Incarceration rates of persons with first-admission psychosis

This prospective study examined jail stay in a cohort of persons with schizophrenia and other psychotic disorders who experienced their first hospital admission and who were participating in the Suffolk County Mental Health Project. Demographic and clinical risk factors for jail placement were investigated over a four-year period after hospital discharge.

The sample included 538 first-admission respondents diagnosed as meeting DSM-IV criteria for having schizophrenia, psychotic mood disorder, or other psychotic disorders. Initial interviews occurred in the hospital; face-to-face follow-ups occurred at the six-, 24-, and 48-month points, and telephone contact was maintained every three to six months. Multivariate logistic regression analysis was used to examine the demographic and clinical risk factors.

Forty-seven respondents (9%) were incarcerated over the follow-up period. Among them, 20 were incarcerated multiple times. The prevalence, incidence, reasons for incarceration, and time served did not vary significantly by diagnosis. The most significant predictors of jail stay and time to incarceration during the follow-up were being male or black and having been incarcerated before admission. Predictive effects of other risk factors (for example, symptom severity or substance abuse) were smaller or statistically insignificant.

The results suggest a need for mental health care professionals to routinely evaluate, document, and collaboratively address incarceration history, especially when working with black males, in an effort to avert future incarceration.