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History of arrest in a population severely mentally ill adults

Mary Castle White, RN, MPH, PhD, School of Nursing, University of California, San Francisco, 2 Koret Way., Room N505, San Francisco, CA 94143-0608, (415) 476-5213, mcwhite@itsa.ucsf.edu, Linda Chafetz, DNSc, Department of Community Health Systems, University of California at San Francisco, 2 Koret Way, San Francisco, CA 94143-0608, Gerri Collins-Bride, RN, MS, ANP, Community Health Systems, University of California San Francisco, 2 Koret Way, San Francisco, CA 94143-0608, and John Nickens, PhD, San Francisco Progress Foundation, 368 Fell St., San Francisco, CA 94102.

Background. Persons with severe mental disorders are over-represented in jails, and arrest is a common experience among those with severe mental illness. Short-term residential settings are used as alternatives to hospitalization for voluntary patients referred from emergency or crisis services, and for in-patients moving to a lower level of care. In San Francisco, clients in these residential settings approximate a community sample of individuals experiencing crises or exacerbations of psychiatric illness. Methods. A community-based sample of severely mentally ill, recruited from residential settings for a clinical trial of a health promotion intervention, was measured at baseline before randomized. In this cross-sectional description, we measured sociodemographic and health-related variables, and their association with a history of arrest and time spent in jail or prison. Results. In this sample of 307 (mean age 37), 71% reported that they had ever been arrested. Arrest by gender was not as different as in other populations, with 76% of males and 61% of females reporting ever arrested. Distribution of arrest by ethnic group was similar to the overall proportion, with the exception that Asians in this sample were considerably less likely to report an arrest (39%). In multiple logistic regression, those who had been arrested were more likely to be male (OR 2.0, 95% CI 1.1-3.5), have lived, before entry into the residential setting, in an institutional setting such as jail, hospital, group living setting, single room occupancy hotel or shelter as compared to those who reported living in a private residence (OR 3.8, 95% CI 2.1-6.8), and self-report a drug problem (OR 2.4, 95% CI 1.3-4.3). While 71% (n=218) reported being arrested, 34% (n=103) reported having spent time in jail or prison. As expected, being male and reporting a drug problem were associated with longer time incarcerated, but ethnicity was also significantly associated with time in jail: mean number of days were 794 for African Americans, 732 for Hispanics, 365 for non-Hispanic Whites, 62 for Asians, and 118 for persons reporting other or mixed ethnicity. Discussion. While short-term residential facilities provide a community-based alternative, persons with severe mental illness have high rates of arrest, especially among those with the combined factors of substance abuse and group housing such as homelessness. Further, differences in time spent in jail reflect the disproportions of ethnic minorities seen in other studies of incarcerated individuals. Further examination of predictors of arrest and incarceration time may lead to targeted interventions.

Learning Objectives:

Keywords: Jails and Prisons, Mental Illness

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Special Issues for Prison Health (Jail and Prison Health Contributed Papers)

The 132nd Annual Meeting (November 6-10, 2004) of APHA