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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.
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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
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E M A E, J J R, G H P VDH, E J E H, C H Z K, K S N, S V, J D L, G J J M S, E K, A T H, M A. Safety First! Residential Group Climate and Antisocial Behavior: A Multilevel Meta-analysis. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2024:306624X241252052. [PMID: 38855815 DOI: 10.1177/0306624x241252052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
A systematic review and multilevel meta-analysis was performed (28 studies and 313 effect sizes) on the relation between residential group climate (i.e., safety, atmosphere, repression, support, growth, structure) and antisocial behavior, including aggression and criminal recidivism. A systematic search was conducted in PsychINFO, ERIC, and OVID Medline up to February 2023. Results showed a small but significant association (r = .20) between residential group climate and antisocial behavior, equivalent to a 23% reduction of antisocial behavior in all clients receiving care in a residential facility with a therapeutic group climate. Moderator analyses showed that experienced safety was more strongly related to antisocial behavior (r = .30) than the other dimensions of group climate (.17 < r < .20), while the effect size was somewhat larger for adults (r = .24) than for youth (r = .15). We conclude that residential facilities should consider safety as a priority and should involve clients in a positive process of change through the development of a therapeutic environment and delivery of evidence-based treatment, addressing their needs from the perspective of rehabilitation.
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Affiliation(s)
- Eltink E M A
- University of Amsterdam; GGZ Centraal, the Netherlands
| | - Roest J J
- University of Applied Sciences Leiden, the Netherlands
| | - Van der Helm G H P
- University of Amsterdam; University of Applied Sciences Leiden, the Netherlands
| | | | - Kuiper C H Z
- University of Amsterdam; University of Applied Sciences Leiden, the Netherlands
| | - Nijhof K S
- Academic Workplace for at-risk Youth (AWRJ); Pluryn; Radboud University Nijmegen, the Netherlands
| | | | | | | | - Knorth E
- University of Groningen, the Netherlands
| | - Harder A T
- Erasmus University Rotterdam, the Netherlands
| | - Assink M
- University of Amsterdam, the Netherlands
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Zielinski MJ, Jahangir T, Praseuth A, Wilson S, McLaughlan CL. Mental Health, Drug Use, and Programming: Applying a Needs Assessment Framework in Arkansas' Largest Jail. JOURNAL OF CORRECTIONAL HEALTH CARE 2024; 30:206-215. [PMID: 38842733 DOI: 10.1089/jchc.23.12.0098] [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: 06/07/2024]
Abstract
Jail programming is rarely informed by site-specific health needs, diagnostic-specific screening tools that are validated, or the input of incarcerated individuals. Using the community needs assessment (CNA) framework, we aimed to fill these gaps among people incarcerated in the Pulaski County Regional Detention Facility (PCRDF), Arkansas' largest jail. Participants were 179 adults at the PCRDF who completed surveys and open-ended questions focused on (a) their mental and behavioral health and (b) programming needs at the facility. Using a concurrent transformative mixed-methods design, we descriptively analyzed surveys and conducted content analysis of the open-ended questions. Over half of participants reported clinically significant anxiety (62.6%), post-traumatic stress disorder (53.1%), and/or depression (50.3%) symptoms; positive substance use disorder screening was especially common (91.7%). Nearly all (97%) individuals queried desired more programming, with the most desired being mental health and substance use programs. Other desired programs included physical health, education, community reintegration, family support, recreation, nutrition, religious/spiritual services, and meditation. Our CNA ensured the input of those directly impacted during program-focused decision making and identified strategies to effectively implement and sustain jail-based programs. Such assessments can be a potential mechanism for addressing the burden of mental and behavioral health problems in jail populations.
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Affiliation(s)
- Melissa J Zielinski
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Tasfia Jahangir
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Amanda Praseuth
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Stephanie Wilson
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Cassandra L McLaughlan
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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Kersten L, Alfano J, Erlanger TE, Helfenstein F, Lanz L, Weiss S, Chilla C, von Planta B, Kapoor M, Borel N, Rocco T, Papageorgiou A, De Brito CF, Bajrami A, Savary V, Mayor M, Hurschler J, Traut A, Brunner D, Vriends N, Stadler C. START NOW WebApp-promoting emotion regulation and resilience in residential youth care and correctional institutions: study protocol for a cluster randomized controlled trial. Trials 2024; 25:341. [PMID: 38778383 PMCID: PMC11112814 DOI: 10.1186/s13063-024-08180-z] [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: 12/26/2023] [Accepted: 05/16/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Adolescents and young adults in residential care and correctional institutions face various challenges, leading to negative life outcomes. Implementation barriers within these institutions, such as limited financial and spatial resources, pose significant hurdles to providing necessary support. Web-based approaches address these challenges by offering cost-effective, accessible solutions. This study aims to assess the efficacy of a newly developed web-based version of the existing evidence-based START NOW skills training in fostering emotion regulation and resilience among institutionalized adolescents and young adults. We present the study protocol (Version 5, August 2023) of the trial titled "Implementation of an e-version of the skills training START NOW for promoting emotion regulation and resilience in residential youth care and correctional institutions". METHODS The study is a monocentric, prospective, confirmatory randomized controlled trial with 150 institutionalized adolescents and young adults with a need to improve resilience (predefined cut-offs). Participating institutions will be randomized to one of three conditions: (i) 9-week web-based group training guided by a facilitator, (ii) 9-week web-based self-help training, (iii) and treatment as usual. The primary endpoint is the change in psychological flexibility, assessed by the Avoidance and Fusion Questionnaire for Youth score, from baseline to follow-up 12 weeks post skills training. Secondary objectives encompass assessing pre-post changes in psychological flexibility and other psychological health-related outcome measures in participating adolescents, young adults, and caretakers from baseline, to post training, and to 12- and 24-week follow-ups. DISCUSSION This study evaluates the efficacy of START NOW as web-based training for institutionalized adolescents and young adults, providing valuable insights into web-based interventions and aiming to optimize support levels. TRIAL REGISTRATION {2A AND 2B}: ClinicalTrials.gov NCT05313581. Registered on 6 April 2022.
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Affiliation(s)
- Linda Kersten
- Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002, Basel, Switzerland
| | - Janine Alfano
- Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002, Basel, Switzerland
| | - Tobias E Erlanger
- Department of Clinical Research, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Fabrice Helfenstein
- Department of Clinical Research, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Lelia Lanz
- Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002, Basel, Switzerland
| | - Stefan Weiss
- Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002, Basel, Switzerland
| | - Chiara Chilla
- Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002, Basel, Switzerland
| | - Beryll von Planta
- Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002, Basel, Switzerland
| | - Madlaina Kapoor
- Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002, Basel, Switzerland
| | - Nathalie Borel
- Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002, Basel, Switzerland
| | - Tabea Rocco
- Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002, Basel, Switzerland
| | - Andreas Papageorgiou
- Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002, Basel, Switzerland
| | - Catarina Fernandes De Brito
- Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002, Basel, Switzerland
| | - Arzie Bajrami
- Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002, Basel, Switzerland
| | - Valentine Savary
- Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002, Basel, Switzerland
| | - Melanie Mayor
- Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002, Basel, Switzerland
| | - Jana Hurschler
- Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002, Basel, Switzerland
| | - Alex Traut
- Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002, Basel, Switzerland
| | - Donja Brunner
- Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002, Basel, Switzerland.
| | - Noortje Vriends
- Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002, Basel, Switzerland
| | - Christina Stadler
- Department of Child and Adolescent Psychiatry, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002, Basel, Switzerland
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Sousa M, Gouveia C, Cunha O, de Castro Rodrigues A. The Effectiveness of Schema Therapy in Individuals Who Committed Crimes: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2024:15248380241254082. [PMID: 38770912 DOI: 10.1177/15248380241254082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Research suggests that individuals who commit crimes often exhibit various early maladaptive schemas (EMSs). EMSs are a broad and pervasive theme or pattern consisting of memories, emotions, cognitions, and bodily sensations concerning oneself and one's relationships with others. Furthermore, EMSs play a crucial role in the onset and maintenance of different types of offending behaviors, highlighting the need to implement schema therapy (ST) for perpetrators. Therefore, the present systematic review assesses the effectiveness of ST for individuals who committed crimes. Four databases (PubMed, Scopus, Web of Science, and Scielo) were searched for studies examining the effectiveness of ST for individuals who committed crimes. Seventeen studies were identified, but only 15 met the criteria for inclusion. Results showed that ST can lead to beneficial effects in EMSs, schema modes, personality symptoms, and risk factors to commit crimes (e.g., cognitive distortions). However, the studies, besides being scarce, revealed some methodological limitations. ST is a promising therapy for individuals who committed crimes, despite the studies' methodological shortcomings, which prevent us from drawing more firm conclusions. Although promising, more research is needed to enhance our understanding of the impact of ST therapies in forensic settings.
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Affiliation(s)
- Marta Sousa
- Psychology Research Center (CIPSI), School of Psychology, University of Minho, Campus de Gualtar, Braga
| | - Cláudia Gouveia
- Psychology Research Center (CIPSI), School of Psychology, University of Minho, Campus de Gualtar, Braga
| | - Olga Cunha
- Lusófona University, HEI-Lab: Digital Human-Environment Interaction Labs, Porto, Portugal
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Carmo C, Iacob V, Brás M, Fernandes J. Effects of a Mindfulness-Based Intervention on Male Portuguese Prisoners. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2024; 68:677-692. [PMID: 35723515 DOI: 10.1177/0306624x221106333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Mindfulness-based interventions (MBIs) in prison environments have revealed positive benefits for prisoners' physical and psychological health. This study aimed to verify the efficacy of an MBI program in decreasing depressive symptoms, anxiety, stress, negative effects, and increasing positive affects, self-esteem, and mindfulness state and capacity in prisoners. The sample comprised 44 Portuguese male prisoners, who were divided into two groups: the mindfulness training group (n = 22) and the control group (n = 22). The mindfulness training group demonstrated increased self-esteem and mindfulness capacities. Qualitative analysis showed the usefulness of the training for inmates, not only in their daily prison life, but also post-release and the importance of breathing in coping with anxious and stressful situations. These findings suggest the benefits of MBI in prison settings and propose that these interventions may hold the potential to improve prisoners' reintegration into society.
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Affiliation(s)
- Cláudia Carmo
- Universidade do Algarve, Campus de Gambelas, Faro, Portugal
| | - Vivien Iacob
- Universidade do Algarve, Campus de Gambelas, Faro, Portugal
| | - Marta Brás
- Universidade do Algarve, Campus de Gambelas, Faro, Portugal
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Bayrhammer-Savel M, Ortner M, Van Hout MC, Komorowski A. Psychiatric and legal considerations for ketamine treatment within prison settings. Front Psychiatry 2024; 15:1316108. [PMID: 38699451 PMCID: PMC11063772 DOI: 10.3389/fpsyt.2024.1316108] [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: 10/10/2023] [Accepted: 04/02/2024] [Indexed: 05/05/2024] Open
Abstract
The fundamental right to equivalence of health care in prison settings encompasses the provision of medication to address mental health conditions. Considering the increased risk for self-harm among individuals dealing with depression, the limited effectiveness of conservative antidepressants is a major challenge in psychiatry. The high prevalence of suicidal tendencies within prison populations underscores the imperative for state-of-the-art pharmacological treatment to uphold adequate health care standards. Notably, the denial of access to effective medication could be deemed a violation of human rights of people living in prison according to international treaties, domestic law, and United Nations normative standards of detention. This article presents the authors' perspective on the accessibility of ketamine treatment in prison settings, discussing psychiatric and legal considerations as well as current challenges in this context. Implementing novel psychopharmacological interventions may alleviate the distress experienced by individuals struggling with depressive symptoms and suicidality. At the same time, unprecedented treatment alternatives bring along potential issues, including limited understanding of long-term effects and the risk of abuse. Given the scarce data-availability, a pressing need exists for further research on the benefits and risks of ketamine treatment within prison populations.
