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Karystianis G, Simpson P, Lukmanjaya W, Ginnivan N, Nenadic G, Buchan I, Butler T. Automatic Extraction of Research Themes in Epidemiological Criminology From PubMed Abstracts From 1946 to 2020: Text Mining Study. JMIR Form Res 2023; 7:e49721. [PMID: 37738080 PMCID: PMC10559193 DOI: 10.2196/49721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/21/2023] [Accepted: 08/21/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND The emerging field of epidemiological criminology studies the intersection between public health and justice systems. To increase the value of and reduce waste in research activities in this area, it is important to perform transparent research priority setting considering the needs of research beneficiaries and end users along with a systematic assessment of the existing research activities to address gaps and harness opportunities. OBJECTIVE In this study, we aimed to examine published research outputs in epidemiological criminology to assess gaps between published outputs and current research priorities identified by prison stakeholders. METHODS A rule-based method was applied to 23,904 PubMed epidemiological criminology abstracts to extract the study determinants and outcomes (ie, "themes"). These were mapped against the research priorities identified by Australian prison stakeholders to assess the differences from research outputs. The income level of the affiliation country of the first authors was also identified to compare the ranking of research priorities in countries categorized by income levels. RESULTS On an evaluation set of 100 abstracts, the identification of themes returned an F1-score of 90%, indicating reliable performance. More than 53.3% (11,927/22,361) of the articles had at least 1 extracted theme; the most common was substance use (1533/11,814, 12.97%), followed by HIV (1493/11,814, 12.64%). The infectious disease category (2949/11,814, 24.96%) was the most common research priority category, followed by mental health (2840/11,814, 24.04%) and alcohol and other drug use (2433/11,814, 20.59%). A comparison between the extracted themes and the stakeholder priorities showed an alignment for mental health, infectious diseases, and alcohol and other drug use. Although behavior- and juvenile-related themes were common, they did not feature as prison priorities. Most studies were conducted in high-income countries (10,083/11,814, 85.35%), while countries with the lowest income status focused half of their research on infectious diseases (47/91, 52%). CONCLUSIONS The identification of research themes from PubMed epidemiological criminology research abstracts is possible through the application of a rule-based text mining method. The frequency of the investigated themes may reflect historical developments concerning disease prevalence, treatment advances, and the social understanding of illness and incarcerated populations. The differences between income status groups are likely to be explained by local health priorities and immediate health risks. Notable gaps between stakeholder research priorities and research outputs concerned themes that were more focused on social factors and systems and may reflect publication bias or self-publication selection, highlighting the need for further research on prison health services and the social determinants of health. Different jurisdictions, countries, and regions should undertake similar systematic and transparent research priority-setting processes.
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Affiliation(s)
- George Karystianis
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Paul Simpson
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Wilson Lukmanjaya
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Natasha Ginnivan
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Goran Nenadic
- School of Computer Science, University of Manchester, Manchestr, United Kingdom
| | - Iain Buchan
- Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Tony Butler
- School of Population Health, University of New South Wales, Sydney, Australia
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Chaplin E, McCarthy J, Ali S, Marshall-Tate K, Xenitidis K, Harvey D, Childs J, Srivastava S, McKinnon I, Robinson L, Allely CS, Hardy S, Tolchard B, Forrester A. Severe mental illness, common mental disorders, and neurodevelopmental conditions amongst 9088 lower court attendees in London, UK. BMC Psychiatry 2022; 22:551. [PMID: 35962427 PMCID: PMC9373383 DOI: 10.1186/s12888-022-04150-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 07/19/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Court Mental Health Liaison and Diversion Services (CMHLDS) have developed in some countries as a response to the over-representation of mental illness and other vulnerabilities amongst defendants presenting to criminal justice (or correctional) systems. This study examined the characteristics and rates of mental disorder of 9088 defendants referred to CMHLDS. METHOD The study analysed service level data, obtained from the National Health Service's mental health data set, to examine characteristics relating to gender, ethnicity and comorbidity of common mental and neurodevelopmental disorders at five CMHLDS across London between September 2015 and April 2017. RESULTS The sample included 7186 males (79.1%) and 1719 females (18.9%), the gender of 183 (2%) were not recorded. Of those referred, 6616 (72.8%) presented with an identifiable mental disorder and 503 (5.5%) with a neurodevelopmental disorder (NDD). Significantly higher rates of schizophrenia were reported amongst Black defendants (n = 681; 37.2%) and Asian defendants (n = 315; 29%), while higher rates of depression were found amongst White defendants (n = 1007; 22.1%). Substance misuse was reported amongst 2813 defendants (31%), and alcohol misuse amongst 2111 (23.2%), with significantly high rates of substance and alcohol misuse amongst defendants presenting with schizophrenia or personality disorder. CONCLUSIONS This is one of the largest studies to examine mental health needs and vulnerabilities amongst defendants presenting to CMHLDS. It will enable an improved understanding of the required service designs and resources required to manage the healthcare pathways for people attending CMHLDS.
