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Eck M, Da Costa J, Wathelet M, Beunas C, D'Ovidio K, Moncany AH, Thomas P, Fovet T. [Prevalence of mental disorders in French prisons: A systematic review]. L'ENCEPHALE 2024; 50:446-464. [PMID: 38378405 DOI: 10.1016/j.encep.2023.11.028] [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: 06/24/2023] [Revised: 11/20/2023] [Accepted: 11/24/2023] [Indexed: 02/22/2024]
Abstract
INTRODUCTION The prevalence of psychiatric disorders among prisoners remains a major public health issue worldwide. In France, despite the increasing number of persons who are incarcerated (+30% between 1992 and 2002 with a 120% prison overcrowding), and a historical concern about the mental health of persons in detention and its management, no systematic review has been published on this subject. The aim of this article is to present the results of a systematic review of the literature on the prevalence of psychiatric disorders in French prisons. METHOD The reporting of this systematic review conforms to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) checklist. We searched the PubMed and Web of Science databases. We used combinations of keywords relating to prison (prison*, jail*, inmate*), to psychiatry ("mental health", psychiatr*), and to France (France, French). This work was completed with a search through the digital libraries of the École des Hautes Études en Santé Publique (EHESP) and of the Système Universitaire de Documentation (Sudoc) to obtain data from academic works and the gray literature. References cited in studies included in this review were also examined. All references published up to September 2022, written in English or French, presenting the results of original quantitative studies on the prevalence of psychiatric disorders in correctional settings were included. Two researchers independently extracted data from included references according to a pre-established protocol. RESULTS Among 501 records identified, a total of 35 papers based on 24 epidemiological studies met the eligibility criteria for inclusion in this review: 16 were cross-sectional, 7 retrospective and 1 both cross-sectional and retrospective. All papers were published between 1999 and 2022. We found one European study, 5 international studies, 18 regional or local studies. Of these, 21 studies had all-male or mixed gender samples (but when the sample was mixed gender, it was always at least 92% male). Almost half of the studies (n=11) involved a small sample of fewer than 500 persons. Half of the studies involved a sample of recently incarcerated persons: 6 involved a random sample of persons in detention, and 1 involved a sample of people incarcerated for more than 5 years. The last 5 studies focused on persons aged over 50 years and incarcerated for more than one year (n=1), incarcerated for sexual offences (n=2), placed in disciplinary cells (n=1) or in a special wing for radicalized or suspected radicalized individuals (n=1). Nine studies used standardized and validated diagnostic tools. According to the 4 studies involving representative samples and using standardized and validated diagnostic tools, the prevalence of the following psychiatric disorders was: 29.4-44.4% for anxiety disorders, 5-14.2% for PTSD, 28-31.2% for mood disorders, 6.9-17% for psychotic disorders, 32% for personality disorders and 11% for ADHD. CONCLUSION This systematic review of the literature highlights the high prevalence of psychiatric disorders in French prisons. The data collected are in line with international studies. The great methodological heterogeneity of the papers included in this review calls for further rigorous research to better understand the rates of mental disorders in French prisons and to explore their determinants.
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Affiliation(s)
- Marion Eck
- Pôle de psychiatrie légale et de conduites addictives en milieu pénitentiaire, centre hospitalier Gérard Marchant, 31057 Toulouse, France; Inserm, U1172 - Lille neuroscience & cognition, université de Lille, 59000 Lille, France.
