Patterns of Self-Reported Mental Health Symptoms and Treatment among People Booked into a Large Metropolitan County Jail.

The Brief Jail Mental Health Screen (BJMHS) is one of the most well-known and frequently used tools to conduct routine mental health screening at jail intake. In prior research, the BJMHS results typically have been evaluated overall (i.e.

Police-mental health co-response versus police-as-usual response to behavioral health emergencies: A pragmatic randomized effectiveness trial.

Background: People with mental illness are overrepresented in United States (US) criminal legal systems. In response, alternatives to traditional police response to behavioral health emergencies have become more common, despite limited evidence for their effectiveness. We conducted the first randomized controlled trial of a police-mental health co-response team to determine program effectiveness relative to a police-as-usual response on key outcomes identified by community stakeholders.

The role of co-occurring disorders in criminal recidivism and psychiatric recovery among adults with opioid use disorder and criminal-legal involvement: A statewide retrospective cohort study.

Introduction: Individuals with opioid use disorder (OUD) in the criminal-legal system commonly present co-occurring mental health disorders. However, evidence-based treatment for high-risk populations such as those with co-occurring disorders is often unavailable within jails and prisons. Coordination of timely and affordable access to behavioral health treatment following incarceration is critical to address the multidimensional needs of people with co-occurring needs.

Antecedents of fatal overdose in an adult cohort identified through administrative record linkage in Indiana, 2015-2022.

Background: The United States continues to experience unprecedented rates of overdose mortality and need to identify effective policies or practices that can be implemented. This study aims to measure the prevalence, frequency, timing, and rate of touchpoints that occurred prior to a fatal overdose where communities might intervene.

Methods: In collaboration with Indiana state government, we conducted record-linkage of statewide administrative datasets to vital records (January 1, 2015, through August 26, 2022) to identify touchpoints (jail booking, prison release, prescription medication dispensation, emergency department visits, and emergency medical services).

Supply-side predictors of fatal drug overdose in the Washington/Baltimore HIDTA region: 2016-2020.

Background: Rising rates of fentanyl- and polydrug-involved drug overdose deaths have prompted inquiry into the role of drug supply in fatal overdose outcomes in the United States. To date, however, there have been few empirical investigations of drug enforcement strategies on fatal overdose rates, despite knowledge that both drug use and supply are often geographically distributed. To address this limitation, we examined measures of drug enforcement as predictors of next-year fatal overdose rates in the Washington/Baltimore High Intensity Drug Trafficking Area (W/B HIDTA).

Evaluation of a Police-Mental Health Co-response Team Relative to Traditional Police Response in Indianapolis.

Objective: Criminal justice and emergency medical service (EMS) outcomes were compared for individuals experiencing a behavioral health crisis who received a response from a co-response team (CRT) or a usual response from the police after a 911 call.

Methods: A prospective, quasi-experimental design was used to examine outcomes of a CRT pilot tested in Indianapolis (August-December 2017). Weighted multivariable models examined effects of study condition (CRT group, N=313; usual-response group, N=315) on immediate booking, emergency detention, and subsequent jail bookings and EMS encounters.

Individual and county-level variation in outcomes following non-fatal opioid-involved overdose.

Background: A lack of large-scale, individually linked data often has impeded efforts to disentangle individual-level variability in outcomes from area-level variability in studies of many diseases and conditions. This study investigated individual and county-level variability in outcomes following non-fatal overdose in a state-wide cohort of opioid overdose patients.

Methods: Participants were 24 031 patients treated by emergency medical services or an emergency department for opioid-involved overdose in Indiana between 2014 and 2017.

Barriers and facilitators to the use of the SSI/SSDI Outreach, Access, and Recovery (SOAR) model with justice-involved adults.

Objective: The purpose of this study was to identify barriers and facilitators to use of the SSI/SSDI Outreach, Access, and Recovery (SOAR) model with justice-involved adults.

Method: Using a modified snowball sampling strategy, we distributed an online mixed-methods survey to SOAR providers with known criminal justice collaborations. Participants were 58 providers who completed or supervised completion of SOAR applications for justice-involved adults and who represented unique agencies across 29 states.

Validating Imputation Procedures to Calculate Corrected Opioid-Involved Overdose Deaths, Marion County, Indiana, 2011-2016.

Objectives: Understanding the scope of the current opioid epidemic requires accurate counts of the number of opioid-involved drug overdose deaths. Given known errors and limitations in the reporting of these deaths, several studies have used statistical methods to develop estimates of the true number of opioid-involved overdose deaths. This study validates these procedures using a detailed county-level database of linked toxicology and vital records data.

Principles and practices of risk assessment in mental health jail diversion programs.

