1
|
Walsh SM, Muyambi K, Dennis S, Hutchinson S, Turnbull T, Tan KL, Dettwiller P, Bressington D, Gray R, Howard L, Andrews J, Muthuramalingam S, Versace VL, Jones MF. Behavioural activation for people in custody with depression: A protocol for a feasibility randomised controlled study. PLoS One 2024; 19:e0304767. [PMID: 38870235 PMCID: PMC11175500 DOI: 10.1371/journal.pone.0304767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 05/15/2024] [Indexed: 06/15/2024] Open
Abstract
People in custody are at high risk of developing depression. Accessing psychological treatments in a prison setting is a particular challenge, in part, due to difficulties accessing specialist mental health workers. Behavioural Activation (BA) may be helpful in improving health outcomes for people in custody experiencing depressive symptoms. The aim of this study is to establish the feasibility and acceptability of custodial health nurses delivering BA to improve depressive symptoms of people in custody. We will conduct a pilot randomised controlled trial with process observation examining the feasibility and acceptability of BA in treating people in custody with depressive symptoms. 60 people in custody presenting with depressive symptoms will be randomised to receive BA plus treatment as usual (TAU) or TAU provided by custodial health nurses. Eight custodial health nurses will be recruited, trained, and deliver BA. BA will be delivered twice a week for six weeks, with sessions lasting up to 30 minutes. Changes in depression and quality of life (QoL) will be assessed at baseline, 6 weeks, and 3 months post-intervention. Participants will be interviewed to understand feasibility and acceptability of BA in prison settings. The findings will inform the design of a randomised controlled trial to test the efficacy of BA for people in custody with depression. Findings will help determine whether BA for depression is suited to prison health care system and services. Improving depressive symptoms in people in custody has benefits beyond prison settings. The Central Adelaide Local Health Network Human Research Ethics Committee and University of South Australia Human Research Ethics Committee have approved the study. The trial results will be disseminated through peer-reviewed journals and scientific conferences and reported to local stakeholders and policy makers. If feasibility and acceptability is demonstrated, we will seek to progress to an effectiveness study. A potential strength of the trial model proposed, is in its scalability, with potential to increase the trial sites and locations. This trial has been prospectively registered with the Australian New Zealand Clinical Trials Registry (reference number: ACTRN12623000346673p). Trial registration ACTRN12623000346673p.
Collapse
Affiliation(s)
- Sandra M. Walsh
- University of South Australia Department of Rural Health, Whyalla Norrie, South Australia, Australia
- University of South Australia IIMPACT in Health, Adelaide, South Australia, Australia
| | - Kuda Muyambi
- University of South Australia Department of Rural Health, Whyalla Norrie, South Australia, Australia
- University of South Australia IIMPACT in Health, Adelaide, South Australia, Australia
| | - Shaun Dennis
- University of South Australia Department of Rural Health, Whyalla Norrie, South Australia, Australia
- Flinders and Upper North Local Health Network, Whyalla Integrated Mental Health Service, Whyalla, South Australia, Australia
| | - Steven Hutchinson
- South Australia Prison Health Service, Central Adelaide Local Health Network, South Australia, Australia
| | - Tom Turnbull
- South Australia Prison Health Service, Central Adelaide Local Health Network, South Australia, Australia
| | - Kuan Liung Tan
- University of South Australia Department of Rural Health, Whyalla Norrie, South Australia, Australia
- University of South Australia IIMPACT in Health, Adelaide, South Australia, Australia
| | - Pascale Dettwiller
- University of South Australia Department of Rural Health, Whyalla Norrie, South Australia, Australia
| | - Daniel Bressington
- Faculty of Nursing, Charles Darwin University, Casuarina, Northern Territory, Australia
- Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
| | - Richard Gray
- University of South Australia Department of Rural Health, Whyalla Norrie, South Australia, Australia
- La Trobe University, Bundoora, Victoria, Australia
| | - Lucy Howard
- South Australia Prison Health Service, Central Adelaide Local Health Network, South Australia, Australia
| | - Joanne Andrews
- South Australia Prison Health Service, Central Adelaide Local Health Network, South Australia, Australia
| | | | - Vincent L. Versace
- Faculty of Health, Deakin Rural Health, School of Medicine, Deakin University, Warrnambool, Victoria, Australia
| | - Martin F. Jones
- University of South Australia Department of Rural Health, Whyalla Norrie, South Australia, Australia
- University of South Australia IIMPACT in Health, Adelaide, South Australia, Australia
- La Trobe University, Bundoora, Victoria, Australia
| |
Collapse
|
2
|
Karachaliou E, Douzenis P, Chatzinikolaou F, Pantazis N, Martinaki S, Bali P, Tasios K, Douzenis A. Prisoners' Perceptions and Satisfaction with Telepsychiatry Services in Greece and the Effects of Its Use on the Coercion of Mental Healthcare. Healthcare (Basel) 2024; 12:1044. [PMID: 38786454 PMCID: PMC11121354 DOI: 10.3390/healthcare12101044] [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: 03/31/2024] [Revised: 05/04/2024] [Accepted: 05/17/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Prisoners are often associated with mental health and substance use disorders. Coercive measures are widely used in prison settings. The objective of this study was to compare inmates' perceptions and satisfaction with telepsychiatry versus face-to-face consultation and the effects of telepsychiatry on the use of coercive measures. The sample consisted of 100 male inmates from various backgrounds who had experienced both approaches of services (face to face and telepsychiatry). METHOD The data were obtained through an interview where the individuals completed a Demographic Data Questionnaire, a Participant Satisfaction Questionnaire to assess satisfaction with face-to-face psychiatric services, and a Participant Satisfaction Questionnaire to assess their satisfaction with services offered via telepsychiatry. Additionally, calculations of time spent waiting for a face-to-face psychiatric evaluation and time spent in handcuffs and in confined spaces were made before and after the introduction of telepsychiatry. RESULTS Statistically significant improvements (all p-values < 0.001) were noted in waiting times, support for relapse prevention, follow up, quality of mental health care, quality of care in the management of psychiatric problems and related medication, behavior of psychiatrists, duration of the assessment, sense of comfort, and confidentiality. Telepsychiatry led to the elimination of time spent in handcuffs and in confined spaces (transport vehicles). CONCLUSION According to the results of this study, telepsychiatry is an acceptable method of service delivery in correctional facilities and was associated with a reduction of coercive practices.
Collapse
Affiliation(s)
| | - Phoebe Douzenis
- University Hospitals of Derby and Burton, Derby DE22 3NE, UK;
| | - Fotios Chatzinikolaou
- Department of Laboratory of Forensic Medicine and Toxicology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Nikos Pantazis
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Sophia Martinaki
- Department of Social Work, University of West Attica, 12241 Athens, Greece;
| | - Panagiota Bali
- Second Department of Psychiatry, Medical School, University General Hospital “Attikon”, National and Kapodistrian University of Athens, 12462 Chaidari, Greece;
| | | | - Athanasios Douzenis
- Department of Psychiatry, School of Medicine, National & Kapodistrian University of Athens, 15772 Athens, Greece;
| |
Collapse
|
3
|
Blees A, Jakobowitz S, Hofer J, Konrad N, Krebs J, Opitz-Welke A. Self-harm among inmates of the Berlin prison system. Front Psychiatry 2024; 15:1362188. [PMID: 38757137 PMCID: PMC11096798 DOI: 10.3389/fpsyt.2024.1362188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 04/22/2024] [Indexed: 05/18/2024] Open
Abstract
Introduction Self-harming behavior in prisoners is a prevalent phenomenon, with international studies estimating a 4% prevalence rate. However, studies on self-injurious behavior in the German prison system are currently lacking. Therefore, our study aims to conduct an initial assessment. Methods The Criminological Service for the Berlin Prison System distributed questionnaires on incidents of self-harm to all Berlin prisons, except for juvenile detention centers. The questionnaires were supplemented with medical data, such as psychiatric diagnoses and medication. Results 62 questionnaires were returned, which could be attributed to 52 inmates. Compared to the average population in the Berlin prison system, the study sample exhibited variations in age, gender distribution and nationality. 94% of the inmates received a psychiatric diagnosis. Two-thirds of the male inmates had substance use disorders, while 83% of the female inmates had emotionally unstable personality resp. borderline disorders. Prior to self-harm, 87% of the inmates were administered psychiatric medication. Discussion Our study found similarities between the study population and international studies in the distribution of certain characteristics. We assume that many of the postulated risk factors can also apply to Berlin prisoners. However, the study is limited by the small number of cases and the absence of a control group.
Collapse
Affiliation(s)
- Alexander Blees
- Institute of Forensic Psychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Prison Hospital Berlin, Berlin, Germany
| | - Sharon Jakobowitz
- Criminological Service for the Berlin Prison System and Social Services of the Judiciary, Berlin, Germany
| | - Jakob Hofer
- Institute of Forensic Psychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Prison Hospital Berlin, Berlin, Germany
| | - Norbert Konrad
- Institute of Forensic Psychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Prison Hospital Berlin, Berlin, Germany
| | - Julia Krebs
- Institute of Forensic Psychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Prison Hospital Berlin, Berlin, Germany
| | - Annette Opitz-Welke
- Institute of Forensic Psychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Prison Hospital Berlin, Berlin, Germany
| |
Collapse
|
4
|
Medeiros Nunes M, Maia CR, de Andrade Santos PR, de Lisboa Lopes Costa A, de Moura SAB, de Andrade Santos PP. Self-mutilation: a systematic review. Forensic Sci Med Pathol 2024:10.1007/s12024-024-00809-4. [PMID: 38613622 DOI: 10.1007/s12024-024-00809-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2024] [Indexed: 04/15/2024]
Abstract
Self-mutilation lesions can represent a clinical diagnosis challenge for healthcare professionals, as patients do not admit to self-mutilation. This leads to failed diagnoses due to the similarity of this condition to other diseases. Searches on the subject were carried out at the PubMed, Periódicos Capes, Scopus, Science Direct and WoS databases, according to the following inclusion criteria: articles in English, Portuguese or Spanish, published from 2018 to June 2023, encompassing case reports, case series and literature reviews. Men are slight more affected by self-mutilation injuries, also presenting the most serious lesions. Self-mutilation injuries are reported globally, mostly in the Asian and American continents. Clinical presentations are varied, but morphology is, in most cases, associated to the form/instrument used for self-mutilation. Greater evidence of diagnosed mental disorders in women and underreporting of these cases in men due to low demands for specialized treatment are noted. A higher prevalence of self-mutilation lesions was verified for men, affecting a wide age range, with the highest number of cases in the USA. The most affected body areas are arms and external genitalia, mostly due to knife use. An association between self-mutilation injuries and mental disorders is clear, with most cases being previously undiagnosed.
Collapse
Affiliation(s)
- Matheus Medeiros Nunes
- Postgraduate Program in Structural and Functional Biology, Department of Morphology, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Caio Rodrigues Maia
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | | | - Antônio de Lisboa Lopes Costa
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Sérgio Adriane Bezerra de Moura
- Postgraduate Program in Structural and Functional Biology, Department of Morphology, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Pedro Paulo de Andrade Santos
- Postgraduate Program in Structural and Functional Biology, Department of Morphology, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil.
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil.
- Centro de Biociências, Departamento de Morfologia, Universidade Federal do Rio Grande do Norte (UFRN), Campus Universitário, Lagoa Nova, CEP 59072-970, Natal, RN, Brasil.
| |
Collapse
|
5
|
Favril L, Rich JD, Hard J, Fazel S. Mental and physical health morbidity among people in prisons: an umbrella review. Lancet Public Health 2024; 9:e250-e260. [PMID: 38553144 DOI: 10.1016/s2468-2667(24)00023-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 02/01/2024] [Accepted: 02/06/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND People who experience incarceration are characterised by poor health profiles. Clarification of the disease burden in the prison population can inform service and policy development. We aimed to synthesise and assess the evidence regarding the epidemiology of mental and physical health conditions among people in prisons worldwide. METHODS In this umbrella review, five bibliographic databases (Web of Science, PubMed, PsycINFO, Embase, and Global Health) were systematically searched from inception to identify meta-analyses published up to Oct 31, 2023, which examined the prevalence or incidence of mental and physical health conditions in general prison populations. We excluded meta-analyses that examined health conditions in selected or clinical prison populations. Prevalence data were extracted from published reports and study authors were contacted for additional information. Estimates were synthesised and stratified by sex, age, and country income level. The robustness of the findings was assessed in terms of heterogeneity, excess significance bias, small-study effects, and review quality. The study protocol was pre-registered with PROSPERO, CRD42023404827. FINDINGS Our search of the literature yielded 1909 records eligible for screening. 1736 articles were excluded and 173 full-text reports were examined for eligibility. 144 articles were then excluded due to not meeting inclusion criteria, which resulted in 29 meta-analyses eligible for inclusion. 12 of these were further excluded because they examined the same health condition. We included data from 17 meta-analyses published between 2002 and 2023. In adult men and women combined, the 6-month prevalence was 11·4% (95% CI 9·9-12·8) for major depression, 9·8% (6·8-13·2) for post-traumatic stress disorder, and 3·7% (3·2-4·1) for psychotic illness. On arrival to prison, 23·8% (95% CI 21·0-26·7) of people met diagnostic criteria for alcohol use disorder and 38·9% (31·5-46·2) for drug use disorder. Half of those with major depression or psychotic illness had a comorbid substance use disorder. Infectious diseases were also common; 17·7% (95% CI 15·0-20·7) of people were antibody-positive for hepatitis C virus, with lower estimates (ranging between 2·6% and 5·2%) found for hepatitis B virus, HIV, and tuberculosis. Meta-regression analyses indicated significant differences in prevalence by sex and country income level, albeit not consistent across health conditions. The burden of non-communicable chronic diseases was only examined in adults aged 50 years and older. Overall, the quality of the evidence was limited by high heterogeneity and small-study effects. INTERPRETATION People in prisons have a specific pattern of morbidity that represents an opportunity for public health to address. In particular, integrating prison health within the national public health system, adequately resourcing primary care and mental health services, and improving linkage with post-release health services could affect public health and safety. Population-based longitudinal studies are needed to clarify the extent to which incarceration affects health. FUNDING Research Foundation-Flanders, Wellcome Trust, National Institutes of Health.
