What works, for whom? Applying novel precision medicine methods to people with mental illness in the justice system.

什么有效，对谁有效？

• 批准号: 10723566
• 负责人: Lina Montoya
• 金额: $ 9.99万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-05 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10723566
• 关键词: Adult; Award; Behavior Therapy; Behavioral; Characteristics; Clinical; Cognitive; Cognitive Therapy; Criminal Justice; Data; Dedications; Development; Foundations; Funding; Goals; Grant; Heterogeneity; Imprisonment; Individual; Intervention; Justice; Knowledge; Learning; Machine Learning; Mediating; Mental disorders; Mentorship; Methods; National Institute of Mental Health; North Carolina; Outcome; Participant; Pathway interactions; Persons; Phase; Policies; Population; Population Heterogeneity; Populations at Risk; Positioning Attribute; Prevention; Prisons; Probability; Public Health; Randomized, Controlled Trials; Recommendation; Recording of previous events; Research; Research Personnel; Research Project Grants; Research Support; Risk Factors; Safety; Services; Statistical Methods; Symptoms; System; Talents; Techniques; Time; Training; Translating; Vulnerable Populations; Work; anti social; court; criminal behavior; demographics; experience; improved outcome; individualized medicine; intervention effect; marginalized community; novel; personalized intervention; policy recommendation; precision medicine; prevent; psychiatric symptom; recidivism; scale up; severe mental illness; skill acquisition; skills; statistics; substance use; theories; trait; treatment as usual; treatment response; treatment strategy; underserved community

PROJECT SUMMARY/ABSTRACT People with serious mental illness (SMI) are substantially overrepresented in the US criminal justice system. In an effort to reduce recidivism among this vulnerable population, average effects of administering single interventions to all have been studied in recent years. These interventions include ones that target SMI symptoms (such as mandated psychiatric services) and others that target criminogenic risk factors (such as cognitive behavioral therapy). However, justice-involved people with SMI are diverse in their characteristics, needs, and risk factors; there is no “one-size-fits-all” solution to prevent recidivism. Decreasing adverse criminal outcomes for this population requires recognizing its heterogeneity. Therefore, the broad objective of this proposal is to understand which interventions work best for which justice-involved people with SMI using state-of-the-art precision medicine methods drawn from causal inference, statistical theory, and machine learning. This is a step toward the long-term goal of identifying optimal ways to reduce criminal behavior in this population by matching interventions to those who need and benefit from them. Supported by a dedicated and talented mentorship team, the training portion of this grant will fill gaps key to achieving this goal: 1) subject-matter training and field experience on SMI in the criminal justice system, 2) development of novel technical methods in precision medicine, 3) skills in translating technical findings to high-impact recommendations for practice and policy, and 4) professional skills development. This rich training will provide a foundation for accomplishing the following research aims to reach the proposal's broad objective: 1) understand the differential pathways that situate this population at risk for re-offending, 2) identify tailored rules for administering interventions to those who benefit from them based on individual characteristics, and 3) assess whether and how the identified rules for matching interventions generalize across the US. This research will leverage randomized controlled trial data, federal data from the Administrative Office of the US Courts, and state data from the North Carolina Department of Public Safety to achieve these aims. Importantly, research from this grant will result in novel statistical precision medicine methods for transporting rules to settings different than those on which they are learned. The aims of this grant are well-aligned with NIMH's strategic goal of striving for prevention and treatments among people with SMI, including, but not limited to, the objectives of: a) advancing methods to match interventions to individuals and populations (especially marginalized and underserved communities) and b) strategies for scaling up interventions for the greatest public health impact. By learning who benefits from which interventions using the latest advances in precision medicine methods, this work has the potential to help stop the so-called “revolving prison door” for justice-involved people with SMI. Further, this research will advance the toolkit for data-supported precision medicine strategies that most efficiently and effectively increase public health and safety.

项目摘要/摘要 在美国刑事司法系统中，患有严重精神疾病的人（SMI）基本上代表了过多的代表。在 努力减少这种脆弱人群中的累犯，平均管理单一的影响 近年来，对所有人的干预措施已经进行了研究。这些干预措施包括针对SMI症状的干预措施 （例如授权的精神病服务）以及针对犯罪风险因素的其他人（例如认知 行为疗法）。但是，具有SMI正义的人的特征，需求和 风险因素；没有“千篇一律的”解决方案来防止累犯。减少不利犯罪结果 对于这个人群，需要认识到其异质性。因此，该提议的广泛目标是 了解哪些干预措施最适合使用最先进的SMI的司法人员 精确医学方法是从因果推理，统计理论和机器学习中得出的。这是一个步骤 实现长期目标，即确定通过匹配来减少该人群中犯罪行为的最佳方法 对需要和受益的人进行干预。在一个敬业且才华横溢的精明团队的支持下， 该赠款的培训部分将填补实现此目标的空白关键：1）主题培训和现场 刑事司法系统中的SMI经验，2）精确开发新型技术方法 医学，3）将技术发现转化为实践和政策建议的技能，以及 4）专业技能发展。这种丰富的培训将为完成以下内容提供基础 研究旨在实现该提案的广泛目标：1）了解所处的差异途径 2）确定对受益的人进行干预措施的量身定制规则的人口 基于个人特征，以及3）评估是否以及如何确定匹配规则 干预措施在整个美国概括。这项研究将利用随机对照试验数据，联邦数据 从美国法院的行政办公室以及北卡罗来纳州公共部的国家数据 安全实现这些目标。重要的是，这项赠款的研究将导致新颖的统计精度 将规则运送到与学到的不同的设置的医学方法。目的 这笔赠款与NIMH的战略目标非常合适，即致力于预防和治疗 SMI，包括但不限于以下对象：a）与个人相匹配的方法 和人口（尤其是边缘化和服务不足的社区）和b）扩大规模的策略 对最大公共卫生影响的干预措施。通过了解谁受益于哪种干预措施 精确医学方法的最新进展，这项工作有可能帮助阻止所谓的“旋转” 为涉及正义的人的监狱门。此外，这项研究将推进数据支持的工具包 精确医学策略最有效，有效地提高公共健康和安全性。