| | - Julien Da Costa
- Pôle de psychiatrie légale et de conduites addictives en milieu pénitentiaire, centre hospitalier Gérard Marchant, 31057 Toulouse, France
| | - Marielle Wathelet
- Pôle de psychiatrie, médecine légale et médecine en milieu pénitentiaire, CHU de Lille, 59000 Lille, France; Fédération régionale de recherche en psychiatrie et santé mentale Hauts-de-France (F2RSM Psy), Saint-André-lez-Lille, France
| | - Clément Beunas
- Fédération régionale de recherche en psychiatrie et santé mentale Hauts-de-France (F2RSM Psy), Saint-André-lez-Lille, France
| | - Kevin D'Ovidio
- Fédération régionale de recherche en psychiatrie et santé mentale Hauts-de-France (F2RSM Psy), Saint-André-lez-Lille, France
| | - Anne-Hélène Moncany
- Pôle de psychiatrie légale et de conduites addictives en milieu pénitentiaire, centre hospitalier Gérard Marchant, 31057 Toulouse, France
| | - Pierre Thomas
- Inserm, U1172 - Lille neuroscience & cognition, université de Lille, 59000 Lille, France; Pôle de psychiatrie, médecine légale et médecine en milieu pénitentiaire, CHU de Lille, 59000 Lille, France
| | - Thomas Fovet
- Inserm, U1172 - Lille neuroscience & cognition, université de Lille, 59000 Lille, France; Pôle de psychiatrie, médecine légale et médecine en milieu pénitentiaire, CHU de Lille, 59000 Lille, France
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Fazel S, Favril L. The importance of excluding selected samples when estimating prevalence of mental disorders in the general prison population-A response to Baggio and Efthimiou (2024). CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2024; 34:391-395. [PMID: 38880952 DOI: 10.1002/cbm.2349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 06/07/2024] [Indexed: 06/18/2024]
Affiliation(s)
- Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Louis Favril
- Faculty of Law and Criminology, Ghent University, Ghent, Belgium
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Wheeler PB, Miller-Roenigk B, Jester J, Stevens-Watkins D. PTSD diagnosis and nonmedical use of benzodiazepines among African American incarcerated men: the mitigating effect of John Henry active coping. J Ethn Subst Abuse 2024; 23:537-550. [PMID: 35876082 PMCID: PMC9868189 DOI: 10.1080/15332640.2022.2101575] [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] [Indexed: 01/26/2023]
Abstract
The current study examined the relationship between PTSD and nonmedical use of benzodiazepines (BZDs) based on level of John Henry Active Coping (JHAC) among African American incarcerated men. Data were derived from the Helping Incarcerated Men (HIM) Study (n = 208). Nonmedical use of BZDs was measured for the 30 days before incarceration. Current PTSD diagnosis and JHAC were determined using DSM-5 criteria and the JHAC Scale. Adjusted logistic regression analyses showed PTSD diagnosis was significantly associated with nonmedical BZD use (p = .011), but that JHAC did not significantly mitigate this relationship. African American incarcerated men may experience an unmet need with regards to mental health treatment.
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Mundt AP, Cifuentes-Gramajo PA, Baranyi G, Fazel S. Worldwide incidence of suicides in prison: a systematic review with meta-regression analyses. Lancet Psychiatry 2024; 11:536-544. [PMID: 38823401 DOI: 10.1016/s2215-0366(24)00134-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/11/2024] [Accepted: 04/16/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND Suicide is a leading cause of death during imprisonment. This systematic review aimed to synthesise available evidence of prison suicide incidence worldwide. METHODS We systematically searched the scientific literature, data repositories, and prison system reports, supplemented by correspondence with prison administrations. We included reports on people living in prison but excluded studies in preselected groups (by age or offence type). Absolute numbers and incidence rates of suicide mortality per 100 000 person-years by sex and country were extracted from 2000 to 2021. IQRs were used to describe the suicide incidence in different world regions. Incidence rate ratios comparing suicides of people living in prison with age-standardised general populations were calculated. We conducted meta-regression analyses on national-level and prison-level factors to examine heterogeneity. The study protocol was pre-registered with PROSPERO, CRD42021296819. FINDINGS We included three scientific studies, 124 official reports, and 11 datasets from email correspondence. Between 2000 and 2021, there were 29 711 reported suicides during 91·2 million person-years of imprisonment in 82 jurisdictions worldwide (sex-specific data available for 13 289 individuals: 12 544 [94·4%] male and 745 [5·6%] female individuals). There were large variations between countries, with most studies reporting suicide rates in the range of 24-89 per 100 000 person-years in both sexes (22-86 in male individuals and 25-107 in female individuals). In meta-regression analyses, Europe (vs other regions), high-income countries (vs low-income and middle-income countries), and countries with lower incarceration rates (vs those with higher incarceration rates) had higher suicide rates. Incidence rate ratios between people who are incarcerated and age-standardised general populations in the same jurisdictions were typically in the range of 1·9-6·0 in male and 10·4-32·4 in female individuals. INTERPRETATION Prison services worldwide, and particularly in Europe, should prioritise suicide prevention. Assessment and management of suicide risk in female individuals living in prison need particular attention due to excess mortality relative to community-based populations. Interpretation of synthesised data needs to be done with caution due to high heterogeneity between jurisdictions. FUNDING Agencia Nacional de Investigación y Desarrollo, Economic and Social Research Council, and Wellcome Trust.