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Affiliation(s)
- Eddie Chaplin
- Institute of Health and Social Care, London South Bank University, London, UK.
| | - Jane McCarthy
- grid.13097.3c0000 0001 2322 6764University of Auckland, New Zealand & Visiting Senior Lecturer, King’s College London, London, UK
| | - Salma Ali
- grid.4756.00000 0001 2112 2291Institute of Health and Social Care, London South Bank University, London, UK
| | - Karina Marshall-Tate
- grid.4756.00000 0001 2112 2291Institute of Health and Social Care, London South Bank University, London, UK ,South London and Maudsley NHS Foundation Trust, London, UK
| | | | - Denise Harvey
- grid.4756.00000 0001 2112 2291Institute of Health and Social Care, London South Bank University, London, UK
| | - Jessica Childs
- grid.4756.00000 0001 2112 2291Institute of Health and Social Care, London South Bank University, London, UK ,Together for Mental Wellbeing, London, UK
| | | | - Iain McKinnon
- grid.1006.70000 0001 0462 7212Newcastle University, Newcastle upon Tyne, UK
| | - Louise Robinson
- grid.5379.80000000121662407Manchester University, Manchester, UK
| | - Clare S. Allely
- grid.8752.80000 0004 0460 5971Reader in Forensic Psychology at the University of Salford, Manchester, UK ,grid.8761.80000 0000 9919 9582Affiliate member of the Gillberg Neuropsychiatry Centre at Gothenburg University, Gothenburg, Sweden ,grid.8756.c0000 0001 2193 314XHonorary Research Fellow in the College of Medical, Veterinary and Life Sciences affiliated to the Institute of Health and Wellbeing at the University of Glasgow, Glasgow, UK
| | - Sally Hardy
- grid.8273.e0000 0001 1092 7967University of East Anglia, Norwich, UK
| | - Barry Tolchard
- grid.26597.3f0000 0001 2325 1783Teesside University, Middlesbrough, UK
| | - Andrew Forrester
- grid.5600.30000 0001 0807 5670Forensic Psychiatry, Cardiff University, Cardiff, UK
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Ryland H, Exworthy T, Forrester A. Over 30 years of liaison and diversion in England and Wales: How far have we come, and what is now needed? MEDICINE, SCIENCE, AND THE LAW 2022; 62:85-87. [PMID: 35373643 DOI: 10.1177/00258024221092711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Howard Ryland
- Senior Clinical Researcher, Department of Psychiatry, University of Oxford, Warneford Lane, Oxford OX3 7JX, UK
| | - Tim Exworthy
- Visiting Senior Lecturer, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, London SE5 8AF
- Consultant Forensic Psychiatrist, Cygnet Hospital Stevenage, Stevenage, Hertfordshire, SG1 4YS
| | - Andrew Forrester
- Professor of Forensic Psychiatry, Department of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Haydn Ellis Building, Maindy Road, Cardiff CF244HQ
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McCarthy J, Chaplin E, Hayes S, Søndenaa E, Chester V, Morrissey C, Allely CS, Forrester A. Defendants with intellectual disability and autism spectrum conditions: the perspective of clinicians working across three jurisdictions. PSYCHIATRY, PSYCHOLOGY, AND LAW : AN INTERDISCIPLINARY JOURNAL OF THE AUSTRALIAN AND NEW ZEALAND ASSOCIATION OF PSYCHIATRY, PSYCHOLOGY AND LAW 2022; 29:698-717. [PMID: 36148388 PMCID: PMC9487969 DOI: 10.1080/13218719.2021.1976297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The treatment of vulnerable defendants by criminal justice systems or correctional systems varies within and between countries. The purpose of this paper is to examine three legal jurisdictions - New South Wales in Australia; Norway; England and Wales - to understand the extent of variation in practice within the court systems for defendants with intellectual disabilities (ID) and/or autism spectrum conditions (ASC). Two of the jurisdictions had a process for screening in place, either in police custody or at court, but this was not universally implemented across each jurisdiction. All three jurisdictions had a process for supporting vulnerable defendants through the legal system. Across the three jurisdictions, there was variation in disposal options from a mandatory care setting to hospital treatment to a custodial sentence for serious offences. This variation requires further international exploration to ensure the rights of defendants with ID or ASC are understood and safeguarded.
