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New Research Finds Mentally Ill Inmates Have Lower Recidivism Rates

New research counters old findings that people with mental illness have the highest return rates to prison. The new study demonstrates that inmates with severe mental illnesses alone actually have lower rates of recidivism than those with substance-abuse issues or no mental or substance-abuse issues.

Past studies compared inmates with severe mental illnesses, such as schizophrenia and severe affective disorders, with a general population of released inmates and found that those with mental illnesses had higher recidivism rates.

The current study evaluated recidivism among released inmates from one of the country’s largest jail systems (Philadelphia) and separated inmates into four categories: those with severe mental illnesses, those with a substance-abuse problem, those with dual problems of mental illness and substance abuse, and those with neither problem.

When looking at individual groups, those with mental illnesses alone fared better—even compared with those who had no mental or substance-abuse issues.

The researchers looked at recidivism rates for 20,112 inmates admitted to the Philadelphia jail system in 2003 and then tracked their return rates over the next four years. Using data from Philadelphia’s behavioral health system on Medicaid records and from the Philadelphia Country’s jail system on admission, release, and demographic information, the researchers were able to categorize the individuals into the four groups and follow their re-admissions.

Of those readmitted to jail, 32 percent took place in the first year, 45 percent by year two, 54 percent by year three, and 60 percent by year four.

At the end of four years, 54 percent of those with severe mental illness returned to jail, while 66 percent of those with substance-abuse problems did, 68 percent of those with co-occurring issues did, and 60 percent of those with no diagnosis did.

Each year of the study, those with severe mental illnesses had lower return rates than those in the other three groups.

“These findings point to a possible need for more integrated services for mental and substance abuse,” said the study’s principal investigator, Amy B. Wilson, “and more attention being paid generally to the ways that substance abuse involvement among people with serious mental illness complicates these individuals’ involvement with the criminal justice system.” Wilson is assistant professor of social work at Case Western Reserve University.

Source: Jan. 17, 2012, news release. Findings from the study, “Examining the impact of mental illness and substance use on recidivism in a county jail,” were reported in the International Journal of Law and Psychiatry.

Rats Exhibit Empathy for Each Other

Hard to believe rats can be altruistic? Check out the video at the Science Now website, which has this caption: “Liberated: A brave and empathetic rat learns to free a trapped cagemate.”

The accompanying article, by Dan Ferber, which was posted Dec. 8, notes that “For decades researchers have debated whether nonhuman animals possess [empathy]. Now a new study shows that rats will free a trapped cagemate in distress. The results mean that these rodents can be used to help determine the genetic and physiological underpinnings of empathy in people.” 

The researchers showed that three quarters of the rats with trapped cagemates learned to open a door that freed their cagemate, while only one rat in six without a trapped cagemate learned to open the same door.

The researchers also examined the rats’ motivation for freeing their cagemates. They were able to rule out simple curiosity or the desire for company as motivations. 

“The rats also freed trapped cagemates even when they had the option of bumping open an identical container and obtaining five chocolate chips for themselves, which showed that their motivation to help was on par with their desire for a tasty treat. 

“In fact, half of the time they even shared chips by leaving one or two for the trapped rat,” Feber wrote.

“Similar behavior has been observed in monkeys and chimpanzees. But unlike those animals, rats can be readily used in laboratory studies to investigate which brain structures underlie empathy and helping behavior and whether empathy is acquired through nature or nurture.”

Guilt Is Major Factor in Veteran PTSD

“A new study finds that guilt is a major factor in the development of post-traumatic stress disorder among veterans in combat. ...

“According to the researchers, servicemembers who lived through an attack that killed other servicemembers, or witnessed an attack that resulted in the unintentional death of civilians, women, or children may suffer from survivors’ guilt. These feelings of guilt may ultimately manifest themselves as post-traumatic stress disorder. …

“Typically, the American Psychiatric Association has linked post-traumatic stress disorder to violence during combat, fear of being killed, and loss of friends in combat. …

“According to the researchers, [PTSD] that is linked to a moral injury is typically more severe than PTSD that results from being part of a near-death experience.”

Source: Dec. 6 blog on The Veterans Law Group website.

Suicidal Risk Factors Identified for Pregnant Women and New Mothers

Increased screening of pregnant women and new mothers for major depression and conflicts with intimate partners may help identify women at risk for suicide, a University of Michigan Health System-led analysis of federal data concludes.

Only a small percentage of women who take their own lives are pregnant or have recently become mothers, but their frequent interactions with the healthcare system provide important opportunities for providers to intervene if risk factors become better understood, the researchers say.

The study analyzed five years of suicide data from the National Violent Death Reporting System, which was introduced in 2003. The dataset is unique for linking multiple sources of information together to provide details that include demographics, pregnancy status, mental health and substance-abuse status, and precipitating circumstances.

More than half of the women who killed themselves had a known mental health diagnosis, with mood disorder being the most common at 95 percent. Nearly half were known to have a depressed mood leading up to the suicide.

Postpartum women were more likely to have been identified as having a depressed mood in the two weeks prior to suicide than other women, the study found.

Researchers found many similarities that did not vary significantly by pregnancy status: 56 percent of all victims had a known mental health diagnosis; 32 percent had previously attempted suicide; and 28 percent had a known alcohol or substance-abuse issue at the time of death.

The researchers also found that while education level and marital status were very similar across pregnant, postpartum, and non-pregnant suicides, Hispanic women were far more likely to take their own lives while pregnant (10 percent of suicides among pregnant women) or within a year of pregnancy (9 percent of post-partum suicides) than when not pregnant (4 percent of non-pregnancy-associated suicides).

The researchers acknowledge some inherent limitations of the data. Their sample of 2,083 suicides among women of plausible child-bearing age (15-54), was drawn only from the 17 states where data was available. It is also was impossible to interview the victims and get a full picture of mental health conditions, unreported domestic violence, and other precipitating factors.

Source; citation: “Mental Health, substance use, and intimate partner problems among pregnant and postpartum suicide victims in the National Violent Death Reporting System,” General Hospital Psychiatry, doi:10.1016/j.genhosppsych.2011.09.017.