Dissertations & Theses (Open Access)

Date of Award

8-2020

Degree Name

Master of Public Health (MPH)

Advisor(s)

Marlyn A. Allicock

Second Advisor

Folefac Atem

Third Advisor

Jennifer Gonzalez

Abstract

Adverse mental health conditions among incarcerated populations are high, and treatment for these conditions is particularly low. Additionally, there is a culture of stigma in the United States towards those with mental health conditions and violent criminal history, contributing to mass incarceration. The present cross-sectional study sought to assess the association between violent criminal history and mental health symptoms among recently incarcerated homeless adults in Dallas, Texas. This study included 230 participants, taking place at The Bridge Homeless Recovery Center, evaluating non-violent versus violent criminal history. Outcome measures of positive screens for post-traumatic stress disorder, generalized anxiety disorder, and depression utilized the Primary-Care Post-Traumatic Stress Disorder (PC-PTSD-4) tool, Generalized Anxiety Disorder-7 (GAD-7) tool, and Patient Health Questionnaire-8 (PHQ-8, respectively. Information was also gathered regarding age, gender, race/ethnicity, educational attainment, duration of homelessness, illicit drug use, and social connectedness via Lubben Social Network scale. Multivariable unadjusted and adjusted logistic regression models were fit to identify factors associated with the outcomes of post-traumatic stress disorder and generalized anxiety disorder. Additionally, multinomial unadjusted and adjusted logistic regression models were used to identify relative risk ratios for the relationship between depression and violent criminal history. There was no evidence of a statistically significant direct relationship between violent criminal history and positive mental health screenings. Non-Hispanic, Black participants had lower rates of positive mental health screenings for post-traumatic stress disorder and generalized anxiety disorder compared to non-Hispanic, White participants. Additionally, increased severity of depression for non-Hispanic, Black participants was less likely than in non-Hispanic, White participants. Results showed the longer an individual was homeless (two years or greater), they were less likely to be screened positive for all mental health screenings as compared with individuals with shorter duration of homelessness less than two years). Overall, there was found to be a strong relationship between illicit drug use 90 days prior to entering the study and positive mental health screenings for post-traumatic stress disorder, generalized anxiety disorder, and depression. This study found limited evidence of a relationship between violent criminal history and positive mental health disorders. This research represents an important step toward developing informative treatment plans such as increased mental health treatment and increased collaborative care to further prevent adverse mental health conditions among homeless and recently incarcerated

Download

Share

COinS