From Handcuffs to Hallucinations: Prevalence and Psychosocial Correlates of Prior Incarcerations in an Urban Predominantly African American Sample of Hospitalized Patients with First-Episode Psychosis

摘要

High rates of incarceration and criminal justice system recidivism among individuals with serious mental illnesses have long been topics of concern, but few studies have examined rates of prior incarceration at the point of first treatment contact. In a sample of 109 urban, low-income, predominantly African American patients hospitalized for first-episode psychosis, 57.8% reported a history of incarceration. Among those who reported having ever been incarcerated, 58.1% had more than one past incarceration, and the mean number of incarcerations was 2.9±3.4. Patients with a history of incarceration had completed fewer years of education, had poorer premorbid academic functioning, reported an earlier age at initiation of cannabis use, and were more likely to have cannabis and alcohol dependence or abuse. Incarceration was also associated with a greater number of psychosocial problems and more severe positive and general psychopathology symptoms. These findings of excessively high rates of past incarceration among urban, predominantly African American, first-episode psychosis patients—along with the associations between past incarceration and diverse adverse psychosocial and clinical characteristics—serve as a call to action for early psychosis researchers, program developers, policy makers, and clinical and forensic psychiatrists.