Risk of incarceration between cohorts of veterans with and without mental illness discharged from inpatient units.
OBJECTIVE
This study examined the risk of incarceration among cohorts of veterans treated in the Department of Veterans Affairs (VA) Connecticut Healthcare System. Incarceration rates of persons with and without mental illness were compared and adjusted for various clinical and service utilization variables. Data were compared before and after the closure of over 80% of the Connecticut VA psychiatric inpatient beds in 1996.


METHODS
Data from five annual cohorts of patients (1993-1997) treated in an inpatient unit in the VA Connecticut Healthcare System (N=36,385) were merged with state Department of Correction data. Logistic regression models were used to identify risk factors for incarceration.


RESULTS
Bivariate analysis showed that incarceration rates were higher for VA patients with psychiatric disorders and with substance use disorders than for those without such diagnoses, but there were no significant increases in likelihood of incarceration over these years of extensive closures. In multiple logistic regression analysis only diagnoses of substance use disorders and major depression were independently associated with an increased likelihood of incarceration, whereas schizophrenia, personality disorders, and co-occurring psychiatric and substance use disorders were not independently associated with increased likelihood in multivariate analysis.


CONCLUSIONS
Alcohol and drug problems appeared to account for much of the risk of incarceration among hospitalized veterans during the study period. Unlike in previous studies, schizophrenia and related psychotic disorders were not independently associated with an increased risk of incarceration.
Erickson
Steven K
SK
Department of Psychiatry, Yale University and VA Connecticut Healthcare System, 950 Campbell Ave., West Haven, CT 06516, USA. steven.erickson@yale.edu
Rosenheck
Robert A
RA
Trestman
Robert L
RL
Ford
Julian D
JD
Desai
Rani A
RA
D000328:Adult; D015331:Cohort Studies; D003237:Connecticut; D003415:Crime / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006271:Health Facility Closure / Q000706:statistics & numerical data; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006787:Hospitals, Veterans / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients / Q000523:psychology / Q000706:statistics & numerical data*; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008875:Middle Aged; D016017:Odds Ratio; D010351:Patient Discharge / Q000706:statistics & numerical data; D011330:Prisons; D012306:Risk; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000523:psychology; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*