Kelsey A Simpson1, Hrant Gevorgian2, Alex H Kral3, Lynn Wenger3, Philippe Bourgois4, Ricky N Bluthenthal5. 1. Department of Preventive Medicine, University of Southern California Keck School of Medicine, 2001 N Soto Street, Los Angeles, CA, 90089, USA. Electronic address: kasimpso@usc.edu. 2. Rutgers Health Community Medical Center, 99 Route 37 West, Toms River, NJ, 08755, USA. 3. Community Health Research Division, RTI International, 2150 Shattuck Avenue, Suite 800, Berkeley, CA, 94704, USA. 4. Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA. 5. Department of Preventive Medicine, University of Southern California Keck School of Medicine, 2001 N Soto Street, Los Angeles, CA, 90089, USA.
Abstract
California's Welfare and Institutions code 5150 allows for a temporary psychiatric hold (TPH) of individuals who present a danger to themselves or others and/or may be gravely disabled due to mental illness. Little is known about the frequency and predictors of involuntary holds among people who inject drugs (PWID). METHODS: We sought to identify the prevalence and predictors of recent TPHs (within the past 12 months) among a community-recruited sample of PWID in Los Angeles and San Francisco, California during 2017-2018 (N = 531). Multivariable logistic regression modeling was used to evaluate demographic (e.g., age), economic (e.g., homelessness), drug use (e.g., types of drugs used), incarceration (e.g., recent arrest history) and mental health (e.g., lifetime mental health diagnosis) variables associated with recent TPH. RESULTS: Age (40-49 years old vs age 50 or older: AOR = 5.85; 95 % CI = 2.18, 15.67), current homelessness (AOR = 3.75; 95 % CI = 1.28, 11.0), lifetime mental health history (AOR = 6.23; 95 % CI = 2.08, 18.66), and frequency of methamphetamine use (AOR = 1.01; 95 % CI = 1.00, 1.01) were statistically associated with increased odds of having experienced a TPH, while frequency of past month heroin/opioid use was associated with decreased odds of reporting a TPH (AOR = 0.99; 95 % CI = 0.99, 1.00) in multivariable analysis. CONCLUSIONS: Diverse factors were associated with TPH among PWID. Our analysis underscores the need for research on PWID with co-occurring substance-use and mental illness disorders and homelessness. There is urgent need for expanding access to lower barrier publicly funded mental health treatment from a harm-reduction approach.
California's Welfare and Institutions code 5150 allows for a temporary psychiatric hold (TPH) of individuals who present a danger to themselves or others and/or may be gravely disabled due to mental illness. Little is known about the frequency and predictors of involuntary holds among people who inject drugs (PWID). METHODS: We sought to identify the prevalence and predictors of recent TPHs (within the past 12 months) among a community-recruited sample of PWID in Los Angeles and San Francisco, California during 2017-2018 (N = 531). Multivariable logistic regression modeling was used to evaluate demographic (e.g., age), economic (e.g., homelessness), drug use (e.g., types of drugs used), incarceration (e.g., recent arrest history) and mental health (e.g., lifetime mental health diagnosis) variables associated with recent TPH. RESULTS: Age (40-49 years old vs age 50 or older: AOR = 5.85; 95 % CI = 2.18, 15.67), current homelessness (AOR = 3.75; 95 % CI = 1.28, 11.0), lifetime mental health history (AOR = 6.23; 95 % CI = 2.08, 18.66), and frequency of methamphetamine use (AOR = 1.01; 95 % CI = 1.00, 1.01) were statistically associated with increased odds of having experienced a TPH, while frequency of past month heroin/opioid use was associated with decreased odds of reporting a TPH (AOR = 0.99; 95 % CI = 0.99, 1.00) in multivariable analysis. CONCLUSIONS: Diverse factors were associated with TPH among PWID. Our analysis underscores the need for research on PWID with co-occurring substance-use and mental illness disorders and homelessness. There is urgent need for expanding access to lower barrier publicly funded mental health treatment from a harm-reduction approach.
Authors: Charles P O'Brien; Dennis S Charney; Lydia Lewis; James W Cornish; Robert M Post; George E Woody; Jon-Kar Zubieta; James C Anthony; Jack D Blaine; Charles L Bowden; Joseph R Calabrese; Kathleen Carroll; Thomas Kosten; Bruce Rounsaville; Anna Rose Childress; David W Oslin; Helen M Pettinati; Mark A Davis; Robert Demartino; Robert E Drake; Michael F Fleming; Larry Fricks; Alexander H Glassman; Frances R Levin; Edward V Nunes; Robert L Johnson; Clarence Jordan; Ronald C Kessler; Sally K Laden; Darrel A Regier; John A Renner; Richard K Ries; Thomas Sklar-Blake; Constance Weisner Journal: Biol Psychiatry Date: 2004-11-15 Impact factor: 13.382
Authors: Stephanie R Dyal; Alex H Kral; Karina Dominguez Gonzalez; Lynn D Wenger; Ricky N Bluthenthal Journal: Am J Drug Alcohol Abuse Date: 2015-05-13 Impact factor: 3.829
Authors: C Strike; M Rotondi; G Kolla; É Roy; N K Rotondi; K Rudzinski; R Balian; T Guimond; R Penn; R B Silver; M Millson; K Sirois; J Altenberg; N Hunt Journal: Drug Alcohol Depend Date: 2014-01-18 Impact factor: 4.492
Authors: Alex H Kral; Mohsen Malekinejad; Jason Vaudrey; Alexis N Martinez; Jennifer Lorvick; Willi McFarland; H Fisher Raymond Journal: J Urban Health Date: 2010-09 Impact factor: 3.671