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Affiliation(s)
- Jane McCarthy
- Institute of Psychiatry, Psychology & Neuroscience King’s College London, London, UK
- Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand
| | - Eddie Chaplin
- Institute of Health and Social Care, London South Bank University, London, UK
- Correspondence: Eddie Chaplin, Institute of Health and Social Care, London South Bank University, 103 Borough Road, LondonSE1 0AA, UK.
| | - Susan Hayes
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Erik Søndenaa
- Faculty of Medicine, Institute of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
- Forensic Department, St.Olavs Hospital, Trondheim, Norway
| | - Verity Chester
- Hertfordshire Partnership University NHS Foundation Trust, Little Plumstead Hospital, Hospital Road, Norwich, UK
| | - Catrin Morrissey
- Lincolnshire Partnership NHS Foundation Trust and University of Nottingham, Nottingham, UK
| | - Clare S. Allely
- School of Health and Society, Salford University, Salford, UK and affiliate member of the Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Andrew Forrester
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
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Chaplin E, McCarthy J, Marshall-Tate K, Ali S, Xenitidis K, Childs J, Harvey D, McKinnon I, Robinson L, Hardy S, Srivastava S, Allely CS, Tolchard B, Forrester A. Evaluation of a liaison and diversion Court Mental Health Service for defendants with neurodevelopmental disorders. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 119:104103. [PMID: 34628339 DOI: 10.1016/j.ridd.2021.104103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/31/2021] [Accepted: 09/29/2021] [Indexed: 06/13/2023]
Abstract
AIM Neurodevelopmental disorders (NDD) may present as neuropsychiatric problems as well as impairments of motor, cognitive, social and communication functioning. This study describes the introduction of a specialist service with expertise in NDD into an existing court mental health liaison and diversion service to determine if the service would impact on the health needs or disposal outcomes of defendants. METHODS We examined referrals of defendants with NDD disorders over 30-months at a London Magistrates' Court. The pre-existing Court Mental Health (CMH) service was enhanced to provide additional expertise and hereafter referred to as the CMH + NDD Service. Baseline data including gender, ethnicity, remands and the rates of mental disorders was collected from the CMH Service using the existing minimum mental health service dataset. This was compared with data collected from the CMH + NDD Service. RESULTS We found the following rates of NDD 9.5 % (n = 43) for the CMH service, and 9.5 % (n = 79) for the CMH + NDD service. Although overall the rates were the same the number of defendants with a single NDD diagnosis was increased in the CMH + NDD service with ADHD 10 %, ASD and ID 4% higher, the rates of comorbid NDD decreased in the CMH + NDD service compared to baseline. Specific disorders such as depression were recorded at higher rates for NDD defendants in both phases, however, this did not reach significance. In contrast, schizophrenia and delusional disorders, alcohol and substance use were observed at much higher in the non-NDD defendants during both phases of the study. The rates of diagnosis of schizophrenia and delusional disorders increased for the NDD group within the CMH + NDD service. Following the first court appearance, there was a 10 % reduction in custodial remands for defendants with NDD who were seen by the CMH + NDD service (34.2 %, n = 25 in the CMH + NDD service vs 43.8 %, n = 14 in the CMH service). CONCLUSION The study found it is possible to successfully integrate practitioners with expertise of NDD into existing liaison and diversion services. This service enhancement demonstrated modest evidence of service effectiveness, including an increase in the detection of comorbid mental illness and a reduction in custodial remands for defendants with NDD. Further work needs to be completed to examine how this model can be rolled out across multiple courts and in particular, a cost-benefit analysis is required to understand whether an approach involving a cluster of Courts, as opposed to a single site is the most effective approach for this group of defendants.
