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Solbakken LE, Bergvik S, Wynn R. Breaking down barriers to mental healthcare access in prison: a qualitative interview study with incarcerated males in Norway. BMC Psychiatry 2024; 24:292. [PMID: 38632543 PMCID: PMC11025238 DOI: 10.1186/s12888-024-05736-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 04/03/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Mental health problems are highly prevalent in prison populations. Incarcerated persons generally come from disadvantaged backgrounds and are living under extraordinary conditions while in prison. Their healthcare needs are complex compared to the general population. Studies have found that incarcerated individuals are reluctant to seek help and that they experience challenges in accessing mental healthcare services. To some extent, seeking treatment depends on the degree of fit between potential users and health services, and actual use might be a better indication of accessibility than the fact that services are available. This study aimed to explore individual and systemic facilitators and barriers to accessing mental healthcare in a prison context. METHODS An analytical approach drawing on elements of constructivist Grounded theory was the methodological basis of this study. Fifteen male participants were recruited from three prisons in Northern Norway. Data was collected through in-depth interviews on topics such as help-seeking experiences, perceived access to services and availability of health information. RESULTS We found that distrust in the system, challenges with the referral routines, worries about negative consequences, and perceived limited access to mental healthcare were barriers to help-seeking among incarcerated individuals. How prison officers, and healthcare personnel respond to incarcerated persons reporting mental distress could also be critical for their future willingness to seek help. Providing information about mental health and available services, initiating outreaching mental health services, and integrating mental health interventions into treatment programs are examples of efforts that might reduce barriers to accessing services. CONCLUSIONS Facilitating access to mental health services is crucial to accommodate the mental health needs of those incarcerated. This study provides insights into the complex interplay of individual, social and systemic factors that may contribute to the utilization of mental health care among incarcerated persons. We suggest that correctional and healthcare systems review their practices to facilitate access to healthcare for people in prison.
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Affiliation(s)
- Line Elisabeth Solbakken
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, N-9038, Norway
- Division of Mental Health and Substance Use, University Hospital of North, Tromsø, Norway
| | - Svein Bergvik
- Department of Psychology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Rolf Wynn
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, N-9038, Norway.
- Department of Education, ICT and Learning, Østfold University College, Tromsø, Norway.
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Grubbe F, Wagner E, Pogarell O, Dudeck M, Hasan A. [Inpatient Treatment of Mentally Ill Prisoners in General Psychiatric Departments and Hospitals]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2024; 92:128-134. [PMID: 36720233 DOI: 10.1055/a-1981-2883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Inpatient psychiatric treatment of prisoners is organized differently in Germany, depending on the structural conditions of the federal state and prison. There are very few findings on the different possibilities of treatment and the view of the hospitals on this issue. OBJECTIVES Our aim was to gain an up-to-date picture of inpatient treatment of prisoners in general psychiatric departments and hospitals and the challenges these institutions face. METHODS We conducted an anonymous online survey of the frequency, extent, and challenges of inpatient treatment of prisoners. Approximately 460 chief physicians of German general psychiatric departments and hospitals were invited to participate in this survey. In addition to descriptive statistics, we calculated group differences by type of hospital and by subjective responsibility for inpatient care of prisoners. RESULTS A total of 74 chief physicians surveyed participated; 51.4% of the surveyed hospitals provided psychiatric inpatient treatment to prisoners in 2020. Group differences between the different types of hospitals were found only for the presence of anticipated anxiety among regular inpatients. Various differences were found between responsible and non-responsible hospitals, especially with regard to organizational aspects. DISCUSSION For the treatment of mentally ill prisoners, various organizational challenges as well as fears of hospital staff and fellow patients were mentioned by the participants. The type of hospital appears to play a subordinate role here, whereas the responsibility of the hospital for the inpatient treatment of mentally ill prisoners might be more decisive for anticipated concerns and barriers.
