PTSD and Dual Disorders at the Interface of the MH and CJ Systems

MH 和 CJ 系统接口处的 PTSD 和双重障碍

• 批准号: 7876648
• 负责人: KAREN J CUSACK
• 金额: $ 11.46万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-17 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7876648
• 关键词: Address; Admission activity; Area; Behavior; Books; Client; Communities; Complement; Consent; Consultations; Cost Analysis; Costs and Benefits; Country; Criminal Justice; Data; Deinstitutionalization; Development Plans; Disease; Diversion Program; Economics; Effectiveness; Enrollment; Environment; Equilibrium; Evaluation; Feasibility Studies; Fostering; Foundations; Goals; Hand; Health Resources; Health system; High Prevalence; Individual; Inpatients; Intervention; Jail; Law Enforcement Officers; Measurement; Mental Health; Mental Health Services; Mental disorders; Mentally Ill Persons; Outcome; Outpatients; Participant; Persons; Policies; Population; Population Research; Post-Traumatic Stress Disorders; Prevalence; Psychiatric Hospitals; Randomized; Randomized Clinical Trials; Recommendation; Reporting; Research; Research Design; Research Personnel; Research Project Grants; Research Training; Risk; Role; Sampling; Secure; Services; Study Subject; Substance Use Disorder; Substance abuse problem; System; Testing; Time; Training; Trauma; Treatment Effectiveness; Victimization; Work; base; career; career development; community based treatment; cost; cost effectiveness; court; design; experience; improved; knowledge base; non-compliance; offender; programs; severe mental illness; skills; success; treatment as usual; treatment program

DESCRIPTION (provided by applicant): This K01 application presents a career development plan for research on posttraumatic stress disorder (PTSD) and comorbid substance use disorder (SUD) and serious mental illness (SMI) for individuals involved in the criminal justice system. There is an increasing demand for programs that can effectively address the needs of mentally ill persons who cycle in and out of the criminal justice system, yet little is known about the comprehensive needs of these clients and how to intervene in a way that balances costs and benefits. A growing body of research identifies PTSD and comorbid SUD as highly prevalent yet largely overlooked problems among people with SMI served in the mental health system. Although limited research suggests a higher prevalence of traumatic victimization and SUD in jail populations, research exploring the prevalence of PTSD/SUD and its relationship to other mental health and criminal justice outcomes is currently lacking. The proposed training plan complements the candidate's background in mental health services for PTSD by providing hew skills in core areas of criminal justice systems and populations, randomized clinical trials, economic and advanced statistical analysis, and substance abuse. The research plan will use these newly acquired skills to address policy-relevant questions regarding the treatment of individuals with dual disorders in the criminal justice system. Two studies will be undertaken: (1) assessing the prevalence of PTSD/SUD among people with SMI in criminal justice diversion programs and testing whether PTSD is a primary mechanism responsible for the association between trauma, substance abuse, and SMI; and (2) carrying out a pilot feasibility study in a local jail diversion program using a modified CBT treatment for PTSD/SUD with mentally ill offenders. Based on findings from these two preliminary studies a R01 application will be developed to test the treatment-effectiveness and cost-effectiveness of an integrated intervention in a large sample, randomized study design with individuals diverted from jail who have comorbid PTSD/SUD. These training and research experiences will provide the necessary foundation for career success as an independent investigator exploring PTSD and dual disorders at the interface of the mental health and criminal justice systems.

描述（由申请人提供）：该K01申请为参与刑事司法系统的人提供了创伤后应激障碍（PTSD）和合并症药物使用障碍（SUD）和严重精神疾病（SUD）的职业发展计划。人们对计划的需求越来越大，可以有效地满足循环局局长系统的精神病患者的需求，但是对于这些客户的综合需求以及如何以平衡成本和收益的方式进行干预知之甚少。越来越多的研究将PTSD和合并症的SUD确定为在心理卫生系统中遇到的SMI的高度普遍但很大程度上被忽视的问题。尽管有限的研究表明，目前缺乏探索PTSD/SUD的患病率及其与其他心理健康和刑事司法结果的关系的研究，但目前缺乏探索PTSD/SUD的患病率及其与其他心理健康和刑事司法结果的关系的研究。拟议的培训计划通过在刑事司法系统和人群的核心领域，随机临床试验，经济和高级统计分析以及滥用药物的核心领域提供HEW技能来补充候选人为PTSD的心理健康服务背景。该研究计划将利用这些新获得的技能来解决有关刑事司法系统中双重疾病患者的政策相关问题。将进行两项研究：（1）评估刑事司法转移计划中SMI患者中PTSD/SUD的流行，并测试PTSD是否是负责创伤，药物滥用和SMI之间关联的主要机制； （2）在当地的监狱转移计划中使用改良的CBT治疗PTSD/SUD进行了针对精神病患者的PTSD/SUD治疗。根据这两项初步研究的发现，将开发R01的应用，以测试大型样本，随机研究设计的综合干预措施的治疗效果和成本效益，并从患有PTSD/SUD的监狱中转移的个体。这些培训和研究经验将为在心理健康和刑事司法系统的界面上探索PTSD和双重疾病的独立研究人员提供职业成功的必要基础。