Collapse
Affiliation(s)
- Louis Favril
- Institute for International Research on Criminal Policy, Faculty of Law and Criminology, Ghent University, Ghent, Belgium
| | - Josiah D Rich
- Warren Alpert Medical School, Brown University, Providence, RI, USA
| | | | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK.
| |
Collapse
|
6
|
Cramer RJ, Cacace S, Coffey A, Hazlett E, Kaniuka AR, Robertson R, Peiper LJ. Latent profiles and psychosocial correlates of persistent self-injury among incarcerated adults. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2024; 93:101967. [PMID: 38401176 DOI: 10.1016/j.ijlp.2024.101967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/07/2024] [Accepted: 02/17/2024] [Indexed: 02/26/2024]
Abstract
Self-directed violence (SDV), including both suicide and non-suicidal self-injury, represents a major challenge for carceral systems. Persistent self-injury (PSI) is an understudied SDV subtype, especially within the carceral context. The present study addressed three research questions: (a) do naturally occurring SDV subgroups occur within a carceral population (e.g., PSI versus other classes); (b) how SDV groups may be differentiated by verbal or behavioral SDV; and (c) whether demographic, mental health, and incarceration-related factors are associated with SDV subgroups. We conducted a secondary analysis of existing data from a statewide carceral electronic medical record (N = 3527). Latent class analysis supports two SDV subtypes: episodic and persistent self-injury. The PSI class was characterized by significantly greater verbal expressions and behavioral acts of SDV compared to the episodic group. Correlates of the PSI subtype included older age, male sex, prior SDV, and lower depressive symptoms. Findings are discussed with respect to the proposed Diagnostic and Statistical Manual self-injury focused disorder, influential factors on SDV in carceral settings, and recommendations for future research and practice.
Collapse
Affiliation(s)
- Robert J Cramer
- Department of Public Health Sciences, UNC Charlotte, 19201 University City Blvd., Charlotte, NC 28223, USA.
| | - Sam Cacace
- Department of Public Health Sciences, UNC Charlotte, 19201 University City Blvd., Charlotte, NC 28223, USA
| | - Abby Coffey
- NC Division of Public Health, 5605 Six Forks Rd., Raleigh, NC 27609, USA
| | - Emily Hazlett
- Office of Scientific Integrity, Duke University, Durham, NC 27708, USA
| | - Andréa R Kaniuka
- Department of Public Health Sciences, UNC Charlotte, 19201 University City Blvd., Charlotte, NC 28223, USA
| | - Ryan Robertson
- Department of Public Health Sciences, UNC Charlotte, 19201 University City Blvd., Charlotte, NC 28223, USA
| | - Lewis J Peiper
- NC Department of Adult Correction, 831 W. Morgan Street, Raleigh, NC 27699, USA
| |
Collapse
|
7
|
Slade K, Justice L, Martijn F, Borschmann R, Baguley T. Deaths among adults under supervision of the England and Wales' probation services: variation in individual and criminal justice-related factors by cause of death. HEALTH & JUSTICE 2024; 12:10. [PMID: 38411785 PMCID: PMC10898034 DOI: 10.1186/s40352-024-00263-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 02/08/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND The mortality rate among people under probation supervision in the community is greater than that among incarcerated people and that among the general population. However, there is limited research on the distinct vulnerabilities and risks underlying the causes of death in this population. In this retrospective cohort study, we examined the individual and criminal justice-related factors associated with different causes of death. Factors were assessed in relation to the type of supervision, distinguishing between those under post-custodial release and those serving a community sentence. RESULTS The study utilised the official data held by His Majesty's Prison and Probation Service in England and Wales on the deaths of men and women under probation supervision between 01 April 2019 and 31 March 2021 where the cause of death had been definitively recorded (n = 1770). The high risk of deaths primarily caused by external factors (i.e., suspected suicide (10%), homicide (5%), and drug-related death (26%)) in this population was confirmed. A Gaussian Graphical Model (GGM) demonstrated unique relationships with suspected suicide and drug-related deaths for known suicide risk, history of drug use and recent (< 28 days of death) enforcement action due to a breach of probation conditions. Our findings suggest that that familial violence and abuse may be relevant in suicide and drug-related deaths and that minority groups may experience disproportional risk to certain types of death. CONCLUSIONS This study identified unique risk indicators and modifiable factors for deaths primarily caused by external factors in this population within the health and justice spheres. It emphasised the importance of addressing health inequalities in this population and improved joint-working across health and justice. This involves ensuring that research, policies, training, and services are responsive to the complex needs of those under probation supervision, including those serving community sentences. Only then can we hope to see lower rates of death within this population.
Collapse
Affiliation(s)
- Karen Slade
- School of Social Sciences, Department of Psychology, Nottingham Trent University, Nottingham, NG1 4FQ, UK.
| | - Lucy Justice
- School of Social Sciences, Department of Psychology, Nottingham Trent University, Nottingham, NG1 4FQ, UK
| | - Frederica Martijn
- School of Social Sciences, Department of Psychology, Nottingham Trent University, Nottingham, NG1 4FQ, UK
| | - Rohan Borschmann
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, 3052, Australia
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC, 3010, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, 3052, Australia
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Thom Baguley
- School of Social Sciences, Department of Psychology, Nottingham Trent University, Nottingham, NG1 4FQ, UK
| |
Collapse
|
8
|
Li J, Gu H, Xia T. Childhood maltreatment and NSSI in prisoners: mediation through self-identity and moderation by sensation-seeking. Front Psychiatry 2024; 15:1303033. [PMID: 38370562 PMCID: PMC10869573 DOI: 10.3389/fpsyt.2024.1303033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/10/2024] [Indexed: 02/20/2024] Open
Abstract
Introduction The prevalence of non-suicidal self-injury (NSSI) among prisoners is widely recognized. However, most research conducted in prisons setting has focused on lifetime engagement in NSSI, with limited knowledge about its correlates and risk factors during imprisonment. Methods Drawing on the integrated theoretical model of NSSI, this study aimed to examine the combined effects of childhood maltreatment (an environmental factor) and two intrapersonal factors, namely self-identity and sensation-seeking, on NSSI. 1042 Chinese male offenders participated in the current study, and regression analyses is used to examine the relationship among variables. Results The results revealed that self-identity mediated the association between childhood maltreatment and prisoners' NSSI. Sensation-seeking moderated the relationship between self-identity and NSSI, and this connection was only significant for offenders with high sensation-seeking. Discussion We discuss the results of the current research and possible practical implications.
Collapse
Affiliation(s)
- Juan Li
- School of Educational Science, Hunan Normal University, Changsha, China
| | - Honglei Gu
- School of Educational Science, Hunan Normal University, Changsha, China
- Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
| | - Tiansheng Xia
- School of Art and Design, Guangdong University of Technology, Guangzhou, China
| |
Collapse
|
9
|
Santoriello C, De Rosa C, Rufo C, Romano F, Termoli G, Fiorillo G, Caprio L, Vitolo M, Pagano AM. Suicide Risk Screening and Assessment before and after the COVID-19 Pandemic in New Inmates. Healthcare (Basel) 2024; 12:100. [PMID: 38201006 PMCID: PMC10779268 DOI: 10.3390/healthcare12010100] [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: 11/25/2023] [Revised: 12/26/2023] [Accepted: 12/31/2023] [Indexed: 01/12/2024] Open
Abstract
(1) Background: Suicide is the main cause of death in Italian prisons. The largest number of inmates who killed themselves was recorded during three years of the COVID-19 pandemic. This study aimed to explore psychosocial risk factors for suicide among inmates incarcerated before and after the onset of COVID-19. (2) Methods: At prison reception, inmates underwent clinical interviews and were assessed using the Blaauw Scale and Suicide Assessment Scale. Psychological distress, measured by the Symptom Checklist-90-R, was compared between inmates admitted before and after COVID-19. Regression analyses were run to examine psychosocial vulnerabilities associated with suicidal intent in newly incarcerated individuals at risk of suicide. (3) Results: Among the 2098 newly admitted inmates (93.7% male) aged 18 to 87 years (M = 39.93; SD = 12.04), 1347 met the criteria for suicide risk, and 98 exhibited high suicidal intent. Inmates who entered prison after the onset of COVID-19 were older and had fewer social relationships. They had a higher prevalence of recidivism and substance abuse, along with elevated levels of psychological distress. An increase in perceived loss of control, anergia, obsessive-compulsive symptoms, phobic anxiety, and paranoid ideation emerged as the factors most strongly associated with high suicidal intent. (4) Conclusions: These findings support the value of psychosocial screening in promptly identifying inmates at risk of suicide, enabling the implementation of targeted, multi-professional interventions. Future research should replicate these results, with a focus on longitudinal studies that monitor the same inmates throughout their incarceration period.
Collapse
Affiliation(s)
- Carmen Santoriello
- Unità Operativa Semplice Dipartimentale U.O.S.D. Department of Adults and Minors Healthcare, Criminal Area, Local Health Authority of Salerno, 84132 Salerno, Italy
| | | | | | | | | | | | | | | | - Antonio Maria Pagano
- Unità Operativa Semplice Dipartimentale U.O.S.D. Department of Adults and Minors Healthcare, Criminal Area, Local Health Authority of Salerno, 84132 Salerno, Italy
| |
Collapse
|
10
|
Kaggwa MM, Chaimowitz GA, Erb B, Prat S, Davids A, Moulden H, Robbins A, Bradford J, Mamak M, Olagunju AT. Self-harming behaviors and forensic system-related factors: an analysis of the Ontario review board database. BMC Psychiatry 2023; 23:913. [PMID: 38057757 PMCID: PMC10698976 DOI: 10.1186/s12888-023-05394-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/21/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND In Canada, ensuring public safety, and the safety and well-being of accused individuals under the jurisdiction of the provincial review board are very important. While previous studies have reported a significant risk of self-harming behaviors (non-suicidal self-injury and suicide attempt) in forensic psychiatric settings, no large population study has assessed any relationship between forensic system-related factors and self-harming behaviors. A better understanding of these factors can help clinicians implement protective measures to mitigate self-harming behaviors or actions. METHODS Using the Ontario Review Board (ORB) database covering 2014-2015 period (n = 1211, mean age = 42.5 ± 13.37 years, males = 86.1%), we analyzed the prevalence and factors associated with self-harming behaviors, emphasizing the characterization of the forensic system-related factors (ORB status, legal status, type of offense, previous criminal history, and victim relationship). The relationships between the forensic system-related factors and self-harming behaviors were explored using five separate logistic regression models, controlling for clinical and sociodemographic characteristics. RESULTS Approximately 4% of the individuals in the forensic system over the study period engaged in self-harming behaviors Among the studied patients, individuals determined to be unfit to stand trial and inpatients were significantly more likely to have self-harming behaviors. There was no significant relationship between the type of offence, victim relationship, and previous criminal history with self-harming behavior. CONCLUSION Forensic psychiatry inpatients should have close observation, screening, monitoring, and individual tailored management strategies for self-harming behaviors. The findings of this study indicate that forensic system-related factors, especially those that pertain to the status of individuals in the forensic system (i.e., unfit to stand trial and being an inpatient) are more responsible for self-harming behaviors among forensic patients in Ontario.
Collapse
Affiliation(s)
- Mark Mohan Kaggwa
- Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada.
- Department of Psychiatry and Behavioral Sciences, McMaster University, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada.
