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.

项目概要/摘要 大规模监禁患有严重精神疾病（SMI）的人是一场公共卫生和人权危机。 自十九世纪中叶以来，刑事司法系统从未在美国的刑事司法过程中发挥过如此大的作用。 社会对精神疾病做出反应。自 20 世纪 60 年代末以来，研究人员注意到入狱人数不断增加 患有 SMI 的囚犯经常陷入住院、无家可归和被捕的“旋转门”。监禁 是与公共系统接触最明显（也是最痛苦）的时刻之一，并提供了一个窗口 公共精神卫生系统的失败。我们的长期目标是提供信息并严格评估 旨在减少执法部门对精神疾病的反应并结束群体性行为的政策和干预措施 SMI 患者的监禁。根据 NIMH 战略目标 4.1B 和 4.2，本 R34 提案 进一步开发现实世界的数据收集系统，以促进研究和持续监测 与不同地区的准入、服务连续性、公平性以及监禁和无家可归等结果相关 人口和环境。我们的研究方法是利用定期更新的洛杉矶县 (LAC) 全县行政数据库，将 2010 年至 8 个公共机构的个人联系起来 目前，针对监禁和 SMI 进行研究。与 LAC 管理员/提供商和非合作伙伴合作 LAC研究人员，我们将通过算法开发和验证来开发和测试这个数据库， 探索导致监禁的心理健康服务模式，并测试算法和 数据集使用心理健康危机干预措施的试点评估来代替执法响应， 准备 R01 提案，以评估将资源从 新的和现有的精神卫生服务的刑事司法。 LAC 作为我们的研究地点，特别适合- 由于其规模（人口>1000万）和跨越多个关键鸿沟的多样性，因此具有深度： 城市/农村；种族；经济的;文化;和资源可用性。我们的具体目标如下： 目标1： 开发样本确定和关键措施实施的算法，以便研究 通过 SMI 为服务不足的人群提供刑事司法联系和分流计划。目标 2：验证并 通过正式的验证方法并与我们的合作伙伴协商完善这些算法。目标 3：测试 通过询问先有哪些类型的服务模式来研究使用链接数据集和算法的可行性 SMI 患者的监禁情况以及这些模式在地理和人口方面有何不同 小组，并通过对替代危机应对干预措施进行试点评估：谁接受 他们的服务模式在危机服务之前和之后是什么样子，客户之间有何不同 接受新的仅限心理健康的 911 调度服务与联合执法-心理健康危机的人 干预小组的服务，以及与通过警方联系导致逮捕的类似客户相比如何。