Mental and substance use disorders among legal intervention injury cases in California, 2005–2014

Kriszta Farkas, Ellicott C. Matthay, Kara Rudolph, Dana E. Goin, Jennifer Ahern

Research output: Contribution to journalArticle

Abstract

Police use of force is an important public health issue in the US. Recent high-profile incidents suggest a potential link between mental disorders and police use of force, however little research has examined their co-occurrence in the general population. We aimed to assess the overall association between specific mental and substance use disorders (MSUDs) and nonfatal legal intervention injury. We identified nonfatal legal intervention injury cases (n = 90,099) and MSUD diagnoses from all hospital and emergency department (ED) records in California between 2005 and 2014. Age-, sex-, and race-standardized MSUD prevalence estimates among legal intervention injury cases, stratified by inpatient status, were compared to general US population-based estimates from the National Comorbidity Survey Replication. Compared to the general US population, nonaffective psychoses, mood disorders, alcohol use disorders, and drug use disorders were substantially overrepresented among inpatient legal intervention injuries (prevalence difference [PD]: 19.2%, (95% confidence interval [CI]: 18.0, 20.4); PD: 15.3%, (95% CI: 13.9, 16.7); PD: 21.1%, (95% CI: 19.8, 22.4); PD: 29.7%, (95% CI: 28.4, 31.0), respectively). Associations for all except mood disorders were similar but attenuated among ED injury cases. In contrast, anxiety disorders were underrepresented in both inpatient and ED injury cases. Results for mood disorders and suicidal ideation were mixed. In summary, MSUDs characterized by more overt behavioral symptoms were substantially overrepresented among legal intervention injury cases. Findings support the potential importance of interventions to improve treatment and law enforcement recognition of such disorders. Additional research should disentangle the complex relationship between MSUDs and legal intervention injury.

Original languageEnglish (US)
Pages (from-to)136-140
Number of pages5
JournalPreventive Medicine
Volume121
DOIs
StatePublished - Apr 1 2019

Fingerprint

Substance-Related Disorders
Wounds and Injuries
Mood Disorders
Confidence Intervals
Hospital Emergency Service
Inpatients
Police
Population
Law Enforcement
Behavioral Symptoms
Suicidal Ideation
Hospital Departments
Anxiety Disorders
Research
Mental Disorders
Psychotic Disorders
Comorbidity
Public Health
Alcohols

Keywords

  • Legal intervention injury
  • Mental disorders
  • Police use of force
  • Substance use disorder

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

Cite this

Mental and substance use disorders among legal intervention injury cases in California, 2005–2014. / Farkas, Kriszta; Matthay, Ellicott C.; Rudolph, Kara; Goin, Dana E.; Ahern, Jennifer.

In: Preventive Medicine, Vol. 121, 01.04.2019, p. 136-140.

Research output: Contribution to journalArticle

Farkas, Kriszta ; Matthay, Ellicott C. ; Rudolph, Kara ; Goin, Dana E. ; Ahern, Jennifer. / Mental and substance use disorders among legal intervention injury cases in California, 2005–2014. In: Preventive Medicine. 2019 ; Vol. 121. pp. 136-140.
@article{1f0437e1fb6f45129b8f3102e1ef1fdd,
title = "Mental and substance use disorders among legal intervention injury cases in California, 2005–2014",
abstract = "Police use of force is an important public health issue in the US. Recent high-profile incidents suggest a potential link between mental disorders and police use of force, however little research has examined their co-occurrence in the general population. We aimed to assess the overall association between specific mental and substance use disorders (MSUDs) and nonfatal legal intervention injury. We identified nonfatal legal intervention injury cases (n = 90,099) and MSUD diagnoses from all hospital and emergency department (ED) records in California between 2005 and 2014. Age-, sex-, and race-standardized MSUD prevalence estimates among legal intervention injury cases, stratified by inpatient status, were compared to general US population-based estimates from the National Comorbidity Survey Replication. Compared to the general US population, nonaffective psychoses, mood disorders, alcohol use disorders, and drug use disorders were substantially overrepresented among inpatient legal intervention injuries (prevalence difference [PD]: 19.2{\%}, (95{\%} confidence interval [CI]: 18.0, 20.4); PD: 15.3{\%}, (95{\%} CI: 13.9, 16.7); PD: 21.1{\%}, (95{\%} CI: 19.8, 22.4); PD: 29.7{\%}, (95{\%} CI: 28.4, 31.0), respectively). Associations for all except mood disorders were similar but attenuated among ED injury cases. In contrast, anxiety disorders were underrepresented in both inpatient and ED injury cases. Results for mood disorders and suicidal ideation were mixed. In summary, MSUDs characterized by more overt behavioral symptoms were substantially overrepresented among legal intervention injury cases. Findings support the potential importance of interventions to improve treatment and law enforcement recognition of such disorders. Additional research should disentangle the complex relationship between MSUDs and legal intervention injury.",
keywords = "Legal intervention injury, Mental disorders, Police use of force, Substance use disorder",
author = "Kriszta Farkas and Matthay, {Ellicott C.} and Kara Rudolph and Goin, {Dana E.} and Jennifer Ahern",
year = "2019",
month = "4",
day = "1",
doi = "10.1016/j.ypmed.2019.01.003",
language = "English (US)",
volume = "121",
pages = "136--140",
journal = "Preventive Medicine",
issn = "0091-7435",
publisher = "Academic Press Inc.",

