Criminal Justice System Contact & Mortality among Offenders with Mental Illness in British Columbia
with mental illness are over-represented in prison populations around the
world. They are more vulnerable to arrest and more likely to experience
repeated encounters with the criminal justice system. Whether criminal justice
involvement, in and of itself, is associated with higher mortality,
particularly among offenders with mental illness, is unknown.
authors conducted a mediation analysis of mortality rates in a cohort of 79,088
offenders from British Columbia using administrative records spanning
2001-2010, where the mediating variable was the individual-level rate of
339,506 person-years of follow-up, there were 1841 deaths. The diagnosis of
mental illness had no direct association with higher mortality after adjustment
for confounders (HR=0.98, 95% CI 0.86 to 1.06). However, mental illness had an
indirect association with mortality that was mediated through more frequent
criminal justice involvement (HR=1.02, 95% CI 1.01 to 1.04).
findings support the hypothesis that offenders with mental illness experience
higher mortality that is mediated by higher rates of criminal justice contact.
The results of our study indicate that criminal justice diversion programmes
are further warranted because they may contribute to the prevention of
mortality among offenders with mental illness.