Serious mental illness and incarceration: piloting the use of a multi sector linked administrative dataset

严重精神疾病和监禁：试点使用多部门链接的管理数据集

• 批准号: 10355250
• 负责人: JOEL T BRASLOW
• 金额: $ 23.4万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-17 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10355250
• 关键词: Administrator; Algorithms; American; Area; Attention; Caring; Client; Communities; Consult; Consultations; County; Criminal Justice; Crisis Intervention; Data; Data Collection; Data Set; Databases; Development; Diversion Program; Economics; Electronic Health Record; Emergency response; Ensure; Evaluation; Evaluation Research; Event; Failure; Funding; Geographic Locations; Geography; Health; Health Services; Health system; Homelessness; Hospitalization; Human Rights; Imprisonment; Improve Access; Individual; Institution; Intervention; Jail; Joints; Law Enforcement; Learning; Link; Local Government; Los Angeles; Measures; Mental Health; Mental Health Services; Mental disorders; Methods; Monitor; National Institute of Mental Health; Outcome; Outpatients; Pattern; Play; Police; Policies; Population; Population Heterogeneity; Poverty; Preparation; Prisoner; Provider; Public Health; Public Sector; Research; Research Personnel; Resources; Role; Rural; Sampling; Services; Site; Social Work; Societies; Subgroup; System; Testing; Underserved Population; United States; Update; Validation; Work; administrative database; algorithm development; anti-racism; experience; feasibility research; feasibility testing; improved; men; people of color; pressure; programs; response; severe mental illness

Project Summary/Abstract Mass incarceration of individuals with serious mental illness (SMI) is a public health and human rights crisis. Not since the mid-nineteenth century has the criminal justice system played such a large role in how American society responds to mental illness. Since the late 1960s researchers have noted ever-rising numbers of jail inmates with SMI, often caught in a "revolving door" of hospitalization, homelessness, and arrest. Incarceration is one of the most visible (and traumatic) moments of contact with the public system, and provides a window into the failures of the public mental health system. Our long-term objective is to inform and rigorously evaluate policy and interventions that seek to reduce law enforcement response to mental illness and end the mass incarceration of individuals with SMI. In line with NIMH Strategic Objectives 4.1B and 4.2, this R34 proposal furthers the development of a real-world data collection system to facilitate research and ongoing monitoring related to access, service continuity, equity, and outcomes such as incarceration and homelessness in diverse populations and settings. Our research approach is to leverage a regularly-updated Los Angeles County (LAC) county-wide administrative database, which links individuals across 8 public agencies from 2010 to the present, for research around incarceration and SMI. In partnership with LAC administrators/providers and non- LAC researchers, we will develop and test this database through algorithm development and validation, exploration of mental health service patterns leading up to incarceration, and testing of the algorithms and dataset using a pilot evaluation of mental health crisis interventions in lieu of law enforcement response, in preparation for an R01 proposal to evaluate the effects of policies and interventions that shift resources from criminal justice to new and existing mental health services. LAC as our study site allows for a particularly in- depth look because of its size (population>10 million) and diversity across a number of critical divides: urban/rural; racial; economic; cultural; and resource availability. Our specific aims are as follows: Aim 1: Develop algorithms for sample ascertainment and operationalization of key measures to enable the study of criminal justice contact and diversion programs among underserved populations with SMI. Aim 2: Validate and refine these algorithms through formal validation methods and in consultation with our partners. Aim 3: Test the feasibility of research using the linked dataset and algorithms by asking what types of service patterns precede incarceration of individuals with SMI and how these patterns differ across geographic and demographic subgroups, and by conducting a pilot evaluation of alternative crisis response interventions: who receives them, what their service patterns look like before and after the crisis service, how this differs between clients who receive a new mental health-only 911-dispatched service vs. a joint law enforcement-mental health crisis intervention team service, and how this compares to similar clients who had a police contact leading to arrest.

项目摘要/摘要 严重精神疾病（SMI）的大规模监禁是公共卫生和人权危机。 自从十九世纪中叶以来，刑事司法系统在美国的方式中发挥了如此重要的作用 社会应对精神疾病。自1960年代后期以来，研究人员注意到了不断增加的监狱 SMI的囚犯经常被住院，无家可归和逮捕的“旋转门”。监禁 是与公共系统接触的最明显（和创伤）时刻之一，并提供了一个窗口 进入公共心理健康系统的失败。我们的长期目标是告知和严格评估 旨在减少执法对精神疾病的反应并结束群众的政策和干预措施 SMI的人的监禁。与NIMH战略目标4.1b和4.2一致，该R34提案 进一步开发现实世界数据收集系统，以促进研究和持续的监控 与访问，服务连续性，公平性和结果有关，例如不同的监禁和无家可归 种群和设置。我们的研究方法是利用定期过时的洛杉矶县（LAC） 县范围的行政数据库，该数据库将2010年的8个公共机构的个人链接到 目前，涉及监禁和SMI的研究。与LAC管理员/提供商和非 - LAC研究人员，我们将通过算法开发和验证来开发和测试此数据库， 探索导致监禁和测试算法和测试的心理健康服务模式 使用对心理健康危机干预措施的试点评估，以代替执法响应， 为R01提案做准备，以评估将资源从 新的和现有的心理健康服务的刑事司法。 lac作为我们的研究地点，允许特别 深度外观由于其大小（人口> 1000万）和多种关键分歧的多样性： 城市/农村；种族经济的;文化;和资源可用性。我们的具体目的如下：目标1： 开发用于样本确定和关键措施操作的算法，以使研究能够研究 刑事司法的联系和转移计划与SMI服务不足的人群。目标2：验证和 通过正式验证方法并与我们的合作伙伴协商来完善这些算法。目标3：测试 通过询问哪些类型的服务模式之前，使用链接的数据集和算法进行研究的可行性 SMI的个体的监禁以及这些模式在地理和人口统计中如何有所不同 亚组，并通过对替代危机应对干预措施进行试点评估：谁接受 他们，他们的服务模式在危机服务之前和之后的样子，客户之间的不同之处 他们将获得新的仅精神健康的911匹配服务与联合执法 - 心理健康危机 干预团队服务，以及与有警察联系的类似客户进行比较的方式。