Criminal Justice Settings as Possible Sites for Early Detection of Psychotic Disorders and Reducing Treatment Delay
Claire Ramsay Wan, M.P.H.; Beth Broussard, M.P.H.; Patrick Haggard, M.D.; Michael T. Compton, M.D., M.P.H.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300206
June 1, 2014
Objective Interventions to reduce the duration of untreated psychosis should target institutions and key figures that may interact with individuals who have emerging or untreated psychosis. These individuals may come into contact with criminal justice settings, such as jails and prisons. This study sought to determine the frequency of arrests and incarcerations during the duration of untreated psychosis.
Methods Retrospective data were collected from an urban, largely African-American group of 191 patients hospitalized for first-episode psychosis.
Results Thirty-seven percent of participants were incarcerated at some point during their duration of untreated psychosis. Patients who had been incarcerated during this period had a much longer treatment delay, more severe positive symptoms (specifically, hallucinations), and poorer premorbid academic adjustment. For this group, the mean number of incarcerations during the duration of untreated psychosis was 2.0±1.5, the median number of days detained was 30.5, and most were detained for nonviolent, often petty, crimes.
Conclusions Interventions to identify young people with untreated psychosis in jails and prisons and to refer these individuals to appropriate psychiatric care may reach some who would otherwise experience very long delays in treatment initiation. Crisis intervention team training of police officers could serve as one of several approaches for identifying these young people and diverting them into treatment.