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Affiliation(s)
| | - Martin Ortner
- Central Public Prosecutor’s Office for Combating Economic Crimes and Corruption, Vienna, Austria
| | | | - Arkadiusz Komorowski
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
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Willoughby M, Janca E, Kwon S, Johnston B, Collins T, Kinner SA, Johns D, Gallant D, Glover-Wright C, Borschmann R. Interventions to Prevent and Respond to Violence Against Justice-Involved Young Women: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:1036-1052. [PMID: 37170786 PMCID: PMC10913338 DOI: 10.1177/15248380231171183] [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] [Indexed: 05/13/2023]
Abstract
Young women who have had contact with the criminal justice system (justice-involved young women) have an increased risk of being a victim of violence. However, no reviews have synthesized the evidence on interventions to prevent or respond to violence against justice-involved young women. We conducted a scoping review to identify interventions designed to prevent or respond to violence against justice-involved young women. We searched Medline, Criminal Justice Abstracts, Web of Science, and Google Scholar for peer-reviewed and gray literature published in English from January 1, 2000 until March 23, 2021. Consistent with the public health approach to violence, we included primary, secondary, and tertiary interventions. Excluding duplicates, our search returned 5,603 records, 14 of which met our inclusion criteria. We narratively synthesized the included studies, all of which were conducted in the United States. Most included studies examined a tertiary intervention (n = 10), and few examined a primary (n = 2) or secondary (n = 2) intervention. Across the Joanna Briggs Institute Critical Appraisal Tools, the percentage of items met ranged from 0% to 78%. There was some limited evidence that tertiary interventions that included cognitive behavioral therapy reduced the mental health impacts of violence victimization among justice-involved young women. There was little evidence on primary and secondary interventions. Effective and evidence-based interventions to prevent violence victimization and revictimization against justice-involved young women remains a critical gap in knowledge.
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Affiliation(s)
- Melissa Willoughby
- The University of Melbourne, Parkville, VIC, Australia
- Murdoch Children’s Research Institute, Parkville, VIC, Australia
| | - Emilia Janca
- The University of Melbourne, Parkville, VIC, Australia
- Curtin University, Perth, WA, Australia
| | - Sohee Kwon
- The University of Melbourne, Parkville, VIC, Australia
| | | | - Tamlynn Collins
- The University of Melbourne, Parkville, VIC, Australia
- Youth Support and Advocacy Service, Fitzroy, VIC, Australia
| | - Stuart A. Kinner
- The University of Melbourne, Parkville, VIC, Australia
- Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Curtin University, Perth, WA, Australia
- Griffith University, Mount Gravatt, QLD, Australia
| | - Diana Johns
- The University of Melbourne, Parkville, VIC, Australia
| | - David Gallant
- The University of Melbourne, Parkville, VIC, Australia
| | | | - Rohan Borschmann
- The University of Melbourne, Parkville, VIC, Australia
- Murdoch Children’s Research Institute, Parkville, VIC, Australia
- University of Oxford, UK
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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.
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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.
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10
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Zeng Y, Zhang Q, Yan J, Qi K, Ma A, Liu X, Xiao J. The relationship between nature exposure and depression among Chinese prisoners: a moderated mediation model. Front Psychol 2024; 15:1252864. [PMID: 38449757 PMCID: PMC10916799 DOI: 10.3389/fpsyg.2024.1252864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 02/06/2024] [Indexed: 03/08/2024] Open
Abstract
Aim This study examined the association between self-reported nature exposure and depression among Chinese prisoners, as well as the mediating and moderating effects of meaning in life and callous-unemotional (CU) traits, respectively. Background Prisoners are more likely to experience depression than any other mental illness. Exposure to nature has been proposed as a highly cost-effective method of treating their depressive symptoms. However, the mechanism underlying the link between nature exposure and depression among prisoners needs further investigation, as the findings may provide new insights into how to address depression in incarcerated populations. Method Data were collected through a survey conducted in four prisons in southern China from April to May 2022. The participants were 574 prisoners who anonymously completed four questionnaires about nature exposure, meaning in life, depression, and CU traits. Results The results show that: (1) meaning in life significantly mediates the association between nature exposure and depression, and (2) CU traits moderate the connection between nature exposure and meaning in life. Conclusion The current study uncovered that prisoners who contact more with the natural environment have a higher meaning in life and lower depression, and individuals with higher CU traits can benefit more from nature exposure.
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Affiliation(s)
- Yuze Zeng
- School of Criminal Justice, China University of Political Science and Law, Beijing, China
| | - Qingqi Zhang
- School of Sociology, China University of Political Science and Law, Beijing, China
| | - Jinglu Yan
- Institute for Social Science Research, The University of Queensland, Brisbane, QLD, Australia
| | - Ke Qi
- The Psychological Counseling Center, China University of Political Science and Law, Beijing, China
| | - Ai Ma
- School of Sociology, China University of Political Science and Law, Beijing, China
| | - Xiaoqian Liu
- School of Sociology, China University of Political Science and Law, Beijing, China
| | - Junze Xiao
- School of Criminal Justice, China University of Political Science and Law, Beijing, China
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Annett J, Tillson M, Walker M, Webster JM, Staton M. Adverse childhood experiences and mental health among incarcerated women: Self-esteem as a mediating mechanism. CHILD ABUSE & NEGLECT 2023; 146:106486. [PMID: 37788588 PMCID: PMC10841516 DOI: 10.1016/j.chiabu.2023.106486] [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: 04/24/2023] [Revised: 09/04/2023] [Accepted: 09/25/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) and mental health problems are interrelated. However, less is known about this relationship in incarcerated women and how self-esteem impacts this relationship. OBJECTIVE To investigate the relationship between ACEs and mental health problems (traumatic stress, depression, and anxiety) in incarcerated women with opioid use disorder (OUD) and, the possible role of self-esteem as a mediator of the relationship. PARTICIPANTS AND SETTING Incarcerated women (N = 500) were randomly selected from eight Kentucky jails, screened for OUD, and interviewed by research staff. METHODS Regression analyses and mediation models were used to examine the relationship between ACEs, mental health, and self-esteem. RESULTS ACEs were positively correlated with present mental health problems (traumatic stress, r = 0.407, p < .001; depression, r = 0.177, p < .001; and anxiety, r = 0.213, p < .001) and negatively correlated with current self-esteem (r = -0.241, p < .001). Linear regression analyses established that ACEs and self-esteem were significantly related to all three mental health variables of interest. Additionally, self-esteem mediated the relationship between ACEs and mental health. CONCLUSION This study shows that incarcerated women's experiences with ACEs are significantly related to poor mental health. Self-esteem plays a critical role in this relationship.
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Affiliation(s)
- Jaxin Annett
- University of Kentucky College of Education, Department of Educational, School, and Counseling Psychology, 597 S. Upper Street, Lexington, KY 40508, USA; University of Kentucky Center on Drug and Alcohol Research, 643 Maxwelton Ct., Lexington, KY 40506, USA.
| | - Martha Tillson
- University of Kentucky Center on Drug and Alcohol Research, 643 Maxwelton Ct., Lexington, KY 40506, USA.
| | - Meghan Walker
- University of Kentucky College of Medicine, E 1st Ave, Bowling Green, KY 42101, USA.
| | - J Matthew Webster
- University of Kentucky Center on Drug and Alcohol Research, 643 Maxwelton Ct., Lexington, KY 40506, USA; University of Kentucky College of Medicine, Department of Behavioral Science, 1100 Veterans Drive, Lexington, KY 40536, USA.
| | - Michele Staton
- University of Kentucky Center on Drug and Alcohol Research, 643 Maxwelton Ct., Lexington, KY 40506, USA; University of Kentucky College of Medicine, Department of Behavioral Science, 1100 Veterans Drive, Lexington, KY 40536, USA.
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Nakashima M, Matsunaga M, Otani M, Kuga H, Fujisawa D. Development and preliminary validation of the Group Cognitive Therapy Scale. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2023; 2:e128. [PMID: 38867831 PMCID: PMC11114285 DOI: 10.1002/pcn5.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 07/22/2023] [Accepted: 07/25/2023] [Indexed: 06/14/2024]
Abstract
Aim The aim of this research was to create a scale to assess the competency of therapists who conduct group cognitive behavioral therapy (G-CBT). The scale is intended to serve as a tool to aid the training of therapists. Methods Three stepped studies were conducted. Process 1: Through literature review and experts' consensus process, essential skills for G-CBT were articulated and categorized according to the criteria of the Cognitive Therapy Scale, a well-established rating scale for evaluating clinicians' skills in individual cognitive behavioral therapy. The list of those skills was organized into a rating scale. Process 2: Behavioral anchors were added to each skill and were classified by the levels of difficulty (beginner, intermediate, and advanced levels), based on the rating by G-CBT experts. Process 3: Inter-rater reliability and validity of the rating scale were examined in a sample of 41 videotaped G-CBT sessions of actual clinical sessions and educational role-plays. Results The 12-item Group Cognitive Therapy Scale (G-CTS) was developed. It consists of 11 items that are adapted from the original Cognitive Therapy Scale, and a new 12th item called "Intervention using relationships with other participants," which describes therapists' skills to address group dynamics. The G-CTS showed excellent internal consistency (Cronbach's α: 0.95), satisfactory inter-rater reliability (interclass correlation coefficients: 0.65-0.88), and high predictive validity. Conclusion A novel rating scale to evaluate therapists' competency in G-CBT was developed and successfully validated. The G-CTS behavioral checklist created in this study provides concrete guidelines that can be used by therapists to hone their skills in G-CBT.
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Affiliation(s)
- Misuzu Nakashima
- Division of Clinical ResearchNational Hospital Organization Hizen Psychiatric CenterKanzakiSaga PrefectureJapan
| | - Miki Matsunaga
- Department of PsychologyRikkyo UniversityNiizaSaitama PrefectureJapan
| | - Makoto Otani
- Department of Psychosomatic MedicineNTT Medical Center TokyoTokyoJapan
| | - Hironori Kuga
- National Center for Cognitive Behavior Therapy and ResearchNational Center of Neurology and PsychiatryTokyoJapan
| | - Daisuke Fujisawa
- Division of Patient SafetyKeio University School of MedicineTokyoJapan
- Department of NeuropsychiatryKeio University School of MedicineTokyoJapan
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Abbing A, Haeyen S, Nyapati S, Verboon P, van Hooren S. Effectiveness and mechanisms of the arts therapies in forensic care. A systematic review, narrative synthesis, and meta analysis. Front Psychiatry 2023; 14:1128252. [PMID: 37275972 PMCID: PMC10235769 DOI: 10.3389/fpsyt.2023.1128252] [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: 12/20/2022] [Accepted: 04/26/2023] [Indexed: 06/07/2023] Open
Abstract
Introduction Mental health care provided to offenders with psychiatric problems in forensic settings mainly consists of verbal oriented treatments. In addition, experience-based therapies are used such as (creative) arts therapies: (visual) art therapy, music therapy, drama therapy and dance (movement) therapy. There are indications for effectiveness of arts therapies, but a systematic overview of effect studies of all arts therapies in forensic care is lacking. Methods First, we performed a systematic review. Second, Thematic Analysis was used to synthesize the qualitative narrative results and define the hypothesized mechanisms of change. Third, we performed a meta-analysis to investigate the effects of arts therapies in reducing psychosocial problems of offenders. Twenty-three studies were included in the review. Quality and risk of bias was assessed using EPHPP (Effective Public Health Practice Project). Results The included studies were heterogeneous in type of outcome measures and intervention characteristics. Synthesis of mechanisms of change involved in the methodical use of the arts in arts therapies resulted in a description of regulatory processes which are stimulated in arts therapies: perceptive awareness (interoceptive and exteroceptive), the regulation of emotions, stress, impulses, cognitions, social regulation, and self-expression. These processes play a role in developing prevention, coping and self-management skills. Eighteen studies were included in the meta-analyses (11 RCTs/CCTs; 7 pre-post studies). The meta-analyses indicated significant effects on both risk factors (psychiatric symptoms and addiction) and protective factors for criminal behavior (social functioning and psychological functioning). Effects on criminal and/or antisocial behavior were not significant, but this outcome measure was scarcely used among the studies. Discussion The analyses in this study should be considered explorative. More research is needed to gain more solid conclusions about effectiveness and mechanisms of change of arts therapies in forensic institutions. However, the results of this first systematic review, synthesis of mechanisms and meta-analysis in this field are promising and show effects of arts therapies on risk and protective factors in individuals in forensic institutions. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020217884, identifier: CRD42020217884.