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Affiliation(s)
- Felix Grubbe
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Medizinische Fakultät, Universität Augsburg, Bezirkskrankenhaus Augsburg
| | - Elias Wagner
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, LMU München
| | - Oliver Pogarell
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, LMU München
| | - Manuela Dudeck
- Klinik für Forensische Psychiatrie und Psychotherapie der Universität Ulm am BKH Günzburg
| | - Alkomiet Hasan
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Medizinische Fakultät, Universität Augsburg, Bezirkskrankenhaus Augsburg
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Murray C, Coyle B, Morgan H, Marder I, Woods D, Haughey T, Maycock M, Genovesi F, Meek R, Parker A, Smith A, Kay C, Brink G, Rovers H, Haudenhuyse R, Roe D, Contreras-Osorio F, Donohue B, Bohall G, Martinez N, Martos-Garcia D, Whitley M, Norman M, Demalija R, Sherry E, Chitsawang N, Adebayo Aderonmu K, Breslin G. International consensus statement on the design, delivery and evaluation of sport-based interventions aimed at promoting social, psychological and physical well-being in prison. BMJ Open 2024; 14:e075792. [PMID: 38296285 PMCID: PMC10828872 DOI: 10.1136/bmjopen-2023-075792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 01/04/2024] [Indexed: 02/03/2024] Open
Abstract
OBJECTIVE To develop an international consensus statement to advise on designing, delivering and evaluating sport-based interventions (SBIs) aimed at promoting social, psychological and physical well-being in prison. DESIGN Modified Delphi using two rounds of survey questionnaires and two consensus workshops. PARTICIPANTS A multidisciplinary panel of more than 40 experts from 15 international jurisdictions was formed, including representation from the following groups and stakeholders: professionals working in the justice system; officials from sport federations and organisations; academics with research experience of prisons, secure forensic mental health settings and SBIs; and policy-makers in criminal justice and sport. RESULTS A core research team and advisory board developed the initial rationale, statement and survey. This survey produced qualitative data which was analysed thematically. The findings were presented at an in-person workshop. Panellists discussed the findings, and, using a modified nominal group technique, reached a consensus on objectives to be included in a revised statement. The core research team and advisory board revised the statement and recirculated it with a second survey. Findings from the second survey were discussed at a second, virtual, workshop. The core research team and advisory board further revised the consensus statement and recirculated it asking panellists for further comments. This iterative process resulted in seven final statement items; all participants have confirmed that they agreed with the content, objectives and recommendations of the final statement. CONCLUSIONS The statement can be used to assist those that design, deliver and evaluate SBIs by providing guidance on: (1) minimum levels of competence for those designing and delivering SBIs; (2) the design and delivery of inclusive programmes prioritising disadvantaged groups; and (3) evaluation measures which are carefully calibrated both to capture proposed programme outcomes and to advance an understanding of the systems, processes and experiences of sport engagement in prison.
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Affiliation(s)
| | | | | | | | - David Woods
- Ulster University-Belfast Campus, Belfast, UK
| | | | - Matthew Maycock
- University of Dundee, Dundee, UK
- Monash University, Clayton, Victoria, Australia
| | | | - Rosie Meek
- Royal Holloway University of London, Egham, UK
| | - Andrew Parker
- University of Gloucestershire, Cheltenham, Gloucestershire, UK
| | | | - Chris Kay
- Loughborough University, Loughborough, UK
| | - Gerko Brink
- Nederlandse Ministerie van Veiligheid en Justitie, Den Haag, The Netherlands
| | - Hubert Rovers
- European Football for Development Network, Breda, The Netherlands
| | | | - Daniel Roe
- Swedish School of Sport and Health Sciences GIH, Stockholm, Sweden
| | | | | | - Greg Bohall
- Chicago School of Professional Psychology - Downtown Los Angeles Campus, Los Angeles, California, USA
| | | | | | - Meredith Whitley
- Adelphi University, Garden City, New York, USA
- Centre for Sport Leadership, Stellenbosch University, Stellenbosch, South Africa
| | - Mark Norman
- University of Toronto, Toronto, Ontario, Canada
| | | | - Emma Sherry
- Swinburne University of Technology, Hawthorn, Victoria, Australia
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4
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Scott R, Aboud A, Das M, Nambiar N. A prison mental health network in the RANZCP. Australas Psychiatry 2023; 31:157-161. [PMID: 36748240 DOI: 10.1177/10398562221146451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Consider the unique features and challenges of prison psychiatry. CONCLUSIONS A Prison Mental Health Network within the Royal Australian and New Zealand College of Psychiatrists would serve many useful functions including improving the quality of mental health services by promoting high clinical standards and ethical practice by psychiatrists working in prisons.
