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Deakin University CRICOS Provider Code: 00113B Reintegration of police cell detainees into the community: a missed opportunity? Gennady Baksheev School.

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Presentation on theme: "Deakin University CRICOS Provider Code: 00113B Reintegration of police cell detainees into the community: a missed opportunity? Gennady Baksheev School."— Presentation transcript:

1 Deakin University CRICOS Provider Code: 00113B Reintegration of police cell detainees into the community: a missed opportunity? Gennady Baksheev School of Psychology, Centre for Mental Health and Wellbeing Research Deakin University

2 Deakin University CRICOS Provider Code: 00113B Contents Project: Health-related burden of police cell detainees Rationale Methods Key findings Implications for community reintegration

3 Deakin University CRICOS Provider Code: 00113B Psychiatric disorders in police cells? High rates of psychiatric disorders in jails and prisons Psychiatric disorders are important to consider in criminal justice system Suicide; Mortality; Deleterious impact of prison environment; Public safety considerations Little is known about front end of the criminal justice system: police cells It is likely that the mental health-related burden is greater in this context

4 Deakin University CRICOS Provider Code: 00113B Police cell research Available data suggests relatively high levels of symptomatology and substance use disorders (Blaauw et al 1998; Heffernan et al 2003) Deaths in custody: suicide is a leading cause (Johnson, 1982) Substandard police cell conditions (Ombudsman Victoria and OPI, 2006)

5 Deakin University CRICOS Provider Code: 00113B Needs Assessment Criminogenic needs: antisocial thoughts, substance use problems General needs: physical health, accommodation Important for service planning and interagency collaborations Complex health problems among prisoners, such as poor general health

6 Deakin University CRICOS Provider Code: 00113B How can we identify those with a psychiatric disorder? Aims of mental health screening: 1.Accurate identification of those in clinical need 2.Prevent violence and disruptive incidents 3.Allocate limited resources to those in high need 4.Reduce cycles of admission between various services (Nicholls et al 2005) Limited work in police cell context

7 Deakin University CRICOS Provider Code: 00113B Accounting for psychopathology in police cells 1.Importation model History of psychiatric treatment 2.Deprivation model High quality vs low quality police cell facilities 3.Interaction model

8 Deakin University CRICOS Provider Code: 00113B Aims 1.Measure the health-related burden among police cell detainees 2.Examine predictive utility of standardised screening tools for psychiatric disorders 3.Determine the importance of personal and situational factors, and their interaction, in accounting for psychiatric disorders

9 Deakin University CRICOS Provider Code: 00113B An empirical study of health needs in police cells Interviews were conducted with 150 consecutive admissions of males and females to two police stations in metropolitan Melbourne. Systematically recorded: Health needs (General health and mental health, including psychiatric disorders and symptoms) Standardised mental health screening tools Measures of situational factors

10 Deakin University CRICOS Provider Code: 00113B Sample characteristics Gender: 91% (136) male Average age: 30 years (SD=8.95) Current work status: 51% (76) unemployed Marital status: 48% (72) single Country of birth: 75% (113) Australia Average time spent in cells: 32 hours

11 Deakin University CRICOS Provider Code: 00113B Levels of psychiatric disorders Current Disordersn%OR Mood604010.1 Psychotic11715.4 Anxiety40272.2 Substance Use885926.3 Any disorder, no SUD7751- Any disorder11476-

12 Deakin University CRICOS Provider Code: 00113B Individual Needs Total needs: 5 Unmet needs: 3 Most common unmet needs Money (48%)Company (31%)Drugs (31%) Daytime activities (31%)Intimate relationships (30%) Psychological distress (29%) Alcohol (29%) Those with a psychiatric disorder presented with more total and unmet needs compared to those without a psychiatric disorder Gender comparison: similar number and profile of needs (limited data)

13 Deakin University CRICOS Provider Code: 00113B Screening accuracy BJMHSJSAT Disorders% Serious mental illness Proportion correct69.774.7 Sensitivity84.9100 Specificity60.355.8 Positive predictive power85.562.8 Negative predictive power85.5100 Any Axis-I disorder (excl SUD) Proportion correct72.782.0 Sensitivity81.598.7 Specificity64.264.4 Positive predictive power68.874.5 Negative predictive power78.297.9

14 Deakin University CRICOS Provider Code: 00113B Test of explanatory models VariablesBSE Bβ Social desirability−0.280.13 −0.16 ∗ Age0.010.040.02 History of psychiatric treatment−0.090.90−.01 History of psychiatric hospitalisation2.581.01 0.22 ∗ Drug abuse / dependence (current)−0.170.76−0.02 Psychiatric disorder (current, excl SUD)5.940.75 0.59 ∗∗∗ Checklist (Situational factor measure)−0.010.02−0.01 Time spent in cells0.000.020.00 Interaction between disorder & checklist−0.020.03−0.06 Interaction between psychiatric admission & checklist −0.030.04−0.05

15 Deakin University CRICOS Provider Code: 00113B Key findings Rates of psychiatric disorders are significantly higher among police cell detainees compared to general population Increased accuracy in detection of those in clinical need via standardised mental health screening tools Personal factors were the strongest predictors of high levels of psychopathology High level of unmet needs in social and welfare domains

16 Deakin University CRICOS Provider Code: 00113B Implications Service provision in custody Need implementation of standardised screening tools Where treatment is possible, target those with acute psychopathology Linkage with services if released back to the community

17 Deakin University CRICOS Provider Code: 00113B Reintegration of police cell detainees Barriers to reintegration: mental illness, drugs, alcohol, insufficient money, difficulties with daytime activities, and few social connections Functional interagency collaborations are required to effectively manage return of police detainees back into the community APIC model: Assess: clinical and social needs, and public safety risks Plan: for treatment and services to address needs Identify: community and correctional programs Coordinate: the transition plan to ensure implementation

18 Deakin University CRICOS Provider Code: 00113B Acknowledgements Partners: Victoria Police Monash University Victorian Institute of Forensic Mental Health (Forensicare)

19 Deakin University CRICOS Provider Code: 00113B Thank you! Questions or comments? Contact: g.baksheev@deakin.edu.aug.baksheev@deakin.edu.au


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