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J Am Acad Psychiatry Law 35:4:490-500 (2007)
Copyright © 2007 by the American Academy of Psychiatry and the Law.
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Current and Lifetime Psychiatric Illness Among Inmates Not Identified as Acutely Mentally Ill at Intake in Connecticut's Jails

Robert L. Trestman, MD, PhD, Julian Ford, PhD, Wanli Zhang, PhD and Valerie Wiesbrock, MA

Dr. Trestman is Director, Center for Correctional Mental Health Services Research, Dr. Ford is Associate Professor, Dr. Zhang is Research Biostatistician, Ms. Wiesbrock is Research Coordinator, Department of Psychiatry, University of Connecticut Health Center, Farmington, CT. The study was funded in part by the National Institute of Justice (2000-IJ-CX-0044). This paper was presented at the annual meeting of the American Academy of Psychiatry and the Law, Chicago, IL, October 2006. Address correspondence to: Robert L. Trestman, MD, PhD, Departments of Medicine and Psychiatry, University of Connecticut Health Center, 263 Farmington Ave., Farmington CT 06030-5386. E-mail: trestman{at}uchc.edu

This study presents estimates of current and lifetime psychiatric illness among inmates not identified as acutely mentally ill at intake into all five of Connecticut's adult jails (four male facilities and one female facility). Diagnoses were assessed with the Structured Clinical Interview for DSM-IV (SCID), Clinician-Administered PTSD Scale, and the Global Assessment of Functioning (GAF) and are reported by gender and race/ethnicity. The results showed that more than two of three inmates met the criteria for at least one lifetime psychiatric disorder, almost half for an anxiety disorder, and more than one-third for an affective disorder. Overall, estimates of psychiatric morbidity in the women were higher than those in the men, with the exception of antisocial personality disorder (ASPD). Of particular note, borderline personality disorder was diagnosed in 23.2 percent of women and 12.9 percent of men. An allegation of a violent offense was not associated with the presence of mental illness or with a specific diagnosis. Lifetime history of any mental illness was associated with significantly reduced scores (range, 12–15 points reduction) on the Global Assessment of Functioning. The study showed that current and lifetime psychiatric morbidity are elevated among newly incarcerated adults who do not exhibit obvious signs of severe mental illness and are associated with functional impairment. While such disorders do not necessarily require treatment, unrecognized mental illness may place offenders at greater risk while incarcerated than offenders without mental illness. This study reinforces the need for appropriate screening and referral for treatment at intake into jail.




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H. R. Lamb and L. E. Weinberger
Mental Health Courts as a Way to Provide Treatment to Violent Persons With Severe Mental Illness
JAMA, August 13, 2008; 300(6): 722 - 724.
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Copyright © 2007 by the American Academy of Psychiatry and the Law.