title: Predictors of rapid reincarceration in mentally ill young offenders.
abstract: OBJECTIVE
  Describe characteristics of mentally ill young offenders released from custody and predictors of those who rapidly returned to custody.
  
  
  METHODS
  Ambidirectional cohort study of 51 young males with mental disorders released from the largest New South Wales Juvenile Justice Centre (2005-2007), a health file audit at time of release and prospective determination of reincarceration.
  
  
  RESULTS
  Overall 47% were Aboriginal, 43% originated from regional communities, substance disorders were highly prevalent and only 12% accessed prior community mental health care. Over half (57%) satisfied diagnostic criteria for schizophrenia spectrum disorder. In custody, 39% were suicidal and 18% were homicidal. A majority (90%) returned to custody over a median of 28 months; half within five months of release. Schizophrenia/schizophreniform disorder (p<.001), bipolar disorder (p=.001) and schizoaffective disorder (p=.005) predicted rapid reincarceration, with shorter community survival than those without those diagnoses (p=.009). Antipsychotic treatment (p=.006) and treatment duration in custody (p=.006) predicted longer community survival. Aboriginality, younger age, prior incarceration and substance disorders were not predictive of rapid reincarceration.
  
  
  CONCLUSIONS
  Serious mental illness was a significant predictor of rapid reincarceration in young offenders. Treatment improved community survival. The findings highlight the need for optimal psychiatric treatment and post-release care for young offenders with mental illness.
authors.affiliation: Consultant Forensic Psychiatrist, Adolescent Unit, The Forensic Hospital, Justice Health, Sydney, NSW, and; Conjoint Lecturer, School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, and; Forensic Mental Health Service, ACT Health, Canberra, ACT, and; Visiting Fellow, Centre for Mental Health Research, Australian National University, Canberra, ACT, and; The Level 8 Practice, Sydney, NSW Australia johnkas@med.usyd.edu.au.
authors.forename: John
authors.initials: J
authors.lastname: Kasinathan
mesh_terms: D000293:Adolescent; D000328:Adult; D057237:Criminals / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D028642:Persons with Psychiatric Disorders / Q000706:statistics & numerical data*; D009517:New South Wales / Q000453:epidemiology; D011329:Prisoners / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: mental illness; predictors; reincarceration; young offenders