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Affiliation(s)
- Russ Scott
- West Moreton Prison Mental Health Service, Brisbane, Qld, Australia
| | - Andrew Aboud
- West Moreton Prison Mental Health Service, Brisbane, Qld, Australia
| | | | - Narain Nambiar
- 289104Statewide Forensic Mental Health Service, Adelaide, SA, Australia
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Integration, population commissioning and prison health and well-being – an exploration of benefits and challenges through the study of telemedicine. JOURNAL OF INTEGRATED CARE 2022. [DOI: 10.1108/jica-11-2021-0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThis paper seeks to understand relationships between prison healthcare and integrated care systems (ICS), including how these affect the delivery of new healthcare interventions. It also aims to understand how closer integration between prison and ICS could improve cross system working between community and prison healthcare teams, and highlights challenges that exist to integration between prison healthcare and ICS.Design/methodology/approachThe study uses evidence from research on the implementation of a pilot study to establish telemedicine secondary care appointments between prisons and an acute trust in one English region (a cross-system intervention). Qualitative interview data were collected from prison (n = 12) and community (n = 8) healthcare staff related to the experience of implementing a cross-system telemedicine initiative. Thematic analysis was undertaken on interview data, guided by an implementation theory and framework.FindingsThe research found four main themes related to the closer integration between prison healthcare and ICS: (1) Recognition of prison health as a priority; (2) Finding a way to reconcile networks and finances between community and prison commissioning; (3) Awareness of prison service influence on NHS healthcare planning and delivery; and (4) Shared investment in prison health can lead to benefits.Originality/valueThis is the first article to provide research evidence to support or challenge the integration of specialist health and justice (H&J) commissioning into local population health.
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Crole-Rees C, Forrester A. Developing a clinical pathway for traumatic stress in prisons. MEDICINE, SCIENCE, AND THE LAW 2022; 62:4-7. [PMID: 35006013 DOI: 10.1177/00258024211072770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Clare Crole-Rees
- Cardiff University and Cwm Taf Morgannwg University Health Board, Pontypridd, UK
| | - Andrew Forrester
- Forensic Psychiatry, Department of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
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Franke I, Urwyler T, Prüter-Schwarte C. Assisted dying requests from people in detention: Psychiatric, ethical, and legal considerations-A literature review. Front Psychiatry 2022; 13:909096. [PMID: 35966491 PMCID: PMC9374168 DOI: 10.3389/fpsyt.2022.909096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/28/2022] [Indexed: 11/13/2022] Open
Abstract
The principle of equivalence of care states that prisoners must have access to the same standard of health care as the general population. If, as recent court decisions suggest, assisted dying is not limited to people with a terminal physical illness or irremediable suffering, it might also be requested by people with severe mental illness in detention. Some of the countries with legal regulations on assisted dying also have recommendations on how to handle requests from prisoners. However, detention itself can lead to psychological distress and suicidality, so we must consider whether and how people in such settings can make autonomous decisions. Ethical conflicts arise with regard to an individual's free will, right to life, and physical and personal integrity and to the right of a state to inflict punishment. Furthermore, people in prison often receive insufficient mental health care. In this review, we compare different practices for dealing with requests for assisted dying from people in prison and forensic psychiatric facilities and discuss the current ethical and psychiatric issues concerning assisted dying in such settings.