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Affiliation(s)
- Eddie Chaplin
- London South Bank University Institute of Health and Social Care, United Kingdom.
| | - Jane McCarthy
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Karina Marshall-Tate
- London South Bank University Institute of Health and Social Care, United Kingdom; South London and Maudsley NHS Foundation Trust, United Kingdom
| | - Salma Ali
- Newcastle University, United Kingdom
| | | | - Jessica Childs
- London South Bank University Institute of Health and Social Care, United Kingdom
| | - Denise Harvey
- London South Bank University Institute of Health and Social Care, United Kingdom
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Aboaja A, Forsyth B, Bates H, Wood R. Involving service users to identify research priorities in a UK forensic mental health service. BJPsych Bull 2021; 45:321-326. [PMID: 33323154 PMCID: PMC8727379 DOI: 10.1192/bjb.2020.131] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
AIMS AND METHOD Patient and public involvement (PPI) is a priority for health research. PPI improves the relevance and quality of research. The study aimed to involve service users in identifying research priorities for the service. A two-phase adapted Delphi technique was used to generate a list of research topics from service users in secure in-patient mental health settings and on specialist mental health prison wings. Topic content analysis was undertaken. Service users were further consulted, and research themes were ranked in order of priority. RESULTS Of the eight research themes identified, the three given the highest priority by service users were, in descending order, physical health, future plans and moving on, and causes of illness and crime. CLINICAL IMPLICATIONS Service users are willing to be involved in setting research priorities for mental health services. Through non-tokenistic PPI, service users can uniquely shape the research agenda of mental health services.
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Affiliation(s)
- Anne Aboaja
- Roseberry Park Hospital, Tees, Esk and Wear Valleys NHS Foundation Trust, UK
| | - Bunny Forsyth
- Roseberry Park Hospital, Tees, Esk and Wear Valleys NHS Foundation Trust, UK
| | - Helen Bates
- Roseberry Park Hospital, Tees, Esk and Wear Valleys NHS Foundation Trust, UK
| | - Robert Wood
- Roseberry Park Hospital, Tees, Esk and Wear Valleys NHS Foundation Trust, UK
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Ryland H, Forrester A, Exworthy T, Gallagher S, Ramsay L, Khan AA. Liaison and diversion services in South East London: Referral patterns over a 25-year period. Med Leg J 2021; 89:166-172. [PMID: 34219537 DOI: 10.1177/00258172211010558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Criminal justice liaison and diversion services identify people with mental health needs and ensure they receive appropriate support. We describe a 25-year period of one such service that deals with a population of 864,540 in South East London that was set up in 1991. We used data from three time periods. A diagnosis of a mental illness was recorded in 70.0-80.3% of court liaison and diversion referrals. The proportion receiving a hospital order declined from 15.4% in 1991/1992 to 1.1% in 2015/2016; 54/199 (27.1%) of referrals to the police liaison and diversion service were detained in hospital. Although the service is designed to support any individual with a mental health issue, these results suggest that it has dealt mainly with people who have severe mental illness. Further research is required to understand how best to benefit a wider range of people with mental health issues who attend the lower (Magistrates') courts, and whether screening for mental disorders can be applied in liaison and diversion settings to aid the implementation of national policy. We also need to understand how disposal decisions are made, and which are most effective.