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Affiliation(s)
- Adrian P Mundt
- Facultad de Medicina, Universidad Diego Portales, Santiago, Chile; Department of Psychiatry and Mental Health, Hospital Clínico Universidad de Chile, Santiago, Chile.
| | - Pablo A Cifuentes-Gramajo
- Doctorado en Psicoterapia, Medical Faculties and Faculties of Social Sciences, Universidad de Chile and Pontificia Universidad Católica de Chile, Quetzaltenango, Guatemala; Dirección General del Sistema de Investigación, Centro Universitario de Occidente, Universidad de San Carlos de Guatemala, Quetzaltenango, Guatemala
| | - Gergő Baranyi
- Centre for Research on Environment, Society and Health, University of Edinburgh, Edinburgh, UK; Centre for Longitudinal Studies, Institute of Education, University College London, London, UK
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK
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Jang SJ, Johnson BR, Bradshaw M, Na C. Assessing a Faith-Based Program for Trauma Healing Among Jail Inmates: A Quasi-Experimental Study. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2024; 68:936-962. [PMID: 35833446 DOI: 10.1177/0306624x221110804] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This paper assesses a faith-based, short-term program for trauma healing among incarcerated individuals, "Correctional Trauma Healing Program" (CTHP). We hypothesized that participation in the CTHP would reduce negative consequences of lifetime trauma: symptoms of PTSD, state depression, state anger, suicidal ideation, and the risk of interpersonal aggression. We also hypothesized that the reduction, if found, would be partly attributable to anticipated program outcomes (a decrease in vengefulness and an increase in religiosity, forgiveness, perceived forgiveness of God, gratitude to God, and perceived positive impact of the Bible). To test our hypotheses, we conducted a quasi-experimental study of 349 jail inmates in Virginia. Manifest-variable structural equation modeling was applied to analyze data from pretest and posttest surveys. As hypothesized, the CTHP reduced the negative consequences of trauma by increasing religiosity and other positive attributes and decreasing vengefulness directly and/or indirectly via increased religiosity. Implications and limitations of our study are discussed.
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Affiliation(s)
| | | | | | - Chongmin Na
- Seoul National University, Republic of Korea
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Lantz L, Chang Z, Virtanen S. Risk factors for dropout from psychological substance use disorder treatment programs in criminal justice settings. Drug Alcohol Depend 2024; 259:111314. [PMID: 38696932 DOI: 10.1016/j.drugalcdep.2024.111314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 04/18/2024] [Accepted: 04/21/2024] [Indexed: 05/04/2024]
Abstract
BACKGROUND Substance use disorders are highly prevalent in people within the criminal justice system. Psychological programs are the most common type of treatment available and have been shown to decrease recidivism, but dropping out of treatment is common. Risk factors associated with treatment dropout remain unclear in this setting, and whether the risk factors differ by treatment form (group-based vs. individual). METHODS Outcome (treatment dropout) was defined as not finishing the program due to client's own wish, misbehavior, no-shows, or because program leader found client to be unsuitable. Predictors of treatment dropout included a comprehensive set of individual-level clinical, socioeconomic, and crime-related pre-treatment characteristics. Multivariable regression models were used to estimate the associations between predictors and dropout. FINDINGS The study cohort included 5239 criminal justice clients who participated in a psychological treatment program (group-based or individual). Multivariable logistic regression models showed that female sex (OR=1.64, 95% CI 1.20-2.25), age (0.99, [0.97-1.00]), sentence length (0.98, [0.97-0.98]), higher education (0.54, [0.28-1.00]), number of violent offenses (1.03, [1.01-1.05]), and anxiety disorders (1.32, [1.01-1.72]) were associated with dropout from the individual treatment program. For the group-based program, age (OR=0.98, 95% CI 0.96-1.00), sentence length (OR=0.96, 95% CI 0.94-0.98), stimulant use disorder (OR=1.48, 95%, 1.00-2.19), and self-harm (OR 1.52, 95% CI 1.00-2.34) were associated with dropout. CONCLUSIONS We identified certain sociodemographic, crime-related, and clinical characteristics that were particularly important in predicting dropout from psychological treatment. Further, we find that there are similarities and differences in predictors of dropout from group-based and individual treatment forms.