- Mbarara University of Science and Technology, Mbarara, Uganda.
| | - Gary Andrew Chaimowitz
- Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
- Department of Psychiatry and Behavioral Sciences, McMaster University, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
| | - Bailea Erb
- Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
| | - Sébastien Prat
- Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
- Department of Psychiatry and Behavioral Sciences, McMaster University, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
| | - Arianna Davids
- Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
| | - Heather Moulden
- Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
- Department of Psychiatry and Behavioral Sciences, McMaster University, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
| | - Amara Robbins
- Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
| | - John Bradford
- Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
- Department of Psychiatry and Behavioral Sciences, McMaster University, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
- Division of Forensic Psychiatry, University of Ottawa, Ottawa, ON, Canada
| | - Mini Mamak
- Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
- Department of Psychiatry and Behavioral Sciences, McMaster University, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
| | - Andrew Toyin Olagunju
- Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
- Department of Psychiatry and Behavioral Sciences, McMaster University, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, 5000, Australia
| |
Collapse
|
11
|
Austin A, Favril L, Craft S, Thliveri P, Freeman TP. Factors associated with drug use in prison: A systematic review of quantitative and qualitative evidence. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 122:104248. [PMID: 37952319 DOI: 10.1016/j.drugpo.2023.104248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND About a third of people use drugs during their incarceration, which is associated with multiple adverse health and criminal justice outcomes. Many studies have examined factors associated with in-prison drug use, but this evidence has not yet been systematically reviewed. We aimed to systematically review and synthesise the evidence on factors related to drug use in prison. METHODS Three databases (PubMed, PsycINFO and Embase) were systematically searched as well as grey literature, for quantitative, qualitative and mixed-methods studies examining factors related to drug use inside prison. We excluded studies that did not explicitly measure in prison drug use or only measured alcohol and/or tobacco use. Study quality was assessed using the Newcastle Ottawa Scale (NOS) for quantitative studies and Critical Appraisal Skills Programme (CASP) for qualitative studies. The review was prospectively registered on PROSPERO (CRD42021295898). RESULTS Fifty-four studies met the inclusion criteria, reporting data on 26,399 people in prison. Most studies were of low or moderate-quality, and all used self-report to assess drug use. In quantitative studies, studies found that previous criminal justice involvement, poor prison conditions, pre-prison drug use and psychiatric diagnosis were positively associated with drug use in prison. In qualitative studies, reasons for drug use were closely linked to the prison environment lacking purposeful activity and the social context of the prison whereby drug use was seen as acceptable, necessary for cohesion and pressurised. CONCLUSION In the first systematic review of factors associated with drug use in prison, key modifiable risk factors identified from quantitative and qualitative studies were psychiatric morbidity and poor prison conditions. Non-modifiable factors included previous drug use and criminal history linked to substance use. Our findings indicate an opportunity to intervene and improve the prison environment to reduce drug use and associated adverse outcomes.
Collapse
Affiliation(s)
- Alice Austin
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, UK
| | - Louis Favril
- Faculty of Law and Criminology, Ghent University, Belgium
| | - Sam Craft
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, UK
| | - Phoebe Thliveri
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, UK
| | - Tom P Freeman
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, UK.
| |
Collapse
|
12
|
Caravaca-Sánchez F, Aizpurua E, Wolff N. The Prevalence of Prison-based Physical and Sexual Victimization in Males and Females: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2023; 24:3476-3492. [PMID: 36373724 DOI: 10.1177/15248380221130358] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
This systematic review investigated the prevalence of prison-based interpersonal harm by type of victimization (physical and sexual) and sex, along with the heterogeneity among studies using meta-regression. Using Preferred Reporting Items for Systematic Reviews and the Meta-Analysis guidelines, 24 articles met the selection criteria. Study quality was assessed using the Joana Briggs Institute (20.8% deemed low quality, 33.3% moderate, and 45.9% high). Searches were conducted in Criminal Justice Abstracts, PsycINFO, PubMed, and Web of Science. The 24 articles comprised 36 separate samples inclusive of 23,967 incarcerated individuals. The random-effects pooled prevalence estimate of prison-based physical victimization was 18.8%, with slightly higher rates for females (20.3%) than males (18.1%). For sexual victimization, the pooled prevalence estimate was 12.4%, with higher rates among females (15.3%) than males (9.7%). For females, younger individuals reported higher rates of physical and sexual victimization and studies using smaller samples had higher rates of physical victimization. Rates of physical and sexual victimization for men were higher if perpetrators included residents and staff, the recall period was since admission, data was collected using self-administered surveys, and in low-quality studies (sexual victimization only). Rates of prison-based interpersonal harm, while high, varied significantly by type of victimization, sex, and study methodology. High heterogeneity will be reduced only if future studies adhere to best methodological practices in defining and collecting data on interpersonal harm and consistently test risk and prevention factors instrumental to prevention efforts. Study limitations include the exclusion of unpublished and non-English-language studies, small sample sizes for female studies, and methodological "noise" within the literature that reduce predictive precision.
Collapse
Affiliation(s)
| | | | - Nancy Wolff
- Rutgers, The State University of New Jersey, Piscataway, USA
| |
Collapse
|
13
|
Narita Z, Oh H, Koyanagi A, Wilcox HC, DeVylder J. Association of a History of Incarceration and Solitary Confinement with Suicide-Related Outcomes in a General Population Sample from Two U.S. Cities. Arch Suicide Res 2023:1-12. [PMID: 37937913 DOI: 10.1080/13811118.2023.2279523] [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: 11/09/2023]
Abstract
OBJECTIVES To evaluate whether a history of incarceration was associated with increased odds of suicidal ideation and suicide attempts, and to determine if this association was further strengthened when combined with a history of solitary confinement. METHODS We collected cross-sectional data from a general population sample in New York City and Baltimore in March 2017. Participants were categorized based on their history of incarceration and solitary confinement: (1) no incarceration, (2) incarceration-only, and (3) incarceration plus solitary confinement. We compared these three groups, utilizing hierarchical adjustments for sociodemographic factors and adverse childhood experiences. Missing data were accounted for utilizing multiple imputation via chained equation. RESULTS A total of 1221 individuals were analyzed. Those who experienced both incarceration and solitary confinement consistently had higher odds of suicidal ideation (OR, 2.80; 95% CI, 1.43 to 5.48) and suicide attempts (OR, 6.98; 95% CI, 2.77 to 17.61) than never incarcerated individuals. Those who experienced incarceration without solitary confinement had higher odds of suicide attempts (OR, 3.77; 95% CI, 1.35 to 10.56) than never incarcerated individuals, whereas this association was not evident for suicidal ideation. Solitary confinement increased the odds of suicidal ideation even compared to incarceration without solitary confinement (OR, 2.71; 95% CI, 1.09 to 6.74). CONCLUSIONS Our findings support the need to address the higher likelihood of suicide-related outcomes among those in contact with the criminal justice system, and to consider alternatives to solitary confinement.
Collapse
|
14
|
Erlangsen A, Khan M, Su W, Alateeq K, Charfi F, Madsen T, Qin P, Morthorst BR, Thomsen M, Malik A, Bandara P, Fleischmann A, Saeed K. Situation Analysis of Suicide and Self-Harm in the WHO Eastern Mediterranean Region. Arch Suicide Res 2023:1-19. [PMID: 37837375 DOI: 10.1080/13811118.2023.2262532] [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: 10/16/2023]
Abstract
OBJECTIVE An estimated 41,000 lives are lost to suicide each year in World Health Organization Eastern Mediterranean Region Office (WHO EMRO) countries. The objective of this study was to conduct a situation analysis for suicide and self-harm in the WHO EMRO region. METHODS Data on suicide were obtained from the WHO Global Health Estimates for the years 2000-2019. Information on risk groups efforts to prevent self-harm and suicide in the EMRO region were retrieved through scientific studies, grey literature, and public websites. RESULTS During 2000-2019, the age-standardized suicide rate was 6.7 per 100,000 inhabitants, albeit there are concerns regarding data quality. Self-harm and suicide remain criminal acts in more than half of the countries. Few countries have a national plan for prevention of suicide. Toxic agents, such as pesticides and black henna, are easily available and frequently used for suicide in some areas, as are firearms and self-immolation. Successful prevention measures include means restriction and psychosocial interventions after self-harm. CONCLUSION Many WHO EMRO countries remain underserved in terms of mental health care. Decriminalization of suicide and means restriction might be further promoted. Online-based tools for mental health literacy and psychosocial therapy are other options to explore.
Collapse
|
15
|
Arora A, Bojko L, Kumar S, Lillington J, Panesar S, Petrungaro B. Assessment of machine learning algorithms in national data to classify the risk of self-harm among young adults in hospital: A retrospective study. Int J Med Inform 2023; 177:105164. [PMID: 37516036 DOI: 10.1016/j.ijmedinf.2023.105164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 07/06/2023] [Accepted: 07/21/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND Self-harm is one of the most common presentations at accident and emergency departments in the UK and is a strong predictor of suicide risk. The UK Government has prioritised identifying risk factors and developing preventative strategies for self-harm. Machine learning offers a potential method to identify complex patterns with predictive value for the risk of self-harm. METHODS National data in the UK Mental Health Services Data Set were isolated for patients aged 18-30 years who started a mental health hospital admission between Aug 1, 2020 and Aug 1, 2021, and had been discharged by Jan 1, 2022. Data were obtained on age group, gender, ethnicity, employment status, marital status, accommodation status and source of admission to hospital and used to construct seven machine learning models that were used individually and as an ensemble to predict hospital stays that would be associated with a risk of self-harm. OUTCOMES The training dataset included 23 808 items (including 1081 episodes of self-harm) and the testing dataset 5951 items (including 270 episodes of self-harm). The best performing algorithms were the random forest model (AUC-ROC 0.70, 95%CI:0.66-0.74) and the ensemble model (AUC-ROC 0.77 95%CI:0.75-0.79). INTERPRETATION Machine learning algorithms could predict hospital stays with a high risk of self-harm based on readily available data that are routinely collected by health providers and recorded in the Mental Health Services Data Set. The findings should be validated externally with other real-world, prospective data. FUNDING This study was supported by the Midlands and Lancashire Commissioning Support Unit.
Collapse
Affiliation(s)
- Anmol Arora
- School of Clinical Medicine, University of Cambridge, Cambridge, UK; Health Economics Unit, NHS Midlands and Lancashire Commissioning Support Unit, Leyland, UK.
| | - Louis Bojko
- Health Economics Unit, NHS Midlands and Lancashire Commissioning Support Unit, Leyland, UK
| | - Santosh Kumar
- Health Economics Unit, NHS Midlands and Lancashire Commissioning Support Unit, Leyland, UK
| | - Joseph Lillington
- Health Economics Unit, NHS Midlands and Lancashire Commissioning Support Unit, Leyland, UK
| | - Sukhmeet Panesar
- Senior Adviser, Office of Chief Data and Analytics Officer, NHS England and NHS Improvement, UK
| | - Bruno Petrungaro
- Health Economics Unit, NHS Midlands and Lancashire Commissioning Support Unit, Leyland, UK
| |
Collapse
|
16
|
Gao Y, Chen Z, Chen S, Wang S, Lin J. Risk factors for neck pain in college students: a systematic review and meta-analysis. BMC Public Health 2023; 23:1502. [PMID: 37553622 PMCID: PMC10408143 DOI: 10.1186/s12889-023-16212-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 06/28/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND During the COVID-19 epidemic, the prevalence of neck pain among college students has increased due to the shift from offline to online learning and increasing academic and employment pressures. Therefore, this systematic review aimed to identify the personal, occupational, and psychological factors associated with the development of neck pain to promote the development of preventive strategies and early intervention treatment. METHODS Seven electronic databases were searched from inception to December 2022 for cross-sectional studies, cohort studies, case----control studies, and randomized controlled trials (RCTs) on neck pain. The quality of the selected studies were assessed by American Agency for Healthcare Research and Quality (AHRQ) or the Newcastle-Ottawa Scale (NOS). Pooled odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were calculated to evaluate the effects of the included risk factors on neck pain. RESULTS Thirty studies were included, including 18,395 participants. And a total of 33 potentially associated risk factors were identified. Ultimately, 11 risk factors were included in the meta-analysis after assessing, and all results were statistically significant (P < 0.05). The factors supported by strong evidence mainly include the improper use of the pillow (OR = 2.20, 95% CI: 1.39 to 3.48), lack of exercise (OR = 1.88, 95% CI: 1.53 to 2.30), improper sitting posture (OR = 1.97, 95% CI: 1.39 to 2.78), history of neck and shoulder trauma (OR = 2.32, 95% CI: 1.79 to 3.01), senior grade (OR = 2.86, 95% CI: 2.07 to 3.95), staying up late (OR = 1.80, 95% CI: 1.35 to 2.41), long-time electronic product usage daily (OR = 1.53, 95% CI: 1.33 to 1.76), long-time to bow head (OR = 2.04, 95% CI: 1.58 to 2.64), and emotional problems (OR = 2.09; 95% CI: 1.66 to 2.63). Risk factors supported by moderate evidence were high stress (OR = 1.61, 95% CI: 1.02 to 2.52) and female gender (OR = 1.69, 95% CI: 1.52 to 1.87). CONCLUSION This study obtained 11 main risk factors affecting college students neck pain, including improper use of the pillow, lack of exercise, improper sitting posture, history of neck and shoulder trauma, senior grade, staying up late, long-term electronic product usage daily, long time to bow head, high stress, emotional problems and female gender.
