Beyond the bridge: evaluating a novel mental health program in the New York City jail system

Am J Public Health. 2014 Nov;104(11):2212-8. doi: 10.2105/AJPH.2014.302126. Epub 2014 Sep 11.

Abstract

Objectives: We evaluated Beyond the Bridge, a novel mental health program in the New York City jail system designed to provide residentially based cognitive behavioral therapy in jail mental observation units.

Methods: We used propensity score matching and a dose-response analysis. Outcome measures included reduction in violent incidents and fights, reduction in uses of force by corrections officers, reduction in time spent on suicide watch and incidents of self-injurious behavior, and increased length of community survival.

Results: There were significant reductions in all outcomes when we compared program participants (n = 218) with an earlier cohort of patients residing on the mental observation unit before programming began (n = 413). However, when we compared program participants with a cohort of other patients residing on the units at the same time but who chose not to participate (n = 267), only time spent on suicide watch unit (rate ratio [RR] = 0.72; 95% confidence interval [CI] = 0.59, 0.89) and recidivism (RR = 0.70; 95% CI = 0.59,0.83) were significantly reduced.

Conclusions: This evaluation and the model we piloted may provide useful information for other settings contemplating similar interventions.

MeSH terms

  • Adult
  • Cognitive Behavioral Therapy / organization & administration
  • Humans
  • Male
  • Mental Disorders / therapy
  • Mental Health Services / organization & administration*
  • Middle Aged
  • New York City
  • Prisoners / psychology
  • Prisons / organization & administration*
  • Program Evaluation
  • Young Adult