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Affiliation(s)
- Lina Lantz
- Faculty of Medicine, Uppsala University, Sweden
| | - Zheng Chang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
| | - Suvi Virtanen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden; School of Educational Sciences and Psychology, University of Eastern Finland, Finland.
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Fazel S, Favril L. Prevalence of attention-deficit hyperactivity disorder in adult prisoners: An updated meta-analysis. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2024; 34:339-346. [PMID: 38568877 DOI: 10.1002/cbm.2337] [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: 11/07/2023] [Accepted: 03/20/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Previous meta-analyses may have overestimated the prevalence of attention-deficit hyperactivity disorder (ADHD) in prisoners by including data from selected samples. AIMS To estimate the prevalence of ADHD in unselected samples of adults in prison and examine potential sources of heterogeneity by meta-regression and subgroup analyses. METHODS We assessed all studies included in a 2018 systematic review for eligibility and updated the literature search to include studies published up to September 2023. RESULTS A total of 11 studies reporting robust diagnostic data on ADHD in 3919 unselected adults in prison were included. In meta-regression, ADHD prevalence did not differ between men and women but it was significantly higher in studies using a two-phase design. In random sampling studies, the pooled prevalence of ADHD was 8.3% (95% CI: 3.8-12.8) which was further halved after the removal of an outlier. CONCLUSION One in 12 adults in prison have been diagnosed with ADHD. Our findings highlight the importance of using clear and consistent inclusion criteria in meta-analyses of prevalence.
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Affiliation(s)
- Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Louis Favril
- Faculty of Law and Criminology, Ghent University, Ghent, Belgium
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Zielinski MJ, Alkov D, McCauley E, Aminawung JA, Shavit S, Wang EA. Characteristics of recently incarcerated primary care patients with and without a positive posttraumatic stress disorder screening upon clinic intake. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2024; 16:692-700. [PMID: 36729519 PMCID: PMC10497219 DOI: 10.1037/tra0001427] [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: 02/03/2023]
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) is prevalent among people who have been incarcerated. Here, we examined whether screening positive for PTSD was associated with other indicators of poor health, acute healthcare utilization, and poverty among primary care patients upon release from incarceration. METHOD We conducted a cross-sectional survey in a national network of primary care clinics serving people recently released from incarceration. Participants were 416 patients who completed the Primary Care PTSD screen (PC-PTSD) and other questions about mental and physical health, acute healthcare utilization, and economic status within 6 months of release. RESULTS Screening positive for PTSD was associated with worse status across nearly all variables examined, including being more likely to report: poor/fair health (61.6% vs. 41.7%), current depressive symptoms (89.7% vs. 50.8%), lifetime depression diagnosis (63.3% vs. 35.3%), cannabis use since release (20.7% vs. 9.6%), homelessness (31.9% vs. 18.5%), having no cash on hand (56.3% vs. 39.0%) and severe food insecurity (29.3% vs. 18.2%; all ps < .01). Reporting recent suicidality (14.3% vs. 7.0%), alcohol use since release (30.2% vs. 20.0%), and emergency department utilization (20.4% vs. 12.2%) was also more likely (all ps ≤ .03). These trends were largely upheld when controlling for demographic characteristics and chronic physical health conditions using linear probability regression. CONCLUSIONS Primary care patients recently released from incarceration have a need for wrap-around services that address health challenges and poverty. Patients with significant PTSD symptoms face even greater challenges. Identification and treatment of PTSD both during and after incarceration is warranted. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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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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Fitch KV, Pence BW, Rosen DL, Miller VE, Gaynes BN, Swilley-Martinez ME, Kavee AL, Carey TS, Proescholdbell SK, Ranapurwala SI. Suicide Mortality Among Formerly Incarcerated People Compared With the General Population in North Carolina, 2000-2020. Am J Epidemiol 2024; 193:489-499. [PMID: 37939151 DOI: 10.1093/aje/kwad214] [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: 04/13/2023] [Revised: 10/11/2023] [Accepted: 10/27/2023] [Indexed: 11/10/2023] Open
Abstract
We aimed to compare rates and characteristics of suicide mortality in formerly incarcerated people with those of the general population in North Carolina. We conducted a retrospective cohort study of 266,400 people released from North Carolina state prisons between January 1, 2000, and March 1, 2020. Using direct and indirect standardization by age, sex, and calendar year, we calculated standardized suicide mortality rates and standardized mortality ratios comparing formerly incarcerated people with the North Carolina general population. We evaluated effect modification by race/ethnicity, sex, age, and firearm involvement. Formerly incarcerated people had approximately twice the overall suicide mortality of the general population for 3 years after release, with the highest rate of suicide mortality being observed in the 2-week period after release. In contrast to patterns in the general population, formerly incarcerated people had higher rates of non-firearm-involved suicide mortality than firearm-involved suicide mortality. Formerly incarcerated female, White and Hispanic/Latino, and emerging adult people had a greater elevation of suicide mortality than their general-population peers compared with other groups. These findings suggest a need for long-term support for formerly incarcerated people as they return to community living and a need to identify opportunities for interventions that reduce the harms of incarceration for especially vulnerable groups. This article is part of a Special Collection on Mental Health.
