Behavioural Health Services Reduce Recidivism in Ex-prisoners with Co-occurring Mental Health and Substance Use Problems

• In Event: Health Matters and Prisoner Reentry

Abstract

The association between substance use and recidivism is well established and those with co-occurring mental disorders may be at particularly high risk. For those with co-occurring disorders, access to appropriate treatment post-release may be protective, but few studies have been able to rigorously investigate this. In a cohort of 1,318 adults released from prison in Australia we examined the association between co-occurring mental disorder (defined as use of at least one central nervous system medication at the time of release) and risky substance use (assessed using validated screening tools), and return to custody. Compared with those who had neither mental health nor substance use problems, those with co-occurring problems (n=287) had an increased risk of reincarceration (HR=4.58, 95%CI 3.14-6.66) over a median of 621 days of follow-up. Among this group, the hazard of reincarceration was lower in those who had at least one contact with mental health services (n=183; HR=0.50, 95%CI 0.35-0.70) or drug treatment services (n=91; HR=0.67, 95%CI 0.47-1.01) between release and censoring. Contact with health services and recidivism were ascertained through prospective data linkage. The presentation will end with a discussion of models for supporting the re-entry of prisoners with co-occurring substance use and mental health problems.

Authors

• Stuart A. Kinner, University of Melbourne

• Matthew J. Spittal, University of Melbourne

• Emma Thomas, University of Melbourne

• Edward B. Heffernan, Queensland Forensic Mental Health Service

• Faye Taxman, George Mason University