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1.
Prev Med ; 180: 107892, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38342384

RESUMO

OBJECTIVE: Open-source data systems, largely drawn from media sources, are commonly used by scholars due to the lack of a comprehensive national data system. It is unclear if these data provide an accurate and complete representation of firearm injuries and their context. The study objectives were to compare firearm injuries in official police records with media reports to better identify the characteristics associated with media reporting. METHODS: Firearm injuries were identified in open-source media reports and compared to nonfatal firearm injury (n = 1642) data from official police records between January 1, 2021 to December 31, 2022 in Indianapolis, Indiana. Events were matched on date, location, and event circumstances. Four multivariate, multi-level mixed effects logistic regression models were conducted to assess which survivor, event, and community characteristics were associated with media reporting. Data were analyzed 2023 - January 2024. RESULTS: Media reported 41% of nonfatal shootings in 2021 and 45% in 2022(p < 0.05), which is approximately two out of every five shootings. Shootings involving multiple survivors, children, and self-defense were more likely to be reported, whereas unintentional shootings and shootings that occurred in structurally disadvantaged communities were less likely to be reported. CONCLUSIONS: Findings suggest that relying on media reports of firearm injuries alone may misrepresent the numbers and contexts of shootings. Public health interventions that educate journalists about these important issues may be an impactful firearm violence prevention strategy. Also, it is critical to link data systems at the local level to ensure interventions are designed and evaluated using accurate data.


Assuntos
Armas de Fogo , Ferimentos por Arma de Fogo , Criança , Humanos , Estados Unidos , Ferimentos por Arma de Fogo/epidemiologia , Indiana/epidemiologia , Violência , Vigilância da População
2.
Sex Abuse ; 35(5): 539-567, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36289053

RESUMO

It is widely understood that stable housing is a key element in the transition from prison to the community. However, many persons under correctional supervision face substantial barriers in securing and maintaining housing, a fact that is heightened among individuals with a sexual offense conviction. Although frequent movement is commonplace among people on parole, it is unclear how housing changes affect recidivism outcomes and whether such mobility uniquely impacts individuals with a sexual offense conviction. In the present study, we use a quasi-experimental propensity score weighting design to compare a sample of individuals paroled from prison in Michigan for sexual and non-sexual crimes (N = 3930) to consider the role of housing mobility on the likelihood of rearrests and technical revocation, with attention to disaggregating sexual crimes against adults and children. Results suggest that increased movement was distinctly associated with a higher hazard of rearrest for individuals with a sexual offense conviction, and a strong predictor of technical return hazard for both individuals with sexual and non-sexual convictions.


Assuntos
Reincidência , Delitos Sexuais , Adulto , Criança , Humanos , Habitação , Prisões , Comportamento Sexual
3.
Soc Sci Med ; 345: 116723, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38422686

RESUMO

BACKGROUND: People with mental illness are overrepresented in United States (US) criminal legal systems. In response, alternatives to traditional police response to behavioral health emergencies have become more common, despite limited evidence for their effectiveness. We conducted the first randomized controlled trial of a police-mental health co-response team to determine program effectiveness relative to a police-as-usual response on key outcomes identified by community stakeholders. METHODS: Between January 2020 and March 2021, we randomized behavioral health emergency calls for service in one of six police districts in Indianapolis, Indiana to receive a co-response or police-as-usual response during operational hours between 10 a.m. and 5 p.m. Mondays - Fridays. Eligible calls for service were determined via pre-specified phrases indicating a behavioral health incident over the police dispatch radio. Researchers then communicated random assignment with the co-response team to indicate whether they should respond or withhold. Logistic and negative binomial regression were used to assess group differences in emergency medical services (EMS) events within 12 months of the randomized incident along with jail booking, outpatient encounters, and emergency department visits. FINDINGS: We randomized 686 calls for service with co-response completed in 264 cases and police-as-usual response in 267 cases. The overall rate of attrition was similar across conditions and the final sample included 211 co-responses and 224 police-as-usual responses. We found no significant differences in any EMS event (odds ratio [OR]: 1.26; 95% confidence interval [CI]: 0.85-1.88, p = .246) or event counts (incidence rate ratio [IRR]: 0.85; 95% CI: 0.52-1.37, p = .504). We also found no differences in secondary outcomes (jail booking, outpatient encounters, and emergency department visits). DISCUSSION: A police-mental health co-response team model was not more effective than traditional police response on key outcomes. Co-response team models, such as the one reported here, may unintentionally foster emergency services utilization among persons with behavioral health needs. Without a functioning national mental health system, communities in the US will continue to struggle to identify solutions to meet the needs of community members with complex behavioral health issues.


