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Chronic Psychotic Disorders and Correctional Involvement: A Population-Based Matched Case-Control Study in Ontario,
Ruchi Vijh1, Fiona G Kouyoumdjian2,3, Tomisin Iwajomo3,4
1Department of Psychology, University of Calgary, Calgary, Alberta, Canada.
Summary
Individuals with chronic psychotic disorders and correctional involvement had more psychosocial comorbidities and used more acute mental health services, but had fewer psychiatrist visits before entering correctional facilities.
Area of Science:
- Psychiatry
- Criminology
- Public Health
Background:
- Individuals with chronic psychotic disorders are disproportionately represented in correctional facilities.
- Understanding risk factors for correctional involvement in this population is crucial.
Purpose of the Study:
- To compare sociodemographic, clinical, and prior mental health service utilization between individuals with chronic psychotic disorders who were released from correctional facilities and those without correctional involvement.
Main Methods:
- A matched case-control study in Ontario, comparing individuals released from correctional facilities (cases) with those without correctional involvement (controls).
- Analysis included sociodemographic, clinical, and mental health service utilization data from 1 and 3 years prior to correctional involvement.
- Incidence rate ratios were estimated using Poisson and negative-binomial regressions.
Main Results:
- Individuals with correctional involvement exhibited higher material deprivation, residential instability, shorter illness duration, and more psychosocial comorbidities.
- They also showed higher rates of primary care physician visits, emergency department visits, and hospitalizations.
- Conversely, individuals with correctional involvement had a lower rate of psychiatrist visits prior to correctional involvement.
Conclusions:
- Despite higher comorbidities and acute service use, individuals with chronic psychotic disorders involved in the correctional system had low rates of prior psychiatrist visits.
- This suggests potential gaps in specialized mental health care access for this vulnerable population before correctional involvement.
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