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Caravaca-Sánchez F, Aizpurua E, Wolff N. The Prevalence of Prison-based Physical and Sexual Victimization in Males and Females: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2023; 24:3476-3492. [PMID: 36373724 DOI: 10.1177/15248380221130358] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
This systematic review investigated the prevalence of prison-based interpersonal harm by type of victimization (physical and sexual) and sex, along with the heterogeneity among studies using meta-regression. Using Preferred Reporting Items for Systematic Reviews and the Meta-Analysis guidelines, 24 articles met the selection criteria. Study quality was assessed using the Joana Briggs Institute (20.8% deemed low quality, 33.3% moderate, and 45.9% high). Searches were conducted in Criminal Justice Abstracts, PsycINFO, PubMed, and Web of Science. The 24 articles comprised 36 separate samples inclusive of 23,967 incarcerated individuals. The random-effects pooled prevalence estimate of prison-based physical victimization was 18.8%, with slightly higher rates for females (20.3%) than males (18.1%). For sexual victimization, the pooled prevalence estimate was 12.4%, with higher rates among females (15.3%) than males (9.7%). For females, younger individuals reported higher rates of physical and sexual victimization and studies using smaller samples had higher rates of physical victimization. Rates of physical and sexual victimization for men were higher if perpetrators included residents and staff, the recall period was since admission, data was collected using self-administered surveys, and in low-quality studies (sexual victimization only). Rates of prison-based interpersonal harm, while high, varied significantly by type of victimization, sex, and study methodology. High heterogeneity will be reduced only if future studies adhere to best methodological practices in defining and collecting data on interpersonal harm and consistently test risk and prevention factors instrumental to prevention efforts. Study limitations include the exclusion of unpublished and non-English-language studies, small sample sizes for female studies, and methodological "noise" within the literature that reduce predictive precision.
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Affiliation(s)
| | | | - Nancy Wolff
- Rutgers, The State University of New Jersey, Piscataway, USA
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Every-Palmer S, Ross B, Flewett T, Rutledge E, Hansby O, Bell E. Eye movement desensitisation and reprocessing (EMDR) therapy in prison and forensic services: a qualitative study of lived experience. Eur J Psychotraumatol 2023; 14:2282029. [PMID: 38010818 PMCID: PMC10993806 DOI: 10.1080/20008066.2023.2282029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 10/30/2023] [Indexed: 11/29/2023] Open
Abstract
Background: Posttraumatic stress disorder (PTSD) is common in people with serious mental illness who come into contact with the criminal justice system. Little evidence exists on EMDR treatment in forensic mental health, with no prior qualitative research exploring lived experience perspectives.Objective: This qualitative study recruited adult forensic mental health patients with PTSD and psychotic disorders, predominantly schizophrenia, who had received EMDR as part of a clinical trial, either in prison or in hospital. We sought to understand their experiences of EMDR therapy while receiving forensic care.Method: Ten in-depth, semi-structured qualitative interviews were undertaken and analysed using thematic analysis. We used an inductive, realist approach, reporting the experiences, meanings, and reality of the participants.Results: Five overarching themes were identified. First, severe trauma was ubiquitous and participants felt Seriously Messed Up by their traumatic experiences, with debilitating and enduring PTSD symptoms contributing to offending and psychosis ('giving the voices something to feed on'). Second, EMDR was regarded with Early Scepticism. Third, the therapy itself was initially emotionally taxing and Not Easy but participants generally felt safe and persevered. Fourth, they were often surprised and delighted by results (And it Worked!), describing significant symptom reduction and personal transformation. Lastly, EMDR Fits the Forensic Setting, bringing empowerment in a place perceived as disempowering. People reported changes that increased their hope in a violence-free future.Conclusions: The limited research on EMDR in forensic mental health is unfortunate given how common PTSD is in mentally unwell offenders and its potential to impede recovery and contribute to further offending. This first qualitative study found participants experienced positive transformative change, extending beyond symptom reduction. Themes support previously published quantitative outcomes showing EMDR to be safe and effective in this cohort. EMDR was well suited to a forensic setting and was seen as an empowering therapy.Trial registration: Australian New Zealand Clinical Trials Registry identifier: ACTRN12618000683235.Study registration: The study was registered on the Australia and New Zealand Clinical Trials Network, registration number ACTRN12618000683235 (registered prospectively, 24 April 2018), https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id = 374682.
