Substance use, mental health, chronic medical conditions and criminal justice contact in a nationally representative sample

Abstract

Purpose The amount of overlap between criminal justice practices and public health is growing and more research is needed to guide new initiatives. This study was designed to assess the relationships between various chronic medical conditions, substance use severity, mental health indicators and criminal justice contact using the National Survey on Drug Use and Health. Design/methodology/approach Analyses were conducted in three stages to comprehensively examine the relationships between various indicators of physical health, mental health, substance use severity and criminal justice contact. Findings Results demonstrate indicators of substance use severity surpass physical and mental health conditions as stronger determinants of any criminal justice contact, as well as repeated interactions with police. In addition, combinations of multiple conditions increase the likelihood of criminal justice involvement, but substance use remains a consistent factor contributing to the strongest associations. These findings highlight the importance of capitalizing on the initial point of criminal justice contact to address substance use to prevent further and subsequent involvement in the system. Research limitations/implications Criminal justice initiatives based on least harm solutions require evidence to support public health-oriented approaches. The unique approach to examining the intersection of criminal justice practices and health provided in this study can be used to inform alternates to arrest. Practical implications The least harmful practices should be adopted to address health conditions at the time of criminal justice contact. These practices should focus heavily on injection drug use as a primary factor associated with the prior arrest. Practices designed to divert arrestees with health conditions away from jails are needed. Law enforcement practices can significantly benefit from public health-oriented approaches. Originality/value Criminal justice initiatives based on least harm solutions require evidence to support public health-oriented approaches. The unique approach to examining the intersection of criminal justice practices and health provided in this study can be used to inform alternates to arrest.

The prevalence of self-reported mental illness among those imprisoned in New South Wales across three health surveys, from 2001 to 2015

“…Mental illnesses across the diagnostic spectrum have been found to be associated with both violent and non-violent offending (Chowdhury et al, 2021; Stevens et al, 2015), and particular symptoms, such as paranoia and delusional beliefs, have been shown to be important in driving some offending behaviour (Coid et al, 2013, 2016). As well as having a direct impact on the likelihood of offending, mental illness is associated with a number of factors that may increase the risk of criminal justice contact such as substance use (Kopak, 2021) and socio-economic indicators such as homelessness, unemployment and financial hardship, suggesting a process of the ‘criminalisation’ of the socially disadvantaged (Baldry and Russell, 2017). Even among those who offend, those with mental illness have higher rates of conviction and incarceration (Stewart et al, 2020) and return to prison sooner after release (Cloyes et al, 2010; Stewart and Wilton, 2014).…”