Eligibility criteria for participation in mental health jail diversion programs often specify that, to be diverted, a candidate must not pose a level of threat to public safety that cannot be managed in the community. Risk assessment tools were developed to increase consistency and accuracy in estimates of threat to public safety. Consequently, risk assessment tools are being used in many jurisdictions to inform decisions regarding an individual's appropriateness and eligibility for mental health jail diversion and the strategies that may be successful in mitigating risk in this context.

Racial differences in overdose events and polydrug detection in Indianapolis, Indiana.

Background: We examine racial disparities in drug overdose death rates by analyzing trends in fatal and nonfatal overdose outcomes in a large metropolitan area (Indianapolis, Indiana).

Methods: Death certificate and toxicology records for accidental drug overdose deaths from 2011 to 2018 were linked with emergency medical services (EMS) data. Bivariate comparisons examined differences in toxicology findings at the time of death as well as prior EMS events both overall and by indicator of non-fatal overdose.

Results of the Brief Jail Mental Health Screen Across Repeated Jail Bookings.

Objective: The Brief Jail Mental Health Screen (BJMHS) is widely used at intake in county jails to identify detainees who may have serious mental illness and who should be referred for further mental health evaluation. The BJMHS may be administered multiple times across repeated jail bookings; however, the extent to which results may change over time is unclear. To that end, the authors examined the odds of screening positive on the BJMHS across repeated jail bookings.

Criminal Justice Professionals' Attitudes Toward Mental Illness and Substance Use.

Despite the high prevalence of behavioral health disorders in justice settings and prior research on the importance of attitudes in successful treatment outcomes for behavioral health populations, few studies have examined criminal justice professionals' attitudes toward mental illness and substance use. We conducted a state-wide survey of 610 criminal justice professionals using items adapted from the Drug and Drug Problems Perceptions Questionnaire (Albery et al. 2003) to examine attitudes toward mental illness and substance use as a function of criminal justice position and personal contact.

Barriers and facilitators to implementing an urban co-responding police-mental health team.

Background: In an effort to reduce the increasing number of persons with mental illness (PMI) experiencing incarceration, co-responding police-mental health teams are being utilized as a way to divert PMI from the criminal justice system. Co-response teams are typically an inter-agency collaboration between police and mental health professionals, and in some cases include emergency medical personnel. These teams are intended to facilitate emergency response by linking patients to mental health resources rather than the criminal justice system, thus reducing burdens on both the criminal justice systems as well as local healthcare systems.

Identifying Unreported Opioid Deaths Through Toxicology Data and Vital Records Linkage: Case Study in Marion County, Indiana, 2011-2016.

Objectives: To demonstrate the severity of undercounting opioid-involved deaths in a local jurisdiction with a high proportion of unspecified accidental poisoning deaths.

Methods: We matched toxicology data to vital records for all accidental poisoning deaths (n = 1238) in Marion County, Indiana, from January 2011 to December 2016. From vital records, we coded cases as opioid involved, specified other substance, or unspecified.

EMS naloxone administration as non-fatal opioid overdose surveillance: 6-year outcomes in Marion County, Indiana.

Background And Aims: Despite rising rates of opioid overdose in the United States, few studies have examined the frequency of non-fatal overdose events or mortality outcomes following resuscitation. Given the widespread use of naloxone to respond to overdose-related deaths, naloxone administration may provide a useful marker of overdose events to identify high-risk users at heightened risk of mortality. We used naloxone administration by emergency medical services as a proxy measure of non-fatal overdose to examine repeat events and mortality outcomes during a 6-year period.

Peer-support intervention for postpartum depression: Participant satisfaction and program effectiveness.

Objective: Postpartum mood disorders represent a serious problem affecting 10-20% of women and support groups offer a promising intervention modality. The current study examined participant satisfaction with and effectiveness of a peer-facilitated postpartum support group.

Intervention: The program consists of a free, peer-support group, developed to increase social support and destigmatise postpartum mood symptoms.

Effectiveness of Mental Health Courts in Reducing Recidivism: A Meta-Analysis.

Objective: Mental health courts (MHCs) were developed to address the overrepresentation of adults with mental illnesses in the U.S. criminal justice system through diversion into community-based treatment.

Reliability and Validity of START and LSI-R Assessments in Mental Health Jail Diversion Clients.

Risk assessment instruments are increasingly used in mental health jail diversion programs. This study examined the reliability and validity of Short-Term Assessment of Risk and Treatability (START) and Level of Service Inventory-Revised (LSI-R) assessments overall and by client race. Research assistants completed START and LSI-R assessments for 95 diversion clients.

Recidivism following mental health court exit: Between and within-group comparisons.

Over the past decade, Mental Health Courts (MHCs) have spread rapidly across the U.S. These courts aim to reduce recidivism among adults with mental illnesses through diversion into community-based treatment.