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Affiliation(s)
- Susanna Every-Palmer
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Brigit Ross
- Mental Health, Addiction and Intellectual Disability Services, Te Whatu Ora Health New Zealand, Capital, Coast and Hutt Valley, Wellington, New Zealand
| | - Tom Flewett
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Eoghan Rutledge
- Mental Health, Addiction and Intellectual Disability Services, Te Whatu Ora Health New Zealand, Capital, Coast and Hutt Valley, Wellington, New Zealand
| | - Oliver Hansby
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
- Mental Health, Addiction and Intellectual Disability Services, Te Whatu Ora Health New Zealand, Capital, Coast and Hutt Valley, Wellington, New Zealand
| | - Elliot Bell
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
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Crole-Rees C, Kalebic N, Tomlin J, Forrester A. Can prisons be trauma-informed? Reflections on the development of a trauma-informed approach. J Forensic Leg Med 2023; 100:102609. [PMID: 37984320 DOI: 10.1016/j.jflm.2023.102609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/29/2023] [Accepted: 10/21/2023] [Indexed: 11/22/2023]
Affiliation(s)
- Clare Crole-Rees
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Hadyn Ellis Building, Maindy Road, Cathays, Cardiff, CF24 4HQ, UK; Oxford Health NHS Foundation Trust, UK.
| | - Natasha Kalebic
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Hadyn Ellis Building, Maindy Road, Cathays, Cardiff, CF24 4HQ, UK
| | - Jack Tomlin
- School of Law and Criminology, University of Greenwich, London, UK
| | - Andrew Forrester
- Forensic Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Haydn Ellis Building, Maindy Road, Cathays, Cardiff, CF24 4HQ, UK
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14
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Arias JJ, Morgado L, Prost SG. Forgotten and without Protections: Older Adults in Prison Settings. Hastings Cent Rep 2023; 53:17-24. [PMID: 38131491 DOI: 10.1002/hast.1540] [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] [Indexed: 12/23/2023]
Abstract
The number of older adults incarcerated in prisons is growing significantly, and there is a great need for legal authority, processes, and resources to mitigate individual and social burdens of elder neglect and abuse within these settings. Older adults in prison may be particularly vulnerable to abuse, neglect, or exploitation. They are dependent on the carceral system for basic resources, are at risk for retaliatory actions for reporting mistreatment, and bear disproportionately high health burdens. This essay first considers standards and resources for mitigating elder mistreatment in the community and residential-care settings in contrast to the available resources in prisons. Arguing that a conceptual model of elder abuse tailored to the prison population is needed, the essay proposes a research agenda through which such a model could be developed. The model could then be used in the creation of policy for detecting and mitigating elder mistreatment of incarcerated people. The essay concludes with a call to action to address the rift in legal protections and processes that leave older adults in prison at increased risk of abuse and neglect without a clear pathway for recourse.
