Abstract
BackgroundThe number of older adults on parole and probation is growing at an unprecedented rate, yet little is known about the mental health needs and treatment utilization patterns among this group. The objective of this study is to compare the prevalence of serious or moderate mental illness (SMMI), and the proportion of those with SMMI who receive mental health treatment, among community-dwelling older adults on correctional supervision (parole or probation) vs. not on correctional supervision.MethodsDesign: Cross-sectional analysis of data from the 2008–2014 National Surveys for Drug Use and Health (NSDUH).Setting: Population-based national survey data.Participants: Older adults (age ≥ 50) who participated in the NSDUH between 2008 and 2014 (n = 44,624). Participants were categorized according to whether they were on parole or probation during the 12 months prior to survey completion (n = 379) vs. not (n = 44,245).Measurements: Probable SMMI was defined using a validated measure in the NSDUH. Mental health treatment included any outpatient mental health services or prescriptions over the 12 months prior to survey completion. We compared the prevalence of SMMI, and the proportion of those with SMMI who received any treatment, by correctional status.ResultsOverall, 7% (N = 3266) of participants had SMMI; the prevalence was disproportionately higher among those on parole or probation (21% vs. 7%, p < 0.001). Sixty-two percent of those with SMMI received any mental health treatment, including 81% of those on parole or probation and 61% of those who were not (p < 0.001). This result remained statistically significant after logistic regression accounted for differences in sociodemographics and health.ConclusionsSMMI is disproportionally prevalent among older adults on parole or probation, and community correctional supervision programs may be facilitating linkages to needed community-based mental health treatment.
Highlights
serious or moderate mental illness (SMMI) was reported among 20.9% (n = 79) of older adults on parole or probation, and 7.2% (n = 3187) of those not on community supervision (p < 0.001; see Fig. 1)
We found that the prevalence of SMMI was higher among those on parole or probation compared to all Parole or Probation
A higher proportion of older adults on parole or probation received treatment for serious or moderate mental illness compared to those older adults with SMMI who were not on community correctional supervision
Summary
Community correctional programs, such as parole and probation, form an important coordinating bridge between the criminal justice and community healthcare systems for individuals with mental illness (Epperson et al, 2014; Lamberti, 2016; Morrissey, Fagan, & Cocozza, 2009; Munetz & Griffin, 2006; Osher & King, 2015), but little is known about their role in mental health servicesMental health-related conditions are more prevalent among older adults on parole or probation than older (2019) 7:4 adults without justice involvement, including past-year major depression (15% vs. 5%), serious psychological distress (22% vs. 6%), alcohol use disorders (20% vs. 3%), and drug use disorders (7% vs. 0.6%) (Bryson et al, 2017). The combination of advancing age and mental illness may define a subgroup of justice-involved individuals with exceptional difficulty following release from incarceration, including a profound need for structured support and mental health services, and significant barriers to healthcare access. In this study, we determined the prevalence of serious or moderate mental illness (SMMI) among older adults on parole or probation, and assessed the percentage of those with SMMI who received any mental health treatment over the course of 1 year. The objective of this study is to compare the prevalence of serious or moderate mental illness (SMMI), and the proportion of those with SMMI who receive mental health treatment, among community-dwelling older adults on correctional supervision (parole or probation) vs not on correctional supervision
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