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Affiliation(s)
- Annemarie Abbing
- Department of Clinical Psychology, Faculty of Psychology, Open University, Heerlen, Netherlands
- Department of Arts Therapies, Professorship Anthroposophic Healthcare, University of Applied Sciences, Leiden, Netherlands
- KenVaK, Research Centre for the Arts Therapies, Heerlen, Netherlands
| | - Suzanne Haeyen
- KenVaK, Research Centre for the Arts Therapies, Heerlen, Netherlands
- Special Research Group Arts and Psychomotor Therapies/Master of Arts Therapies, Hogeschool van Arnhem en Nijmegen University of Applied Sciences, Nijmegen, Netherlands
- Scelta, Expert Centre for Personality Disorders Apeldoorn, GGNet, Centre for Mental Health, Apeldoorn, Netherlands
| | - Sashank Nyapati
- Department of Arts Therapies, Professorship Anthroposophic Healthcare, University of Applied Sciences, Leiden, Netherlands
| | - Peter Verboon
- Department of Methodology and Statistics, Faculty of Psychology, Open University, Heerlen, Netherlands
| | - Susan van Hooren
- Department of Clinical Psychology, Faculty of Psychology, Open University, Heerlen, Netherlands
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Malik N, Facer-Irwin E, Dickson H, Bird A, MacManus D. The Effectiveness of Trauma-Focused Interventions in Prison Settings: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2023; 24:844-857. [PMID: 34711095 DOI: 10.1177/15248380211043890] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is overrepresented in prison relative to community populations and can be difficult to manage in an environment which can inherently exacerbate trauma-related symptomology. Little is known about the effectiveness of trauma-focused interventions in prison and less is known about factors that moderate the effectiveness of these interventions. AIM/METHODS We examined the effectiveness of trauma-focused interventions in prison relative to prison controls using meta-analytic techniques. We further used meta-regression analysis to examine treatment, methodological and participant-level moderators to determine factors that increased the effectiveness of these interventions. RESULTS From 16 studies eligible for the meta-analysis, we found a small but significant effect size for trauma-focused interventions. Phase 2 trauma processing interventions and interventions delivered individually led to greater reductions in PTSD symptoms. Studies utilizing an active treatment control resulted in smaller effect sizes than those using waitlist or no contact controls. Treatment length, study quality, outcome type, and gender were not significant moderators of treatment effectiveness. CONCLUSION Findings from this review are encouraging but should be interpreted with caution. Results suggest that trauma processing therapies, and individual modality trauma-focused interventions can be effective and delivered successfully in prison. However, inadequate comparison groups do not allow a firm conclusion to be drawn. There is a need for high quality Randomized Controlled Trial's that additionally measure Complex PTSD, utilize a modular treatment approach, and include treatments recommended in the National Institute for health and Care Excellence (NICE) guidelines such as Trauma-focused CBT and Eye Movement Desensitization Reprocessing (EMDR).
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Affiliation(s)
- Nabeela Malik
- Forensic and Neurodevelopmental Sciences Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Older Adults Psychiatry, North East London Foundation NHS Trust, London, England, United Kingdom
| | - Emma Facer-Irwin
- Forensic and Neurodevelopmental Sciences Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Clinical Psychology, School of Health and Social Care, University of Essex, Colchester, United Kingdom
- Joint first author
| | - Hannah Dickson
- Forensic and Neurodevelopmental Sciences Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Annie Bird
- Forensic and Neurodevelopmental Sciences Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Deirdre MacManus
- Forensic and Neurodevelopmental Sciences Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Consultant Forensic Psychiatrist; HMP Wandsworth, South London and Maudsley NHS Trust, London, England, United Kingdom
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Updyke A, Ghose T. "We're the CHATS old-heads": Engaging with evidence-based practice in a reentry agency. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:945-961. [PMID: 36383698 DOI: 10.1002/jcop.22964] [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: 07/18/2022] [Revised: 10/04/2022] [Accepted: 10/17/2022] [Indexed: 06/16/2023]
Abstract
Philadelphia has one of the country's largest populations re-entering society after incarceration. Reentry services have been critiqued for their ineffectiveness. Scholars note the lack of evidence-based practices (EBPs) in the field, and the challenges of translating them. Through a case study of one reentry agency implementing an EBP, we examine engagement with the intervention by clients and service providers. Qualitative interviews were conducted with clients and staff (n = 35). A grounded theory using sensitizing concepts approach was used to analyze the data. Productive engagement with the intervention was facilitated by: (1) translatability of the core EBP elements so that they addressed client and staff needs, (2) accessibility to the intervention by enhancing subjective ownership and successfully navigating logistical barriers, and (3) collectivity among participants and staff that helped them address societal and structural barriers. Productive engagement with an EBP can resist carceral processes in reentry service-provision.
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Affiliation(s)
- Alison Updyke
- Department of Graduate Social Work, West Chester University, West Chester, Pennsylvania, USA
| | - Toorjo Ghose
- School of Social Policy and Practice, University of Pennsylvania, Pennsylvania, Philadelphia, USA
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Baldwin G, Beazley P. A systematic review of the efficacy of psychological treatments for people detained under the Mental Health Act. J Psychiatr Ment Health Nurs 2023. [PMID: 36655589 DOI: 10.1111/jpm.12897] [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: 08/05/2022] [Revised: 12/10/2022] [Accepted: 01/08/2023] [Indexed: 01/20/2023]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: International reviews have looked at therapy outcomes for patients on mental health wards, showing it is associated with reduced emotional distress and readmission. Reviews have not looked at which specific treatments are most effective. No review has been done in England and Wales for patients detained specifically under the Mental Health Act. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE The paper gives an overview of the limited evidence in England and Wales. The paper shows which therapies have been measured. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Larger studies are needed across all types of patient wards in England and Wales with random allocation to types of therapy and longer-term follow-up. More studies are needed where researchers are not aware of the therapy being delivered. More studies need to use a mixture of patient and clinician outcome measures. Outcomes should also measure incident, readmission and reoffending rates. More evidence is needed from patients who are female, non-white and who are diagnosed with depression and anxiety. ABSTRACT INTRODUCTION: The efficacy of psychological interventions delivered under the Mental Health Act (1983) (MHA) in England and Wales is unclear. While meta-analyses have reviewed acute and forensic psychological interventions in wider geographical areas, there has been no review specifically in the unique MHA context. AIM A systematic review was conducted of psychological outcomes for inpatients detained under the MHA in England and Wales. METHOD Diagnoses and type of psychological intervention were not restricted, provided a psychological outcome measure was used. Studies were identified through APA PsychInfo, MEDLINE, CINAHL and Academic Search using a combination of key terms. Data extraction included effect direction, statistical significance, intervention type, format and duration, study size, inpatient setting, control group and study quality. RESULTS High-quality evidence was sparse. Some improvements were found in overall well-being, self-esteem, social functioning, problem-solving, substance use, anger, offending attitudes, fire-setting, violence, anxiety, depression, personality disorder and psychosis. However, the overall evidence base is lacking. DISCUSSION Larger-scale randomized controlled trials are needed across secure, acute and learning disability inpatient settings in England and Wales with longer term follow-up, blind assessors and both self-report and clinician-rated measures, as well as incident, readmission and reoffending rates. Greater representation is needed of females, non-white groups and affective disorders. CLINICAL IMPLICATIONS The efficacy of psychological interventions for inpatients detained under the MHA in England and Wales remains unclear. Clinicians are encouraged to use relevant outcome measures in relation to treatment goals, to monitor the efficacy of interventions being offered to this client group. RELEVANCE TO MENTAL HEALTH NURSING This paper highlights the current body of evidence for psychological interventions in inpatient settings within England and Wales, which is an environment in which mental health nursing plays an important role in patients' recovery. This evidence is also particularly important as there is a shift in clinical practice to training nursing staff to deliver some of the low-intensity psychological interventions, such as behavioural activation, solution-focussed therapy and motivational interviewing.
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Affiliation(s)
- George Baldwin
- Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, Norfolk, UK
| | - Peter Beazley
- Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, Norfolk, UK
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17
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Duan W, Wang Z, Yang C, Ke S. Are risk-need-responsivity principles golden? A meta-analysis of randomized controlled trials of community correction programs. JOURNAL OF EXPERIMENTAL CRIMINOLOGY 2023:1-24. [PMID: 36644318 PMCID: PMC9825096 DOI: 10.1007/s11292-022-09550-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
Objectives Using meta-analysis to determine the effect size of the recidivism rate of participants in community correction programs that are conducted entirely in community settings. Methods Following the Preferred Reported Items for Systematic Reviews and Meta-analyses (PRISMA), 25 qualified studies contributed 35 independent effect sizes. Results Full participation in a program significantly reduced the recidivism rate. Participant age was a significant moderator of heterogeneity. Those aged over 18 have lower recidivism rates. Interventions that fully follow the Risk-Need-Responsivity (RNR) design principles achieved similar results to those that did not. Recidivism rates increase more than 12 months after the program ends. Conclusions The effectiveness of community correctional programs varies depending on the participant's age. The RNR principles are not golden. The above factors should be carefully considered when conducting intervention design in the future. Results should be interpreted with caution due to the literature's high heterogeneity and low quality. Supplementary Information The online version contains supplementary material available at 10.1007/s11292-022-09550-w.
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Affiliation(s)
- Wenjie Duan
- School of Social and Public Administration, East China University of Science and Technology, Shanghai, China
| | - Zichuan Wang
- School of Social and Public Administration, East China University of Science and Technology, Shanghai, China
| | - Caiyun Yang
- Department of Sociology, School of Philosophy and Law & Political Science, Shanghai Normal University, Xuhui District, 100 Guilin Road, Shanghai, 200234 China
| | - Shuting Ke
- Department of Sociology, School of Philosophy and Law & Political Science, Shanghai Normal University, Xuhui District, 100 Guilin Road, Shanghai, 200234 China
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Fovet T, Villa C, Belet B, Carton F, Bauer T, Buyle-Bodin S, D’Hondt F, Bouchard JP. Le psychotraumatisme en milieu pénitentiaire. ANNALES MÉDICO-PSYCHOLOGIQUES, REVUE PSYCHIATRIQUE 2022. [DOI: 10.1016/j.amp.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Boyas JF, McCoy LM, Woodiwiss JL, Adams JE. Applying the Stress Process Theory to Assess Correlates of Suicide Ideation-to-Action Among Persons on Parole in the United States. Community Ment Health J 2022; 59:664-679. [PMID: 36378459 PMCID: PMC9664423 DOI: 10.1007/s10597-022-01047-0] [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: 10/23/2021] [Accepted: 10/20/2022] [Indexed: 11/16/2022]
Abstract
There is limited knowledge regarding precipitating factors associated with suicidality among persons on parole. Pairing the suicide ideation-to-action framework and stress process theory, the present study aimed to characterize sources of major stress (drug use, physical health, and mental health) and their associations to suicide ideation, planning, and attempt among a national sample of persons on parole. This study included a subsample of persons on parole (N = 1725) using pooled national data from the National Survey on Drug Use and Health (2015-2019). A series of logistic regression results indicate that various drug use, physical health, and mental health factors significantly influenced all three suicidality measures. Due to this population's unique experiences and numerous barriers following release from prison, it is essential to personalize interventions geared toward this population to meet their specific needs and address suicidality based on where they fall on this continuum.