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15
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Gaba A, Helm A, Shaffer PM, Pridgen B, Drawbridge D, Smelson D. Community reentry: Racial/ethnic differences in unmet needs among adults with co-occurring opioid use and mental health disorder. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2023; 91:101924. [PMID: 37690361 DOI: 10.1016/j.ijlp.2023.101924] [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: 07/28/2022] [Revised: 05/30/2023] [Accepted: 08/26/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Adults with co-occurring opioid use and mental health disorder (COD) recently released from incarceration have many social and health needs that place them at the most significant risk for overdose and poor reentry outcomes. Little is known about racial/ethnic differences in this population. METHODS To examine racial/ethnic differences in social and health needs, data were analyzed for 293 adults with COD within two weeks of release, a high-risk period for overdose, from six Massachusetts jails. RESULTS Overall, participants (62.6% non-Hispanic White, 23.1% Hispanic, 14.3% non-Hispanic Black, and 73.5% male) reported multiple health and social needs across groups. Chi-square tests and Kruskal-Wallis one-way ANOVAs were used to compare social and health needs among racial/ethnic groups. Non-Hispanic Black participants reported more problems with crack/cocaine, whereas Non-Hispanic White and Hispanic participants reported more problems with opioids (p < .001). Despite similar lifetime rates of illicit substance use, non-Hispanic Black and Hispanic participants received less treatment (p < .001). Non-Hispanic White participants reported more opioid and alcohol use (p < .006), trauma symptoms (p = .020), utilization of behavioral health treatment (p = .008), and more medical needs than Hispanic and/or non-Hispanic Black participants (p = .001). Non-Hispanic Black and Hispanic participants reported more needs related to social determinants of health (p = .008). CONCLUSIONS While re-entry is a vulnerable period for all adults with COD, this paper identifies specific needs by race/ethnicity and proposes strategies to advance equity and improve care for all formerly incarcerated adults with a COD.
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Affiliation(s)
- Ayorkor Gaba
- Department of Psychiatry, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA 01655, United States of America.
| | - Abigail Helm
- Department of Psychiatry, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA 01655, United States of America.
| | - Paige M Shaffer
- Department of Psychiatry, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA 01655, United States of America.
| | - Bailey Pridgen
- Department of Psychiatry, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA 01655, United States of America
| | - Dara Drawbridge
- Department of Psychiatry, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA 01655, United States of America.
| | - David Smelson
- Department of Psychiatry, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA 01655, United States of America.
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Dogan-Dixon J, Thrasher SS, Thorpe S, Wheeler P, Stevens-Watkins D. The roles of vicarious trauma exposure and perceived social support in codeine syrup misuse among Black men living in prisons. JOURNAL OF COMMUNITY PSYCHOLOGY 2023. [PMID: 37794735 DOI: 10.1002/jcop.23093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 09/12/2023] [Accepted: 09/18/2023] [Indexed: 10/06/2023]
Abstract
Using General Strain Theory, this study investigates the effects of vicarious trauma exposure and perceived social support on nonmedical codeine syrup misuse among Black incarcerated men nearing community re-entry. Data were drawn from the Helping Incarcerated Men project, a study examining mental health, substance misuse, and human immunodeficiency virus (HIV) risk behaviors among Black men living in prisons who were within 180 days of release. A total of 200 Black men self-reported demographics (i.e., age and length of incarceration after age 18), vicarious trauma exposure (e.g., ever witnessing an assault with a weapon and a sudden accidental death), perceived social support, and nonmedical codeine syrup misuse. Findings from the logistic regression analysis showed witnessing an assault with a weapon and a sudden accidental death increased the likelihood of codeine syrup misuse. Perceived social support was not associated with codeine syrup misuse. Implications for practice and future research are discussed.
