324815
Using Cross-System Administrative Data to Identify Criminal Justice Involvement of Persons with Intellectual or Developmental Disabilities and Associated Health Consequences
To identify crime victimization and perpetration by adults receiving developmental disability services (DD consumers), and associated emergency department visits and hospitalizations.
Method
This was a cross-sectional study of all consumers receiving services from Kalamazoo Community Mental Health and Substance Abuse Services (KCMHSAS) in 2009 (N=5906). A database was built integrating administrative records from KCMHSAS, county prosecutor’s office, and the two county hospitals for the 2000-2010 period.
Results
Compared to other consumers, DD consumers (N=631) were significantly less likely to have any involvement in police-reported crime (13.2% DD vs. 26.7% non-DD-consumers, p<.001). Relative to other crime- involved consumers, DD-crime-involved consumers were more likely to be victims (55.4% DD-victims vs. 36.9% non-DD-victims, p=.002). Although a fewer in number, DD-consumers who perpetrated a crime were significantly more likely than non-DD-perpetrators to commit an assault crime as opposed to a property crime (100% DD-perpetrators vs. 80.6% non-DD-perpetrators, p=.015). Compared to DD consumers who were not crime-involved, those that were had higher high-school-graduation rates and were more likely to be minority race.
Among DD-consumers, criminal-justice-involvement, regardless if it was as a victim or perpetrator, was associated with greater emergency department visits (63.9% DD-crime-involved vs. 36.9% DD-non-crime-involved, p<.001) and increased psychiatric hospitalization (8.4% DD-crime-involved vs. 2.6% DD-non-crime-involved, p=.005). Criminal-justice involvement had no measurable association with medical hospitalization rates.
Conclusion
While less likely to be crime-involved than non-DD consumers, a notable minority of DD consumers are both victims and perpetrators of crime. This crime involvement is associated with increased emergency department visits and psychiatric hospitalizations.
Learning Areas:
Administer health education strategies, interventions and programsAssessment of individual and community needs for health education
Chronic disease management and prevention
Epidemiology
Planning of health education strategies, interventions, and programs
Public health or related research
Learning Objectives:
Design a dataset that integrates data from multiple systems (criminal justice, hospital, community mental health) in order to identify how presence in one system is related to prevalence and utilization in another, among adults with intellectual/developmental disabilities.
Identify characteristics that place adults with intellectual/developmental disabilities at particular risk for criminal justice involvement, as a victim or as a perpetrator
Describe psychiatric hospitalizations and emergency department visits that are associated with criminal justice involvement
Keyword(s): Data Collection and Surveillance, Disabilities
Qualified on the content I am responsible for because: I conceived of the original study question, developed the study design, collected and analyzed the data, and led the data interpretation efforts. This analysis is part of a larger study of criminal justice involvement and acute medical care utilization by consumers of Kalamazoo Community Mental Health and Substance Abuse Services. I am the principal investigator in the larger study.
Any relevant financial relationships? Yes
| Name of Organization | Clinical/Research Area | Type of relationship |
|---|---|---|
| Kalamazoo Community Mental Health and Substance Abuse Services | Health & Injury Prevention | Consultant |
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.