Spotlight on Research at COPH – Across the United States, two million persons with serious mental illnesses are booked into jails each year. According to the National Center on Addiction and Substance Abuse at Columbia University, about 40% of state prison and local jail inmates have substance use disorders, and 25% have substance use disorders with mental illness. There is a substantial overlap between the behavioral health and criminal justice systems. Dr. Shinobu Watanabe-Galloway and her research team worked with the Behavioral Health Division of the Nebraska Department of Health and Human Services and county jail and state corrections systems to conduct a study to examine the characteristics of individuals with mental illness who have had criminal justice encounters, and the patterns of those encounters. The study found that half of adults who receive Nebraska’s behavioral health services in a community setting had been to jail at least once in five years. Substance abuse alone and in combination with mental illness appears to increase the risk for a criminal justice encounter. The study also found that about 70% of people in substance abuse treatment had been to jail or prison at least once in five years.
Mental illness and substance-related disorders are also over-represented in the homeless population. In 2011, at least 7,013 people experienced homelessness in Douglas, Sarpy, and Pottawattamie Counties. Our community trails the national rates of reductions in the homeless population in all respects except for homeless people who have mental illness and other disabling conditions. Scarce resources are a reality in our community’s future. The US Department of Housing and Urban Development and the US Department of Health and Human Services are increasingly pushing for human services systems to understand client/patient use patterns in order to achieve systemic outcomes. In the case of homelessness, the Homeless Emergency and Rapid Transition to Housing Act of 2009 set forth system performance expectations that motivate communities to understand the return-on-investment of federal dollars. Dr. Watanabe-Galloway has been partnering with the Metro Area Continuum of Care for the Homeless to plan and conduct a study to investigate health care utilization patterns among chronically homeless adults and the impact of housing support services. The study was funded through the UNMC College of Public Health’s Mutual Fund Program and is expected to be completed in the spring of 2013.
Shinobu Watanabe-Galloway, PhD, is an associate professor in the UNMC COPH Department of Epidemiology.