Collapse
Affiliation(s)
- Yifang Gao
- School of Health, Fujian Medical University, Fuzhou, China
| | - Zhiming Chen
- The Third Hospital of Fuqing City, Fuzhou, China
| | - Shaoqing Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Fujian Provincial Collaborative Innovation Center of Geriatric Rehabilitation and Industry Promotion, Fuzhou, China
| | - Shizhong Wang
- School of Health, Fujian Medical University, Fuzhou, China.
- Fujian Provincial Collaborative Innovation Center of Geriatric Rehabilitation and Industry Promotion, Fuzhou, China.
| | - Jianping Lin
- School of Health, Fujian Medical University, Fuzhou, China.
- Fujian Provincial Collaborative Innovation Center of Geriatric Rehabilitation and Industry Promotion, Fuzhou, China.
| |
Collapse
|
17
|
Perry AE, Zawadzka M, Lapinski P, Moore K, Rychlik J, Nowak B. Cultural adaptation of a UK evidence-based problem-solving intervention to support Polish prisoners at risk of suicidal behaviour: a cross-sectional survey using an Ecological Validity Model. BMJ Open 2023; 13:e069252. [PMID: 37423634 DOI: 10.1136/bmjopen-2022-069252] [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: 07/11/2023] Open
Abstract
OBJECTIVE To complete a cultural adaptation of a UK evidence-based problem-solving intervention to support Polish prisoners at risk of suicidal behaviour. DESIGN A cross-sectional survey participatory design using an Ecological Validity Model. SETTING The study was a collaboration between: the Academy of Justice, in Warsaw, the University of Lodz, two Polish prisons (ZK Raciborz and ZK Klodzko) and the University of York (UK). METHODS The adaptation process included an examination of the use of language, metaphors and content (ie, culturally appropriate and syntonic language), the changing of case study scenarios (relevance and acceptability) and maintenance of the theoretical underpinning of the problem-solving model (intervention comprehensibility and completeness). Four stages used: (1) a targeted demonstration for Polish prison staff, (2) a wider audit of the skills with Polish prison staff and students, (3) forward and back-translation of the adapted package, and (4) two iterative consultations with participants from stages (1) and (2) and prison officers from two Polish prisons. PARTICIPANTS Self-selecting volunteer participants included: targeted prison staff (n=10), prison staff from the wider Polish penitentiary system (n=39), students from the University of Lodz (n=28) and prison officers from two Polish prisons (n=12). MAIN OUTCOMES AND MEASURES Acceptability and feasibility of the training package, reported in a series of knowledge user surveys. RESULTS The recognised benefits of using the skills within the training package included: enhancing communication, reflective development, collaborative working, changing behaviour, empowering decision-making, relevance to crisis management situations and use of open-ended questions. The skills were endorsed to be used as part of future penitentiary training for prison officers in Poland. CONCLUSIONS The skills had widespread appeal for use across the Polish penitentiary system. The materials were deemed relevant while adhering to the comprehensibility of the intervention. Further evaluation of the intervention should be explored using a randomised controlled trial design.
Collapse
Affiliation(s)
- Amanda E Perry
- Department of Health Sciences, University of York, York, UK
| | | | - Piotr Lapinski
- Department of Occupational Therapy, University of Physical Education in Warsaw, Faculty of Rehabilitation, Warsaw, Poland
| | | | | | | |
Collapse
|
18
|
Gray AL, Viljoen JL. Violence and Suicidal/Nonsuicidal Self-Injury Among Adolescents Undergoing Residential Treatment: An Examination of the Predictive Validity of the SAVRY, START:AV, and VRS-YV. CRIMINAL JUSTICE AND BEHAVIOR 2023; 50:931-952. [PMID: 37323998 PMCID: PMC10265301 DOI: 10.1177/00938548231165531] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Using a retrospective study design, predictive validity of the Structured Assessment of Violence Risk in Youth, Short-Term Assessment of Risk and Treatability: Adolescent Version (START: AV), and the Violence Risk Scale-Youth Version (VRS-YV) was examined among 87 adolescents referred to a residential treatment program. With few exceptions, moderate to high accuracy was achieved for the three measures in predicting violence and suicidal/nonsuicidal self-injury occurring during the adolescents' time in treatment. Accuracy of the measures peaked within 90 days for violence and gradually increased over the 180-day follow-up for suicidal/nonsuicidal self-injury. Dynamic factors were more predictive of repeated events involving violence relative to static/historical factors, whereas only factors from the START: AV were predictive of repeated events involving suicidal/nonsuicidal self-injury. These results emphasize the need for further examining the risk of adverse outcomes beyond violence among adolescents.
Collapse
|
19
|
Guillot CR, Kelly ME, Phillips NB, Su MY, Douglas ME, Poe DJ, Berman ME, Liang T. BDNF and stress/mood-related interactions on emotional disorder symptoms, executive functioning, and deliberate self-harm. J Psychiatr Res 2023; 163:195-201. [PMID: 37220696 PMCID: PMC10330730 DOI: 10.1016/j.jpsychires.2023.05.060] [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: 01/30/2023] [Revised: 04/12/2023] [Accepted: 05/16/2023] [Indexed: 05/25/2023]
Abstract
Some prior research has suggested that the brain-derived neurotrophic factor (BDNF) gene may amplify responses related to life stress (e.g., depression and anxiety) or associated with negative moods (e.g., self-harm and diminished cognitive functioning). The purpose of this study was to investigate whether stress/mood-related associations with depressive and anxiety symptoms, deliberate self-harm, and executive functioning (EF) are moderated by genotypic variations in BDNF rs10835210 (a relatively understudied BDNF polymorphism) in a nonclinical sample. As part of a larger study, European American social drinkers (N = 132; 43.9% female; M age = 26.0, SD = 7.6) were genotyped for BDNF rs10835210 and were administered self-report measures of subjective life stress, depressive and anxiety symptoms, and history of non-suicidal self-injury (NSSI) and behavioral measures of EF and deliberate self-harm. Results indicated that BDNF significantly moderated the life stress associations with depressive symptoms and NSSI, the anxious mood association with EF, and the depressed mood association with deliberate self-harm behavior. Each of these BDNF × stress/mood interactions were characterized by stress/mood associations that were stronger in individuals with the AA genotype (homozygous for the minor allele) than in individuals possessing a genotype that included the major allele (AC or CC). The main limitations of the present study were use of a cross-sectional design, modest sample size, and investigating only one BDNF polymorphism. Despite these limitations and though preliminary, current findings suggest that variations in BDNF may confer vulnerability to stress or mood, which may result in more adverse emotional, cognitive, or behavioral outcomes.
Collapse
Affiliation(s)
| | - Megan E Kelly
- Department of Psychology, University of North Texas, USA
| | | | - Mei-Yi Su
- Department of Psychology, University of North Texas, USA
| | | | - Darian J Poe
- Department of Social Work, Psychology, and Philosophy, Texas Woman's University, USA
| | | | | |
Collapse
|
20
|
Svendsen VG, Stavseth MR, Skardhamar T, Bukten A. Psychiatric morbidity among women in Norwegian prisons, 2010-2019: a register-based study. BMC Psychiatry 2023; 23:390. [PMID: 37268924 DOI: 10.1186/s12888-023-04886-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 05/18/2023] [Indexed: 06/04/2023] Open
Abstract
PURPOSE Research suggests that women in prison have more mental health problems than men and are prone to suffer from more severe psychiatric disorders. This study utilizes national registry data to describe demographic and psychiatric gender differences in Norwegian prisons, and to investigate comorbid psychiatric disorders and time trends in psychiatric morbidity among women. METHODS Longitudinal data from the Norwegian Prison Release Study linked with the Norwegian Patient Registry and data from Statistics Norway provided information on health care utilization, socioeconomic status, and history of psychiatric disorders among all individuals (nwomen = 5,429; nmen = 45,432) who were incarcerated in a Norwegian prison between 2010 and 2019. RESULTS Women were more likely than men to have a history of any psychiatric disorder (75% vs. 59%). Substance use disorders and dual disorders were highly prevalent in both genders, yet highest among women (56 and 38% respectively, versus 43 and 24% among men). From 2010 to 2019, we found a considerable increase in the 12-month prevalence of most diagnostic categories among women entering prison. CONCLUSION Psychiatric and dual disorders are highly prevalent in Norwegian prisons, and especially among women. The proportion of women entering prison with a recent history of mental health problems has increased rapidly over the last decade. Women's prison institutions need to adjust health and social services, and awareness about substance use and other psychiatric disorders in order to meet the increasing proportion of women facing these challenges.
Collapse
Affiliation(s)
- Vegard G Svendsen
- Norwegian Centre for Addiction Research, SERAF, University of Oslo, Building 45, Kirkeveien 166, Oslo, 0450, Norway.
| | - Marianne Riksheim Stavseth
- Norwegian Centre for Addiction Research, SERAF, University of Oslo, Building 45, Kirkeveien 166, Oslo, 0450, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Torbjørn Skardhamar
- Department of Sociology and Human Geography, University of Oslo, Oslo, Norway
| | - Anne Bukten
- Norwegian Centre for Addiction Research, SERAF, University of Oslo, Building 45, Kirkeveien 166, Oslo, 0450, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
21
|
Sariaslan A, Larsson H, Hawton K, Pitkänen J, Lichtenstein P, Martikainen P, Fazel S. Physical injuries as triggers for self-harm: a within-individual study of nearly 250 000 injured people with a major psychiatric disorder. BMJ MENTAL HEALTH 2023; 26:e300758. [PMID: 37380367 PMCID: PMC10577735 DOI: 10.1136/bmjment-2023-300758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/15/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Although there is robust evidence for several factors which may precipitate self-harm, the contributions of different physical injuries are largely unknown. OBJECTIVE To examine whether specific physical injuries are associated with risks of self-harm in people with psychiatric disorders. METHODS By using population and secondary care registers, we identified all people born in Finland (1955-2000) and Sweden (1948-1993) with schizophrenia-spectrum disorder (n=136 182), bipolar disorder (n=68 437) or depression (n=461 071). Falls, transport-related injury, traumatic brain injury and injury from interpersonal assault were identified within these subsamples. We used conditional logistic regression models adjusted for age and calendar month to compare self-harm risk in the week after each injury to earlier weekly control periods, which allowed us to account for unmeasured confounders, including genetics and early environments. FINDINGS A total of 249 210 individuals had been diagnosed with a psychiatric disorder and a physical injury during the follow-up. The absolute risk of self-harm after a physical injury ranged between transport-related injury and injury from interpersonal assault (averaging 17.4-37.0 events per 10 000 person-weeks). Risk of self-harm increased by a factor of two to three (adjusted OR: 2.0-2.9) in the week following a physical injury, as compared with earlier, unexposed periods for the same individuals. CONCLUSIONS Physical injuries are important proximal risk factors for self-harm in people with psychiatric disorders. CLINICAL IMPLICATIONS Mechanisms underlying the associations could provide treatment targets. When treating patients with psychiatric illnesses, emergency and trauma medical services should actively work in liaison with psychiatric services to implement self-harm prevention strategies.
Collapse
Affiliation(s)
- Amir Sariaslan
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Henrik Larsson
- School of Medical Sciences, Örebro University, Örebro, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Keith Hawton
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Joonas Pitkänen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- International Max Planck Research School for Population Health and Data Science, Rostock, Germany
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Pekka Martikainen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Centre for Health Equity Studies (CHESS), Stockholm University and Karolinska Institutet, Stockholm, Sweden
- Max Planck Institute for Demographic Research, Rostock, Germany
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
| |
Collapse
|
22
|
McTernan N, Griffin E, Cully G, Kelly E, Hume S, Corcoran P. The incidence and profile of self-harm among prisoners: findings from the Self-Harm Assessment and Data Analysis Project 2017-2019. Int J Prison Health 2023; 19:565-577. [PMID: 37125411 DOI: 10.1108/ijph-02-2023-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
PURPOSE Internationally, rates of suicide and lifetime self-harm are higher in prisoners compared to the general population. This study aims to identify specific characteristics of self-harming behaviour and to establish a profile of prisoners who engage in self-harm. DESIGN/METHODOLOGY/APPROACH Data from the Self-Harm Assessment and Data Analysis Project (SADA) on self-harm episodes in prisons in the Republic of Ireland during 2017-2019 was used. Annual rates per 1,000 were calculated by age and gender. FINDINGS The rate of self-harm between 2017 and 2019 was 31 per 1,000 prisoners for men and six times higher at 184 per 1,000 prisoners for women. The rate of self-harm was twice as high among prisoners on remand than sentenced prisoners (60.5 versus 31.3 per 1,000). The highest rates of self-harm among sentenced prisoners were observed among 18-29-year-old men (45 per 1,000) and women (125 per 1,000). The rate of self-harm was higher among women prisoners in all age groups. Contributory factors associated with self-harm were mainly related to mental health but also linked to a prisoner's environment and relationships. PRACTICAL IMPLICATIONS There is a need to ensure access to timely and suitable mental health services, including both appropriate referral and provision of evidence-based mental health interventions to address the needs of these cohorts. ORIGINALITY/VALUE To the best of the authors' knowledge, this is the first national study to systematically examine incidence and patterns of self-harm among the prison population in Ireland. The recording of severity/intent of each episode is novel when assessing self-harm among the prison population.
