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Comorbid Medical, Psychiatric, and Substance-Use Disorders in Veterans With Legal Involvement

Rather than disease-specific care, integrated care is needed for older veterans involved in the criminal legal system (CLS) because of a high risk of co-occurring mental illness, substance use disorders (SUDs), and medical multimorbidity, a study shows.

Using health records from the Veterans Health Administration facilities in 2019, researchers identified 4.7 million veterans aged 50 and older receiving care. Prevalence of mental illness, SUDs, medical multimorbidity, and the co-occurrence of these conditions was estimated among veterans with CLS involvement as indicated by Veterans Justice Programs encounters.

The results showed: “An estimated 0.5% (n = 24,973) of veterans aged 50 and older had CLS involvement. For individual conditions, veterans with CLS involvement had a lower prevalence of medical multimorbidity compared with veterans without but had a higher prevalence of all mental illnesses and SUDs. After adjusting for demographic factors, CLS involvement remained associated with concurrent mental illness and SUD (adjusted odds ratio [aOR] 5.52, 95% CI = 5.35–5.69), SUD and medical multimorbidity (aOR = 2.09, 95% CI = 2.04–2.15), mental illness and medical multimorbidity (aOR = 1.04, 95% CI = 1.01–1.06), and having all 3 simultaneously (aOR = 2.42, 95% CI = 2.35–2.49).”

Source: Medical Care