The incarceration of individuals with severe mental disorders.
Adult; Female; Humans; Male; Middle Aged; Ohio/epidemiology; Criminal Law; Deinstitutionalization; Forensic Psychiatry/*trends; Mental Disorders/classification/*epidemiology/therapy; Mental Health Services/*statistics & numerical data; Mood Disorders/epidemiology; Prisons/*statistics & numerical data; Psychotic Disorders/epidemiology; Schizophrenia/epidemiology; Substance-Related Disorders/epidemiology/therapy; Diagnosis; Dual (Psychiatry)
This study examines the extent to which severely mentally disabled (SMD) patients in one county mental health system were incarcerated in the local jail and examines characteristics of a sample (N = 30) of such individuals. We found that in the study year, 7.9% of known SMD patients had at least one incarceration in the county jail. Diagnoses were predominantly in the schizophrenia spectrum with 70% also actively abusing substances at the time of incarceration. The majority of crimes were non-violent and substance abuse related. Half of the sample was judged to be candidates for diversion programs. Our findings are consistent with recent literature confirming that substance abusing SMD individuals are at high risk of incarceration and could benefit from integrated mental health and substance abuse treatment.
Munetz M R; Grande T P; Chambers M R
Community mental health journal
2001
2001-08
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Relevance of routine admission electrocardiograms for psychiatric patients.
Adult; Aged; Arrhythmias; Cardiac/diagnosis/*epidemiology/etiology; Comorbidity; Cost Savings; Diagnosis; Diagnostic Tests; Dual (Psychiatry); Electrocardiography/economics/*statistics & numerical data; Female; Humans; Male; Mental Disorders/diagnosis/*epidemiology/rehabilitation; Middle Aged; Myocardial Ischemia/diagnosis/*epidemiology/etiology; Patient Admission/economics/*statistics & numerical data; Routine/economics/*statistics & numerical data; Sensitivity and Specificity; Treatment Outcome
OBJECTIVE: To make clinically relevant recommendations for electrocardiogram (ECG) testing among psychiatric patients, the study examined the practice of ordering ECGs for this population. METHODS: The records of 4,045 patients consecutively admitted for psychiatric care to seven community teaching hospitals over one year were examined. The frequency of ECG orders was documented, and abnormal ECG results were grouped into two categories: relevant to psychiatric treatment (ischemia or conduction defects) and incidental to treatment (minor abnormalities and screening abnormalities). For those with abnormalities, additional cardiac follow-up data were recorded. Associations between ECG results and patients' characteristics were analyzed. RESULTS: ECGs were performed for 2,857 (71 percent) of first admissions, of which 2,225 (78 percent) showed neither relevant nor screening abnormalities. Eighteen percent of those tested had relevant abnormalities, most commonly a first-degree atrioventricular block or some evidence of a myocardial infarction. ECG screening abnormalities were found for another 4 percent, primarily left ventricular hypertrophy (3 percent), but no follow-up occurred for 46 percent of these patients. Among patients under 40 years of age, 8 percent had relevant abnormalities, and 3 percent had screening abnormalities. Among patients without apparent cardiac risk, 10 percent had relevant and 3 percent had screening abnormalities. More than half the patients who had a second or third admission during the year had a repeat ECG, even when previous ECGs were normal. CONCLUSIONS: Routine ECG is not an effective treatment or screening tool in this population, and substantial cost savings could result from more selective testing, particularly among young patients, those at low risk, and those with repeat admissions.
Heiselman D E; Bredle D L; Kessler E; Rutecki G W; Hines R M; Whittier F C; Bunn P D; Ognibene A J
Psychiatric services (Washington, D.C.)
1997
1997-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1176/ps.48.10.1323" target="_blank" rel="noreferrer noopener">10.1176/ps.48.10.1323</a>
Involuntary treatment of substance abuse disorders.
*Commitment of Mentally Ill/legislation & jurisprudence; Adult; Cost of Illness; Diagnosis; Dual (Psychiatry); Ethics; Human Rights; Humans; Male; Medical; Substance-Related Disorders/economics/*rehabilitation; United States
The authors argue for the extension of mandatory treatment to persons gravely disabled by substance abuse. The problem is examined from ideological, clinical, legal, economic, and ethical perspectives.
Galon P A; Liebelt R A
New directions for mental health services
1997
1905-6
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1002/yd.2330237506" target="_blank" rel="noreferrer noopener">10.1002/yd.2330237506</a>