment engagement, number of OAT episodes and proportion of follow-up time in OAT (presented in quartile groupings: lowest, low-mid, low-high, highest) using zero-inflated negative binomial regression (total charges). All models were adjusted for sociodemographic, criminographic, and treatment-related variables.Findings10 744 new OAT entrants were included in the study. 5751 (53·5%) people were charged with an offence. In adjusted analyses, OAT was associated with an initial benefit in delaying the time to first charge (hazard ratio 0·43, 95% CI 0·33-0·55) and reducing total charge-days (0·39, 95% CI 0·30-0·52); however, these protective effects reduced over time. Total charge rates were higher as the number of OAT episodes increased (incident rate ratio [IRR] 1·13, 95% CI 1·11-1·15), and when relatively lower proportions of time were spent in OAT (IRR among the lowest three quartiles ranged from 1·11 [95% CI 1·02-1·21] to 1·22 [95% CI 1·12-1·33]).InterpretationOAT was associated with a reduction in overall charge rates and was more protective as treatment engagement increased. Maximising treatment retention is crucial to achieving long-term health and social benefits of OAT.FundingAustralian National Health and Medical Research Council, Australian Institute of Criminology, National Institute on Drug Abuse, Australian Government Department of Health, UNSW Sydney.
| S-EPMC6673674 | biostudies-literature
Project description:Spillovers from the Affordable Care Act Medicaid expansion to other social-sector outcomes have received little attention. One that may be especially salient for public policy is the impact of expanded eligibility on jail-related outcomes. This study compares recidivism outcomes in three non-expansion counties to nearby expansion counties before and after Medicaid expansion. Using forty-eight months of arrest data from six urban county jails, we conduct comparative interrupted time series analyses to describe changes in the probability of rearrest and the number of arrests before and after Medicaid expansion. Consistent with previous literature, we find mixed results. In two case studies, Medicaid expansion is associated with decreased rates of recidivism. In the other, we find differential increases in jail-based recidivism after Medicaid expansion. We use contextual information from site visits and stakeholder interviews to understand the factors that may mediate and moderate the relationship between Medicaid expansion and return to jail.
| S-EPMC7702715 | biostudies-literature