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Affiliation(s)
- Javier F Boyas
- School of Social Work and Human Services, Troy University, 211D Wright Hall, Troy, AL, 36082, USA.
| | - Leah M McCoy
- School of Social Work, The University of Georgia, 279 Williams St, Athens, GA, 30602, USA
| | - Jana L Woodiwiss
- School of Social Work, The University of Georgia, 279 Williams St, Athens, GA, 30602, USA
| | - Jacqueline E Adams
- School of Social Work, The University of Georgia, 279 Williams St, Athens, GA, 30602, USA
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Sustained impacts of North Carolina prison therapeutic diversion units on behavioral outcomes, mental health, self-injury, and restrictive housing readmission. Prev Med 2022; 164:107318. [PMID: 36283487 DOI: 10.1016/j.ypmed.2022.107318] [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: 05/27/2022] [Revised: 09/20/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022]
Abstract
Therapeutic Diversion Units (TDUs) in North Carolina prisons are intended to reduce cycling of individuals with mental health conditions through restrictive housing (i.e., solitary confinement). This paper investigates if previously identified benefits of TDU are sustained when individuals return to the general prison population. Using administrative data on 3170 people, we compare individuals placed in TDUs to TDU-eligible individuals (i.e., individuals with mental health needs) placed in restrictive housing. We use survival analysis methods to estimate hazard ratios (HRs) with confidence intervals (CIs), controlling for confounders. Compared to restrictive housing placement, TDU placement reduced the hazard of infractions (HR: 0.66; 95% CI: 0.52, 0.84) and subsequent restrictive housing placement (HR: 0.64; 95% CI: 0.55, 0.73) but increased the hazard of self-harm (HR: 2.67; 95% CI: 1.66, 4.29) upon program release to the general prison population. These findings suggest a need for additional investments and research on restrictive housing diversion programming, including post-diversion program supports.
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21
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Facer-Irwin E, Karatzias T, Bird A, Blackwood N, MacManus D. PTSD and complex PTSD in sentenced male prisoners in the UK: prevalence, trauma antecedents, and psychiatric comorbidities. Psychol Med 2022; 52:2794-2804. [PMID: 33431085 PMCID: PMC9647511 DOI: 10.1017/s0033291720004936] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is highly prevalent within prison settings, yet is often unidentified and undertreated. Complex PTSD (CPTSD) has been recently formally recognised in the International Classification of Diseases 11th revision (ICD-11) diagnostic framework but has never been explored in prison settings. We aimed to establish the prevalence of ICD-11 PTSD and CPTSD in a UK prison sample using a validated instrument (the International Trauma Questionnaire). We also explored the associations of these two diagnoses with their traumatic antecedents and psychiatric comorbidities. METHOD Randomly selected male, sentenced prisoners in a large medium-security prison in south London (N = 221) took part in a clinical interview which assessed PTSD, CPTSD, trauma histories, and comorbid disorders. Multinomial logistic regression was performed to examine differences between those with PTSD or CPTSD, and those without symptoms. RESULTS A total of 7.7% (95% CI 4.5-12) of the male sentenced prisoners met diagnostic criteria for ICD-11 PTSD and 16.7% (95% CI 12.1-22.3) for CPTSD. A diagnosis of PTSD was associated with more recent traumatic exposure, comorbid generalised anxiety disorder, alcohol dependence, and Cluster B personality disorder. A diagnosis of CPTSD was associated with complex trauma exposure antecedents (developmental, interpersonal, repeated, or multiple forms), and comorbid with anxiety, depression, substance misuse, psychosis, and ADHD. CONCLUSIONS This study confirms that CPTSD is a very common and comorbid condition in male prisoners. There is an urgent need to develop trauma-informed care in prisons.
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Affiliation(s)
- Emma Facer-Irwin
- Researcher; Forensic and Neurodevelopmental Sciences Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Thanos Karatzias
- Professor of Mental Health; School of Health & Social Care, Edinburgh Napier University, Edinburgh, Scotland
- Clinical & Health Psychologist; Rivers Centre for Traumatic Stress, NHS Lothian, Edinburgh, Scotland
| | - Annie Bird
- Research Assistant; Forensic and Neurodevelopmental Sciences Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Nigel Blackwood
- Clinical Reader in Forensic Psychiatry; Forensic and Neurodevelopmental Sciences Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
- Consultant Forensic Psychiatrist; HMP Wandsworth, South London & Maudsley NHS Foundation Trust, London, England
| | - Deirdre MacManus
- Clinical Reader in Forensic Psychiatry; Forensic and Neurodevelopmental Sciences Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
- Consultant Forensic Psychiatrist; London and South East NHS Veterans’ Mental Health Service, Camden and Islington NHS Trust; HMP Wandsworth, South London and Maudsley NHS Trust, London, England
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Psychotherapy for Serious Mental Illness in Solitary Confinement: Metacognition and the Promotion of Meaning and Recovery. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2022. [DOI: 10.1007/s10879-022-09567-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Zhang J, Zheng Z, Wang L, Luberto CM, Sophie Zhang M, Wen Y, Su Q, Jiao C. Effectiveness of a 4-Day Mindfulness-Based Intervention in a 2-Month Follow-Up for Chinese Incarcerated People. Behav Ther 2022; 53:981-994. [PMID: 35987553 DOI: 10.1016/j.beth.2022.04.004] [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: 06/02/2021] [Revised: 03/26/2022] [Accepted: 04/05/2022] [Indexed: 11/02/2022]
Abstract
Mindfulness-based interventions, an evidence-based stress reduction approach, may help incarcerated people cope with stress-related problems in the challenging environment of prison. However, due to their unique living environment, the duration and instructor guidance required by standard mindfulness-based interventions would be infeasible in most prisons. Therefore, the aims of the current study were to test the effects of two different 4-day interventions (i.e., instructor-guided and audio-based) with content similar to Mindfulness-Based Cognitive Therapy for newly incarcerated males, and to compare the effectiveness of the two interventions relative to a no-intervention control group. Using daily assessments, we explored changes in perceived stress, insomnia, and negative affect in the 56 days following the instructor-guided (N = 25), audio-based (N = 21), and control (N = 44) intervention; length of mindfulness practice during the follow-up was also compared between the two intervention groups. Hierarchical linear model results showed significantly greater linear decreases in perceived stress after both mindfulness interventions during the 56-day follow-up (γ11 = -0.011, p < .001, 95% CI [-0.017, -0.004] for instructor-guided intervention; γ12 = -0.013, p < .001, 95% CI [-0.018, -0.006] for audio-based intervention), as compared to the control group. Compared to the control group, the instructor-guided group reported a significantly greater decrease in insomnia (γ11 = -0.007, p < .001, 95% CI [-0.014, -0.002]), but the audio-based group did not (γ12 = -0.002, p = .160, 95% CI [-.007, .004]). Neither mindfulness-based intervention group reported a significantly greater decrease in negative affect compared to the control group (γ11 = -0.002, p = .170, 95% CI [-0.005, 0.001] for instructor-guided intervention; γ12 = -0.002, p = .150, 95% CI [-0.006, 0.002] for audio-based intervention). No significant difference between the two intervention groups was found in the change of outcomes (γ11 = 0.002, -0.005 and 0.000, p = .350, .130 and .390, 95% CI [-0.008, 0.011], 95% CI [-0.014, 0.004] and 95% CI [-0.004, 0.006] subsequently for perceived stress, insomnia and negative affect). Daily mindfulness practice was significantly longer for the audio-based group on the first day of follow-up (γ02 = -0.758, p < .05, 95% CI [-1.333, -0.129]), but it gradually decreased to the same amount as the instructor-guided group (t (32) = 0.051, p = .959). Short-term mindfulness interventions, either instructor-guided or audio-based, appear to be beneficial for Chinese prisoners in reducing stress. Live instruction may have potential benefit in reducing insomnia and sustaining daily practice.
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Affiliation(s)
- Jieting Zhang
- School of Psychology, Shenzhen University; The Shenzhen Humanities & Social Sciences, Key Research Bases of the Center for Mental Health, Shenzhen University.
| | | | - Lina Wang
- School of Design and Art, Beijing Institute of Technology, Zhuhai
| | | | | | - Yuhua Wen
- Dongguan Prison of Guangdong Province
| | - Qi Su
- Dongguan Prison of Guangdong Province
| | - Can Jiao
- School of Psychology, Shenzhen University; The Shenzhen Humanities & Social Sciences, Key Research Bases of the Center for Mental Health, Shenzhen University.
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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: 0] [Impact Index Per Article: 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.
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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
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25
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Marsh SC, Russell KN, Evans WP. Trickle down Registration: Exploring the Lived Experiences of Partners of Persons Registered as a Sexual Offender. HEALTH COMMUNICATION 2022; 37:1041-1046. [PMID: 33601988 DOI: 10.1080/10410236.2021.1888455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Accessing stigmatized persons for research purposes can be difficult, and accessing their significant others is perhaps even more challenging. We present here our defining moments of recruiting and surveying partners of persons registered as sexual offenders for our research on courtesy stigma. The challenges and successes of our journey are described within the larger hypothesis that close relationships are an important source of social support associated with adjustment and well-being outcomes for people involved in the justice system as well as their families. Ultimately, we suggest our reflections will not only encourage other researchers to seek the input of hard-to-reach populations in justice, health, and policy contexts, but also to incorporate the experiences of underrepresented voices, elucidate findings and lessons learned from these unique populations, and engage in reflexive health communication and research strategies with highly stigmatized populations.
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Affiliation(s)
- Shawn C Marsh
- Judicial Studies, Communication Studies, and Social Psychology, University of Nevada, Reno
| | | | - William P Evans
- Judicial Studies, Communication Studies, and Social Psychology, University of Nevada, Reno
- Human Development, Family Science, and Counseling, University of Nevada, Reno
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26
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Thekkumkara SN, Jagannathan A, Muliyala KP, Murthy P. Psychosocial Interventions for Prisoners with Mental and Substance Use Disorders: A Systematic Review. Indian J Psychol Med 2022; 44:211-217. [PMID: 35656427 PMCID: PMC9125461 DOI: 10.1177/02537176211061655] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
PURPOSE OF THE REVIEW The prevalence of mental and substance use disorders is three to five times higher than that of the general population. Psychosocial interventions are effective in identifying and managing mental health and substance use disorders. This article aims to review the randomized control studies which have used nonpharmacological interventions alone or in combination with pharmacological interventions for managing mental and substance use disorders in prison/correctional settings. COLLECTION AND ANALYSIS OF DATA Studies included were randomized control trials and pilot randomized studies that assessed the impact of psychosocial interventions for prisoners with mental disorders and substance use disorders. A comprehensive search for articles was done by the primary author (Sreekanth Nair Thekkumkara) in the following databases: PubMed, ProQuest, PsychArticles, and Google Scholar (search engine), for the period June 1, 2000, to December 31, 2020. RESULTS AND CONCLUSIONS The 21 studies included in the review had a sample size of 34 to 759. The settings of all the interventions were the prison and different types of psychosocial interventions were provided across the studies. The average duration of intervention ranged between 10 min and 120 min with the frequency of one to six sessions per week for 1 to 36 months. All the 21 Randomized Control Trials (RCTs) were nonIndian studies. Overall, the results of the included studies showed significant improvement postintervention (motivational intervention, interpersonal therapy, cognitive behavior therapy, positive psychology intervention, music therapy, and acceptance and commitment therapy) on primary outcome measures such as symptom severity of depression, anxiety, and substance abuse prisoners. Positive effects were observed on secondary outcome measures such as motivation, aggression, follow up rates, and recidivism. A limited number of studies have focused on evaluating psychosocial interventions in prison settings. Most of the interventions were tested in prisoners with substance use disorder alone or in those with dual diagnoses and in high-income countries.
