Relationship between race and ethnicity and forensic clinical triage dispositions.
OBJECTIVE
Racial and ethnic disparities in the criminal justice system have been widely reported, as have racial and ethnic disparities in diagnoses and certain aspects of clinical management. This study examined the association between race and ethnicity and dispositions for pretrial defendants who were referred for forensic mental health evaluations.


METHODS
Available data were reviewed for all defendants in Massachusetts who were referred to a Massachusetts court clinic from 1994 to 2001 for a screening evaluation of their competence to stand trial, their criminal responsibility, or both. Logistic regression models were developed to assess the relationship between defendants' race and ethnicity and the likelihood that they would be referred for inpatient evaluation and the likelihood that they would be evaluated within a strict-security facility. Race or ethnicity of the pretrial defendants was identified by clinicians.


RESULTS
Blacks, but not Hispanics, were significantly more likely than whites to be referred for an inpatient evaluation after an outpatient forensic screening evaluation. Among male defendants, both Hispanics and blacks were more likely than whites to be referred for an inpatient evaluation in a strict-security facility, regardless of diagnoses and the level of severity of the criminal charges.


CONCLUSIONS
Racial and ethnic disparities in disposition decisions exist within the forensic mental health system. These disparities, however, likely reflect numerous clinician and nonclinician variables.
University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, Massachusetts 01655, USA. debra.pinals@dmh.state.ma.us
Debra A
DA
Pinals
Ira K
IK
Packer
William
W
Fisher
Kristen
K
Roy-Bujnowski
D000328:Adult; D003415:Crime / Q000208:ethnology* / Q000706:statistics & numerical data; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D005555:Forensic Psychiatry / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D001523:Mental Disorders / Q000175:diagnosis / Q000208:ethnology; D008605:Mental Health Services / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D014218:Triage / Q000706:statistics & numerical data*