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Affiliation(s)
- Irina Franke
- Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany.,Psychiatric Services of Grisons, Chur, Switzerland
| | - Thierry Urwyler
- Office of Corrections and Rehabilitation, Department of Research and Development, Zurich, Switzerland.,Faculty of Law, University of Lucerne, Lucerne, Switzerland.,Faculty of Law, University of Zurich, Zurich, Switzerland
| | - Christian Prüter-Schwarte
- Faculty of Medicine and University Hospital Cologne, Institute for the History of Medicine and Medical Ethics, University of Cologne, Cologne, Germany.,Faculty of Health Sciences, Department of Social Philosophy and Ethics in the Health Sciences, University Witten/Herdecke, Witten, Germany.,Department of Forensic Psychiatry and Psychotherapy II, LVR Hospital Cologne, Cologne, Germany
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Woodall J, Freeman C. Developing health and wellbeing in prisons: an analysis of prison inspection reports in Scotland. BMC Health Serv Res 2021; 21:314. [PMID: 33827565 PMCID: PMC8026093 DOI: 10.1186/s12913-021-06337-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 03/30/2021] [Indexed: 11/30/2022] Open
Abstract
Background The Scottish Prison Service (SPS) has been long regarded for its progressive policy approach to health promotion in prison. It is one of the few countries with a strategic plan for health promotion implementation. Given the paucity of understanding in relation to the concept of a health promoting prison, this study assessed routinely collected prison inspection data to understand and distil learning in regard the practical implementation of health-promoting prisons. Methods Her Majesty’s Chief Inspector of Prisons for Scotland (HMIPS) oversees the independent inspection of all prisons. This desk-based study analysed openly accessible inspection reports from a public repository. The sample was limited to inspection reports using the 2018 revised Standards to ensure comparability between reports. Eight unique inspection reports meeting this criterion were downloaded between January and October 2020. The prisons had their inspections undertaken between May 2018 and January 2020. Data from the reports which focused on ‘health and wellbeing’ were inductively coded using NVivo 12 to support thematic analysis. Results Results are presented against the values and principles outlined in the SPS’ own framework for promoting health in prison. All of the institution reports contained evidence of fairness and justice in their prison and understandings of health inequalities were recognised by staff. There were also examples of mutual (peer) support between people in prison; good relationships between staff and prisoners; and strong health promotion leadership. Conversely, some environmental conditions hindered the development of health promotion – this included staffing shortages and some practices fostering health inequity. Even where a prison was reported as having health promotion activities in place these were focused on a narrow range of individual risk factors such as smoking cessation or substance misuse. Far less attention was paid to wider health determinants. Conclusions Scotland has been at the forefront of attempts to embed a health promoting prison philosophy in their justice system. Inspection data focusing on ‘health and wellbeing’ were analysed, but the analysis suggests that more could be done to ensure a health promoting setting. The way prisons inspectors are assessing health and wellbeing in particular areas is very narrow, with the focus exclusively on healthcare without a wider appreciation of how other areas of prison life can impact.
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Affiliation(s)
- James Woodall
- School of Health and Community Studies, Leeds Beckett University, Leeds, UK.
| | - Charlotte Freeman
- School of Health and Community Studies, Leeds Beckett University, Leeds, UK
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Fovet T, Amad A, Horn M, Thomas P, Chan-Chee C. Utilization of Hospital-Level Mental Health Care Services for Inmates in France: A Transversal Study. Psychiatr Serv 2020; 71:824-828. [PMID: 32264798 DOI: 10.1176/appi.ps.201900497] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES No study has assessed utilization of hospital-level mental health care for French prisoners. In particular, the impact of unités hospitalières spécialement aménagées (UHSAs; "specially equipped hospital units"), the full-time inpatient psychiatric wards for inmates created in 2010, remains unknown. The aim of this study was to describe the overall patterns of psychiatric hospitalization for detained people in France during 2016. METHODS The study was conducted by using a national psychiatric hospital discharge database. The authors identified incarcerated people who were hospitalized in UHSAs, general psychiatric hospitals, maximum-security unités pour malades difficiles (UMDs; "units for difficult patients"), and day treatment hospitals for inmates known as services médico-psychologiques régionaux (SMPRs; "regional medical-psychological services"), from January 1 to December 31, 2016. RESULTS In 2016, 4,392 incarcerated patients (7,027 admissions) were hospitalized (92% males). Overall, 1,944 patients were hospitalized in UHSAs, 1,787 in general psychiatric hospitals, 97 in UMDs, and 1,465 in SMPRs. That year, 815 patients (19%) were admitted to at least two different facilities. The mean cumulative length of stay per patient was 86.7 days (95% confidence interval=80.1-93.3; median=27 days), with longer durations of stay in UMDs and SMPRs than in UHSAs and general psychiatric hospitals. CONCLUSIONS Despite the recent creation of UHSAs, the hospitalization of inmates in general psychiatric hospitals remains frequent in France. Future research should consider the value of further developing UHSAs.