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Affiliation(s)
- Sreekanth Nair Thekkumkara
- Dept. of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Aarti Jagannathan
- Dept. of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Krishna Prasad Muliyala
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Pratima Murthy
- Professor of Psychiatry, Director National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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27
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Bright AM, Higgins A, Grealish A. Women's experiences of prison-based mental healthcare: a systematic review of qualitative literature. Int J Prison Health 2022; 19:181-198. [PMID: 35192246 PMCID: PMC10427976 DOI: 10.1108/ijph-09-2021-0091] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/25/2021] [Accepted: 01/11/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE The rate of female committals to prison has grown rapidly in recent years. Women in prison are likely to have trauma histories and difficulties with their mental health. This paper aims to synthesise the findings of qualitative literature to gain a deeper understanding of the experiences of women in the context of prison-based mental health care. DESIGN/METHODOLOGY/APPROACH A systematic search of five academic databases, Cumulative Index to Nursing and Allied Health Literature, Applied Social Sciences Index and Abstracts, Psychological Information Database (PsycINFO), Excerpta Medica DataBASE (EMBASE) and Medline, was completed in December 2020. This study's search strategy identified 4,615 citations, and seven studies were included for review. Thomas and Harden's (2008) framework for thematic synthesis was used to analyse data. Quality appraisal was conducted using the Joanna Briggs Institute Checklist for Qualitative Research (Lockwood et al., 2015). FINDINGS Four analytic themes were identified that detail women's experiences of prison-based mental health care: the type of services accessed and challenges encountered; a reduction in capacity to self-manage mental well-being; the erosion of privacy and dignity; and strained relationships with prison staff. There is a paucity of research conducted with women in the context of prison-based mental health care. The findings suggest there is a need for greater mental health support, including the need to enhance relationships between women and prison staff to promote positive mental health. ORIGINALITY/VALUE To the best of the authors' knowledge, this is the first systematic review conducted on the experiences of women in the context of prison-based mental health care.
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Affiliation(s)
- Ann-Marie Bright
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Agnes Higgins
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Annmarie Grealish
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland and Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, UK
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28
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Crole-Rees C, Forrester A. Developing a clinical pathway for traumatic stress in prisons. MEDICINE, SCIENCE, AND THE LAW 2022; 62:4-7. [PMID: 35006013 DOI: 10.1177/00258024211072770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Clare Crole-Rees
- Cardiff University and Cwm Taf Morgannwg University Health Board, Pontypridd, UK
| | - Andrew Forrester
- Forensic Psychiatry, Department of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
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29
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Franke I, Urwyler T, Prüter-Schwarte C. Assisted dying requests from people in detention: Psychiatric, ethical, and legal considerations-A literature review. Front Psychiatry 2022; 13:909096. [PMID: 35966491 PMCID: PMC9374168 DOI: 10.3389/fpsyt.2022.909096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/28/2022] [Indexed: 11/13/2022] Open
Abstract
The principle of equivalence of care states that prisoners must have access to the same standard of health care as the general population. If, as recent court decisions suggest, assisted dying is not limited to people with a terminal physical illness or irremediable suffering, it might also be requested by people with severe mental illness in detention. Some of the countries with legal regulations on assisted dying also have recommendations on how to handle requests from prisoners. However, detention itself can lead to psychological distress and suicidality, so we must consider whether and how people in such settings can make autonomous decisions. Ethical conflicts arise with regard to an individual's free will, right to life, and physical and personal integrity and to the right of a state to inflict punishment. Furthermore, people in prison often receive insufficient mental health care. In this review, we compare different practices for dealing with requests for assisted dying from people in prison and forensic psychiatric facilities and discuss the current ethical and psychiatric issues concerning assisted dying in such settings.
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Affiliation(s)
- Irina Franke
- Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany.,Psychiatric Services of Grisons, Chur, Switzerland
| | - Thierry Urwyler
- Office of Corrections and Rehabilitation, Department of Research and Development, Zurich, Switzerland.,Faculty of Law, University of Lucerne, Lucerne, Switzerland.,Faculty of Law, University of Zurich, Zurich, Switzerland
| | - Christian Prüter-Schwarte
- Faculty of Medicine and University Hospital Cologne, Institute for the History of Medicine and Medical Ethics, University of Cologne, Cologne, Germany.,Faculty of Health Sciences, Department of Social Philosophy and Ethics in the Health Sciences, University Witten/Herdecke, Witten, Germany.,Department of Forensic Psychiatry and Psychotherapy II, LVR Hospital Cologne, Cologne, Germany
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30
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Lennox C, Leonard S, Senior J, Hendricks C, Rybczynska-Bunt S, Quinn C, Byng R, Shaw J. Conducting Randomized Controlled Trials of Complex Interventions in Prisons: A Sisyphean Task? Front Psychiatry 2022; 13:839958. [PMID: 35592376 PMCID: PMC9110768 DOI: 10.3389/fpsyt.2022.839958] [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: 12/20/2021] [Accepted: 03/29/2022] [Indexed: 11/26/2022] Open
Abstract
Randomized Controlled Trials (RCT) are the "gold standard" for measuring the effectiveness of an intervention. However, they have their limitations and are especially complex in prison settings. Several systematic reviews have highlighted some of the issues, including, institutional constraints e.g., "lock-downs," follow-ups, contamination of allocation conditions and a reliance on self-report measures. In this article, we reflect on our experiences and will describe two RCTs. People in prison are a significantly disadvantaged and vulnerable group, ensuring equitable and effective interventions is key to reducing inequality and promoting positive outcomes. We ask are RCTs of complex interventions in prisons a sisyphean task? We certainly don't think so, but we propose that current accepted practice and research designs may be limiting our understanding and ability to test complex interventions in the real-world context of prisons. RCTs will always have their place, but designs need to be flexible and adaptive, with the development of other rigorous methods for evaluating impact of interventions e.g., non-randomized studies, including pre-post implementation studies. With robust research we can deliver quality evidence-based healthcare in prisons - after all the degree of civilization in a society is revealed by entering its prisons.
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Affiliation(s)
- Charlotte Lennox
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Sarah Leonard
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Jane Senior
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Caroline Hendricks
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Sarah Rybczynska-Bunt
- Community and Primary Care Research Group, University of Plymouth, Plymouth, United Kingdom
| | - Cath Quinn
- Community and Primary Care Research Group, University of Plymouth, Plymouth, United Kingdom
| | - Richard Byng
- Community and Primary Care Research Group, University of Plymouth, Plymouth, United Kingdom
| | - Jenny Shaw
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, United Kingdom
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31
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Favril L. Epidemiology, Risk Factors, and Prevention of Suicidal Thoughts and Behaviour in Prisons: A Literature Review. Psychol Belg 2021; 61:341-355. [PMID: 34900324 PMCID: PMC8622377 DOI: 10.5334/pb.1072] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 10/19/2021] [Indexed: 12/21/2022] Open
Abstract
Suicide is a global public health concern that affects all echelons of society, albeit not equally so. Compared with adults in the general population, incarcerated offenders are at increased risk to consider, attempt, and die by suicide, which represents a substantial burden of morbidity and mortality in prisons worldwide. This review synthesises recent literature pertaining to the epidemiology, risk factors, and prevention of suicidal thoughts and behaviour among prisoners, and outlines a framework which emphasises the interplay between individuals (importation) and their surroundings (deprivation). The available evidence suggests that prison-specific stressors may exacerbate risk of suicide in an already vulnerable population characterised by complex health and social care needs. Emerging data point to differential mechanisms through which prisoners come to think about suicide and subsequently progress to suicidal behaviour. As risk of suicide is determined by a complex web of synergistically interacting factors, its management and prevention demands a cross-sectoral policy and service response that includes targeted interventions aimed at high-risk prisoners in combination with population strategies that promote the health and wellbeing of all people in prison.
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Affiliation(s)
- Louis Favril
- Institute for International Research on Criminal Policy, Faculty of Law and Criminology, Ghent University, BE
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32
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Pelizza L, Zambelli U, Rossi E, Verdoliva G, Maestri D, De Amicis I, Paraggio C, Zaimovic A, Veneri B, Urbani B, Gran Dall'Olio D, Adriani A, Cutrino S, Bertoli S, Paulillo G, Pellegrini P. Mental health interventions in an Italian prison: the Parma integrated approach. Int J Prison Health 2021; 17:520-532. [PMID: 38902899 DOI: 10.1108/ijph-07-2020-0046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Mental health interventions for Italian prisoners with mental disorders remain a problematic issue, despite radical changes in general psychiatric care and a 2008 major government reform transferring mental health care in prison to the National Health Service. The aim of this study is to describe the mental health intervention model implemented since January 2020 for prisoners allocated in the Parma Penitentiary Institutes (PPI). This approach is specifically based on specialized, "person-centered" and "person-tailored" therapeutic-rehabilitation plans in line with psychiatric treatments usually provided in community mental health-care centers of the Parma Department of Mental Health. DESIGN/METHODOLOGY/APPROACH All the processes and procedures included in the PPI intervention model were first carefully illustrated, paying special attention to the service for newly admitted prisoners and each typology of specialized therapeutic-rehabilitation treatment potentially provided. Additionally, a preliminary descriptive process analysis of the first six months of clinical activity was also performed. FINDINGS Since January 2020, 178 individuals entered the PPI service for newly admitted prisoners. In total, 83 (46.7%) of them were engaged in the services of the PPI mental health-care team (35 with pathological addiction and 48 with mental disorders): 56 prisoners were offered an integrated mental health intervention and 27 exclusively an individual psychological or psychiatric treatment. ORIGINALITY/VALUE The results support the potential applicability of an integrated mental health intervention in prison, planning a person-tailored rehabilitation in close collaboration with the prisoners, their families and the local mental health/social services.
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Affiliation(s)
- Lorenzo Pelizza
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Ursula Zambelli
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Enrico Rossi
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Germana Verdoliva
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Davide Maestri
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Ilaria De Amicis
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Cecilia Paraggio
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Amir Zaimovic
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Bruno Veneri
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Beatrice Urbani
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Diana Gran Dall'Olio
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Adriana Adriani
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Stefania Cutrino
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Silvia Bertoli
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Giuseppina Paulillo
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Pietro Pellegrini
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
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Schosser A, Senft B, Rauner M. The benefit of an ambulant psychiatric rehabilitation program in Vienna, Austria: an uncontrolled repeated measures study. CENTRAL EUROPEAN JOURNAL OF OPERATIONS RESEARCH 2021; 30:19-48. [PMID: 34658666 PMCID: PMC8501920 DOI: 10.1007/s10100-021-00773-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/09/2021] [Indexed: 06/13/2023]
Abstract
We investigated the benefit of a 6-week ambulant psychiatric rehabilitation program in an ambulant psychiatric rehabilitation clinic in Vienna, Austria, from January 2014 to December 2016 by an uncontrolled repeated measures study. The potential of this intervention program was assessed by effectiveness and cost measures using suitable statistical analyses. We compared the effectiveness and cost measures of this ambulant psychiatric rehabilitation program on patients for the period of up to 12 months after discharge to the period of 12 months before admission to the intervention program based on self-reported catamnesis questionnaires. For the program's effectiveness measures, we accounted for both psychological indices for measuring depression severity, symptom burden, and functioning to document the health improvement of patients and economy-related indices such as the number of sick leave days for patients. For the program's cost measures, both direct tangible treatment and medication costs and indirect tangible costs based on the productivity loss measured in non-working days of the patients were considered. The results significantly demonstrated that all psychological effectiveness measures for the patients highly improved by the 6-weeks rehabilitation program and remained rather stable 12 months after discharge. We found that costs for the 6-week ambulant psychiatric rehabilitation program could be easily covered within 12 months after discharge once a total societal cost perspective was considered. Even additional total cost savings of up to over 5000 Euro could be achieved which were highest for employed patients, followed by unemployed patients receiving rehabilitation allowance due to both their high direct medication and treatment costs as well as high indirect costs for productivity loss. The most important finding was that this treatment program was especially beneficial for rehabilitation patients in earlier stages of psychiatric diseases who were still employed, indicating the need for early intervention in mental disorder.