Collapse
Affiliation(s)
- Niall McTernan
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Eve Griffin
- National Suicide Research Foundation, University College Cork, Cork, Ireland and School of Public Health, University College Cork, Cork, Ireland
| | - Grace Cully
- National Suicide Research Foundation, University College Cork, Cork, Ireland and School of Public Health, University College Cork, Cork, Ireland
| | | | | | - Paul Corcoran
- National Suicide Research Foundation, University College Cork, Cork, Ireland and School of Public Health, University College Cork, Cork, Ireland
| |
Collapse
|
23
|
Zhong W, Zhao A, Lan H, Ren Z, Mao S, Zhang J, Li P, Szeto IMY, Wang P, Zhang Y. Sleep quality, antepartum depression and self-harm thoughts in pregnant Chinese women. J Affect Disord 2023; 327:292-298. [PMID: 36754093 DOI: 10.1016/j.jad.2023.01.127] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 02/10/2023]
Abstract
BACKGROUND Previous literature has shown a significant association between sleep and depression, whereas limited studies have examined the association of sleep quality with self-harm ideation in pregnant Chinese women. METHODS A total of 898 pregnant women (first to third trimester) from the Young Investigation Study were enrolled in this study. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to assess sleep quality. Antepartum depression and self-harm ideation were evaluated using the Edinburgh Postnatal Depression Scale (EPDS). Multivariable logistic regression models were used to calculate odds ratios (ORs) and 95 % confidence intervals (CIs). RESULTS In this sample, the prevalence of poor sleep quality and antepartum depression was 44.3 % and 24.4 %, respectively. Furthermore, 12.8 % of women were considered as having self-harm ideation. Individuals in different trimesters reported similar prevalence of self-harm thoughts. Women were more likely to report self-harm thoughts if they were categorized as poor sleep quality or antepartum depression. And women with moderate or severe depression had higher risk of self-harm ideation and poor sleep, compared with those with mild depression. Although sleep quality indirectly influenced self-harm thoughts through the mediation effect of depressive symptoms, poor sleep quality was still associated with a 2.62-fold increased odds of self-harm ideation among women in the second trimester (OR = 2.62; 95 % CI: 1.11-6.21), after adjustment for depression. LIMITATIONS Causality cannot be inferred. Results should be generalized carefully. Depression was evaluated by a screening tool rather than clinical interviews. CONCLUSIONS The prevalence of poor sleep quality, depressive symptoms and self-harm ideation in pregnant Chinese women were noteworthy and high. Besides, a direct effect was also found between sleep quality and self-harm thoughts among women in the second trimester. Our findings suggest the need to identify and intervene when sleep disturbances are observed in women during pregnancy.
Collapse
Affiliation(s)
- Wuxian Zhong
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China
| | - Ai Zhao
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Hanglian Lan
- Inner Mongolia Dairy Technology Research Institute Co., Ltd., Hohhot 010110, China; Yili Maternal and Infant Nutrition Institute, Beijing 100071, China
| | - Zhongxia Ren
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China
| | - Shuai Mao
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China
| | - Jian Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China
| | - Pin Li
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China
| | - Ignatius Man-Yau Szeto
- Inner Mongolia Dairy Technology Research Institute Co., Ltd., Hohhot 010110, China; Yili Maternal and Infant Nutrition Institute, Beijing 100071, China
| | - Peiyu Wang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing 100191, China
| | - Yumei Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China.
| |
Collapse
|
24
|
Favril L. Drug use before and during imprisonment: Drivers of continuation. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 115:104027. [PMID: 37060886 DOI: 10.1016/j.drugpo.2023.104027] [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: 12/01/2022] [Revised: 03/27/2023] [Accepted: 04/03/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND Many people who enter prison have recently used drugs in the community, a substantial portion of whom will continue to do so while incarcerated. To date, little is known about what factors may contribute to the continuation of drug use during imprisonment. METHODS Self-reported data were collected from a random sample of 1326 adults (123 women) incarcerated across 15 prisons in Belgium. Multivariate regression was used to investigate associations between in-prison drug use and sociodemographic background, criminological profile, drug-related history, and mental health among participants who reported pre-prison drug use. RESULTS Of all 1326 participants, 719 (54%) used drugs in the 12 months prior to their incarceration and 462 (35%) did so while in prison. There was a strong association between drug use before and during imprisonment (OR = 6.77, 95% CI 5.16-8.89). Of those who recently used drugs in the community, half (52%) continued to do so while incarcerated. Factors independently associated with continuation (versus cessation) were young age, treatment history, polydrug use, and poor mental health. In a secondary analysis, initiation of drug use while in prison was further related to incarceration history and low education. CONCLUSION Persistence of drug use following prison entry is common. People who continue to use drugs inside prison can be differentiated from those who discontinue in terms of drug-related history and mental health. Routine screening for drug use and psychiatric morbidity on admission to prison would allow for identifying unmet needs and initiating appropriate treatment.
Collapse
Affiliation(s)
- Louis Favril
- Faculty of Law and Criminology, Ghent University, Belgium.
| |
Collapse
|
25
|
Erlangsen A, Qin P, Madsen T, Hawton K, Osler M, Hjorthøj C, Benros ME, Ethelberg S, Mølbak K, Laursen TM, Nordentoft M, Nilsson SF. Association between SARS-CoV-2 infection and self-harm: Danish nationwide register-based cohort study. Br J Psychiatry 2023; 222:167-174. [PMID: 36636817 PMCID: PMC10895503 DOI: 10.1192/bjp.2022.194] [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: 10/24/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Case studies have linked SARS-CoV-2 infection to suicidal behaviour. However, conclusive evidence is lacking. AIMS To examine whether a history of SARS-CoV-2 infection or SARS-CoV-2-related hospital admission was associated with self-harm in the general population and in high-risk groups. METHOD A cohort design was applied to nationwide data on all people aged ≥15 years and living in Denmark between 27 February 2020 and 15 October 2021. Exposure was identified as having had a positive SARS-CoV-2 PCR test, and further assessed as SARS-CoV-2-related hospital admission. Rates of probable self-harm were examined using adjusted incidence rate ratios (aIRRs). The following subgroups were identified: (a) lower educational level, (b) chronic medical conditions, (c) disability pension, (d) mental disorders, (e) substance use disorders, and history of (f) homelessness and (g) imprisonment. RESULTS Among 4 412 248 included individuals, 260 663 (5.9%) had tested positive for SARS-CoV-2. Out of 5453 individuals presenting with self-harm, 131 (2.4%) had been infected. Individuals with a history of a positive SARS-CoV-2 test result had an aIRR for self-harm of 0.86 (95% CI 0.72-1.03) compared with those without. High rates were found after a SARS-CoV-2-related hospital admission (aIRR = 7.68; 95% CI 5.61-10.51) or a non-SARS-CoV-2-related admission (aIRR = 10.27; 95% CI 9.65-10.93) versus non-infected and not admitted. In sensitivity analyses with a more restrictive definition of self-harm, a positive PCR test was associated with lower rates of self-harm. CONCLUSIONS Individuals with a PCR-confirmed SARS-CoV-2 infection did not have higher rates of self-harm than those without. Hospital admission in general, rather than being SARS-CoV-2 positive. seemed to be linked to elevated rates of self-harm.
Collapse
Affiliation(s)
- Annette Erlangsen
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark; Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Copenhagen, Denmark; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; and Center of Mental Health Research, Australian National University, Canberra, Australia
| | - Ping Qin
- National Center for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Trine Madsen
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark; Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Copenhagen, Denmark; and Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Keith Hawton
- Centre for Suicide Research, University of Oxford, Oxford, UK; and Oxford Health NHS Foundation Trust, Oxford, UK
| | - Merete Osler
- Center for Clinical Research and Prevention, Bispebjerg & Frederiksberg Hospitals, Copenhagen, Denmark; and Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Carsten Hjorthøj
- Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital, Hellerup, Denmark; and Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Michael E. Benros
- Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Copenhagen, Denmark; and Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Steen Ethelberg
- Infectious Disease Epidemiology & Prevention, Statens Serum Institut, Copenhagen, Denmark; and Department of Global Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kåre Mølbak
- Epidemiological Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark; and Department of Veterinary and Animal Science, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Munk Laursen
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
| | - Merete Nordentoft
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark; Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Copenhagen, Denmark; and Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Sandra Feodor Nilsson
- Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital, Hellerup, Denmark
| |
Collapse
|
26
|
Liu H, Mok YC, Lau KL, Hou WK. Measuring everyday adaptation after imprisonment: The post-release living inventory for ex-prisoners (PORLI-ex). Int J Clin Health Psychol 2023; 23:100352. [PMID: 36467266 PMCID: PMC9712557 DOI: 10.1016/j.ijchp.2022.100352] [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: 07/07/2022] [Accepted: 10/31/2022] [Indexed: 12/02/2022] Open
Abstract
Background The number of ex-prisoners worldwide has constantly been increasing in recent years. Currently, little is known about post-release daily adaptation, not to mention valid and reliable instruments for post-release daily routines pertinent to mental health. Objective This study aims to develop and validate a self-report instrument, hereafter referred to as Post Release Living Inventory for Ex-prisoners (PORLI-ex). Methods Three separate samples of ex-prisoners were recruited to complete an online survey (N=1,277, age range=17-89 years, 53.2% male, 72% white). Results The final model evidenced acceptable goodness-of-fit and consisted of 45 items on nine dimensions, which loaded on three second-order factors: Consolidation (three dimensions; e.g., Institutional Routines), Replacement (two dimensions; e.g., Maladaptive Behaviors), and Addition (four dimensions; e.g., Socializing with Ex-prisoner Friends) (α=.695-.915). Convergent validity was demonstrated in the positive correlations with IADL, SOLI, MLQ, GSE-6, and MSPSS. Discriminant validity was demonstrated in the weak correlations with the LEC-5 and perceived social and personal cost of punishment. Criterion-related validity was demonstrated in the correlations with psychiatric symptoms and crime-related outcomes and incremental validity in the correlations with these measures independent of the scores on IADL, SOLI, MLQ, GSE-6, and MSPSS. Conclusion This study calls for more resources on fostering psychological strengths and resilience through regularizing basic daily life experiences on top of traditional interventions for risk management among the ex-prisoners.
Collapse
Affiliation(s)
- Huinan Liu
- Department of Psychology, The Education University of Hong Kong, Hong Kong SAR, China
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China
| | - Yuen Chi Mok
- The Society of Rehabilitation and Crime Prevention, Hong Kong SAR, China
| | - Ka Lok Lau
- The Society of Rehabilitation and Crime Prevention, Hong Kong SAR, China
| | - Wai Kai Hou
- Department of Psychology, The Education University of Hong Kong, Hong Kong SAR, China
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
27
|
Predicting suicidal and self-injurious events in a correctional setting using AI algorithms on unstructured medical notes and structured data. J Psychiatr Res 2023; 160:19-27. [PMID: 36773344 DOI: 10.1016/j.jpsychires.2023.01.032] [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] [Received: 11/19/2022] [Revised: 01/23/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023]
Abstract
Suicidal and self-injurious incidents in correctional settings deplete the institutional and healthcare resources, create disorder and stress for staff and other inmates. Traditional statistical analyses provide some guidance, but they can only be applied to structured data that are often difficult to collect and their recommendations are often expensive to act upon. This study aims to extract information from medical and mental health progress notes using AI algorithms to make actionable predictions of suicidal and self-injurious events to improve the efficiency of triage for health care services and prevent suicidal and injurious events from happening at California's Orange County Jails. The results showed that the notes data contain more information with respect to suicidal or injurious behaviors than the structured data available in the EHR database at the Orange County Jails. Using the notes data alone (under-sampled to 50%) in a Transformer Encoder model produced an AUC-ROC of 0.862, a Sensitivity of 0.816, and a Specificity of 0.738. Incorporating the information extracted from the notes data into traditional Machine Learning models as a feature alongside structured data (under-sampled to 50%) yielded better performance in terms of Sensitivity (AUC-ROC: 0.77, Sensitivity: 0.89, Specificity: 0.65). In addition, under-sampling is an effective approach to mitigating the impact of the extremely imbalanced classes.
Collapse
|
28
|
Identification of Risk Factors for Suicide and Insights for Developing Suicide Prevention Technologies: A Systematic Review and Meta-Analysis. HUMAN BEHAVIOR AND EMERGING TECHNOLOGIES 2023. [DOI: 10.1155/2023/3923097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
Suicide is a termite that engulfs close to seven hundred thousand people worldwide each year. Existing work on risk factors that predict suicide lacks statistical associations, does not consider most countries, and has a wide range of risk factor domains. The goal of this systematic review and meta-analysis is to enhance our current understanding of suicidality by identifying risk factors that are most strongly associated with suicide and their impact on developing technological interventions for suicide prevention. A search strategy was carried out on four databases: (1) PsycINFO, (2) IEEE Xplore, (3) the ACM Digital Library, and (4) PubMed, and twenty-five studies were included based on the inclusion criteria. Factors statistically associated with suicide are any diagnosed mental disorder, adverse life events, past suicide attempts, low education level, loneliness or high levels of isolation, bipolar disorder, depression, multiple chronic health conditions, family history of suicide, sexual trauma, and being female. Domain-wise, comorbid disorders, and behavior-related risk factors are most strongly associated with suicide. We present a new hierarchical model of risk factors for suicide that advances our understanding of suicide and its causes. Finally, we present open research directions and considerations for developing suicide prevention technologies.
