Identifying Individuals With Early Psychosis in Jail: Lessons Learned for Coordinated Specialty Care Services

• Published in: Psychiatric services (Washington, D.C.) Vol. 75; no. 5; p. 470
• Main Authors: Compton, Michael T, Tan de Bibiana, Jason, Pope, Leah G
• Format: Journal Article
• Language: English
• Published: United States 01.05.2024
• Subjects: Adult; Early Diagnosis; Feasibility Studies; Female; Humans; Jails; Male; Mental Health Services - organization & administration; Prisoners - psychology; Psychotic Disorders - diagnosis; Psychotic Disorders - therapy; Referral and Consultation; Young Adult; Schizophrenia; Early intervention; Early psychosis; Coordinated specialty care; Criminal legal system; Criminal justice
• ISSN: 1557-9700
• DOI: 10.1176/appi.ps.20230125

This study sought to establish the feasibility of a two-component intervention embedded within a jail setting that would detect detainees with early psychosis and connect them to coordinated specialty care (CSC) in the community upon release. The two components of the intervention were a targeted educational campaign for correction officers and a specialized early engagement support service to facilitate jail discharge planning. Jail detainees with early psychosis were referred to the project and assessed for positive and negative symptoms, substance use, and duration of untreated psychosis (DUP). During a 24-month period, 25 individuals were referred, of whom eight were eligible and interviewed. The sociodemographic and clinical characteristics of the jail detainees were similar to those of individuals in hospital settings. The median DUP was 36 weeks. One of the eight detainees with early psychosis was successfully referred to CSC; for the other detainees, social or criminal legal factors precluded referral. A targeted educational campaign for correction officers and a specialized early engagement support service can be implemented in a jail setting, and referrals can be facilitated. Success of the campaign may depend on having dedicated liaisons within the jail setting (e.g., among correctional health staff) as well as liaisons in local CSC programs and leadership. Changes in the law and policy environments (e.g., criminal legal system reform) and changes in organizational practices and processes for corrections, correctional health, and local CSC programs (such as those made during the COVID-19 pandemic) require ongoing collaborations.