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Affiliation(s)
- Alexandra Schosser
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
- Zentren für seelische Gesundheit, BBRZ-Med, Schererstrasse 30, 1210 Vienna, Austria
- Faculty of Medicine, Sigmund Freud University, Freudplatz 3, 1020 Vienna, Austria
- Arbeitsgemeinschaft für Verhaltensmodifikation, Paris-Lodron-Straße 32, 5020 Salzburg, Austria Birgit Senf Vienna, Austria
| | - Birgit Senft
- Zentren für seelische Gesundheit, BBRZ-Med, Schererstrasse 30, 1210 Vienna, Austria
| | - Marion Rauner
- Faculty of
Business, Economics, and Statistics, Institute for Business Decisions and
Analytics, University of Vienna, Oskar-Morgenstern-Platz
1, 1090 Vienna, Austria
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Beaudry G, Yu R, Perry AE, Fazel S. Effectiveness of psychological interventions in prison to reduce recidivism: a systematic review and meta-analysis of randomised controlled trials. Lancet Psychiatry 2021; 8:759-773. [PMID: 34419185 PMCID: PMC8376657 DOI: 10.1016/s2215-0366(21)00170-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/03/2021] [Accepted: 04/23/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Repeat offending, also known as criminal recidivism, in people released from prison has remained high over many decades. To address this, psychological treatments have been increasingly used in criminal justice settings; however, there is little evidence about their effectiveness. We aimed to evaluate the effectiveness of interventions in prison to reduce recidivism after release. METHODS For this systematic review and meta-analysis, we searched the Cochrane Central Register of Controlled Trials, Embase, Global Health, MEDLINE, PsycINFO, and Google Scholar for articles published from database inception to Feb 17, 2021, without any language restrictions. We searched for randomised controlled trials (RCTs) that evaluated the effect of psychological interventions, delivered to adolescents and adults during incarceration, on recidivism outcomes after release. We excluded studies of solely pharmacological interventions and of participants in secure psychiatric hospitals or special residential units, or attending therapies mainly delivered outside of the prison setting. We extracted summary estimates from eligible RCTs. Data were extracted and appraised according to a prespecified protocol, with effect sizes converted to odds ratios. We used a standardised form to extract the effects of interventions on recidivism and estimated risk of bias for each RCT. Planned sensitivity analyses were done by removing studies with fewer than 50 participants. Our primary outcome was recidivism. Data from individual RCTs were combined in a random-effects meta-analysis as pooled odds ratios (ORs) and we explored sources of heterogeneity by comparing effect sizes by study size, control group, and intervention type. The protocol was pre-registered with PROSPERO, CRD42020167228. FINDINGS Of 6345 articles retrieved, 29 RCTs (9443 participants, 1104 [11·7%] females, 8111 [85·9%] males, and 228 [2·4%] unknown) met the inclusion criteria for the primary outcome. Mean ages were 31·4 years (SD 4·9, range 24·5-41·5) for adult participants and 17·5 years (SD 1·9; range 14·6-20·2) for adolescent participants. Race or ethnicity data were not sufficiently reported to be aggregated. If including all 29 RCTs, psychological interventions were associated with reduced reoffending outcomes (OR 0·72, 95% CI 0·56-0·92). However, after excluding smaller studies (<50 participants in the intervention group), there was no significant reduction in recidivism (OR 0.87, 95% CI 0·68-1·11). Based on two studies, therapeutic communities were associated with decreased rates of recidivism (OR 0·64, 95% CI 0·46-0·91). These risk estimates did not significantly differ by type of control group and other study characteristics. INTERPRETATION Widely implemented psychological interventions for people in prison to reduce offending after release need improvement. Publication bias and small-study effects appear to have overestimated the reported modest effects of such interventions, which were no longer present when only larger studies were included in analyses. Findings suggest that therapeutic communities and interventions that ensure continuity of care in community settings should be prioritised for future research. Developing new treatments should focus on addressing modifiable risk factors for reoffending. FUNDING Wellcome Trust, Fonds de recherche du Québec - Santé.
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Affiliation(s)
| | - Rongqin Yu
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Amanda E Perry
- Department of Health Sciences, University of York, York, UK
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK.
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Fontao M, Schorer L, Ross T. [Therapeutic Factors in Offender Treatment: A Systematic Review]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2021; 89:483-495. [PMID: 33902150 DOI: 10.1055/a-1432-1634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This paper presents a systematic literature review of international research on therapeutic factors in offender treatment. The review was based on the PRISMA criteria; PsycINFO and PSYNDEX as well as references given in included studies were browsed. Only quantitative empirical studies published between 1990 and 2018 were included. In this paper, evidence for common factors (therapeutic alliance, social climate, feedback) and therapist factors (interpersonal skills/characteristics, personality, therapy expectations) from 19 journal articles are reported. Some tendencies emerged, but there was no conclusive evidence on the effect of common factors and therapist factors on the therapy outcome. This non-conclusive evidence is mostly due to the methodological shortcomings of primary studies, heterogeneity of outcome variables and the low number of studies that looked at each of these variables. In sum, there is not enough evidence to date to show a strong relationship between common factors and therapist factors and a (positive) outcome in the treatment of offenders.
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Affiliation(s)
| | | | - Thomas Ross
- Zentrum für Psychiatrie Reichenau, Klinik für Forensische Psychiatrie und Psychotherapie, Universität Ulm Medizinische Fakultät
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de Geus EQJ, Milders MV, van Horn JE, Jonker FA, Fassaert T, Hutten JC, Kuipers F, Grimbergen C, Noordermeer SDS. Acquired Brain Injury and Interventions in the Offender Population: A Systematic Review. Front Psychiatry 2021; 12:658328. [PMID: 34025480 PMCID: PMC8138134 DOI: 10.3389/fpsyt.2021.658328] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/08/2021] [Indexed: 11/13/2022] Open
Abstract
Background and Aims: The prevalence of acquired brain injury (ABI) in offender populations appears much higher than in the general population, being estimated at 50% compared to 12%, respectively. Taking into account ABI-related cognitive and social impairments or behavioral changes in forensic treatments might be relevant and may improve treatment outcomes. The aim of the current review is to summarize and integrate the literature on psychological interventions or treatments for consequences of ABI in the forensic setting. Reviewing this literature could provide crucial information for improving treatment options for offenders with ABI, which may contribute to reducing recidivism. Methods: The PubMed/MEDLINE, PsychInfo, CINAHL, COCHRANE, and Web of Science databases were searched for studies in adult offenders with ABI that evaluated the effect of psychological interventions with a focus on ABI-related impairments and recidivism. Results: This review identified four intervention studies that met the inclusion criteria. These included an adult population (≥18-year-old) in a forensic setting (given the focus of the current review on treatment, defined here as an environment in which offenders are treated while being incarcerated or as outpatients), non-pharmacological treatments and were published in English or Dutch between 2005 and 2020. All studies reported some positive effects of the intervention on interpersonal behavior, cognition and recidivism. The aspects of the interventions that seemed most beneficial included personalized treatment and re-entry plans, support for the individual and their environment and psychoeducation about the effects of ABI. Discussion: Although positive effects were reported in the studies reviewed, all studies had methodological limitations in terms of sample size, study design and outcome measures which affects the strength of the evidence. This limits strong conclusions and generalizability to the entire offender population. Conclusion: Despite high prevalence of ABI in offender populations, interventions in forensic settings seldom address the effect of ABI. The few studies that did take ABI into account reported positive effects, but those results should be interpreted with caution. Future studies are warranted, since this does seem an important venue to improve treatment, which could eventually contribute to reducing recidivism.
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Affiliation(s)
- Esther Q J de Geus
- Department of Clinical Neuro- and Development Psychology, Faculty of Behavioral Sciences, Section of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Maarten V Milders
- Department of Clinical Neuro- and Development Psychology, Faculty of Behavioral Sciences, Section of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | - Frank A Jonker
- Department of Clinical Neuro- and Development Psychology, Faculty of Behavioral Sciences, Section of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Altrecht, Vesalius, Amsterdam, Netherlands
| | | | | | | | | | - Siri D S Noordermeer
- Department of Clinical Neuro- and Development Psychology, Faculty of Behavioral Sciences, Section of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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Li H, Zhang X, You C, Chen X, Cao Y, Zhang G. Can Viewing Nature Through Windows Improve Isolated Living? A Pathway Analysis on Chinese Male Prisoners During the COVID-19 Epidemic. Front Psychiatry 2021; 12:720722. [PMID: 34880787 PMCID: PMC8645568 DOI: 10.3389/fpsyt.2021.720722] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 10/22/2021] [Indexed: 11/13/2022] Open
Abstract
Nature exposure is known to promote life satisfaction and well-being, and indirect exposure through windows is likely to benefit isolated populations. However, whether such type of exposure can benefit prisoners, the extremely isolated population, is unknown. In the current study, we investigated 326 male prisoners from three prisons in southwest China. Psychological variables including depression, anxiety, loneliness, distress tolerance, life satisfaction, and well-being were measured using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), short-form UCLA Loneliness Scale (ULS-6), Distress Tolerance Scale (DTS), Satisfaction with Life Scale (SWLS), and 5-item World Health Organization Well-Being Index (WHO-5), respectively. Structural equation modeling was employed to identify the pathways from the visibility of nature through windows to prisoners' life satisfaction and well-being. Our results demonstrated that visibility of nature promoted the frequency and duration of viewing nature through windows. The frequency directly affected well-being, but the duration did not effectively affect any measured variables. The visibility of nature enhanced life satisfaction mainly via direct effects but enhanced well-being mainly via indirect effects. Regarding the indirect pathways, the visibility of nature increased distress tolerance and thus reduced loneliness and mental health problems. The reduced mental health problem, in turn, promoted life satisfaction and well-being. Our findings suggest that nature exposure through windows is effective in enhancing prisoners' life satisfaction and well-being. The policymaker may need to consider nature-based solutions such as indirect nature exposure in prions to benefit isolated populations.
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Affiliation(s)
- Hansen Li
- Key Lab of Physical Fitness Evaluation and Motor Function Monitoring of General Administration of Sports of China, Institute of Sports Science, College of Physical Education, Southwest University, Chongqing, China
| | - Xing Zhang
- Department of Basketball and Volleyball, Chengdu Sport University, Chengdu, China
| | - Chengming You
- National Forestry and Grassland Administration Key Laboratory of Forest Resources Conservation and Ecological Safety on the Upper Reaches of the Yangtze River, Sichuan Province Key Laboratory of Ecological Forestry Engineering on the Upper Reaches of the Yangtze River, Long-Term Research Station of Alpine Forest Ecosystems, Institute of Ecology and Forestry, Sichuan Agricultural University, Chengdu, China
| | - Xin Chen
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Yang Cao
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden.,Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Guodong Zhang
- Key Lab of Physical Fitness Evaluation and Motor Function Monitoring of General Administration of Sports of China, Institute of Sports Science, College of Physical Education, Southwest University, Chongqing, China
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Simpson AIF, Gerritsen C, Maheandiran M, Adamo V, Vogel T, Fulham L, Kitt T, Forrester A, Jones RM. A Systematic Review of Reviews of Correctional Mental Health Services Using the STAIR Framework. Front Psychiatry 2021; 12:747202. [PMID: 35115956 PMCID: PMC8806032 DOI: 10.3389/fpsyt.2021.747202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 12/13/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Rising demand for correctional mental health services (CMHS) in recent decades has been a global phenomenon. Despite increasing research, there are major gaps in understanding the best models for CMHS and how to measure their effectiveness, particularly studies that consider the overall care pathways and effectiveness of service responses. The STAIR (Screening, Triage, Assessment, Intervention, and Re-integration) model is an evidence-based framework that defines and measures CMHS as a clinical pathway with a series of measurable, and linked functions. METHOD We conducted a systematic review of the reviews of CMHS elements employing PRISMA guidelines, organized according to STAIR pillars. We assessed the quality of included studies using the AMSTAR-2 criteria. Narrative reviews were read and results synthesized. RESULTS We included 26 review articles of which 12 were systematic, metaanalyses, and 14 narrative reviews. Two systematic reviews and seven narrative reviews addressed screening and triage with strong evidence to support specific screening and triage systems. There was no evidence for standardised assessment approaches. Eight systematic reviews and seven narrative reviews addressed interventions providing some evidence to support specific psychosocial interventions. Three systematic reviews and six narrative reviews addressed reintegration themes finding relatively weak evidence to support reintegration methods, with interventions often being jurisdictionally specific and lacking generalizability. CONCLUSIONS The STAIR framework is a useful way to organize the extant literature. More research is needed on interventions, assessment systems, care pathway evaluations, and reintegration models.