Assuntos
Serviços Médicos de Emergência , Transtornos Mentais , Humanos , Polícia , Saúde Mental , Emergências , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Transtornos Mentais/psicologia
4.
Psychiatr Serv ; 73(4): 366-373, 2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-34433289

RESUMO

OBJECTIVE: Criminal justice and emergency medical service (EMS) outcomes were compared for individuals experiencing a behavioral health crisis who received a response from a co-response team (CRT) or a usual response from the police after a 911 call. METHODS: A prospective, quasi-experimental design was used to examine outcomes of a CRT pilot tested in Indianapolis (August-December 2017). Weighted multivariable models examined effects of study condition (CRT group, N=313; usual-response group, N=315) on immediate booking, emergency detention, and subsequent jail bookings and EMS encounters. Sensitivity of outcomes to follow-up by a behavioral health unit (BHU) was also examined. RESULTS: Individuals in the CRT group were less likely than those in the usual-police-response group to be arrested immediately following the 911 incident (odds ratio [OR]=0.48, 95% confidence interval [CI]=0.25-0.92) and were more likely to experience any EMS encounter at 6- and 12-month follow-up (OR range=1.71-1.85, p≤0.015 for all). Response type was not associated with jail bookings at 6 or 12 months. Follow-up BHU services did not reduce bookings or EMS encounters. CRT recipients with BHU follow-up were more likely than those without BHU follow-up to have a subsequent EMS contact (OR range=2.35-3.12, p≤0.001 for all). These findings differed by racial group. CONCLUSIONS: CRT responses may reduce short-term incarceration risk but not long-term EMS demand or risk of justice involvement. Future research should consider the extent to which CRT and follow-up services improve engagement with stabilizing treatment services, which may reduce the likelihood of future crises.


Assuntos
Serviços de Saúde Mental , Polícia , Direito Penal , Humanos , Saúde Mental , Estudos Prospectivos
5.
Psychiatr Rehabil J ; 44(4): 310-317, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34881932

RESUMO

OBJECTIVE: We examined dispositions of crisis response team (CRT) events over 2 years in a large Midwestern city. METHOD: Between January 1, 2018 and December 31, 2019, the CRT self-dispatched to mental/behavioral health-related 9-1-1 calls. Data utilized for analysis included demographic information of persons in crisis, crisis type, and crisis event dispositions. Crisis types were mental health, self-harm, and substance use related. Event dispositions included immediate detention, arrest, transport, and issue resolved. Multinomial regression models were used to predict crisis event dispositions as a function of the three crisis types, controlling for covariates. The sample included 1,426 events to distinct individuals. RESULTS: Most CRT events involved persons who were White (47.7%; n = 680), male (56.1%; n = 800), and an average of 39.3 years of age (SD = 16.6). Most crises were mental health (65.4%; n = 932), followed by self-harm (31.7%; n = 452), and substance use (25.9%; n = 370). Events were generally resolved at the scene (55.0%, n = 784); over a quarter resulted in immediate detention (26.9%, n = 384), followed by voluntary transport (14.0%, n = 200), and arrest (4.1%, n = 58). Crisis type was a significant predictor of event dispositions: Self-harm crises were associated with immediate detention and voluntary transport, and substance use crises with arrest. Homelessness was also a significant predictor of arrest. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The findings provide a better understanding of the short-term impact of CRTs. Data highlight how crisis type indicators predict event dispositions, demonstrating potential for more efficient emergency responder utilization by dispatching units according to crisis type. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Transtornos Mentais , Serviços de Saúde Mental , Transtornos Relacionados ao Uso de Substâncias , Intervenção em Crise , Humanos , Aplicação da Lei , Masculino , Transtornos Mentais/epidemiologia , Saúde Mental , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
6.
Eval Program Plann ; 66: 39-47, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29024835

RESUMO

Cell phones in correctional facilities have emerged as one of the most pervasive forms of modern contraband. This issue has been identified as a top priority for many correctional administrators in the United States. Managed access, a technology that utilizes cellular signals to capture transmissions from contraband phones, has received notable attention as a promising tool to combat this problem. However, this technology has received little evaluative attention. The present study offers a foundational process evaluation and draws upon output measures and stakeholder interviews to identify salient operational challenges and subsequent lessons learned about implementing and maintaining a managed access system. Findings suggest that while managed access captures large volumes of contraband cellular transmissions, the technology requires significant implementation planning, personnel support, and complex partnerships with commercial cellular carriers. Lessons learned provide guidance for practitioners to navigate these challenges and for scholars to improve future evaluations of managed access.


