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Civil commitment law, mental health services, and US homicide rates

Abstract

Purpose  

The study considers whether involuntary civil comment (ICC) statute provisions are associated with homicide rates. Do statutes
based solely upon dangerousness criteria versus broader ICC-criteria—i.e. “need for treatment,” “protection of health and
safety,” and family protection–have differential associations related to their goal of reducing the frequency of homicide?

Method  

State-level data were obtained from online data bases and key-informant surveys. Ordinary-least-squares and Poisson regression
were used to evaluate the association between statute characteristics, mental health system characteristics, and 2004 Homicide
Rates after controlling for firearm-control-law restrictiveness and social-economic-demographic-geographic-and-political indicators
historically related to homicide rate variation.

Results  

Poisson and OLS models, respectively, were significant: likelihood ratio χ2 = 108.47, df = 10; p < 0.000 and Adj. R
2 = 0.72; df = 10, 25; F = 10.21; p < 0.000. Poisson results indicate that social-economic-demographic-geographic-and-political-indicators had the strongest
association with state homicide rates (p < 0.000). Lower rates were associated with: broader ICC-criteria (p ≤ 0.01), fewer inpatient-bed access problems (p ≤ 0.03), and better mental health system ratings (p ≤ 0.04).
OLS results indicate that social-economic-demographic-geographic-and-political indicators accounted for 25% of homicide rate
variation. Broader ICC-criteria were associated with 1.42 less homicides per 100,000. Less access to psychiatric inpatient-beds
and more poorly rated mental health systems were associated with increases in the homicide rates of 1.08 and 0.26 per 100,000,
respectively.

Conclusions  

While social-economic-demographic-geographic-and-political indicators show the strongest association with homicide rate variation,
the results show the importance and potentially preventive utility of broader ICC criteria, increased psychiatric inpatient-bed
access, and better performing mental health systems as factors contributing to homicide rate variation.

  • Content Type Journal Article
  • Category Original Paper
  • Pages 1-10
  • DOI 10.1007/s00127-011-0450-0
  • Authors
    • Steven P. Segal, Mental Health and Social Welfare Research Group and the Mack Center on Mental Health and Social Conflict, School of Social Welfare, University of California, 120 Haviland Hall (MC# 7400), Berkeley, CA 94720-7400, USA
    • Journal Social Psychiatry and Psychiatric Epidemiology
    • Online ISSN 1433-9285
    • Print ISSN 0933-7954
Posted in: Journal Article Abstracts on 11/14/2011 | Link to this post on IFP |
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