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Affiliation(s)
- Alexander I F Simpson
- Forensic Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Cory Gerritsen
- Department of Forensic Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | | | - Vito Adamo
- Department of Forensic Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Tobias Vogel
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Lindsay Fulham
- Department of Forensic Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Tamsen Kitt
- Department of Psychology, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Andrew Forrester
- Forensic Psychiatry, Department of Psychological Medicine and Clinical Neursciences, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Roland M Jones
- Department of Forensic Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
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Zhong S, Zhu X, Mellsop G, Zhou J, Wang X. Correlates of Presence and Remission of Post-trauma Stress Disorder in Incarcerated Women: A Case-Control Study Design. Front Psychiatry 2021; 12:748518. [PMID: 34955914 PMCID: PMC8692654 DOI: 10.3389/fpsyt.2021.748518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 10/29/2021] [Indexed: 11/13/2022] Open
Abstract
Women in prison are vulnerable to post-trauma stress disorder (PTSD). However, little is known about the presence of PTSD in imprisoned women or of the natural course of that disorder. The purpose of this study was to assess the risk factors for PTSD in incarcerated women and document correlations of remission. We conducted a retrospective case-control study in the Female Prison of Hunan Province, China. Participants were screened for PTSD and depression using the Chinese version of the MINI International Neuropsychiatric Interview (MINI) 5.0. Of the 2,322 women screened, 220 met the criterion for PTSD on admission. Remission (N = 142) and non-remission PTSD (N = 78) were then separated depending on current PTSD status. History of drug use (OR = 0.43, 95% CI: 0.28-0.66, p < 0.001) and violent offense (OR = 1.56, 95% CI: 1.17-2.09, p < 0.001) were associated with the presence of PTSD. Positive associations with remission were found for longer length of sentence (61-120 vs. 13-60 months) (OR = 4.20, 95% CI: 1.50-11.75, p = 0.006), violent offense (OR = 2.50, 95% CI: 1.12-5.60, p = 0.03), and comorbid depression (OR = 29.69, 95% CI: 3.50-251.78, p = 0.002); while a negative correlate was identified for past depression (OR = 0.24, 95% CI: 0.11-0.53, p < 0.001). Although some incarcerated women with PTSD can spontaneously remit, this study suggested certain criminological and clinical risk factors are associated with the presence of PTSD and others with remission over time. Timely screening and effective intervention should be tailored for individuals with PTSD in prisons.
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Affiliation(s)
- Shaoling Zhong
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Xiaomin Zhu
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Graham Mellsop
- Waikato District Health Board (DHB), Hamilton, New Zealand
| | - Jiansong Zhou
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Xiaoping Wang
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
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Gonete KA, Tariku A, Wami SD, Akalu TY. Dietary diversity practice and associated factors among adolescent girls in Dembia district, northwest Ethiopia, 2017. Public Health Rev 2020; 41:23. [PMID: 33062379 PMCID: PMC7547502 DOI: 10.1186/s40985-020-00137-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 09/25/2020] [Indexed: 11/10/2022] Open
Abstract
Background Dietary diversity is defined as the number of food groups or items consumed over a reference period, and usually, it is a problem in developing countries including Ethiopia. Inadequate dietary diversity is one of a major public health problem and can result in physical, emotional, and psychological changes among adolescents. However, studies on dietary diversity among school children were very limited. Hence, this study aimed at determining dietary diversity practices and factors among adolescents in Dembia district. Methods A school-based cross-sectional study was conducted from March 1 to April 15, 2017, at Dembia district, northwest Ethiopia. A total of 474 study subjects were selected using the multi-stage sampling technique. A structured and pre-tested questionnaire was used to collect the data. Dietary diversity was measured through standard tool adopted from Food and Nutrition Technical Assistance (FANTA) 2016 using the 24-h recall method. A multivariable binary logistic regression model was employed to identify factors associated with a diversified diet. Result This study illustrated that 32.3% (95% CI 27.9–36.8) of the adolescents had adequate dietary diversity. Inadequate dietary diversity was significantly associated with being Muslim (AOR = 0.3; 95% CI 0.1–0.7), self-employment (AOR = 0.3; 95% CI 0.1–0.9), middle (AOR = 0.5; 95% CI 0.3–0.8) and high wealth category (AOR = 0.3; 95% CI 0.2–0.6), and underweight (AOR = 3.5; 95% CI 1.3–9.5). Conclusion The findings of this study showed that only one-third of adolescent girls have adequate dietary diversity. Low level of dietary diversification suggested points to the need for strengthening efforts targeting to improve the healthy dietary practice of adolescents by giving due attention to poor households and undernourished adolescents.
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Affiliation(s)
- Kedir Abdela Gonete
- Department of Human Nutrition, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Amare Tariku
- Department of Human Nutrition, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Sintayehu Daba Wami
- Department of Environmental and Occupational Health, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Temesgen Yihunie Akalu
- Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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Pringer SM, Wagner NJ. Use of Trauma‐Informed Care With Incarcerated Offenders. JOURNAL OF ADDICTIONS & OFFENDER COUNSELING 2020. [DOI: 10.1002/jaoc.12075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Sarah M. Pringer
- Department of Applied Clinical and Educational SciencesIndiana State University
- Now at Department of Counseling, Educational Psychology and ResearchThe University of Memphis
| | - Nathaniel J. Wagner
- Department of Applied Clinical and Educational SciencesIndiana State University
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Amoke CV, Ede MO, Nwokeoma BN, Onah SO, Ikechukwu-Ilomuanya AB, Albi-Oparaocha FC, Nweke ML, Amoke CV, Amadi KC, Aloh HE, Anyaegbunam EN, Nwajiuba CA, Onwuama OP, Ede KR, Ononaiwu AI, Nweze T. Effects of group cognitive-behavioral therapy on psychological distress of awaiting-trial prison inmates. Medicine (Baltimore) 2020; 99:e18034. [PMID: 32332591 PMCID: PMC7220664 DOI: 10.1097/md.0000000000018034] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND/OBJECTIVES The level of psychological distress among awaiting-trial inmates is rapidly increasing in Nigeria. Studies have recommended increasing attention and additional psychological intervention that could improve the psychological wellbeing of prisoners. This study evaluates the effect of cognitive behavioral therapy on psychological distress among awaiting-trial prison inmates in Nigeria. METHODS A total of 34 awaiting-trial prison inmates in Enugu state Nigeria were used as the study participants. Two measures (perceived emotional distress inventory and general health Questionnaire) were used for data collection. Repeated measures with analysis of variance (ANOVA) were used to examine the effects of the intervention. Effect sizes were also reported with partial Eta Squared ((Equation is included in full-text article.)). RESULTS The result showed that there was no significant difference in psychological distress between the treatment and no-intervention groups. The results showed that CBT had a significant effect on psychological distress of awaiting-trial prison inmates when compared to their counterparts in the no-intervention group at Time 2. Additionally, the efficacy of CBT on the psychological distress of awaiting-trial prison inmates was significantly sustained at the follow-up measurements (Time 3). CONCLUSION This study suggests that cognitive behavioral therapy is an effective intervention for decreasing psychological distress among awaiting-trial prison inmates. Additionally, the impactful benefit of the intervention can persist in overtime. Therefore, cognitive behavioral therapists can further explore the efficacy of CBT using various cultures.
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Affiliation(s)
| | | | - Bonaventure N. Nwokeoma
- Department of Sociology and Anthropology, Faculty of Social Sciences, University of Nigeria, Nsukka
| | - Sebastian O. Onah
- Department of Sociology and Anthropology, Faculty of Social Sciences, University of Nigeria, Nsukka
| | | | - Florence C. Albi-Oparaocha
- Department of Educational Foundations, Faculty of Education, Alex Ekwueme Federal University, Ndufu-Alike Ebonyi State
| | - Maduka L. Nweke
- Department of Physiology, Faculty of Basic Medical Sciences, College of Medicine, University of Nigeria, Ituku Ozalla Enugu Campus
| | | | - Kingsley C. Amadi
- Department of Sociology and Anthropology, Faculty of Social Sciences, University of Nigeria, Nsukka
| | - Henry E. Aloh
- Health Economics and Research Unit, Department of Health Services, Alex Ekwueme Federal University, Ndufu-Alike Ebonyi State
| | - Emenike N. Anyaegbunam
- Department of Psychology, Faculty of Management, Alex Ekwueme Federal University, Ndufu-Alike Ebonyi State
| | - Chinyere A. Nwajiuba
- Department of Educational Foundations, Faculty of Education, Alex Ekwueme Federal University, Ndufu-Alike Ebonyi State
| | | | - Kelechi R. Ede
- Department of Agricultural Science Education, University of Nigeria, Nsukka
| | | | - Tina Nweze
- Department of Educational Foundations, Ebonyi State University, Abakaliki Nigeria
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Saran A, White H, Kuper H. Evidence and gap map of studies assessing the effectiveness of interventions for people with disabilities in low-and middle-income countries. CAMPBELL SYSTEMATIC REVIEWS 2020; 16:e1070. [PMID: 37131970 PMCID: PMC8356326 DOI: 10.1002/cl2.1070] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Background There are approximately 1 billion people in the world with some form of disability. This corresponds to approximately 15% of the world's population (World Report on Disability, 2011). The majority of people with disabilities (80%) live in low- and middle-income countries (LMICs), where disability has been shown to disproportionately affect the most disadvantaged sector of the population. Decision makers need to know what works, and what does not, to best invest limited resources aimed at improving the well-being of people with disabilities in LMICs. Systematic reviews and impact evaluations help answer this question. Improving the availability of existing evidence will help stakeholders to draw on current knowledge and to understand where new research investments can guide decision-making on appropriate use of resources. Evidence and gap maps (EGMs) contribute by showing what evidence there is, and supporting the prioritization of global evidence synthesis needs and primary data collection. Objectives The aim of this EGM is to identify, map and describe existing evidence of effectiveness studies and highlight gaps in evidence base for people with disabilities in LMICs. The map helps identify priority evidence gaps for systematic reviews and impact evaluations. Methods The EGM included impact evaluation and systematic reviews assessing the effect of interventions for people with disabilities and their families/carers. These interventions were categorized across the five components of community-based rehabilitation matrix; health, education, livelihood, social and empowerment. Included studies looked at outcomes such as, health, education, livelihoods, social inclusion and empowerment, and were published for LMICs from 2000 onwards until January 2018. The searches were conducted between February and March 2018. The EGM is presented as a matrix in which the rows are intervention categories (e.g., health) and subcategories (e.g., rehabilitation) and the column outcome domains (e.g., health) and subdomains (e.g., immunization). Each cell lists the studies for that intervention for those outcomes, with links to the available studies. Included studies were therefore mapped according to intervention and outcomes assessed and additional filters as region, population and study design were also coded. Critical appraisal of included systematic review was done using A Measurement Tool to Assess Systematic Reviews' rating scale. We also quality-rated the impact evaluation using a quality assessment tool based on various approaches to risk of bias assessment. Results The map includes 166 studies, of which 59 are systematic reviews and 107 impact evaluation. The included impact evaluation are predominantly quasiexperimental studies (47%). The numbers of studies published each year have increased steadily from the year 2000, with the largest number published in 2017.The studies are unevenly distributed across intervention areas. Health is the most heavily populated area of the map. A total of 118 studies of the 166 studies concern health interventions. Education is next most heavily populated with 40 studies in the education intervention/outcome sector. There are relatively few studies for livelihoods and social, and virtually none for empowerment. The most frequent outcome measures are health-related, including mental health and cognitive development (n = 93), rehabilitation (n = 32), mortality and morbidity (n = 23) and health check-up (n = 15). Very few studies measured access to assistive devices, nutrition and immunization. Over half (n = 49) the impact evaluation come from upper-middle income countries. There are also geographic gaps, most notably for low income countries (n = 9) and lower-middle income countries (n = 34). There is a fair amount of evidence from South Asia (n = 73) and Sub-Saharan Africa (n = 51). There is a significant gap with respect to study quality, especially with respect to impact evaluation. There appears to be a gap between the framing of the research, which is mostly within the medical model and not using the social model of disability. Conclusion Investing in interventions to improve well-being of people with disabilities will be critical to achieving the 2030 agenda for sustainable development goals. The EGM summarized here provides a starting point for researchers, decision makers and programme managers to access the available research evidence on the effectiveness of interventions for people with disabilities in LMICs in order to guide policy and programme activity, and encourage a more strategic, policy-oriented approach to setting the future research agenda.
