Exploring a Mental Health Crisis : An Examination of Mental Health Arrests in Benton County, OR

Benton County, Oregon is presently experiencing a crisis level of police contacts with mentally ill suspects. The cause of this sudden increase is currently unknown and local law enforcement is not adequately equipped or funded to respond to this development. This report summarizes the recent literature on law enforcement encounters with and responses to the chronically and severely mentally ill and relates it to the local context of Benton County. Quantitative analysis of local arrest data was conducted to determine the nature of the population of mentally ill suspects and attempt to identify causes of the recent increase in mental health arrests. While no community-level predictors of mental illness are found significant, a selection of potential alternative explanations are explored, a variety of future research hypotheses are presented, and a series of policy recommendations are made to address the crisis

Examining the Relationship of Substance Use and Sexual Orientation

In this paper we examine the effects of self-reported sexual orientation on substance abuse. Using data on a random sample of 6713 individuals in Washington State, this study examines causes and correlates of substance use by sexual minorities, an at-risk and treatment underserved population. Logistic regression results indicate homosexual orientation is a significant positive predictor of past year marijuana use, past year hard drug use, past year binge drinking, and lifetime alcohol addiction. Bisexual orientation is a significant predictor of past year marijuana use, past year hard drug use, and past year binge drinking. Potential causal mechanisms for these elevated patterns of substance use are discussed

University Researcher and Law Enforcement Collaboration : Lessons From a Study of Justice-Involved Persons With Suspected Mental Illness

In 2012, heads of local law enforcement agencies in Benton County, Oregon, contacted researchers at Oregon State University to discuss a problem: a sharp rise in the amount of contact between police and suspects displaying symptoms of mental illness. This initial contact led to an ongoing collaborative examination of the nature, causes, and consequences of the rise in police contacts. In this article, the authors describe this collaboration between researchers and law enforcement officials from the perspective of both parties, situating it within the context of mental illness in the American criminal justice system. The collaborators draw on firsthand experiences and prior collaborations to discuss the benefits of, challenges in, and recommendations for university-police research collaborations. While such collaborations may pose challenges (related to relationship definition, data collection and analysis, outputs, and relationship maintenance), the potential benefits—for researchers and law enforcement agencies—are substantial.This is an author's peer-reviewed final manuscript, as accepted by the publisher. The published article is copyrighted by The Authors and published by SAGE Publications. It can be found at: https://doi.org/10.1177/0306624X1559939

Making sense of big data in health research: Towards an EU action plan.

Medicine and healthcare are undergoing profound changes. Whole-genome sequencing and high-resolution imaging technologies are key drivers of this rapid and crucial transformation. Technological innovation combined with automation and miniaturization has triggered an explosion in data production that will soon reach exabyte proportions. How are we going to deal with this exponential increase in data production? The potential of "big data" for improving health is enormous but, at the same time, we face a wide range of challenges to overcome urgently. Europe is very proud of its cultural diversity; however, exploitation of the data made available through advances in genomic medicine, imaging, and a wide range of mobile health applications or connected devices is hampered by numerous historical, technical, legal, and political barriers. European health systems and databases are diverse and fragmented. There is a lack of harmonization of data formats, processing, analysis, and data transfer, which leads to incompatibilities and lost opportunities. Legal frameworks for data sharing are evolving. Clinicians, researchers, and citizens need improved methods, tools, and training to generate, analyze, and query data effectively. Addressing these barriers will contribute to creating the European Single Market for health, which will improve health and healthcare for all Europeans

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Collective efficacy and the built environment.

Collective efficacy is a prominent explanation for neighborhood crime concentrations. Just as crime is concentrated in particular neighborhoods, within-neighborhoods crime is concentrated in particular criminogenic locations. Research suggests criminogenic locations are determined by features of the built environment. This study links collective efficacy with situational opportunity to propose that collective efficacy facilitates the removal of criminogenic features of the built environment. I test this by examining associations 1) between past collective efficacy and present criminogenic features of the built environment, as well as 2) between those built environment features and crime, net of present collective efficacy. These are modeled using piecewise structural equations with generalized linear mixed-effect regressions on data from 1,641 blocks in 343 Chicago neighborhoods. Four types of police-reported crime are modeled using eight block-level built environment features in the 2003 Chicago Community Area Health Study (CCAHS; N = 3,074) and neighborhood collective efficacy from the CCAHS and the 1995 Project in Human Development in Chicago Neighborhoods (PHDCN) Community Survey (N = 7,672). Findings suggest neighborhoods with high collective efficacy maintain low rates of crime in part by limiting criminogenic built environment features, in particular, abandoned buildings. This crime control pathway is important because changes to the built environment are long lasting and reduce the need for future interventions against crime

Disorder in the Neighborhood: A Large-Scale Field Experiment on Disorder, Norm Violation, and Pro-Social Behavior

