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Health Services Use Among Jailed Women with Alcohol Use Disorders

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Abstract

Correctional facilities now house unprecedented numbers of women with complex treatment needs. This investigation applied the Behavioral Model for Vulnerable Populations to study 168 jailed women with alcohol use disorders. It described the sample’s predisposing (age, race, victimization), enabling (health insurance), and need (self-reported medical, substance use, and mental health problems) factors and examined associations of these factors with pre-incarceration services utilization. Most participants had clinically significant levels of depression and PTSD symptoms, most took psychiatric medications, and most had been victimized. Participants reported considerable health services utilization. Younger, Black, and uninsured women utilized fewer medical and mental health services. Drug use was associated with less use of medical services, but more use of alcohol and drug services. High rates of health services use support the need for integrated, ongoing care for substance-using women before, during, and after incarceration.

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Funding

This research was funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA; R01 AA021732; PIs Stein and Johnson) and the Department of Veterans Affairs (VA), Health Services Research and Development Service (RCS 00-001 to Dr. Timko). The trial is registered at clinicaltrials.gov (Clinical Trials #NCT0197093). NIAAA and VA did not participate in the design, collection, analysis, or interpretation of the data, the writing of the manuscript, or the decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Center for Innovation to Implementation, VA Palo Alto Health Care System and Stanford University School of Medicine, 795 Willow Road, Menlo Park, CA, 94025, USA

    Christine Timko PhD

  2. Division of Public Health, College of Human Medicine, Michigan State University, 200 East 1st Street, Flint, MI, 48502, USA

    Jennifer E. Johnson PhD

  3. Behavioral Medicine and Addictions Research, Butler Hospital, 345 Blackstone Boulevard, Providence, RI, 02906, USA

    Megan Kurth MPH, Bradley J. Anderson PhD & Michael D. Stein MD

  4. Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, 222 Richmond St, Providence, RI, 02903, USA

    Yael Chatav Schonbrun PhD

  5. Department of Health Law, Policy, & Management, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA

    Michael D. Stein MD

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  1. Christine Timko PhD
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  2. Jennifer E. Johnson PhD
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  3. Megan Kurth MPH
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  4. Yael Chatav Schonbrun PhD
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  5. Bradley J. Anderson PhD
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  6. Michael D. Stein MD
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Corresponding author

Correspondence to Christine Timko PhD.

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Ethical Approval

All procedures were reviewed and approved by the Institutional Review Board of Butler Hospital.

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The authors declare that they have no conflicts of interest.

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Timko, C., Johnson, J.E., Kurth, M. et al. Health Services Use Among Jailed Women with Alcohol Use Disorders. J Behav Health Serv Res 46, 116–128 (2019). https://doi.org/10.1007/s11414-018-9634-7

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  • DOI: https://doi.org/10.1007/s11414-018-9634-7

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