Community Reentry of Persons with Severe Mental Illness Released from State Priso

从州立监狱释放的严重精神疾病患者重返社区

• 批准号: 8053854
• 负责人: LINDA K FRISMAN
• 金额: $ 49.7万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-15 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8053854
• 关键词: Address; Adopted; Adoption; Affect; Area; Collaborations; Communities; Community Integration; Connecticut; Country; Criminal Justice; Data; Deinstitutionalization; Economics; Equilibrium; Face; Freedom; Government; Health; Health Policy; Home environment; Hospitalization; Imprisonment; Individual; Inpatients; Intervention; Justice; Linear Models; Measures; Medicaid; Mental Health; Mental disorders; Mentally Ill Persons; National Institute of Mental Health; Outcome; Outpatients; Persons; Pharmaceutical Preparations; Policies; Prisoner; Prisons; Psychiatric Hospitals; Public Health; Research; Research Design; Services; Social Welfare; Substance abuse problem; Supervision; System; Testing; Time; Treatment Protocols; Washington; abstracting; authority; community based service; community living; community reentry; community reintegration; comparison group; cost effectiveness; design; disability; follow-up; frontier; knowledge base; meetings; offender; policy implication; programs; public health relevance; recidivism; research study; restoration; severe mental illness; statistics

DESCRIPTION (provided by applicant): Project Summary/Abstract Mentally ill persons involved in the criminal justice system represent the new frontier for community mental health and disability research. The scope of this problem is truly staggering with upwards of 86,000 persons with severe mental illness (SMI) released from prisons each year with high rates of recidivism. The loss of Medicaid benefits by incarcerated offenders is thought to be a major obstacle to successful community reentry. Several states have adopted expedited Medicaid restoration programs to reconnect eligible prisoners to their benefits prior to release. Early benefit restoration can avoid disruptions in medication regimens and treatments for offenders with SMI when they are released to the community. However, no rigorous research has been conducted to establish the cost-effectiveness of these policies. The proposed responds to with RFA-MH-09-050 from the NIMH with a three-year study that addresses these concerns by undertaking an assessment of Medicaid restoration policies in Connecticut and Washington State for released prisoners who have SMI with regard to three outcomes-subsequent recidivism, hospitalizations, and outpatient mental health and substance abuse service use. Two complementary study designs and analytic approaches will be implemented to address the impact (Aim 1) and cost-effectiveness (Aim 2) of these policies. The first is a difference-in-difference design comparing individuals with SMI and those without SMI centered on a policy adoption date of April 1, 2005 in Connecticut and January 1, 2006 in Washington with three years pre and two years post data in each state. The second is a quasi-experimental study design focused on the post-period only comparing individuals with SMI who received expedited Medicaid restoration (treatment group) vs. those who did not (comparison group) over a two-year follow-up period using a hierarchical linear modeling framework. Propensity score matching will be used with both designs to achieve balance between groups on all observed measures. The proposed study is well-aligned with RFA-MH-09-050 in that it addresses an important mental health policy issue for state authorities, takes advantage of a wealth of administrative data from two states, applies an array of analytical strategies from the fields of economics and statistics to address an important state mental health policy issue, and responds to the call for research about justice-involved persons with severe mental illness as put forth in the President's New Freedom Commission on Mental Health (2002). PUBLIC HEALTH RELEVANCE: All across the US mentally ill offenders are returning to their home communities. Research needs to identify their needs and how they can successfully reintegrated into community life without further criminal justice involvements. This proposal is addressed to this major public health problem.

描述（由申请人提供）：参与刑事司法系统的项目摘要/摘要精神病患者代表了社区心理健康和残疾研究的新领域。这个问题的范围确实令人震惊，每年从监狱中释放出高度的86,000人患有严重精神疾病（SMI），其累犯率很高。被监禁罪犯失去医疗补助福利被认为是成功社区重新进入的主要障碍。几个州已经采用了加急的医疗补助恢复计划，以在释放之前将合格的囚犯重新连接为其福利。早期的福利恢复可以避免在将SMI释放给社区时的药物治疗方案和治疗方案的干扰。但是，尚未进行严格的研究来确定这些政策的成本效益。拟议中的NIMH对RFA-MH-09-050做出了为期三年的研究，该研究通过评估康涅狄格州和华盛顿州的医疗补助恢复政策，以解决这些问题，以释放释放的囚犯，这些囚犯对三种成果，及早进行了苏打，及后的弥撒性，住院，住院和药水虐待和良好的虐待服务。将实施两种互补的研究设计和分析方法，以解决这些政策的影响（AIM 1）和成本效益（AIM 2）。第一个是一种差异差异设计，比较了SMI的个人，而没有SMI的人则以2005年4月1日在康涅狄格州和2006年1月1日在华盛顿的政策采用日期中心，并在每个州的三年前和两年后的数据。第二个是一项准实验研究设计，重点是仅比较SMI的个人，他们接受了加快医疗补助恢复（治疗组），而不是在两年的随访期内使用层次线性建模框架进行了两年的随访期。倾向得分匹配将用于两种设计，以在所有观察到的措施上之间达到平衡。拟议的研究与RFA-MH-09-050进行了良好的一致性，因为它解决了国家当局的重要心理健康政策问题，利用来自两个州的大量行政数据，应用了经济学和统计领域的一系列分析策略，以解决重要的国家心理健康政策问题，并应对司法疾病的疾病呼吁，以对精神疾病进行研究，以应对官方疾病的疾病，将其置于2002年的精神疾病中，这是针对精神疾病的新自由（将其作为新的精神疾病（将其作为新的精神疾病）置于委员会中，该公司的疾病（将其作为新的自由疾病（将其置于官方疾病中）。 公共卫生相关性：整个美国精神病患者都将返回其家庭社区。研究需要确定他们的需求以及他们如何在没有进一步的刑事司法参与的情况下成功地重新融入社区生活。该提案解决了这个主要的公共卫生问题。