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Affiliation(s)
- Thomas Fovet
- Lille Neurosciences and Cognition, Lille University Hospital, University of Lille, and National Institute of Health and Medical Research, U1172, Lille, France (Fovet, Amad, Horn, Thomas); Public Health France, Saint Maurice, France (Chan-Chee)
| | - Ali Amad
- Lille Neurosciences and Cognition, Lille University Hospital, University of Lille, and National Institute of Health and Medical Research, U1172, Lille, France (Fovet, Amad, Horn, Thomas); Public Health France, Saint Maurice, France (Chan-Chee)
| | - Mathilde Horn
- Lille Neurosciences and Cognition, Lille University Hospital, University of Lille, and National Institute of Health and Medical Research, U1172, Lille, France (Fovet, Amad, Horn, Thomas); Public Health France, Saint Maurice, France (Chan-Chee)
| | - Pierre Thomas
- Lille Neurosciences and Cognition, Lille University Hospital, University of Lille, and National Institute of Health and Medical Research, U1172, Lille, France (Fovet, Amad, Horn, Thomas); Public Health France, Saint Maurice, France (Chan-Chee)
| | - Christine Chan-Chee
- Lille Neurosciences and Cognition, Lille University Hospital, University of Lille, and National Institute of Health and Medical Research, U1172, Lille, France (Fovet, Amad, Horn, Thomas); Public Health France, Saint Maurice, France (Chan-Chee)
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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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Arnau F, García-Guerrero J, Benito A, Vera-Remartínez EJ, Baquero A, Haro G. Sociodemographic, Clinical, and Therapeutic Aspects of Penitentiary Psychiatric Consultation: Toward Integration Into the General Mental Health Services. J Forensic Sci 2019; 65:160-165. [PMID: 31343744 DOI: 10.1111/1556-4029.14137] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 06/25/2019] [Accepted: 07/01/2019] [Indexed: 11/30/2022]
Abstract
The characteristics of mental disorders, as well as deficiencies in their treatment, must be properly defined. This was a prospective, longitudinal, observational study, in which all men referred to a penitentiary psychiatric consultation of three penitentiary centers in Spain were invited to participate. Those who consented to participation (1328) were interviewed at the baseline timepoint and at intervals for up to 3 years. The presence of mental disorders was high: 68.2% had a cluster B personality disorder, 14% had an affective and/or anxiety disorders, 13% had schizophrenia, and over 80% had a dual disorder. Polypharmacy was the norm. Moreover, the health care received in prison did not match that provided in the community in terms of quantity and quality. These results should help to facilitate the design of mental healthcare provision for prisoners, focusing on both the most frequent patient profiles and equality of care.
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Affiliation(s)
- Francisco Arnau
- Research Team TXP, Department of Medicine, Universidad Cardenal Herrera-CEU, CEU Universities, Calle Grecia 31, Castellón, 12002, España.,Department of Psychiatry, Consorcio Hospital Provincial de Castellón, Avenida Dr. Clará, 19, Castellón, 12002, España
| | | | - Ana Benito
- Research Team TXP, Department of Medicine, Universidad Cardenal Herrera-CEU, CEU Universities, Calle Grecia 31, Castellón, 12002, España.,Torrente Mental Health Unit, Plaza de la Concordia, 4, Torrente, 46900, Valencia, Spain
| | | | - Abel Baquero
- Research Team TXP, Department of Medicine, Universidad Cardenal Herrera-CEU, CEU Universities, Calle Grecia 31, Castellón, 12002, España.,Fundación Amigó, Partida Sensal, 271, Castellón, 12005, Spain
| | - Gonzalo Haro
- Research Team TXP, Department of Medicine, Universidad Cardenal Herrera-CEU, CEU Universities, Calle Grecia 31, Castellón, 12002, España.,Department of Psychiatry, Consorcio Hospital Provincial de Castellón, Avenida Dr. Clará, 19, Castellón, 12002, España
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