}

TY - JOUR

T1 - Mental and substance use disorders among legal intervention injury cases in California, 2005–2014

AU - Farkas, Kriszta

AU - Matthay, Ellicott C.

AU - Rudolph, Kara

AU - Goin, Dana E.

AU - Ahern, Jennifer

PY - 2019/4/1

Y1 - 2019/4/1

N2 - Police use of force is an important public health issue in the US. Recent high-profile incidents suggest a potential link between mental disorders and police use of force, however little research has examined their co-occurrence in the general population. We aimed to assess the overall association between specific mental and substance use disorders (MSUDs) and nonfatal legal intervention injury. We identified nonfatal legal intervention injury cases (n = 90,099) and MSUD diagnoses from all hospital and emergency department (ED) records in California between 2005 and 2014. Age-, sex-, and race-standardized MSUD prevalence estimates among legal intervention injury cases, stratified by inpatient status, were compared to general US population-based estimates from the National Comorbidity Survey Replication. Compared to the general US population, nonaffective psychoses, mood disorders, alcohol use disorders, and drug use disorders were substantially overrepresented among inpatient legal intervention injuries (prevalence difference [PD]: 19.2%, (95% confidence interval [CI]: 18.0, 20.4); PD: 15.3%, (95% CI: 13.9, 16.7); PD: 21.1%, (95% CI: 19.8, 22.4); PD: 29.7%, (95% CI: 28.4, 31.0), respectively). Associations for all except mood disorders were similar but attenuated among ED injury cases. In contrast, anxiety disorders were underrepresented in both inpatient and ED injury cases. Results for mood disorders and suicidal ideation were mixed. In summary, MSUDs characterized by more overt behavioral symptoms were substantially overrepresented among legal intervention injury cases. Findings support the potential importance of interventions to improve treatment and law enforcement recognition of such disorders. Additional research should disentangle the complex relationship between MSUDs and legal intervention injury.

AB - Police use of force is an important public health issue in the US. Recent high-profile incidents suggest a potential link between mental disorders and police use of force, however little research has examined their co-occurrence in the general population. We aimed to assess the overall association between specific mental and substance use disorders (MSUDs) and nonfatal legal intervention injury. We identified nonfatal legal intervention injury cases (n = 90,099) and MSUD diagnoses from all hospital and emergency department (ED) records in California between 2005 and 2014. Age-, sex-, and race-standardized MSUD prevalence estimates among legal intervention injury cases, stratified by inpatient status, were compared to general US population-based estimates from the National Comorbidity Survey Replication. Compared to the general US population, nonaffective psychoses, mood disorders, alcohol use disorders, and drug use disorders were substantially overrepresented among inpatient legal intervention injuries (prevalence difference [PD]: 19.2%, (95% confidence interval [CI]: 18.0, 20.4); PD: 15.3%, (95% CI: 13.9, 16.7); PD: 21.1%, (95% CI: 19.8, 22.4); PD: 29.7%, (95% CI: 28.4, 31.0), respectively). Associations for all except mood disorders were similar but attenuated among ED injury cases. In contrast, anxiety disorders were underrepresented in both inpatient and ED injury cases. Results for mood disorders and suicidal ideation were mixed. In summary, MSUDs characterized by more overt behavioral symptoms were substantially overrepresented among legal intervention injury cases. Findings support the potential importance of interventions to improve treatment and law enforcement recognition of such disorders. Additional research should disentangle the complex relationship between MSUDs and legal intervention injury.

KW - Legal intervention injury

KW - Mental disorders

KW - Police use of force

KW - Substance use disorder

UR - http://www.scopus.com/inward/record.url?scp=85061784983&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061784983&partnerID=8YFLogxK

U2 - 10.1016/j.ypmed.2019.01.003

DO - 10.1016/j.ypmed.2019.01.003

M3 - Article

C2 - 30759367

AN - SCOPUS:85061784983

VL - 121

SP - 136

EP - 140

JO - Preventive Medicine

JF - Preventive Medicine

SN - 0091-7435

ER -