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Affiliation(s)
- Howard Ryland
- Bracton Centre, Oxleas NHS Foundation Trust, London, UK
| | - Andrew Forrester
- Greater Manchester Mental Health NHS Foundation Trust, Prestwich, UK.,University of Manchester, Manchester, UK
| | - Tim Exworthy
- Cygnet Hospital Stevenage, Stevenage, UK.,Department of Forensic and Developmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Simpson PL, Guthrie J, Jones J, Butler T. Identifying research priorities to improve the health of incarcerated populations: results of citizens' juries in Australian prisons. LANCET PUBLIC HEALTH 2021; 6:e771-e779. [PMID: 34115972 DOI: 10.1016/s2468-2667(21)00050-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/25/2021] [Accepted: 03/03/2021] [Indexed: 12/12/2022]
Abstract
Health disparities in incarcerated populations should guide investment in the health care and research of these communities. Although users of health-care services are important in providing input into decisions about research, the voices of people in prison are absent regarding research into their health. In this Health Policy paper, we present priorities for research into the health of people in prison according to people in prison themselves. By use of a deliberative research approach, citizens' juries were conducted in six prisons (three men's and three women's prisons) in Australia. Participants were selected following submissions of expression of interest forms that were distributed within the prisons. Prerecorded information by experts in the health of incarcerated people was shown to participants. Participants deliberated for up to 4 h before agreeing on five research priorities. All citizens' juries endorsed mental health as a number one research priority. Prison health-care services, alcohol and other drug use, education, and infectious diseases were identified as research priorities by most citizens' juries. Focal points within priorities included serious mental illness; grief and trauma; medication management; health-care service access, quality, and resources; drug withdrawal and peer support; prison-based needle and syringe programmes; and health and life skills education. If endeavours in research priority setting are to consider health equity goals, the views of our most health affected citizens need to be included.
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Affiliation(s)
- Paul L Simpson
- School of Population Health, University of New South Wales (UNSW Sydney), Sydney, NSW, Australia.
| | - Jill Guthrie
- Research School of Population Health, The Australian National University, Canberra, ACT, Australia
| | - Jocelyn Jones
- National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - Tony Butler
- School of Population Health, University of New South Wales (UNSW Sydney), Sydney, NSW, Australia
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Forrester A, Hopkin G, Bryant L, Slade K, Samele C. Alternatives to custodial remand for women in the criminal justice system: A multi-sector approach. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2020; 30:68-78. [PMID: 32212284 DOI: 10.1002/cbm.2144] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 03/01/2020] [Indexed: 05/26/2023]
Abstract
Throughout the world, women involved in criminal justice systems often present with substantial needs and vulnerabilities. Diverting vulnerable people away from prison is government policy in England and Wales, but full psychiatric and social assessments are expensive and hard to access. A screening and quick response initiative - alternatives to custodial remand for women (ACRW) - was implemented across three areas of London (West, South and East) to supplement existing court liaison and diversion services, to assess the feasibility of a supplementary custodial remand service as part of a women's specialist service pathway in the criminal justice system in England. Three mental health trusts and two voluntary sector providers offered this service enhancement - a screening and service link provision in three London boroughs between 2012 and 2014. We conducted a service evaluation using routinely collected service use record data. The service made 809 contacts, of whom 104 had contact on multiple occasions. Many were identified as at risk of self-harm (46%) or had histories of hospital admission for mental disorder (36%), but few were referred either to the liaison and diversion service or specialist mental health services. The largest group of referrals was to women's community services outside the health service (e.g. counselling, domestic violence or sexual abuse services). 180 women had dependent children and 22 were pregnant, increasing the urgency to find non-custodial alternatives. As well as confirming high levels of need amongst women entering the criminal justice system, this evaluation confirms the feasibility of working across sectors in this field, providing an extra layer of service that can complement existing liaison and diversion service provision. The service was responsive and most women using it were kept out of custody. Research is now required to understand the appropriateness of the referrals, the extent to which women follow them through and the impact on their mental health and desistance from offending.
