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

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


Contents

Project: Health-related burden of police cell detainees

•Rationale•Methods•Key findings•Implications for community reintegration


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


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)


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


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


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


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


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


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


Levels of psychiatric disorders

Current Disorders n % OR

Mood 60 40 10.1

Psychotic 11 7 15.4

Anxiety 40 27 2.2

Substance Use 88 59 26.3

Any disorder, no SUD 77 51 -

Any disorder 114 76 -


Individual Needs

•Total needs: 5 Unmet needs: 3

•Most common unmet needsMoney (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)


Screening accuracyBJMHS JSAT

Disorders % %

Serious mental illness Proportion correct 69.7 74.7Sensitivity 84.9 100Specificity 60.3 55.8Positive predictive power 85.5 62.8Negative predictive power 85.5 100Any Axis-I disorder (excl SUD)Proportion correct 72.7 82.0Sensitivity 81.5 98.7Specificity 64.2 64.4Positive predictive power 68.8 74.5Negative predictive power 78.2 97.9


Test of explanatory models

Variables B SE B β

Social desirability −0.28 0.13 −0.16∗

Age 0.01 0.04 0.02

History of psychiatric treatment −0.09 0.90 −.01

History of psychiatric hospitalisation 2.58 1.01 0.22∗

Drug abuse / dependence (current) −0.17 0.76 −0.02

Psychiatric disorder (current, excl SUD) 5.94 0.75 0.59∗∗∗

Checklist (Situational factor measure) −0.01 0.02 −0.01

Time spent in cells 0.00 0.02 0.00 Interaction between disorder & checklist −0.02 0.03 −0.06

Interaction between psychiatric admission & checklist −0.03 0.04 −0.05


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


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


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


Acknowledgements

Partners:

• Victoria Police

• Monash University

• Victorian Institute of Forensic Mental Health (Forensicare)


Thank you!

Questions or comments?

Contact: [email protected]

mailto:[email protected]

Documents

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