Collapse
|
29
|
Kappes JR, Huber DA, Kirchebner J, Sonnweber M, Günther MP, Lau S. Self-Harm Among Forensic Psychiatric Inpatients With Schizophrenia Spectrum Disorders: An Explorative Analysis. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2023; 67:352-372. [PMID: 34861802 DOI: 10.1177/0306624x211062139] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The burden of self-injury among offenders undergoing inpatient treatment in forensic psychiatry is substantial. This exploratory study aims to add to the previously sparse literature on the correlates of self-injury in inpatient forensic patients with schizophrenia spectrum disorders (SSD). Employing a sample of 356 inpatients with SSD treated in a Swiss forensic psychiatry hospital, patient data on 512 potential predictor variables were retrospectively collected via file analysis. The dataset was examined using supervised machine learning to distinguish between patients who had engaged in self-injurious behavior during forensic hospitalization and those who had not. Based on a combination of ten variables, including psychiatric history, criminal history, psychopathology, and pharmacotherapy, the final machine learning model was able to discriminate between self-injury and no self-injury with a balanced accuracy of 68% and a predictive power of AUC = 71%. Results suggest that forensic psychiatric patients with SSD who self-injured were younger both at the time of onset and at the time of first entry into the federal criminal record. They exhibited more severe psychopathological symptoms at the time of admission, including higher levels of depression and anxiety and greater difficulty with abstract reasoning. Of all the predictors identified, symptoms of depression and anxiety may be the most promising treatment targets for the prevention of self-injury in inpatient forensic patients with SSD due to their modifiability and should be further substantiated in future studies.
Collapse
Affiliation(s)
| | | | | | | | | | - Steffen Lau
- Psychiatric University Hospital Zurich, Switzerland
| |
Collapse
|
30
|
Alcántara-Jiménez M, Torres-Parra I, Guillén-Riquelme A, Quevedo-Blasco R. Los Factores Psicosociales en el Suicidio de Presos en Prisiones Europeas: una Revisión Sistemática y Metaanálisis. ANUARIO DE PSICOLOGÍA JURÍDICA 2023. [DOI: 10.5093/apj2022a13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
|
31
|
Cloud DH, Williams B, Haardöerfer R, Hosbey JT, Cooper HL. Self-injury and the embodiment of solitary confinement among adult men in Louisiana prisons. SSM Popul Health 2023; 22:101354. [PMID: 36865676 PMCID: PMC9971521 DOI: 10.1016/j.ssmph.2023.101354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/17/2023] [Accepted: 01/31/2023] [Indexed: 02/04/2023] Open
Abstract
Solitary confinement is a harrowing human rights and public health problem that is currently inflicted as a routine punishment for a litany of prison rule violations, a reactionary tactic to quell resistance to prison conditions, and as a destination of last resort for people serious mental illnesses (SMI) who are especially vulnerable to its harms. An extensive body of research has documented clusters of psychiatric symptoms-emotional distress, cognitive deficits, social withdrawal, anxiety, paranoia, sleeplessness, and hallucinations-linked to solitary confinement that often manifest in decompensating behaviors, which include self-injury and suicide. This study summarizes the historical evolution of solitary confinement, recaps its linkages to self-injury and suicidality, and offers a theoretical framework grounded in ecosocial theory, and supplemented with concepts from theories of dehumanization and carceral geography. Findings bolster extant evidence on the harms of solitary confinement by focusing on whether and how exertions of power by prison staff to deploy mechanisms of dehumanization-as a pathway between SMI and self-injury among a cross section of adult men (n = 517) exposed to solitary confinement in Louisiana prisons in 2017. Findings reinforce the need for structural interventions that diffuse forms of carceral power and practices that continue to subject people to isolation, dehumanization, and violence.
Collapse
Affiliation(s)
- David H. Cloud
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, USA,Amend, Center for Vulnerable Populations, University of California San Francisco, School of Medicine, USA,Corresponding author. Emory University, Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA, 30322, USA.
| | - Brie Williams
- Amend, Center for Vulnerable Populations, University of California San Francisco, School of Medicine, USA
| | - Regine Haardöerfer
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, USA
| | - Justin T. Hosbey
- College of Environmental Design, University of California, Berkeley, USA
| | - Hannah L.F. Cooper
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, USA
| |
Collapse
|
32
|
Soins psychiatriques en détention : quelles spécificités ? ANNALES MÉDICO-PSYCHOLOGIQUES, REVUE PSYCHIATRIQUE 2023. [DOI: 10.1016/j.amp.2022.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
|
33
|
Fovet T, Pignon B, Wathelet M, Benradia I, Roelandt JL, Jardri R, Thomas P, D'Hondt F, Amad A. Admission to jail and psychotic symptoms: a study of the psychotic continuum in a sample of recently incarcerated men. Soc Psychiatry Psychiatr Epidemiol 2023; 58:25-34. [PMID: 35859058 DOI: 10.1007/s00127-022-02339-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 07/08/2022] [Indexed: 01/20/2023]
Abstract
PURPOSE We sought to measure the prevalence of psychotic symptoms (PSs) and psychotic disorders (PDs) in a sample of men entering jail and to compare these prevalences with those observed in the general population. We also aimed to explore the sociodemographic and clinical factors associated with PSs and PDs. METHODS The Mental Health in the Prison Population (MHPP) survey interviewed 630 incarcerated men upon admission to jail, using the Mini International Neuropsychiatric Interview. We looked for associations between sociodemographic and clinical characteristics and the presence of lifetime PSs and PDs in the MHPP and Mental Health in the General Population (MHGP) surveys, which used the same methodology to collect data from the jail and general populations of the same geographical area. RESULTS A higher proportion of PSs without PDs was found in the MHGP group (25.3% vs. 17.8%, p < 0.001), whereas a higher prevalence of PDs was found in the MHPP group (7.0% vs. 2.6%, p < 0.001). The multivariable model indicated that subjects who were single or separated/divorced/widowed and had a history of trauma exposure were at joint risk of PSs and PDs, whereas entering jail was not associated with either PSs or PDs after adjustment for all covariates. CONCLUSION The present study shows that PDs, but not PSs, are more prevalent in men entering jail than in the general population. This overrepresentation could be further explained by the exposure to vulnerability factors found in this population rather than by any specificity related to entering jail.
Collapse
Affiliation(s)
- Thomas Fovet
- Univ. Lille, Inserm, CHU Lille, U1172-LilNcog-Lille Neuroscience & Cognition, Plasticity and Subjectivity Team, F-59000, Lille, France. .,Centre National de Ressources Et de Résilience Lille-Paris (CN2R), 59000, Lille, France.
| | - Baptiste Pignon
- Université Paris Est Créteil (UPEC), INSERM, IMRB, AP-HP, Hôpitaux Universitaires « Henri Mondor », DMU IMPACT, Fondation FondaMental, 94010, Créteil, France
| | - Marielle Wathelet
- Univ. Lille, Inserm, CHU Lille, U1172-LilNcog-Lille Neuroscience & Cognition, Plasticity and Subjectivity Team, F-59000, Lille, France.,Centre National de Ressources Et de Résilience Lille-Paris (CN2R), 59000, Lille, France.,Fédération Régionale de Recherche en Psychiatrie Et Santé Mentale, Hauts-de-France, France
| | - Imane Benradia
- EPSM Lille Métropole, Centre Collaborateur de L'Organisation Mondiale de La Santé Pour La Recherche Et La Formation en Santé Mentale, Lille, France.,ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France
| | - Jean-Luc Roelandt
- EPSM Lille Métropole, Centre Collaborateur de L'Organisation Mondiale de La Santé Pour La Recherche Et La Formation en Santé Mentale, Lille, France.,ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France
| | - Renaud Jardri
- Univ. Lille, Inserm, CHU Lille, U1172-LilNcog-Lille Neuroscience & Cognition, Plasticity and Subjectivity Team, F-59000, Lille, France.,CHU Lille, Fontan Hospital, Child & Adolescent Psychiatry Dpt. & CURE Research Platform, Lille, France
| | - Pierre Thomas
- Univ. Lille, Inserm, CHU Lille, U1172-LilNcog-Lille Neuroscience & Cognition, Plasticity and Subjectivity Team, F-59000, Lille, France.,Fédération Régionale de Recherche en Psychiatrie Et Santé Mentale, Hauts-de-France, France
| | - Fabien D'Hondt
- Univ. Lille, Inserm, CHU Lille, U1172-LilNcog-Lille Neuroscience & Cognition, Plasticity and Subjectivity Team, F-59000, Lille, France.,Centre National de Ressources Et de Résilience Lille-Paris (CN2R), 59000, Lille, France
| | - Ali Amad
- Univ. Lille, Inserm, CHU Lille, U1172-LilNcog-Lille Neuroscience & Cognition, Plasticity and Subjectivity Team, F-59000, Lille, France.,Fédération Régionale de Recherche en Psychiatrie Et Santé Mentale, Hauts-de-France, France
| |
Collapse
|
34
|
Janca E, Keen C, Willoughby M, Borschmann R, Sutherland G, Kwon S, Kinner SA. Sex differences in suicide, suicidal ideation, and self-harm after release from incarceration: a systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol 2023; 58:355-371. [PMID: 36462041 PMCID: PMC9971066 DOI: 10.1007/s00127-022-02390-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 11/14/2022] [Indexed: 12/04/2022]
Abstract
PURPOSE People released from incarceration are at increased risk of suicide compared to the general population. We aimed to synthesise evidence on the incidence of and sex differences in suicide, suicidal ideation, and self-harm after release from incarceration. METHODS We searched MEDLINE, EMBASE, PsycINFO, Web of Science and PubMed between 1 January 1970 and 14 October 2021 for suicide, suicidal ideation, and self-harm after release from incarceration (PROSPERO registration: CRD42020208885). We calculated pooled crude mortality rates (CMRs) and standardised mortality ratios (SMRs) for suicide, overall and by sex, using random-effects models. We calculated a pooled incidence rate ratio (IRR) comparing rates of suicide by sex. RESULTS Twenty-nine studies were included. The pooled suicide CMR per 100,000 person years was 114.5 (95%CI 97.0, 132.0, I2 = 99.2%) for non-sex stratified samples, 139.5 (95% CI 91.3, 187.8, I2 = 88.6%) for women, and 121.8 (95% CI 82.4, 161.2, I2 = 99.1%) for men. The suicide SMR was 7.4 (95% CI 5.4, 9.4, I2 = 98.3%) for non-sex stratified samples, 14.9 for women (95% CI 6.7, 23.1, I2 = 88.3%), and 4.6 for men (95% CI 1.3, 7.8, I2 = 98.8%). The pooled suicide IRR comparing women to men was 1.1 (95% CI 0.9, 1.4, I2 = 82.2%). No studies reporting self-harm or suicidal ideation after incarceration reported sex differences. CONCLUSION People released from incarceration are greater than seven times more likely to die by suicide than the general population. The rate of suicide is higher after release than during incarceration, with the elevation in suicide risk (compared with the general population) three times higher for women than for men. Greater effort to prevent suicide after incarceration, particularly among women, is urgently needed.
