Our mixed-methods study advances understanding of pathways to offending for jailed women with and without mental illness. Life history interviews with 115 women from five U.S. states examined how onset of crime and delinquency varied based on mental health status and trauma exposure. Women in jails had high rates of mental health disorders, with a majority meeting lifetime diagnostic criteria for a serious mental illness (50%), posttraumatic stress disorder (51%), and/or substance use disorder (85%). Cox regression analyses were utilized to examine associations between life experiences and risk of engaging in specific criminalized behaviors. Serious mental illness was associated with substance use, running away as a teen, and drug offending. Substance use disorder was related to earlier onset of substance use and driving under the influence. Intimate partner violence increased women's risks for property crimes, drug offending, and commercial sex work. Witnessing violence increased risks for property crimes, fighting, and use of weapons. Experiences of caregiver violence increased the risk of running away as a teen. Qualitative narratives were reviewed to provide insight into connections between women's experiences and onset of criminal behavior. Findings demonstrate a need for gender-responsive and trauma-informed practices to address mental disorders and victimization among women offenders.
BACKGROUND:The effectiveness of collaborative care of mental health problems is clear for depression and growing but mixed for anxiety disorders, including posttraumatic stress disorder (PTSD). We know little about whether collaborative care can be effective in settings that serve low-income patients such as Federally Qualified Health Centers (FQHCs). OBJECTIVE: We compared the effectiveness of minimally enhanced usual care (MEU) versus collaborative care for PTSD with a care manager (PCM). DESIGN: This was a multi-site patient randomized controlled trial of PTSD care improvement over 1 year. PARTICIPANTS: We recruited and enrolled 404 patients in six FQHCs from June 2010 to October 2012. Patients were eligible if they had a primary care appointment, no obvious physical or cognitive obstacles to participation, were age 18-65 years, planned to continue care at the study location for 1 year, and met criteria for a past month diagnosis of PTSD. MAIN MEASURES: The main outcomes were PTSD diagnosis and symptom severity (range, 0-136) based on the Clinician-Administered PTSD Scale (CAPS). Secondary outcomes were medication and counseling for mental health problems, and health-related quality of life assessed at baseline, 6 months, and 12 months. KEY RESULTS: Patients in both conditions improved similarly over the 1-year evaluation period. At 12 months, PTSD diagnoses had an absolute decrease of 56.7 % for PCM patients and 60.6 % for MEU patients. PTSD symptoms decreased by 26.8 and 24.2 points, respectively. MEU and PCM patients also did not differ in process of care outcomes or health-related quality of life. Patients who actually engaged in care management had mental health care visits that were 14 % higher (p < 0.01) and mental health medication prescription rates that were 15.2 % higher (p < 0.01) than patients with no engagement. CONCLUSIONS:A minimally enhanced usual care intervention was similarly effective as collaborative care for patients in FQHCs.
Mental health care for trauma-exposed populations in conflict-affected developing countries often is provided by primary healthcare providers (PHPs), including doctors, nurses, and lay health workers. The Task Force on International Trauma Training, through an initiative sponsored by the International Society for Traumatic Stress Studies and the RAND Corporation, has developed evidence- and consensus-based guidelines for the mental health training of PHPs in conflict-affected developing countries. This article presents the Guidelines, which provide a conceptual framework and specific principles for improving the quality of mental health training for PHPs working with trauma-exposed populations.
The Children's PTSD lnventoly (CPTSDI) was administered to 76 traumatized and 28 nontraumatized youths. CPTSDI diagnoses were compared to DICA-R and SCID PTSD diagnoses. Moderate to high sensitivity, specijicity, positive and negative predictive powel; and diagnostic efficiency were evidenced across criterion measures. Convergent validiry was evidenced by significant correlations with the Revised Children s Manifest Anxiety Scale, Children s Depression Inventory, Child Behavior Checklist (CBCL) Internalizing scale, and the Junior Eysenck Personality inventory (JEPI) Neuroticism scale. Discriminant validity was observed through nonsignificant correlations with the CBCL Externalizing and the JEPI Extraversion scales.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.