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Affiliation(s)
| | | | - Hannah Kuper
- London School of Hygiene and Tropical Medicine (LSHTM)LondonUK
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Holman LF, Wilkerson S, Ellmo F, Skirius M. Impact of Animal Assisted Therapy on Anxiety Levels Among Mentally Ill Female Inmates. JOURNAL OF CREATIVITY IN MENTAL HEALTH 2020. [DOI: 10.1080/15401383.2020.1729918] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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45
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Riley BJ, Smith D, Baigent MF. Mindfulness and Acceptance-Based Group Therapy: An Uncontrolled Pragmatic Pre-Post Pilot Study in a Heterogeneous Population of Female Prisoners. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2019; 63:2572-2585. [PMID: 31238758 DOI: 10.1177/0306624x19858487] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The rate of females imprisoned worldwide has increased by more than 50% during the last two decades, with recent figures suggesting that, worldwide, the female prison population may still be increasing at a faster rate than males. Despite prevalence rates for psychiatric conditions among female prisoners being significantly higher than males, there is a particular lack of programs specifically designed for women. This preliminary study evaluates the initial effectiveness of a mindfulness and acceptance-based group program in an uncontrolled pragmatic pilot study of a heterogeneous group of incarcerated women with a range of mental health issues. Participants were 59 incarcerated women who engaged in a 10-session group program. Outcome measures comprised the Acceptance and Action Questionnaire-II, Depression Anxiety and Stress Scale, Mindfulness Attention Awareness Scale, and three screening tools derived from the full version of the Patient Health Questionnaire (PHQ-9), to measure depression, binge eating (Patient Health Questionnaire-Binge Eating Disorder [PHQ-ED]), and somatoform disorders (PHQ-15). Results of linear mixed modelling showed improvements in mindfulness and acceptance, and reductions in depression, anxiety, and somatoform symptoms. Furthermore, acceptance and commitment therapy (ACT) was shown to be an acceptable and feasible intervention for female Indigenous Australian prisoners. A mindfulness and acceptance-based group approach appears to be feasible and acceptable in a prison environment for a female prisoners with a range of mental health symptomatology.
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Affiliation(s)
- Ben J Riley
- Flinders University, Adelaide, South Australia, Australia
| | - David Smith
- Flinders University, Adelaide, South Australia, Australia
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Facer-Irwin E, Blackwood NJ, Bird A, Dickson H, McGlade D, Alves-Costa F, MacManus D. PTSD in prison settings: A systematic review and meta-analysis of comorbid mental disorders and problematic behaviours. PLoS One 2019; 14:e0222407. [PMID: 31557173 PMCID: PMC6762063 DOI: 10.1371/journal.pone.0222407] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 08/28/2019] [Indexed: 11/21/2022] Open
Abstract
Purpose Prevalence rates of PTSD are higher in the prison population than in the community. We sought to systematically review the extent to which this disorder is associated with other mental health disorders and problematic suicidal or aggressive behaviours in the prison population. Methods Studies reporting a relationship between PTSD and comorbid mental disorders and/or problematic behaviours in imprisoned adolescent and adult populations were identified from four bibliographic indexes. Primary studies involving clinical interviews, validated instruments leading to DSM or ICD diagnoses, or validated self-report questionnaires such as the PTSD checklist were included. Random-effects meta-analysis was conducted where possible. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Results This review identified 36 studies, with a combined sample of 9594 participants, (6478 male and 2847 female prisoners) from 11 countries. Thirty-four of the identified studies employed a cross-sectional design. We identified significant associations between PTSD and comorbid mental disorders including depression (OR = 3.4, 95% confidence interval (CI): 2.3–4.9), anxiety (OR = 2.9, 95% confidence interval (CI): 1.8–4.7) and substance use (OR = 1.9, 95% confidence interval (CI): 1.5–2.4). We also identified significant associations between PTSD and suicidality (OR = 3, 95% confidence interval (CI): 2.4–3.8) and aggressive behaviours (this latter finding was not subject to meta-analysis). Significant methodological heterogeneity was identified between studies. Conclusions High rates of psychiatric comorbidity among prisoners with PTSD, and links to suicidal behaviour, self-harm and aggressive behaviour, provide further support for the need for trauma-informed treatment approaches in prisons. However, significant gaps in the current evidence were apparent. In particular, a lack of large, longitudinal studies meant that the temporal relationships between PTSD and relevant outcomes cannot currently be determined.
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Affiliation(s)
- Emma Facer-Irwin
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
- * E-mail:
| | - Nigel J. Blackwood
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
| | - Annie Bird
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
| | - Hannah Dickson
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
| | - Daniel McGlade
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
| | - Filipa Alves-Costa
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
| | - Deirdre MacManus
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
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Methamphetamine use drives decreases in viral suppression for people living with HIV released from a large municipal jail: Results of the LINK LA clinical trial. Drug Alcohol Depend 2019; 202:178-184. [PMID: 31352308 PMCID: PMC6686887 DOI: 10.1016/j.drugalcdep.2019.05.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 05/08/2019] [Accepted: 05/08/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND People living with HIV (PLWH) often experience decreases in HIV viral suppression (VS) after release from jail. The Linking Inmates to Care in LA (LINK LA) peer navigation intervention helped maintain VS 12 months after release from jail compared to standard of care. In this study, we analyzed correlates of substance use and tested whether substance use was an independent correlate of decreased VS in LINK LA participants. METHODS We analyzed LINK LA data collected at baseline, 3, and 12 months. We defined high-risk drug use as any reported methamphetamine, cocaine, or opioid use in the 30 days prior to a study visit (or jail entry at baseline). We used generalized linear mixed models to test associations of sociodemographic variables with type of substance used, and we tested correlates of VS while controlling for time, the intervention, and their interaction. RESULTS At baseline (n = 356), 71% of participants reported high-risk drug use: 58%, methamphetamine; 17%, cocaine; 7%, heroin; and 4%, prescription opioids. Non-Hispanic Whites and those younger than 35 were most likely to use methamphetamine; Blacks were most likely to use cocaine; people who inject drugs were most likely to use opioids. Participants who used high-risk drugs had 53% lower adjusted odds than non-users of maintaining VS (AOR 0.47, 95% CI 0.31-0.70, p < 0.001). CONCLUSION High-risk drug use, dominated by methamphetamine use, independently correlated with decreased VS among recently incarcerated PLWH. Improving HIV care continuum outcomes among populations leaving jail requires attention to efforts to address high-risk drug use.
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Dell C, Chalmers D, Stobbe M, Rohr B, Husband A. Animal-assisted therapy in a Canadian psychiatric prison. Int J Prison Health 2019; 15:209-231. [PMID: 31329041 DOI: 10.1108/ijph-04-2018-0020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Prison-based animal programs are becoming increasingly common in North America. The majority focus on community and animal well-being, with less explicit therapeutic goals for human participants. The purpose of this paper is to measure the objectives of a canine animal-assisted therapy (AAT) program in a Canadian psychiatric prison and examine whether the program supports inmates' correctional plans. DESIGN/METHODOLOGY/APPROACH A modified instrumental case study design was applied with three inmates over a 24-AAT-session program. Quantitative and qualitative AAT session data were collected and mid- and end-of-program interviews were held with the inmates, their mental health clinicians and the therapy dog handlers. FINDINGS Inmates connected with the therapy dogs through the animals' perceived offering of love and support. This development of a human-animal bond supported inmates' correctional plans, which are largely situated within a cognitive-behavioral skill development framework. Specifically, inmates' connections with the therapy dogs increased recognition of their personal feelings and emotions and positively impacted their conduct. RESEARCH LIMITATIONS/IMPLICATIONS The findings suggest that prison-based AAT programs emphasizing inmate mental well-being, alongside that of animal and community well-being generally, merit further exploration. It would be worthwhile to assess this AAT program with a larger and more diverse sample of inmates and in a different institutional context and also to conduct a post-intervention follow-up. ORIGINALITY/VALUE This is the first study of a prison-based AAT program in a Canadian psychiatric correctional facility.
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Affiliation(s)
- Colleen Dell
- Department of Sociology, School of Public Health, University of Saskatchewan , Saskatoon, Canada
| | | | - Mark Stobbe
- Department of Sociology, College of Arts and Science, University of Saskatchewan , Saskatoon, Canada
| | - Betty Rohr
- College of Medicine, University of Saskatchewan , Saskatoon, Canada
| | - Alicia Husband
- School of Public Health, University of Saskatchewan , Saskatoon, Canada
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Abstract
PURPOSE OF REVIEW In prisons, resources for psychiatric care are limited, but the population is at high risk for mental disorders. This article aims to review recent findings and developments and to focus on the changing needs of prisoners and consequences for treatment. RECENT FINDINGS The evidence for high general prevalence rates of mental disorders in prison populations can be considered as robust worldwide. Recent meta-analyses focused on specific prevalence rates and found that complex disorders, such as attention deficit hyperactivity disorder and posttraumatic stress disorder, are also more common in prison populations. Interest is growing in studying subgroups with special needs, for example, women and older prisoners. Furthermore, a large amount of research deals with suicide and self-harm, especially risk factors and assessments. Promising results have been obtained for treatment outcome in substance use disorders. Psychological therapies, however, have not yet been proven to have sustaining effects. SUMMARY Considering the growing amount of research on prison inmates' mental health issues and heterogeneous needs, future studies should aim to consolidate previous findings and develop special diagnostic and therapeutic standards for mental healthcare in prisons that consider ethical aspects and human and financial resources.
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Lovett A, Kwon HR, Kidia K, Machando D, Crooks M, Fricchione G, Thornicroft G, Jack HE. Mental health of people detained within the justice system in Africa: systematic review and meta-analysis. Int J Ment Health Syst 2019; 13:31. [PMID: 31080500 PMCID: PMC6501291 DOI: 10.1186/s13033-019-0273-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 03/15/2019] [Indexed: 01/17/2023] Open
Abstract
Worldwide, people with mental disorders are detained within the justice system at higher rates than the general population and often suffer human rights abuses. This review sought to understand the state of knowledge on the mental health of people detained in the justice system in Africa, including epidemiology, conditions of detention, and interventions. We included all primary research studies examining mental disorders or mental health policy related to detention within the justice system in Africa. 80 met inclusion criteria. 67% were prevalence studies and meta-analysis of these studies revealed pooled prevalence as follows: substance use 38% (95% CI 26-50%), mood disorders 22% (95% CI 16-28%), and psychotic disorders 33% (95% CI 28-37%). There were only three studies of interventions. Studies examined prisons (46%), forensic hospital settings (37%), youth institutions (13%), or the health system (4%). In 36% of studies, the majority of participants had not been convicted of a crime. Given the high heterogeneity in subpopulations identified in this review, future research should examine context and population-specific interventions for people with mental disorders.
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Affiliation(s)
- Aish Lovett
- Harvard College, 28 Fernald Drive, Cambridge, MA 02138 USA
| | - Hye Rim Kwon
- Institute of Psychology, Psychiatry, and Neuroscience, King’s College London, 16 De Crespigny Park, Camberwell, London, SE5 8AB UK
| | - Khameer Kidia
- Kushinga, 8 Collina Close, Borrowdale, Harare, Zimbabwe
- Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115 USA
| | - Debra Machando
- Kushinga, 8 Collina Close, Borrowdale, Harare, Zimbabwe
- Department of Psychiatry, University of Zimbabwe, 630 Churchill Avenue, Harare, Zimbabwe
| | - Megan Crooks
- The Ulster Hospital, Upper Newtownards Road, Dundonald, Belfast, BT16 1RH UK
| | - Gregory Fricchione
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114 USA
| | - Graham Thornicroft
- Centre for Global Mental Health, Institute of Psychology, Psychiatry, and Neuroscience, King’s College London, London, UK
| | - Helen E. Jack
- Kushinga, 8 Collina Close, Borrowdale, Harare, Zimbabwe
- Centre for Global Mental Health, Institute of Psychology, Psychiatry, and Neuroscience, King’s College London, London, UK
- Department of Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195 USA
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