Assuntos
Telefone Celular , Prisões/organização & administração , Humanos , Estados Unidos
7.
Health Justice ; 6(1): 21, 2018 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-30467739

RESUMO

BACKGROUND: In an effort to reduce the increasing number of persons with mental illness (PMI) experiencing incarceration, co-responding police-mental health teams are being utilized as a way to divert PMI from the criminal justice system. Co-response teams are typically an inter-agency collaboration between police and mental health professionals, and in some cases include emergency medical personnel. These teams are intended to facilitate emergency response by linking patients to mental health resources rather than the criminal justice system, thus reducing burdens on both the criminal justice systems as well as local healthcare systems. The current study examines the barriers and facilitators of successfully implementing the Mobile Crisis Assistance Team model, a first-responder co-response team consisting of police officers, mental health professionals, and paramedics. Through content analysis of qualitative focus groups with team members and interviews with program stakeholders, this study expands previous findings by identifying additional professional cultural barriers and facilitators to program implementation while also exploring the role of clear, systematic policies and guidelines in program success. RESULTS: Findings demonstrate the value of having both flexible and formal policies and procedures to help guide program implementation; ample community resources and treatment services in order to successfully refer clients to needed services; and streamlined communication among participating agencies and the local healthcare community. A significant barrier to successful program implementation is that of role conflict and stigma. Indeed, members of the co-response teams experienced difficulty transitioning into their new roles and reported negative feedback from other first responders as well as from within their own agency. Initial agency collaboration, information sharing between agencies, and team building were also identified as facilitators to program implementation. CONCLUSION: The current study provides a critical foundation for the implementation of first-responder police-mental health co-response teams. Cultural and systematic barriers to co-response team success should be understood prior to program creation and used to guide implementation. Furthermore, attention must be directed to cultivating community and professional support for co-response teams. Findings from this study can be used to guide future efforts to implement first-response co-response teams in order to positively engage PMI and divert PMI from the criminal justice system.

8.
Int J Offender Ther Comp Criminol ; 61(8): 874-893, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26385191

RESUMO

Access to Recovery (ATR) is a Substance Abuse and Mental Health Services Administration (SAMHSA)-funded initiative that offers a mix of clinical and supportive services for substance abuse. ATR clients choose which services will help to overcome barriers in their road to recovery, and a recovery consultant provides vouchers and helps link the client to these community resources. One of ATR's goals was to provide services to those involved in the criminal justice system in the hopes that addressing substance abuse issues could reduce subsequent criminal behaviors. This study examines this goal by looking at recidivism among a sample of clients in one state's ATR program who returned to the community after incarceration. Results suggest that there were few differential effects of service selections on subsequent recidivism. However, there are significant differences in recidivism rates among the agencies that provided ATR services. Agencies with more resources and a focus on prisoner reentry had better recidivism outcomes than those that focus only on substance abuse services.


Assuntos
Serviços Comunitários de Saúde Mental , Acessibilidade aos Serviços de Saúde , Prisioneiros , Reincidência/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Adulto , Integração Comunitária , Feminino , Humanos , Indiana , Masculino , Reincidência/prevenção & controle
9.
Eval Rev ; 39(3): 308-38, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25948636

RESUMO

BACKGROUND: Evaluations are routinely conducted by government agencies and research organizations to assess the effectiveness of technology in criminal justice. Interdisciplinary research methods are salient to this effort. Technology evaluations are faced with a number of challenges including (1) the need to facilitate effective communication between social science researchers, technology specialists, and practitioners, (2) the need to better understand procedural and contextual aspects of a given technology, and (3) the need to generate findings that can be readily used for decision making and policy recommendations. OBJECTIVES: Process and outcome evaluations of technology can be enhanced by integrating concepts from human factors engineering and information processing. This systemic approach, which focuses on the interaction between humans, technology, and information, enables researchers to better assess how a given technology is used in practice. SUBJECTS: Examples are drawn from complex technologies currently deployed within the criminal justice system where traditional evaluations have primarily focused on outcome metrics. Although this evidence-based approach has significant value, it is vulnerable to fully account for human and structural complexities that compose technology operations. CONCLUSIONS: Guiding principles for technology evaluations are described for identifying and defining key study metrics, facilitating communication within an interdisciplinary research team, and for understanding the interaction between users, technology, and information. The approach posited here can also enable researchers to better assess factors that may facilitate or degrade the operational impact of the technology and answer fundamental questions concerning whether the technology works as intended, at what level, and cost.


Assuntos
Direito Penal , Ergonomia , Avaliação de Processos e Resultados em Cuidados de Saúde , Avaliação da Tecnologia Biomédica , Tomada de Decisões , Prática Clínica Baseada em Evidências , Humanos , Formulação de Políticas , Projetos de Pesquisa
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