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Psychiatric hospital admission and later crime, mental health, and labor market outcomes.

ABSTRACT: Most OECD countries have downsized treatment capacity at psychiatric hospitals substantially. We investigate consequences of these reductions by studying how the decision whether to admit individuals in mental distress to a psychiatric hospital affects their subsequent crime, treatment trajectories, and labor market outcomes. To circumvent nonrandom selection into admission, we use a proxy of occupancy rates prior to a patient's first contact with a psychiatric hospital as an instrument. We find that admissions reduce criminal behavior, likely due to incapacitation, and predominantly for males and those with a criminal record. Furthermore, admission lowers patients' subsequent labor market attachment, likely because a psychiatric hospital admission is an eligibility criterion for welfare benefits.

SUBMITTER: Landerso R

PROVIDER: S-EPMC7756892 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Psychiatric hospital admission and later crime, mental health, and labor market outcomes.

Landersø Rasmus R Fallesen Peter P

Health economics 20201102 1

Most OECD countries have downsized treatment capacity at psychiatric hospitals substantially. We investigate consequences of these reductions by studying how the decision whether to admit individuals in mental distress to a psychiatric hospital affects their subsequent crime, treatment trajectories, and labor market outcomes. To circumvent nonrandom selection into admission, we use a proxy of occupancy rates prior to a patient's first contact with a psychiatric hospital as an instrument. We find ...[more]

PMID: 33140489

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Project description:ObjectiveTo identify factors associated with: admission to a specialist mother and baby unit (MBU) and the impact of perinatal mental illness on early childhood development using a data linkage approach in the 2 years prechildbirth and postchildbirth.MethodsScottish maternity records (SMR02) were linked to psychiatric hospital admissions (SMR04). 3290 pregnancy-related psychiatric admissions for 1730 women were assessed. To investigate factors associated with MBU admission, the group of mothers admitted to an MBU were compared with those admitted to general psychiatric wards. To assess the impact of perinatal mental illness on early child development, a pragmatic indicator for 'at potential risk of adversity', defined as a child who was recorded as requiring intensive treatment at any time under the health plan indicators (HPI) and/or who had no record of completing three doses of the 5-in-1 vaccine by 12 months was generated. Logistic regression models were used to describe the association between each variable and the risk of admission between those with a history of prior psychiatric admission and those without.ResultsWomen admitted to an MBU were significantly more likely to be admitted with non-affective psychosis (OR=1.97, 95% CI 1.22 to 3.18), affective psychosis (OR=2.44, 95% CI 1.37 to 4.33) and non-psychotic depressive episodes (OR=1.93, 95% CI 1.42 to 2.63). They were less likely to come from deprived areas (OR=0.68 95% CI 0.49 to 0.93). Women with a previous history of psychiatric admission were significantly more likely to be located in the two most deprived quintiles. Almost one-third (29%) of children born to mothers with a pregnancy-related psychiatric admission were assessed as 'at potential risk of adversity.'ConclusionsA health informatics approach has potential for improving understanding of social and clinical factors, which contribute to the outcomes of perinatal mental illness, as well as potential adverse developmental outcomes for offspring.

Dataset Information

Psychiatric hospital admission and later crime, mental health, and labor market outcomes.

Publications

Psychiatric hospital admission and later crime, mental health, and labor market outcomes.

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