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Affiliation(s)
- Andrew Forrester
- Health and Justice, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- Offender Health Research Network, University of Manchester, Manchester, UK
| | - Gareth Hopkin
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | | | - Karen Slade
- School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | - Chiara Samele
- Informed Thinking, London, UK
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Forrester A, Hopkin G. Mental health in the criminal justice system: A pathways approach to service and research design. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2019; 29:207-217. [PMID: 31478274 DOI: 10.1002/cbm.2128] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 08/01/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Care pathway approaches were introduced into health care in the 1980s and have become standard international practice. They are now being introduced more specifically for health care in the criminal justice system. Care pathway delivery has the theoretical advantage of encouraging a whole-systems approach for health and social care within the criminal justice system, but how well is it supported by empirical evidence? AIMS The aim of this study is to review the nature and extent of evidence streams supporting health care delivery within interagency pathway developments since 2000. METHOD We used an exploratory narrative method to review the nature and extent of evidence streams supporting health care delivery within interagency pathway developments since 2000. The available literature was reviewed using a keyword search approach with three databases: PubMed, Medline, and Google Scholar. FINDINGS Research in this field has covered police custody, courts, prisons, and the wider community, but there is little that follows the entire career through all these elements of offender placement. Main themes in the research to date, regardless of where the research was conducted, have been counting the disorder or the need, development and evaluation of screening tools, and evaluation of clinical intervention styles. Most evidence to date is simply observational, although the possibility of conducting randomised controlled trials of interventions within parts of the criminal justice system, especially prisons, is now well established. CONCLUSIONS Access to health care while passing through the criminal justice system is essential because of the disproportionately high rates of mental disorder among offenders, and the concept of structured pathways to ensure this theoretically satisfying, but as yet empirically unsupported. Further, substantial cuts in services, generally following government economies, are largely unresearched. Considerable investment in new possibilities, driven by both pressure groups and government, tend to be informed by good will and theory rather than hard evidence and are often not evaluated even after introduction. This must change.
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Affiliation(s)
- Andrew Forrester
- Edenfield Centre, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- Offender Health Research Network, University of Manchester, Manchester, UK
| | - Gareth Hopkin
- Department of Health Policy, London School of Economics and Political Science, London, UK
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Ali S. Autistic spectrum disorder and offending behaviour – a brief review of the literature. ADVANCES IN AUTISM 2018. [DOI: 10.1108/aia-05-2018-0015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper to synthesise much of the existing research on autistic spectrum disorder (ASD) and offending behaviour.
Design/methodology/approach
It considers three key areas, namely, first, a discussion about the nature of ASD and how it might be related to offending behaviour; second, a brief commentary about the prevalence of this population; and, finally, an exploration of the effective management and possible treatment outcomes.
Findings
Methodological limitations have resulted in variable findings which has hindered our understanding of this population. Some of the research is based on small, highly specialist samples making prevalence difficult to measure. The link between ASD and offending is still not well understood, and despite advances in staff training, awareness amongst practitioners remains an underdeveloped area, thus yielding variable treatment outcomes.
Originality/value
This review continues to demonstrate the urgent need for robust research in order to better understand the link between ASD and offending behaviour, to provide tailored, needs-led interventions, and reduce the risk of offending amongst this group as a whole.
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Forrester A, Till A, Simpson A, Shaw J. Mental illness and the provision of mental health services in prisons. Br Med Bull 2018; 127:101-109. [PMID: 30124765 DOI: 10.1093/bmb/ldy027] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 07/19/2018] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Around 11 million people are held in prisons internationally, and criminal justice systems are overburdened with a high prevalence of multiple psychiatric disorders. In England and Wales over 200 000 people enter prisons each year, and in many cases, this facilitates their first contact with mental health services. SOURCES OF DATA Research, evaluations, government reports and independent reviews. AREAS OF AGREEMENT Screening, Triage, Assessment, Intervention and Re-integration (STAIR) are necessary components of prison mental health provision, offering an opportunity to improve the wellbeing of a complex population. AREAS OF CONTROVERSY There are serious problems with service provision across many parts of the world, with human rights abuses occurring in some States. Screening and service delivery models still require substantial development. In England and Wales, self-harm, self-inflicted deaths and violence are increasing. GROWING POINTS Introducing comprehensive mental health models throughout prisons would offer a massive public health initiative, providing new services for the socially disadvantaged. A rights-based framework would be useful in ensuring systemic improvements, especially in low and middle-income countries. AREAS TIMELY FOR DEVELOPING RESEARCH Mechanisms for screening and triage, specific interventions across a broad range of conditions, and practical re-integration models, should be submitted to research across international sites.
