Treatment for Individuals Interacting with the Criminal Justice System

Launched by CAMBRIDGE HEALTH ALLIANCE · Aug 19, 2024

Keywords

ClinConnect Summary

This clinical trial is focused on improving mental health support for individuals who come into contact with the criminal justice system, particularly those at risk for suicide. The goal is to better track and help these individuals as they move in and out of jails and hospitals. By using real-time data from health systems and legal records, the study aims to find ways to reduce the suicide rate in the U.S. For example, if someone is brought into the emergency department under police supervision because they are at risk of harming themselves, this study will help ensure they receive the care they need.

To participate, individuals must be between the ages of 18 and 100 and have had some form of police involvement between 2009 and 2019. There are different groups within the study, including one for patients from Cambridge and nearby cities, and another for those brought to the emergency department for mental health evaluations. Participants can expect to contribute to important research that could lead to better mental health interventions for people in similar situations in the future. If you or someone you know fits the criteria and is interested in taking part, this trial could be an opportunity to help improve mental health care for those who need it most.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Treatment as Usual (TAU) arm
• • 1. Cambridge Health Alliance (CHA) patients from the cities other than Cambridge considered to be in the "catchment area" of CHA (Everett, Chelsea, Somerville, Medford, Malden, and Winthrop)
• • 2. Ages 18-100
• • 3. Identified as having police involvement between 2009 and 2019. Treatment as Usual patients will be identified using "targeted limited chart review methods" used in our prior studies, "scraping" clinical notes in the Electronic Health Records for criminal justice involvement. Initial Identification terms, "police", "arrest", "court", "summons", "jail", and "crime" will be used to identify candidates for police involvement, downloading the sentence in which the keyword appeared and the sentence before and after. Next, an iterative process of editing of the search terms will be conducted to remove patients with negation of the keyword ("did not commit a crime"), and other sentence characteristics that generate false positives ("cardiac arrest"). Samples of the resulting dataset will be taken, accuracy assessed by examining the surrounding sentences, leading to further iterations and repetition of the process until a high level of accuracy is achieved.
• • 2. Family and Social Justice Section (FSJS) arm
• • 1. Cambridge Health Alliance patients from Cambridge
• • 2. Ages 18-100
• • 3. Individuals who have come into contact with the Cambridge Police Department (as identified in the Family and Social Justice Section data) between 2009 and 2019.
• • 3. Family and Social Justice Section plus Navigator (FSJS+Navigator) arm
• • 1. Recruited during the study period in the CHA ED
• • 2. Ages 18-100
• • 3. Individuals who are brought into the Emergency Department under police supervision (excluding individuals currently incarcerated)
• • involuntarily brought to the Emergency Department for psychiatric evaluation because they are considered to be a risk to themselves or others (MA Law 123(12)); or
• • the subject of a police call for service for a mental health issue who are willingly admitted to the Emergency Department
• • Exclusion Criteria
• • 1. Treatment as Usual (TAU) arm
• • 1. Cambridge Health Alliance patients residing in the City Cambridge are excluded from the TAU arm
• • 2. Under the age of 18
• • 3. Individuals with no identified criminal legal system contact during the study time period (no criminal legal involvement found in the targeted limited chart review method).
• • 4. Any individual incarcerated at the Middlesex Jail/Prison that has not been released by the end of the period of data collection (December 31, 2019).
• • 2. Family and Social Justice Section (FSJS) arm
• • 1. Cambridge Health Alliance patients outside of Cambridge will be excluded from the FSJS arm
• • 2. Under the age of 18
• • 3. Any individual incarcerated at the Middlesex Jail/Prison that has not been released by the end of the period of data collection (December 31, 2019)
• • 3. Family and Social Justice Section plus Navigator (FSJS+Navigator) arm
• • 1. Under the age of 18
• • 2. Any individual who becomes incarcerated during the course of the study
• • 3. Individuals who enter the Emergency Department not under police supervision
• • For example, individuals will be excluded who voluntarily come to the ED seeking psychiatric care because they feel they may be a risk to themselves or others
• • Individuals brought to the ED from a jail or court ordered to the ED as an alternative to jail or prison