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Psychiatr Serv. 2010 Jan;61(1):45-9. doi: 10.1176/

General medical problems of incarcerated persons with severe and persistent mental illness: a population-based study.

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Cecil G. Sheps Center for HealthServices Research, Chapel Hill, North Carolina, USA.



Persons with severe mental illness have higher rates of chronic general medical illness compared with the general population. Similarly, compared with the general population, incarcerated persons have higher rates of chronic medical illness; however, there is little information about the synergy between severe mental illness and incarceration and the general medical problems of consumers. To address this gap in the literature this study addressed the following question: are consumers with a history of incarceration at greater risk of general medical problems compared with consumers without such a history?


Administrative data were used to compare the medical problems of 3,690 persons with severe mental illness with a history of incarceration and 2,042 persons with severe mental illness with no such history.


Consumers with a history of incarceration were more likely than those with no such history to have infectious, blood, and skin diseases and a history of injury. Furthermore, when analyses controlled for gender, race, age, and substance use disorders, consumers with an incarceration history were 40% more likely to have any general medical problem and 30% more likely to have multiple medical problems.


The findings presented here call for better communication among local public health and mental health providers and jails and better integration of primary care and behavioral health care among community mental health providers. Also, research should be accelerated on evidence-based interventions designed to divert persons with severe mental illness from the criminal justice system and facilitate community reentry for persons with severe mental illness who are released from jails and prisons.

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