Abstract Background Mental disorders are highly prevalent among offenders. In Amsterdam, the Psychiatric Emergency Service and the Public Prosecutor’s Office jointly implemented a post-booking diversion program to improve clinical outcomes and reduce recidivism among people suspected of an offence and referred for psychiatric assessment. Aim To identify demographic, clinical and legal factors associated with rearrest among participants in a post-booking diversion program. Methods In this prospective observational study, 292 participants were followed for one year. Using routinely collected demographic, psychiatric, and judicial data, we applied a two-step negative binomial regression analysis to examine associations between demographic, clinical, and legal variables and the number of rearrests. First, bivariate associations between potential predictors and the number of rearrests were examined. Second, a comprehensive multivariate model was fitted including all significant predictors from step 1. Results During follow-up, 42% of participants were rearrested. Participants with substance use disorders initially showed a higher rate of rearrest (Incidence Rate Ratio (IRR) = 1.92, 95% Confidence Interval (CI) 1.17–3.15, p = .01), but diagnostic category was no longer associated with rearrest after adjustment for covariates. Independent predictors of rearrest included receiving a subpoena or arraignment (IRR = 2.70, 95% CI 1.48–4.93, p = .001), homelessness (IRR = 2.41, 95% CI 1.32–4.37, p = .004), welfare dependence (IRR = 1.54, 95% CI 1.01–2.36, p = .045), and prior-year arrests (IRR = 1.16, 95% CI 1.07–1.27, p < .001). Conclusions In this post-booking diversion program, social and legal vulnerabilities—rather than psychiatric diagnosis—were associated with rearrests. Addressing homelessness, economic instability, and prior justice involvement may be more effective in reducing recidivism than interventions focusing solely on mental health treatment. Broader diversion strategies integrating social support and housing in itiatives are warranted.
Zoeteman et al. (Wed,) studied this question.