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Affiliation(s)
- A Forrester
- Offender Health Research Network, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, UK
| | - A Till
- School of Psychiatry, Health Education North West (Mersey), Regatta Place, Summers Road, Brunswick Business Park, Liverpool, UK
| | - A Simpson
- Centre for Addiction and Mental Health, 250 College Street, Toronto, Canada
| | - J Shaw
- Offender Health Research Network, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, UK
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McKinnon I, Finch T. Contextualising health screening risk assessments in police custody suites - qualitative evaluation from the HELP-PC study in London, UK. BMC Public Health 2018; 18:393. [PMID: 29566649 PMCID: PMC5863839 DOI: 10.1186/s12889-018-5271-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 03/08/2018] [Indexed: 12/05/2022] Open
Abstract
Background In the UK, police custody officers have a responsibility to screen for health morbidity and vulnerability among detainees. This study aimed to develop an understanding of the barriers to performing effective health screening in police custody suites, understand the impact of screening tools on practice within the custody suite, and to identify factors that could hinder or facilitate the future implementation of a new screening intervention in this environment. Methods A qualitative study was conducted alongside a quantitative evaluation of a novel screening tool. Qualitative methods included observation of the custody environment, semi-structured interviews with police staff, and elicitation of comments from detainees about their experiences of screening. Data were analysed inductively using thematic analysis. Normalization Process Theory (NPT) was used to inform data collection and as a framework for higher level analysis of findings. Results Five overall constructs were identified that develop understanding of the integration of health screening within custody: the workability of risk assessment screening tools; the effect of the custody environment and the people therein; shifts in professional roles and interrelationships amongst staff; cultural responses to risk and liability in police work; how infrastructure, knowledge and skills can impact on detainee safety. Conclusions Health and risk assessment screening in police custody is a complex and demanding activity which extends beyond the delivery of a screening tool. Professional roles, the demanding environment and police culture impact on the overall process. Recommendations for improved integration of health and risk assessment screening in wider police custody practice are proposed. Electronic supplementary material The online version of this article (10.1186/s12889-018-5271-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Iain McKinnon
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, NE4 5PT, UK. .,Northumberland Tyne and Wear NHS Foundation Trust, Morpeth, NE61 3BP, UK.
| | - Tracy Finch
- Department of Nursing, Midwifery and Health, Northumbria University, Coach Lane Campus West, Newcastle upon Tyne, NE7 7XA, UK
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Hopkin G, Messina E, Thornicroft G, Ruggeri M. Reform of Italian forensic mental health care. Challenges and opportunities following Law 81/2014. Int J Prison Health 2018; 14:1-3. [PMID: 29480770 DOI: 10.1108/ijph-05-2017-0022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Gareth Hopkin
- Department of Social Policy, London School of Economics and Political Science, London, United Kingdom of Great Britain and Northern Ireland
| | - Ester Messina
- Section of Psychiatry, Department of Neuroscience Biomedicine and Movement, University of Verona, Verona, Italy
| | - Graham Thornicroft
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Mirella Ruggeri
- Section of Psychiatry, Department of Neuroscience Biomedicine and Movement, University of Verona, Verona, Italy
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Chaplin E, McCarthy J, Forrester A. Defendants with autism spectrum disorders: what is the role of court liaison and diversion? ADVANCES IN AUTISM 2017. [DOI: 10.1108/aia-08-2017-0018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to examine the role of liaison and diversion services working in the lower courts (also known as Magistrates’ courts) with regard to autism spectrum disorders (ASDs) and their assessment, in particular, the role of pre-sentence and psychiatric reports and interviews.
Design/methodology/approach
Current practice is described in the lower courts in the context of current legislation and procedures.
Findings
When writing reports, there is a need for expertise to offer an opinion on future risk, disposal and what needs to be in place to support people with ASDs. No assumptions should be made when reporting on the basis of an ASD diagnosis alone and each case must be assessed on its individual merits while ensuring that individual human rights are protected.
Originality/value
There is currently a sparse literature examining ASD in court settings. This paper seeks to clarify the current practice.
