•patients with unstable housing had 60% higher rate
•females had higher rate of return than men
•severity of symptoms marginally predictive
•some drugs were predictive (methamphetamine & crack); cannabis, opiates don't appear to be predictive. #WRI2019 #BuildMomentum
Summary of findings:
•most common offence types associated with higher rate of return are relatively minor
•patients with schizophrenia had twice the rate of return than those without #WRI2019 #BuildMomentum
Hazard ratios:
•female: 1.22
•schizophrenia spectrum: 1.96
•mood/anxiety disorder: 0.69
•breach of probation: 1.24
•sexual assault: 0.59
•theft/robbery: 1.49
•homelessness: 1.61
•crack use: 1.22
•methamphetamine use: 1.23
•BPRS (severity): 1.01
#WRI2019 #BuildMomentum
Re-referral rate:
•26.4% of individuals were re-referred at least once within the first year
•31.6% of individuals were re-referred within first 2 years
•Highest number of times a client re-referred: 14
#WRI2019 #BuildMomentum
•4,704 admissions, 3,034 individuals
•75.7% males, 734 females
•Mean age 35.5
•Median time at risk was 534.5 days (7.5–1109.5 days) #WRI2019 #BuildMomentum
Predictors of return to corrections:
•participants: all clients discharged from 2016-01-01 to 2018-12-31
•measures: age, gender, diagnoses, substance use, BPRS total, charges, housing, ethnicity, length of stay
•analyses: multiple failure-time analysis
#WRI2019 #BuildMomentum
Shortcomings in the literature:
•some predictors remain unexamined in survival analysis framework
•diagnosis variables have been non-specific
•substances used remain unspecified
•combinations of predictors seldom examined #WRI2019 #BuildMomentum
Legal factors (reasons for release, reasons for return) not predictive for recidivism #WRI2019 #BuildMomentum
•Odds of having 4+ prior incarcerations is 2.7 times higher among inmates with psychiatric diagnosis
•Prisoners with severe mental illness (SMI) return to custody 1 year earlier than non-SMI inmates
#WRI2019 #BuildMomentum
Severe mental illness prevalent in correctional settings:
•major depression: 10.2% of male and 14.1% of female inmates
•psychotic disorder: 3.6% of male and 3.9% of female inmates
#WRI2019 #BuildMomentum
Research questions:
•What is the rate of return to correctional mental health service?
•What are the characteristics associated with return?
#WRI2019 #BuildMomentum
2-year recidivism rates in Canada: approximately 40% #WRI2019 #BuildMomentum
1-year readmission rates for patients with mental illness in Canada:
•37% in one year
•41% of people with schizophrenia
•54% of people with schizophrenia and substance use disorders
#WRI2019 #BuildMomentum
Last talk in this set: Cory Gerritsen on "Predictors of Return to Custody Among Mentally Disordered Inmates." #WRI2019 #BuildMomentum
3-month follow-up: maintained knowledge of mental illness and confidence. 75% said they applied what they learned to a moderate or great extent. #WRI2019 #BuildMomentum
Qualitative findings:
•plans to use active listening
•recognition that each person is different
•importance of validating emotions #WRI2019 #BuildMomentum
Findings: gains in knowledge of mental health, ability to identify and assist with inmates with mental health disorders. #WRI2019 #BuildMomentum
•Hearing voices exercise: worked in triad where 1 person would list names and addresses of 3 people, and a second person would have to repeat that information while a third whispered in their ear, simulating voices. How hard to learn w/ competing stimuli. #WRI2019 #BuildMomentum
Experiential learning:
•Personal space awareness…
#WRI2019 #BuildMomentum
Now Laura Hayos talking about the training itself. Learning modalities:
1. didactic teaching
2. group activities and discussions
3. case-based learning
4. simulation training—recreate real situations but using an actor
#WRI2019 #BuildMomentum
Officers' mental health: maintaining good mental
health, resources #WRI2019 #BuildMomentum
Mental health awareness:
•what is mental health/mental illness
•presentation and what to look for in corrections
•stigma
•substance use
•recovery #WRI2019 #BuildMomentum
Curriculum development—learning objectives:
1. increase understanding of how mental disorders present in corrections
2. develop awareness of suicide and violence risk
3. apply communication strategies to help inmates cope #WRI2019 #BuildMomentum
•90+% said training would increase their confidence. #WRI2019 #BuildMomentum
•65% said on an average day, they had >15 interactions with inmates they thought were exhibiting behaviours possibly indicative of mental health problems #WRI2019 #BuildMomentum
Needs assessment: received 34 completed needs assessment (85% response rate).
•59% said they didn't feel they had adequate training. #WRI2019 #BuildMomentum
•Mental illness overrepresented in corrections.
•Correctional officers not trained to understand mental illnesses. Trained in safety and security, not healthcare.
Are correctional officers interested in knowing about mental illness and mental health? #WRI2019 #BuildMomentum
Now Tanya Connors talking about "Training MCSCS Correctional Officers to Better Meet the Mental Health Needs of Inmates." #WRI2019 #BuildMomentum
Very good interrater reliability. Gwet's AC coefficient (0.8 is considered good):
•psychiatrists, on vignettes: 0.85
•clinicians, on vignettes: 0.87
•inmate assessment: 0.93
#WRI2019 #BuildMomentum
•did this 3 times to look at test–retest reliability.
•11 clinicians rated vignettes, 60 joint patient ratings by psychiatrists and clinicians
#WRI2019 #BuildMomentum