Collapse
Affiliation(s)
- Emilia Janca
- Curtin School of Population Health, Curtin University, 410 Koorliny Way, Bentley, WA, 6102, Australia. .,Justice Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia.
| | - Claire Keen
- Justice Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC 3053 Australia
| | - Melissa Willoughby
- Justice Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC 3053 Australia ,Centre for Adolescent Health, Murdoch Children’s Research Institute, 50 Flemington Road, Parkville, VIC 3052 Australia
| | - Rohan Borschmann
- Justice Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC 3053 Australia ,Centre for Adolescent Health, Murdoch Children’s Research Institute, 50 Flemington Road, Parkville, VIC 3052 Australia ,Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX UK ,Melbourne School of Psychological Sciences, The University of Melbourne, Grattan Street, Parkville, VIC Australia
| | - Georgina Sutherland
- Disability and Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC 3053 Australia
| | - Sohee Kwon
- Justice Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC 3053 Australia
| | - Stuart A. Kinner
- Curtin School of Population Health, Curtin University, 410 Koorliny Way, Bentley, WA 6102 Australia ,Justice Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC 3053 Australia ,Centre for Adolescent Health, Murdoch Children’s Research Institute, 50 Flemington Road, Parkville, VIC 3052 Australia ,Mater Research Institute-UQ, University of Queensland, Mater Hospital, Raymond Terrace, South Brisbane, QLD 4101 Australia ,Griffith Criminology Institute, Griffith University, 176 Messines Ridge Road, Mount Gravatt, QLD 4122 Australia ,School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004 Australia
| |
Collapse
|
35
|
Aitchison G, Essex R. Self-harm in immigration detention: political, not (just) medical. JOURNAL OF MEDICAL ETHICS 2022:medethics-2022-108366. [PMID: 36581458 DOI: 10.1136/jme-2022-108366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 12/11/2022] [Indexed: 06/17/2023]
Abstract
Self-harm within immigration detention centres has been a widely documented phenomenon, occurring at far higher rates than the wider community. Evidence suggests that factors such as the conditions of detention and uncertainty about refugee status are among the most prominent precipitators of self-harm. While important in explaining self-harm, this is not the entire story. In this paper, we argue for a more overtly political interpretation of detainee self-harm as resistance and assess the ethical implications of this view, drawing on interviews with detainees from Australia's offshore system. Self-harm by detainees is not only a medical 'condition' arising in response to oppression but a form of political action to lessen or contest it. We first establish how self-harm could be conceptualised as resistance. We then discuss its political purpose, noting it serves at least three functions: intrinsic, instrumental and disruptive or coercive. Viewing detainee self-harm as political resistance is a supplement to (rather than a substitute for) a medical approach. However, conceptualising self-harm this way has several advantages, namely, moving away from the idea that such behaviour is 'maladaptive', recognising detainees as political agents, combatting government claims of 'manipulation' and 'blackmail' and clarifying the duties of healthcare workers who work in detention.
Collapse
Affiliation(s)
- Guy Aitchison
- International Relations, Politics and History, Loughborough University, Loughborough, Leicestershire, UK
| | - Ryan Essex
- Institute for Lifecourse Development, University of Greenwich, London, UK
| |
Collapse
|
36
|
Depression in Male Inmates. Clin Pract 2022; 13:1-13. [PMID: 36648841 PMCID: PMC9844394 DOI: 10.3390/clinpract13010001] [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: 11/20/2022] [Revised: 12/18/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
Introduction: The prevalence of psychiatric morbidity is high among incarcerated individuals. Severe mental disorder is five to ten times higher among prisoners compared to the general population. Several factors are held to be responsible for the high prevalence of depression in prison: mainly poor living conditions (narrow room, loss of privacy), limited interpersonal relationships, and lack of mental health access. Inmates are at increased risk of all-cause mortality, suicide, self-harm, violence, and victimization while those with mental disorders are involved in conflicts and are more likely to be charged with prison rules. Purpose: To explore depression among male inmates. Methods and material: In the study, 101 male inmates were enrolled. Data were collected by the completion of a “self-rating depression scale (SDS)-Zung” which included participants’ characteristics. The statistical significance level was p < 0.05. Results: Of the 101 participants, 51.4% of inmates were under 40 years old, 54.5% were married, 45.6% had been convicted of homicide and 38.6% had a life sentence. Normal depression levels were experienced by 62.4% of the participants, while 21.8% were mildly depressed, 14.9% were moderately depressed and 1.0% severely depressed. Foreign prisoners had statistically significant higher scores of depression compared to Greeks (median 48 vs. 45, p = 0.012); those suffering from a chronic disease compared to those who did not (median 48 vs. 45, p = 0.038); those who had spent time in solitary confinement compared to those who had not (median 46 vs. 43.5, p = 0.038) as well as those who had not considered harming themselves compared to those who had thought of it (median 46 vs. 44, p = 0.017). Conclusion: Given that prison populations are marginalized and deprived of the rights that people in the community benefit from, establishing the prevalence of depression in male inmates and its associated characteristics may help to formulate recommendations for future prison health care services. Clinical, research, and policy efforts are needed to improve prison mental health.
Collapse
|
37
|
Browne C, Chemjong P, Korobanova D, Jang S, Yee N, Marr C, Rae N, Ma T, Spencer SJ, Dean K. Self-harm risk screening on prison entry: assessing the predictive validity of self-harm history and recent ideation in men and women. Int J Prison Health 2022; 19:414-426. [PMID: 36422644 DOI: 10.1108/ijph-12-2021-0115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Rates of self-harm are elevated in prison, and there is limited evidence to support the efficacy of brief risk screening at reception to predict and prevent self-harm. This study aims to examine the predictive validity of the self-harm/suicide screening items embedded in a prison mental health screening tool from two key domains strongly associated with risk: previous suicidal/self-harm behaviour, and recent ideation. DESIGN/METHODOLOGY/APPROACH A sample of men and women were screened on entry to prison, with eight screening items covering the two key domains of risk. Follow-up data on self-harm incidents were collected for 12 months post-screening. The predictive validity of individual screening items, item combinations and cumulative screening score was examined for the overall sample and for men and women separately. FINDINGS Individual screening items across the two domains were all strongly associated with self-harm in the follow-up period, with odds ratios varying from 2.34 to 9.24. The predictive validity of both individual items, item scores and item combinations demonstrated high specificity but low to moderate sensitivity, and modest area under the curves (AUCs). Predictive validity was generally better for men than women; however, differences were not statistically significant. PRACTICAL IMPLICATIONS Identifying those at risk of self-harm in prisons remains challenging and brief universal screening at prison entry should be only one component of a broader prison risk assessment and management strategy. ORIGINALITY/VALUE To the best of the authors' knowledge, this study is one of very few to prospectively examine self-harm behaviour following risk screening. Predictive validity was examined in a representative sample of individuals in custody, and for men and women separately.
Collapse
Affiliation(s)
- Christie Browne
- Justice Health and Forensic Mental Health Network, Malabar, Australia and Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Prabin Chemjong
- Justice Health and Forensic Mental Health Network, Malabar, Australia; Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia and Western Sydney Local Health District, Blacktown, Australia
| | - Daria Korobanova
- Justice Health and Forensic Mental Health Network, Malabar, Australia; Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia and Western Sydney Local Health District, Blacktown, Australia
| | - Seyoung Jang
- Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Natalia Yee
- Justice Health and Forensic Mental Health Network, Malabar, Australia and Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Carey Marr
- Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Natasha Rae
- Justice Health and Forensic Mental Health Network, Malabar, Australia and Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Trevor Ma
- Justice Health and Forensic Mental Health Network, Malabar, Australia and Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Sarah-Jane Spencer
- Justice Health and Forensic Mental Health Network, Malabar, Australia, and Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Kimberlie Dean
- Justice Health and Forensic Mental Health Network, Malabar, Australia and Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| |
Collapse
|
38
|
Favril L, Yu R, Uyar A, Sharpe M, Fazel S. Risk factors for suicide in adults: systematic review and meta-analysis of psychological autopsy studies. EVIDENCE-BASED MENTAL HEALTH 2022; 25:148-155. [PMID: 36162975 PMCID: PMC9685708 DOI: 10.1136/ebmental-2022-300549] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/31/2022] [Indexed: 11/29/2022]
Abstract
QUESTION Effective prevention of suicide requires a comprehensive understanding of risk factors. STUDY SELECTION AND ANALYSIS Five databases were systematically searched to identify psychological autopsy studies (published up to February 2022) that reported on risk factors for suicide mortality among adults in the general population. Effect sizes were pooled as odds ratios (ORs) using random-effects models for each risk factor examined in at least three independent samples. FINDINGS A total of 37 case-control studies from 23 countries were included, providing data on 40 risk factors in 5633 cases and 7101 controls. The magnitude of effect sizes varied substantially both between and within risk factor domains. Clinical factors had the strongest associations with suicide, including any mental disorder (OR=13.1, 95% CI 9.9 to 17.4) and a history of self-harm (OR=10.1, 95% CI 6.6 to 15.6). By comparison, effect sizes were smaller for other domains relating to sociodemographic status, family history, and adverse life events (OR range 2-5). CONCLUSIONS A wide range of predisposing and precipitating factors are associated with suicide among adults in the general population, but with clear differences in their relative strength. PROSPERO REGISTRATION NUMBER CRD42021232878.
Collapse
Affiliation(s)
- Louis Favril
- Faculty of Law and Criminology, Ghent University, Ghent, Belgium
| | - Rongqin Yu
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Abdo Uyar
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Michael Sharpe
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
| |
Collapse
|
39
|
Clemente-Faustino JAR, de Guzman AB. Understanding the Self-Harming Behavior of Filipino Male Detainees (32-58 Years Old): A Descriptive Phenomenology. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2022:306624X221124833. [PMID: 36181293 DOI: 10.1177/0306624x221124833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Self-harming behavior (SHB) has become a significant health issue among several populations, including adolescents, traumatized individuals, and persons deprived of liberty. Undoubtedly, incarceration takes a toll on inmates' mental health due to several stressful experiences while in custody. These taxing events make them vulnerable to maladaptive coping strategies, such as SHB. To date, many studies on this behavior have focused on high-income countries. Research has not explored much on this behavior among inmates in developing countries such as the Philippines. This phenomenological inquiry aims to characterize the experiences of select older male Filipino detainees engaged in SHB. Through vertical and horizontal analyses of the narratives shared, this study conceptualized the Self-Harming Behavior of Older Filipino Detainees as Tension and Compression. This model shows the forces that either pull or push the detainees to engage in self-injurious acts. Specifically, the seven themes surfaced: life dispositions, jail ecology, emotional baggage, physically and chemically-induced self-harming behavior, consequences, coping strategies, and cognizance. Findings from this inquiry may necessitate the provision of adequate and comprehensive prevention and intervention services for the self-harmers in jail, which are geared toward implementing a thorough psychological evaluation and promoting sound psychological well-being.
Collapse
|
40
|
Stijelja S, Mishara BL. Preventing suicidal and self-Injurious behavior in correctional facilities: A systematic literature review and meta-analysis. EClinicalMedicine 2022; 51:101560. [PMID: 35898320 PMCID: PMC9309412 DOI: 10.1016/j.eclinm.2022.101560] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/25/2022] [Accepted: 06/27/2022] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Rates of suicide and self-harm are elevated in carceral institutions. Inmates are a vulnerable group since they are exposed to multiple risk factors. This paper critically reviews empirical research on programs to prevent suicidal and self-harmful behaviors in correctional facilities and summarizes effect sizes across studies. METHODS We searched PsychINFO, PubMed, IEEEXPLORE and the CRISE Documentation Centre Database to identify relevant articles published before June 2022. Inclusion criteria were: peer-reviewed and with outcome data on effectiveness of prevention activities. Two reviewers independently assessed 905 articles to determine inclusion eligibility. Quality was assessed by two independent reviewers using the Quality Assessment Tool for Quantitative Studies. Meta-analyses using random-effect models were used to pool effect sizes for each outcome. This review was conducted in accordance with PRISMA guidelines. FINDINGS Twenty-four of the 905 articles, published between 1980 and 2022, were included. Studies were frequently conducted in the United States (n=13; 54%) and used varying study designs; most frequently pre-post with no control group (n=9; 38%). Sample sizes and interventions varied considerably. Most were of moderate quality (n=21; 88%). On average, prevention programs in correctional facilities were effective in decreasing suicide deaths (pooled rate ratio of 0·35 [95% CI 0·23 to 0·55; p<0·001]; I2=68·01%), incidents of self-harm (pooled Hedges'g of -0·54 (95% CI: -1·03 to -0·05; p=0·031]; I2=81·34%), and suicidal ideation (pooled Hedges'g of -0·39 [95% CI: -0·65 to -0·14; p=0·003]; I2=47·09%). INTERPRETATION Prevention activities are effective in reducing suicide death, self-harm and suicidal ideation in correctional settings. Multicomponent programs, which include several preventive activities, seem to be most effective in reducing suicide deaths. Future evaluation studies should control for confounding variables by including control groups, having larger samples and limiting attrition. Standards for suicide prevention in jails and prisons should be included in National suicide prevention strategies. FUNDING None.
Collapse
Affiliation(s)
- Stefan Stijelja
- Centre for Research and Intervention on Suicide, Ethical Issues and End of Life Practices, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Brian L. Mishara
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
- Corresponding author at: CRISE-UQAM, C.P. 8888, Succ. Centre-ville, Montréal, Québec H3C 3P8, Canada.
| |
Collapse
|
41
|
Childhood maltreatment and nonsuicidal self-injury among younger Chinese prisoners: the mediating role of self-esteem. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03647-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
42
|
Favril L, Shaw J, Fazel S. Prevalence and risk factors for suicide attempts in prison. Clin Psychol Rev 2022; 97:102190. [PMID: 36029609 DOI: 10.1016/j.cpr.2022.102190] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/28/2022] [Accepted: 08/03/2022] [Indexed: 11/18/2022]
Abstract
Suicidal behaviour represents a substantial burden of morbidity and mortality in prisons worldwide. We aimed to synthesise the evidence on prevalence and risk factors for suicide attempts during incarceration. In this systematic review and meta-analysis, we searched four bibliographic databases for studies (published up to May 31, 2022) reporting on adults sampled from the general prison population who attempted suicide while incarcerated and an unselected comparison group. A total of 20 studies comprising 19,882 individuals (6.5% women) in 20 countries were eligible for inclusion. The pooled prevalence of suicide attempts during incarceration was 8.6% (95% CI 6.1-11.2) in men and 12.2% (95% CI 7.1-17.2) in women. Across all 36 risk factors studied, the strongest associations were found for suicidal ideation, previous self-harm, and markers of psychiatric morbidity. Prison-related risk factors included solitary confinement, victimisation, and poor social support while incarcerated. Sensitivity analyses indicate that risk factors for near-lethal suicide attempts are similar to those for suicide attempts more generally. In addition to providing a synthesis of previous work, our systematic review highlights several key limitations of the extant literature, which provide directions for future research.
