title: Disparities in Mental Health Referral and Diagnosis in the New York City Jail Mental Health Service.
abstract: OBJECTIVE
  To better understand jail mental health services entry, we analyzed diagnosis timing relative to solitary confinement, nature of diagnosis, age, and race/ethnicity.
  
  
  METHODS
  We analyzed 2011 to 2013 medical records on 45,189 New York City jail first-time admissions.
  
  
  RESULTS
  Of this cohort, 21.2% were aged 21 years or younger, 46.0% were Hispanic, 40.6% were non-Hispanic Black, 8.8% were non-Hispanic White, and 3.9% experienced solitary confinement. Overall, 14.8% received a mental health diagnosis, which was associated with longer average jail stays (120 vs 48 days), higher rates of solitary confinement (13.1% vs 3.9%), and injury (25.4% vs 7.1%). Individuals aged 21 years or younger were less likely than older individuals to receive a mental health diagnosis (odds ratio [OR] = 0.86; 95% confidence interval [CI] = 0.80, 0.93; P < .05) and more likely to experience solitary confinement (OR = 4.99; 95% CI = 4.43, 5.61; P < .05). Blacks and Hispanics were less likely than Whites to enter the mental health service (OR = 0.57; 95% CI = 0.52, 0.63; and OR = 0.49; 95% CI = 0.44, 0.53; respectively; P < .05), but more likely to experience solitary confinement (OR = 2.52; 95% CI = 1.88, 3.83; and OR = 1.65; 95% CI = 1.23, 2.22; respectively; P < .05).
  
  
  CONCLUSIONS
  More consideration is needed of race/ethnicity and age in understanding and addressing the punishment and treatment balance in jails.
authors.affiliation: Fatos Kaba, Angela Solimo, Jasmine Graves, Sarah Glowa-Kollisch, Allison Vise, Ross MacDonald, Anthony Waters, Zachary Rosner, Nathaniel Dickey, and Homer Venters are with the Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, NY. Sonia Angell is with the Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene.
authors.forename: Fatos
authors.initials: F
authors.lastname: Kaba
authors.affiliation: Fatos Kaba, Angela Solimo, Jasmine Graves, Sarah Glowa-Kollisch, Allison Vise, Ross MacDonald, Anthony Waters, Zachary Rosner, Nathaniel Dickey, and Homer Venters are with the Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, NY. Sonia Angell is with the Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene.
authors.forename: Angela
authors.initials: A
authors.lastname: Solimo
authors.affiliation: Fatos Kaba, Angela Solimo, Jasmine Graves, Sarah Glowa-Kollisch, Allison Vise, Ross MacDonald, Anthony Waters, Zachary Rosner, Nathaniel Dickey, and Homer Venters are with the Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, NY. Sonia Angell is with the Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene.
authors.forename: Jasmine
authors.initials: J
authors.lastname: Graves
authors.affiliation: Fatos Kaba, Angela Solimo, Jasmine Graves, Sarah Glowa-Kollisch, Allison Vise, Ross MacDonald, Anthony Waters, Zachary Rosner, Nathaniel Dickey, and Homer Venters are with the Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, NY. Sonia Angell is with the Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene.
authors.forename: Sarah
authors.initials: S
authors.lastname: Glowa-Kollisch
authors.affiliation: Fatos Kaba, Angela Solimo, Jasmine Graves, Sarah Glowa-Kollisch, Allison Vise, Ross MacDonald, Anthony Waters, Zachary Rosner, Nathaniel Dickey, and Homer Venters are with the Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, NY. Sonia Angell is with the Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene.
authors.forename: Allison
authors.initials: A
authors.lastname: Vise
authors.affiliation: Fatos Kaba, Angela Solimo, Jasmine Graves, Sarah Glowa-Kollisch, Allison Vise, Ross MacDonald, Anthony Waters, Zachary Rosner, Nathaniel Dickey, and Homer Venters are with the Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, NY. Sonia Angell is with the Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene.
authors.forename: Ross
authors.initials: R
authors.lastname: MacDonald
authors.affiliation: Fatos Kaba, Angela Solimo, Jasmine Graves, Sarah Glowa-Kollisch, Allison Vise, Ross MacDonald, Anthony Waters, Zachary Rosner, Nathaniel Dickey, and Homer Venters are with the Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, NY. Sonia Angell is with the Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene.
authors.forename: Anthony
authors.initials: A
authors.lastname: Waters
authors.affiliation: Fatos Kaba, Angela Solimo, Jasmine Graves, Sarah Glowa-Kollisch, Allison Vise, Ross MacDonald, Anthony Waters, Zachary Rosner, Nathaniel Dickey, and Homer Venters are with the Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, NY. Sonia Angell is with the Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Rosner
authors.affiliation: Fatos Kaba, Angela Solimo, Jasmine Graves, Sarah Glowa-Kollisch, Allison Vise, Ross MacDonald, Anthony Waters, Zachary Rosner, Nathaniel Dickey, and Homer Venters are with the Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, NY. Sonia Angell is with the Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene.
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Dickey
authors.affiliation: Fatos Kaba, Angela Solimo, Jasmine Graves, Sarah Glowa-Kollisch, Allison Vise, Ross MacDonald, Anthony Waters, Zachary Rosner, Nathaniel Dickey, and Homer Venters are with the Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, NY. Sonia Angell is with the Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene.
authors.forename: Sonia
authors.initials: S
authors.lastname: Angell
authors.affiliation: Fatos Kaba, Angela Solimo, Jasmine Graves, Sarah Glowa-Kollisch, Allison Vise, Ross MacDonald, Anthony Waters, Zachary Rosner, Nathaniel Dickey, and Homer Venters are with the Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, NY. Sonia Angell is with the Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene.
authors.forename: Homer
authors.initials: H
authors.lastname: Venters
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003710:Demography; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology / Q000628:therapy*; D009519:New York City / Q000453:epidemiology; D011330:Prisons; D012017:Referral and Consultation / Q000706:statistics & numerical data*