Thesis (Master's)--University of Washington, 2017-09A highly-visible paper, published in Science, using field experiments in a Groningen neighborhood found strong support for the broken windows hypothesis: disorder increases norm violations (Keizer et al. 2008). The study has been replicated in several other European countries. We attempt to replicate this study in the U.S. by embedding a mailbox field experiment in six Seattle neighborhoods that vary in social capital and collective efficacy. Our experiment places a lost letter with a visible $5 bill near the mailbox. The treatment is graffiti and/or trash in the area. We examine three outcomes: passersby ignoring the letter, stealing the letter (a norm violation), or mailing the letter (a form of altruism). We use multinomial and nested logit methods to model the 2,786 cases. Results indicate physical disorder attenuates pro-social behavior while neighborhood collective efficacy and concentrated disadvantage are associated with rates of norm violation. Overall, we fail to replicate Keizer et al. but find evidence that disorder attenuates pro-social behavior

Integrating Collective Efficacy and Criminal Opportunity: Disorder, the Built Environment, and Policing

Thesis (Ph.D.)--University of Washington, 2021This dissertation proposes an integrative theory that links social structural explanations of neighborhood crime to opportunity-based situational explanations for crime. The first chapter of this dissertation argues that the neighborhood-level theories of collective efficacy and broken windows may be unified into a multilevel theory of situations using Cohen and Felson’s (1979) routine activities theory and a pragmatist model of roles and perception. I discuss empirical implications of this integrated theory. The second chapter proposes that collective efficacy inhibits crime in part by permitting neighborhoods to remove and prevent built environment features that generate criminal opportunities. I find evidence collective efficacy is negatively related to the presence of abandoned buildings and mixed land use which, in turn, promote crime. The third chapter interrogates the role of police efficacy---resident perceptions of police effectiveness and legitimacy---in collective efficacy theory. In contrary to established research in this area, I find evidence that collective efficacy causally precedes police efficacy. In the conclusion I discuss implications for future research and advocate for situating collective efficacy in a multi-level crime, opportunity, and political economy framework

Broken Windows, Informal Social Control, and Crime: Assessing Causality in Empirical Studies.

An important criminological controversy concerns the proper causal relationships between disorder, informal social control, and crime. The broken windows thesis posits that neighborhood disorder increases crime directly and indirectly by undermining neighborhood informal social control. Theories of collective efficacy argue that the association between neighborhood disorder and crime is spurious because of the confounding variable informal social control. We review the recent empirical research on this question, which uses disparate methods, including field experiments and different models for observational data. To evaluate the causal claims made in these studies, we use a potential outcomes framework of causality. We conclude that, although there is some evidence for both broken windows and informal control theories, there is little consensus in the present research literature. Furthermore, at present, most studies do not establish causality in a strong way

Inequalities in Exposure to Firearm Violence by Race, Sex, and Birth Cohort From Childhood to Age 40 Years, 1995-2021.

IMPORTANCE: The past quarter-century has seen both sharp declines and increases in firearm violence in the United States. Yet, little is known about the age of first exposure to firearm violence and how it may differ by race, sex, and cohort. OBJECTIVE: To examine race, sex, and cohort differences in exposure to firearm violence in a representative longitudinal study of children who grew up in periods with varying rates of firearm violence in the United States and to examine spatial proximity to firearm violence in adulthood. DESIGN, SETTING, AND PARTICIPANTS: This population-based representative cohort study included multiple cohorts of children followed-up from 1995 through 2021 in the Project on Human Development in Chicago Neighborhoods (PHDCN). Participants included Black, Hispanic, and White respondents from 4 age cohorts of Chicago, Illinois, residents, with modal birth years of 1981, 1984, 1987, and 1996. Data analyses were conducted from May 2022 to March 2023. MAIN OUTCOMES AND MEASURES: Firearm violence exposure, including age when first shot, age when first saw someone shot, and past-year frequency of fatal and nonfatal shootings within 250 m of residence. RESULTS: There were 2418 participants in wave 1 (in the mid-1990s), and they were evenly split by sex, with 1209 males (50.00%) and 1209 females (50.00%). There were 890 Black respondents, 1146 Hispanic respondents, and 382 White respondents. Male respondents were much more likely than female respondents to have been shot (adjusted hazard ratio [aHR], 4.23; 95% CI, 2.28-7.84), but only moderately more likely to have seen someone shot (aHR, 1.48; 95% CI, 1.27-1.72). Compared with White individuals, Black individuals experienced higher rates of all 3 forms of exposure (been shot: aHR, 3.05; 95% CI, 1.22-7.60; seen someone shot: aHR, 4.69; 95% CI, 3.41-6.46; nearby shootings: adjusted incidence rate ratio [aIRR], 12.40; 95% CI, 6.88-22.35), and Hispanic respondents experienced higher rates of 2 forms of violence exposure (seen someone shot: aHR, 2.59; 95% CI, 1.85-3.62; nearby shootings: aIRR, 3.77; 95% CI, 2.08-6.84). Respondents born in the mid-1990s who grew up amidst large declines in homicide but reached adulthood during city and national spikes in firearm violence in 2016 were less likely to have seen someone shot than those born in the early 1980s who grew up during the peak of homicide in the early 1990s (aHR, 0.49; 95% CI, 0.35-0.69). However, the likelihood of having been shot did not significantly differ between these cohorts (aHR, 0.81; 95% CI, 0.40-1.63). CONCLUSIONS AND RELEVANCE: In this longitudinal multicohort study of exposure to firearm violence, there were stark differences by race and sex, yet the extent of exposure to violence was not simply the product of these characteristics. These findings on cohort differences suggest changing societal conditions were key factors associated with whether and at what life stage individuals from all race and sex groups were exposed to firearm violence