Collapse
Affiliation(s)
- Louis Favril
- Faculty of Law and Criminology, Ghent University, Ghent, Belgium.
| | - Jenny Shaw
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
| |
Collapse
|
43
|
Wang YJ, Lei L, Huang Y. Factors associated with venous thromboembolism in the paediatric intensive care unit: A systematic review and meta‐analysis. Nurs Crit Care 2022. [DOI: 10.1111/nicc.12813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ya Jing Wang
- West China School of Nursing, Sichuan University/Nursing Department, West China Second University Hospital Sichuan University Chengdu China
- Nursing Department West China Second University Hospital, Sichuan University Chengdu China
| | - Lei Lei
- Nursing Department West China Second University Hospital, Sichuan University Chengdu China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) Ministry of Education Chengdu China
| | - Yan Huang
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) Ministry of Education Chengdu China
- Department of pediatric Intensive Care Unit, Nursing Department, West China second University Sichuan University Chengdu China
| |
Collapse
|
44
|
Liu RT, Walsh RFL, Sheehan AE, Cheek SM, Sanzari CM. Prevalence and Correlates of Suicide and Nonsuicidal Self-injury in Children: A Systematic Review and Meta-analysis. JAMA Psychiatry 2022; 79:718-726. [PMID: 35612875 PMCID: PMC9134039 DOI: 10.1001/jamapsychiatry.2022.1256] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Considerably less is known about self-injurious thoughts and behaviors (SITBs) in preadolescence than older age groups, owing partly to the common view that young children are incapable of suicidal thoughts. Yet, preadolescent suicide has increased in recent years and is now the fifth leading cause of death in this age group, leading the National Institute of Mental Health to identify it as a priority for research and intervention. OBJECTIVE To assess prevalence estimates of preadolescent SITBs, identify correlates of these outcomes, and conduct head-to-head comparisons of preadolescent and adolescent SITBs in terms of associated characteristics. DATA SOURCES MEDLINE, PsycINFO, and Embase were systematically searched from inception through December 23, 2021, for studies on the prevalence and correlates of preadolescent SITBs. The search was restricted to English language publications and peer-reviewed journals. STUDY SELECTION Two reviewers independently identified studies providing data on prevalence and correlates of preadolescent SITBs. DATA EXTRACTION AND SYNTHESIS Two reviewers independently extracted data from each study, and the Joanna Briggs Institute Checklist for Prevalence Studies was used to assess study quality. Pooled prevalence and Cohen d were derived from random-effects meta-analyses. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline was followed. MAIN OUTCOMES AND MEASURES Prevalence and correlates of suicidal ideation, suicide attempts, suicide deaths, and nonsuicidal self-injury among preadolescents. RESULTS Fifty-eight studies with 626 486 590 individuals were included. Lifetime prevalence of suicide in the general population was 0.79 per 1 million children. Prevalence for lifetime suicidal thoughts, suicide attempts, and nonsuicidal self-injury among preadolescents were 15.1%, 2.6%, and 6.2%, respectively, in community samples. These data suggest that approximately 17.0% of preadolescents with suicidal ideation transition to attempting suicide. Across several analyses, male individuals appear more likely to have SITBs in preadolescence than adolescence. Correlate data were modest for SITBs other than suicidal ideation, but among specific disorders, attention-deficit/hyperactivity disorder (suicidal ideation: d = 0.54 [95% CI, 0.34-0.75]) and depression (suicidal ideation: d = 0.90 [95% CI, 0.71-1.09]; suicide attempts: d = 0.47 [95% CI, 0.26-0.68]) emerged as the strongest correlates. Among interpersonal factors, child maltreatment (suicidal ideation: d = 2.62 [95% CI, 1.56-3.67]) and parental support (suicidal ideation: d = -0.34 [95% CI, -0.46 to -0.22]) yielded the largest effect sizes. CONCLUSIONS AND RELEVANCE In this systematic review anda meta-analysis, although preadolescent suicide deaths were rare, other SITB types occur with concerning frequency. Male individuals were at greater risk for SITBs in preadolescence relative to adolescence. Attention-deficit/hyperactivity disorder, child maltreatment, and parental support were especially relevant to suicidal ideation, as well as depression for suicidal thoughts and behaviors, in this age group. Further study, especially of SITBs other than suicidal ideation, is needed.
Collapse
Affiliation(s)
- Richard T. Liu
- Department of Psychiatry, Massachusetts General Hospital, Boston,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Rachel F. L. Walsh
- Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania
| | - Ana E. Sheehan
- Department of Psychological and Brain Sciences, University of Delaware, Newark
| | - Shayna M. Cheek
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
| | - Christina M. Sanzari
- Department of Psychology, University at Albany, State University of New York, Albany
| |
Collapse
|
45
|
Hewson T, Gutridge K, Bernard Z, Kay K, Robinson L. A systematic review and mixed-methods synthesis of the experiences, perceptions and attitudes of prison staff regarding adult prisoners who self-harm. BJPsych Open 2022; 8:e102. [PMID: 35659128 PMCID: PMC9230562 DOI: 10.1192/bjo.2022.70] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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
BACKGROUND Self-harm, including suicide, is common among prisoners. Staff attitudes and perceptions regarding self-harm may affect quality of care and patient safety. AIMS To systematically review the experiences, perceptions and attitudes of staff in adult prisons regarding self-harm. METHOD Systematic searches of EMBASE, Medline, PsycINFO and CINAHL databases were conducted, and supplemented by hand-searching and grey literature review, to identify relevant English-language articles published since the year 2000. Articles were screened by two authors and evaluated with standardised quality appraisal tools. Qualitative data were analysed thematically, whereas quantitative data were narratively synthesised because of high study heterogeneity. RESULTS Two thousand articles were identified, of which 32 were included, involving 6389 participants from five countries. Most studies were moderate (n = 15) or poor (n = 10) quality, and seven were rated as good quality. Staff frequently witnessed self-harm and described multiple perceived risk factors and causes of this. Perceptions that self-harm is 'manipulative' or 'attention-seeking' were associated with hostility toward prisoners and lower quality of care. Perceived barriers to preventing and managing self-harm included low staffing levels, prison environments and culture, poor staff confidence and insufficient training. The importance of multidisciplinary teamwork and building staff-prisoner relationships were highlighted. Staff occasionally experienced intense psychological reactions to self-harm, which resulted in adaptive or maladaptive coping that influenced their capacity to care. CONCLUSIONS There are mixed attitudes and perceptions toward self-harm among prison staff. Further training, support and resources are required to protect staff's well-being and improve self-harm prevention and management in prisons.
Collapse
Affiliation(s)
- Thomas Hewson
- Faculty of Biology, Medicine and Health, University of Manchester, UK; and North West School of Psychiatry, Health Education England, University of Manchester, UK
| | - Kerry Gutridge
- Centre for Women's Mental Health, University of Manchester, UK
| | - Zara Bernard
- Greater Manchester Mental Health NHS Foundation Trust, UK
| | - Kathryn Kay
- Greater Manchester Mental Health NHS Foundation Trust, UK
| | - Louise Robinson
- Division of Psychology and Mental Health, University of Manchester, UK; and Lancashire and South Cumbria NHS Foundation Trust, UK
| |
Collapse
|
46
|
Morris NP, Edwards ML. Addressing Shortages of Mental Health Professionals in U.S. Jails and Prisons. JOURNAL OF CORRECTIONAL HEALTH CARE 2022; 28:209-214. [PMID: 35653752 DOI: 10.1089/jchc.21.08.0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Many jails and prisons in the United States do not have enough mental health professionals (MHPs) to meet the mental health needs of the people incarcerated in these facilities. This article examines strategies used to address MHP shortages in U.S. jails and prisons, including compensation incentives, telemental health services, interdisciplinary health care, flexible work schedules, and training rotations in correctional settings. These measures may help alleviate some of the shortages of MHPs in correctional facilities; however, these shortages will likely persist without broader policy reforms that decrease the size of U.S. correctional populations or increase the number of MHPs across the country.
Collapse
Affiliation(s)
- Nathaniel P Morris
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Matthew L Edwards
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| |
Collapse
|
47
|
Ricarte JJ, Caravaca-Sánchez F, Barry TJ, Aizpurua E. Suicide behaviours in incarcerated males: Links to psychopathic traits, forms of aggression to others, personal characteristics, and current penitentiary variables. J Forensic Leg Med 2022; 89:102357. [DOI: 10.1016/j.jflm.2022.102357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 04/23/2022] [Accepted: 04/27/2022] [Indexed: 11/26/2022]
|
48
|
Carter A, Butler A, Willoughby M, Janca E, Kinner SA, Southalan L, Fazel S, Borschmann R. Interventions to reduce suicidal thoughts and behaviours among people in contact with the criminal justice system: A global systematic review. EClinicalMedicine 2022; 44:101266. [PMID: 35072018 PMCID: PMC8763634 DOI: 10.1016/j.eclinm.2021.101266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/15/2021] [Accepted: 12/20/2021] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND People who experience incarceration die by suicide at a higher rate than those who have no prior criminal justice system contact, but little is known about the effectiveness of interventions in other criminal justice settings. We aimed to synthesise evidence regarding the effectiveness of interventions to reduce suicide and suicide-related behaviours among people in contact with the criminal justice system. METHODS We searched Embase, PsycINFO, MEDLINE, and grey literature databases for articles published between 1 January 2000 and 1 June 2021. The protocol was registered with PROSPERO (CRD42020185989). FINDINGS Thirty-eight studies (36 primary research articles, two grey literature reports) met our inclusion criteria, 23 of which were conducted in adult custodial settings in high-income, Western countries. Four studies were randomised controlled trials. Two-thirds of studies (n=26, 68%) were assessed as medium quality, 11 (29%) were assessed as high quality, and one (3%) was assessed as low quality. Most had considerable methodological limitations and very few interventions had been rigorously evaluated; as such, drawing robust conclusions about the efficacy of interventions was difficult. INTERPRETATION More high-quality evidence from criminal justice settings other than adult prisons, particularly from low- and middle-income countries, should be considered a priority for future research. FUNDING This work was funded by the Australian government's National Suicide Prevention Taskforce. RB is supported by a National Health and Medical Research Council (NHMRC) Emerging Leader Investigator Grant (EL2; GNT2008073). MW is supported by a NHMRC Postgraduate Scholarship (GNT1151103). SF was funded by the NIHR HTA Programme (HTA Project:16/159/09).
Collapse
Affiliation(s)
- Annie Carter
- Justice Health Unit, Centre for Health Equity; Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Amanda Butler
- Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
| | - Melissa Willoughby
- Justice Health Unit, Centre for Health Equity; Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
- Centre for Adolescent Health; Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Emilia Janca
- Justice Health Unit, Centre for Health Equity; Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Stuart A. Kinner
- Justice Health Unit, Centre for Health Equity; Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
- Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
- Mater Research Institute-UQ, University of Queensland, Brisbane, Queensland, Australia
- Griffith Criminology Institute, Griffith University, Brisbane, Queensland, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Louise Southalan
- Justice Health Unit, Centre for Health Equity; Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Seena Fazel
- Department of Psychiatry, University of Oxford; Oxford Health NHS Foundation Trust, Oxford, UK
| | - Rohan Borschmann
- Justice Health Unit, Centre for Health Equity; Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
- Centre for Adolescent Health; Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Psychiatry, University of Oxford; Oxford Health NHS Foundation Trust, Oxford, UK
- Melbourne School of Psychological Sciences; The University of Melbourne, Parkville, Victoria, Australia
- Corresponding Author: A/Prof. Rohan Borschmann, PhD DClinPsych BBSc PG-Dip (Psych) MAPS, Dame Kate Campbell Senior Research Fellow / Psychologist, Justice Health Unit, Centre for Health Equity; Melbourne School of Population and Global Health, The University of Melbourne, Level 4, 207 Bouverie street, Carlton, 3010, VIC Australia. Tel: +61 3 8344 0093; Fax: +61 3 8341 6212.
| |
Collapse
|
49
|
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.
Collapse
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
| |
Collapse
|
50
|
Tully J. Management of ADHD in Prisoners-Evidence Gaps and Reasons for Caution. Front Psychiatry 2022; 13:771525. [PMID: 35370827 PMCID: PMC8973692 DOI: 10.3389/fpsyt.2022.771525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 02/04/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
- John Tully
- School of Medicine, University of Nottingham, Nottingham, United Kingdom
| |
Collapse
|