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McKinnon IG, Thomas SDM, Noga HL, Senior J. Police custody health care: a review of health morbidity, models of care and innovations within police custody in the UK, with international comparisons. Risk Manag Healthc Policy 2016; 9:213-226. [PMID: 27695373 PMCID: PMC5028165 DOI: 10.2147/rmhp.s61536] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
This paper is a scoping review of the available evidence regarding health care issues in police custody. It describes the types and prevalence of health disorders encountered in custody and provides an overview of current practice and recent innovations in police custody health care. In contrast to the health of prisoners, the health of police custody detainees has, until recently, received little academic or clinical attention. Studies on health care in police custody identified for this review are limited to a few geographical jurisdictions, including the UK, continental Europe, North America, and Australia. There are significant health concerns among police detainees including acute injury, chronic physical health problems, mental and cognitive disorders, and the risks associated with drug and alcohol intoxication or withdrawal. There is some evidence that deaths in police custody have reduced where attention has been paid to the latter issue. Police personnel continue to experience difficulties identifying detainees with health issues relevant to their safe detention, but research shows that the use of evidence-based screening tools improves detection of such morbidities. Innovations in police custody health care mainly relate to detainees with mental disorders, including improved identification of illness, timely access to mental health services, the protection of the rights of mentally disordered detainees, and the diversion of mentally disordered persons from the criminal justice system into appropriate health and social care interventions. There is a lack of rigorous research relating to interventions for physical health problems, protecting those at risk of substance withdrawal, and detainees with preexisting or peri-arrest injures. Research to improve the health of police custody detainees requires greater priority, focusing on case identification and service redesign to address high levels of morbidity and to facilitate health promotion and prevention activities.
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Affiliation(s)
- Iain G McKinnon
- Institute of Health and Society, Newcastle University, Academic Psychiatry, Campus for Ageing and Vitality
- Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Stuart DM Thomas
- School of Global, Urban and Social Studies, RMIT University, Melbourne, VIC
- Legal Intersections Research Centre, University of Wollongong, Wollongong, NSW
- Southern Clinical School, Monash University, Clayton, VIC, Australia
| | - Heather L Noga
- School of Criminology, Simon Fraser University, Burnaby, BC, Canada
| | - Jane Senior
- Offender Health Research Network, University of Manchester, Manchester, UK
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17
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Hopkin G, Samele C, Singh K, Craig T, Valmaggia L, Forrester A. Prison Mental Health In-reach: The Effect of Open Referral Pathways. PSYCHIATRY, PSYCHOLOGY, AND LAW : AN INTERDISCIPLINARY JOURNAL OF THE AUSTRALIAN AND NEW ZEALAND ASSOCIATION OF PSYCHIATRY, PSYCHOLOGY AND LAW 2016; 24:152-158. [PMID: 31983946 PMCID: PMC6818432 DOI: 10.1080/13218719.2016.1197813] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In England and Wales, mental health in-reach teams manage high levels of mental disorder in prisons, but problems with reception screening and referral triage have been identified. As one potential solution, we examined the effect of an open referral pathway upon one in-reach team by evaluating its referrals and caseload across two time periods (in 2008 and 2011). There was a doubling of team referrals (from 101 to 203) with significantly improved identification of people with no mental health history. There was further evidence for a lowering of thresholds for referral and assessment, an approach that can be seen as helpful within a system that is known to under-identify mental health problems. Despite limitations, this evaluation offers some evidence for the effectiveness of open referral systems. It also raises questions about the potential effects of liaison and diversion services that are presently being piloted for national introduction.
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Affiliation(s)
- Gareth Hopkin
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Chiara Samele
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Karan Singh
- Department of Forensic Psychiatry, Kent and Medway NHS and Social Care Partnership Trust, Maidstone, UK
| | - Tom Craig
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Lucia Valmaggia
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Andrew Forrester
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
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Forrester A, Till A, Senior J, Shaw J. Competitive tendering and offender health services. Lancet Psychiatry 2015; 2:859-61. [PMID: 26462209 DOI: 10.1016/s2215-0366(15)00414-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 08/22/2015] [Accepted: 08/24/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Andrew Forrester
- South London and Maudsley NHS Foundation Trust, London, UK; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Alex Till
- Mersey Deanery, Health Education North West, Liverpool, UK
| | - Jane Senior
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Jenny Shaw
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
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