Gun-Related and Other Violent Crime After Involuntary Commitment and Short-Term Emergency Holds

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Figure 1.
Distribution of sample by legal status and outcome events over the study period.
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Figure 2.
Expected and observed occurrence of non–gun-involved and gun-involved violent crime arrests following short-term hold with and without involuntary commitment, and neither status.
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Figure 3.
Kaplan-Meier survival curves for any violent crime by legal status, 1998–2011.
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Figure 4.
Hazard ratios (95% CI) for violent crime arrest by gun involvement and legal status.

Table 1

Sample Characteristics by Legal Status Group

Characteristics	Total Study Population	Legal Status
Characteristics	Total Study Population	No Short-Term Hold or Involuntary Commitment	Short-Term Hold Only	Short-Term Hold With Involuntary Commitment
Age, y
18–43	55,573 (72.1)	29,086 (65.9)	24,145 (80.1)	2,342 (84.3)
44 or older	21,475 (27.9)	15,042 (34.1)	5,997 (19.9)	436 (15.7)
Sex
Female	42,759 (55.5)	27,000 (61.2)	14,671 (48.7)	1,088 (39.2)
Male	34,289 (44.5)	17,128 (38.8)	15,471 (51.3)	1,690 (60.8)
Race/ethnicity
White	32,533 (42.2)	16,124 (36.5)	14,869 (49.3)	1,540 (55.4)
Black	15,879 (20.6)	8,575 (19.4)	6,590 (21.9)	714 (25.7)
Hispanic/Latinx	27,589 (35.8)	18,862 (42.7)	8,236 (27.3)	491 (17.7)
Other race/ethnicity	1,047 (1.4)	567 (1.3)	447 (1.5)	33 (1.2)
Diagnosis
Major depression	39,696 (51.5)	27,408 (62.1)	11,626 (38.6)	662 (23.8)
Schizophrenia spectrum	22,378 (29.0)	9,070 (20.6)	11,859 (39.3)	1,449 (52.2)
Bipolar disorder	14,974 (19.4)	7,650 (17.3)	6,657 (22.1)	667 (24.0)
Substance use disorder
No	66,274 (86.0)	40,512 (91.8)	23,808 (79.0)	1,954 (70.3)
Yes	10,774 (14.0)	3,616 (8.2)	6,334 (21.0)	824 (29.7)
Total	77,048 (100.0)	44,128 (100.0)	30,142 (100.0)	2,778 (100.0)

Table 2

Risk Factors for Violent Crime Arrest, by Gun Involvement in Crime

Predictor	Type of Violent Crime
	Any		Not Gun-Involved		Gun-Involved
	Hazard Ratio	Standard Error (95% CI)	Hazard Ratio	Standard Error (95% CI)	Hazard Ratio	Standard Error (95% CI)
Legal status
None	Reference		Reference		Reference
Short-term hold only	1.84	0.0339 (1.72–1.96)^{^d}	1.86	0.0360 (1.74–2)^{^d}	1.55	0.1000 (1.27–1.88)^{^d}
Involuntary commitment	1.25	0.0746 (1.08–1.45)^{^b}	1.29	0.0777 (1.11–1.5)^{^b}	0.86	0.2590 (0.52–1.43)^{^e}
Primary psychiatric diagnosis
Major depression	Reference		Reference		Reference
Bipolar disorder	1.26	0.0334 (1.18–1.34)^{^d}	1.28	0.0350 (1.2–1.37)^{^d}	0.99	0.1132 (0.79–1.23)^{^e}
Schizophrenia spectrum	1.13	0.0311 (1.07–1.2)^{^d}	1.11	0.0330 (1.04–1.19)^{^c}	1.23	0.0923 (1.03–1.48)^{^a}
Substance use disorder
No	Reference		Reference		Reference
Yes	1.66	0.0304 (1.56–1.76)^{^c}	1.67	0.0319 (1.56–1.77)^{^d}	1.48	0.0968 (1.22–1.78)^{^d}
Age	0.97	0.0011 (0.96–0.97)^{^c}	0.97	0.0012 (0.96–0.97)^{^d}	0.97	0.0034 (0.96–0.98)^{^d}
Sex
Female	Reference		Reference		Reference
Male	1.85	0.0269 (1.76–1.95)^{^d}	1.82	0.0285 (1.72–1.93)^{^d}	2.01	0.0831 (1.71–2.37)^{^d}
Race/ethnicity
White	Reference		Reference		Reference
Black/African American	1.57	0.0305 (1.48–1.66)^{^d}	1.42	0.0324 (1.33–1.51)^{^d}	3.40	0.0993 (2.8–4.13)^{^d}
Hispanic/Latino	0.93	0.0334 (0.87–0.99)^{^e}	0.86	0.0355 (0.8–0.92)^{^d}	1.90	0.1070 (1.54–2.34)^{^d}
Other race/ethnicity	0.93	0.1146 (0.74–1.16)^{^e}	0.93	0.1183 (0.74–1.17)^{^e}	0.88	0.4539 (0.36–2.13)^{^e}

Observations were censored following any gun-disqualifying felony conviction or death. Estimates are based on 709 gun-related arrests and 5,747 non–gun-related arrests among 77,048 individuals over 168 months of observations from 1998 to 2011. Legal status was treated as time-varying, while the values of other displayed covariates were fixed. The models were also controlled for community tenure, a time-varying measure of the proportion of days residing in the community each month (range 0–100%). The hazard ratio for age refers to the change associated with each year of increasing age, measured as a continuous variable. The underlying proportional hazard assumption cannot be rejected with the Kolgomorov-type supremum test.
↵a p < .05.
↵b p < .01.
↵c p < .001.
↵d p < .0001.
↵e Not significant.