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Affiliation(s)
- Jardin Dogan-Dixon
- Department of Educational School and Counseling Psychology, University of Kentucky, Lexington, Kentucky, USA
| | | | - Shemeka Thorpe
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, Kentucky, USA
| | - Paris Wheeler
- Department of Educational School and Counseling Psychology, University of Kentucky, Lexington, Kentucky, USA
| | - Danelle Stevens-Watkins
- Department of Educational School and Counseling Psychology, University of Kentucky, Lexington, Kentucky, USA
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Svingen E. PTSD and crime propensity: Stress systems, brain structures, and the nature of the relationship. Heliyon 2023; 9:e18381. [PMID: 37519662 PMCID: PMC10375856 DOI: 10.1016/j.heliyon.2023.e18381] [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: 03/18/2023] [Revised: 06/22/2023] [Accepted: 07/16/2023] [Indexed: 08/01/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) is the most commonly found disorder among the prison population; however, research has been slow to study it as a potential cause of crime. This review examines the neurophysiological changes in the organism associated with PTSD and connects them to crime and antisocial behaviour. Patients with PTSD suffer from a hyperactive sympathetic nervous system (SNS), an overactive amygdala that results in a hypoactive hypothalamic‒pituitary‒adrenal (HPA) axis, and a reduced hippocampal volume. All these features have been separately associated with aggressivity and antisocial behaviour; however, no consensus has been reached. Moreover, very little research has addressed the need to study the interaction between several stress-response systems. As a result, although there is some indication that patients with PTSD are probabilistically more likely to commit acts of crime, no conclusive results on the influence of PTSD on crime propensity can yet be drawn. Future research should address the interaction between the stress-response systems to understand the nature of antisocial behaviour and violence as well as to study any possible links between PTSD prevalence and possible unrest in prisons.
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18
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Paulino A, Kuja-Halkola R, Fazel S, Sariaslan A, Rietz ED, Lichtenstein P, Brikell I. Post-traumatic stress disorder and the risk of violent crime conviction in Sweden: a nationwide, register-based cohort study. Lancet Public Health 2023; 8:e432-e441. [PMID: 37244673 DOI: 10.1016/s2468-2667(23)00075-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) has been linked to violent crime in veteran populations. However, whether there is a link between PTSD and violent crime in the general population is not known. This study aimed to investigate the hypothesised association between PTSD and violent crime in the Swedish general population and to investigate the extent to which familial factors might explain this association using unaffected sibling control individuals. METHODS This nationwide, register-based cohort study assessed individuals born in Sweden in 1958-93 for eligibility for inclusion. Individuals who died or emigrated before their 15th birthday, were adopted, were twins, or whose biological parents could not be identified were excluded. Participants were identified and included from the National Patient Register (1973-2013), the Multi-Generation Register (1932-2013), the Total Population Register (1947-2013), and the National Crime Register (1973-2013). Participants with PTSD were matched (1:10) with randomly selected control individuals from the population without PTSD by birth year, sex, and county of residence in the year of PTSD diagnosis for the matched individual. Each participant was followed up from the date of matching (ie, the index person's first PTSD diagnosis) until violent crime conviction or until being censored at emigration, death, or Dec 31, 2013, whichever occurred first. Stratified Cox regressions were used to estimate the hazard ratio of time to violent crime conviction ascertained from national registers in individuals with PTSD compared with control individuals. To account for familial confounding, sibling analyses were conducted, comparing the risk of violent crime in a subsample of individuals with PTSD with their unaffected full biological siblings. FINDINGS Of 3 890 765 eligible individuals, 13 119 had a PTSD diagnosis (9856 [75·1%] of whom were female and 3263 [24·9%] of whom were male), were matched with 131 190 individuals who did not, and were included in the matched cohort. 9114 individuals with PTSD and 14 613 full biological siblings without PTSD were also included in the sibling cohort. In the sibling cohort, 6956 (76·3%) of 9114 participants were female and 2158 (23·7%) were male. Cumulative incidence of violent crime convictions after 5 years was 5·0% (95% CI 4·6-5·5) in individuals diagnosed with PTSD versus 0·7% (0·6-0·7) in individuals without PTSD. At the end of follow-up (median follow-up time 4·2 years, IQR 2·0-7·6), cumulative incidence was 13·5% (11·3-16·6) versus 2·3% (1·9-2·6). Individuals with PTSD had a significantly higher risk of violent crime than the matched control population in the fully-adjusted model (hazard ratio [HR] 6·4, 95% CI 5·7-7·2). In the sibling cohort, the risk of violent crime was also significantly higher in the siblings with PTSD (3·2, 2·6-4·0). INTERPRETATION PTSD was associated with increased risk of violent crime conviction, even after controlling for familial effects shared by siblings and in the absence of SUD or a history of violent crime. Although our results might not be generalisable to less severe or undetected PTSD, our study could inform interventions that aim to reduce violent crime in this vulnerable population. FUNDING None.
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Affiliation(s)
- Anabelle Paulino
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Psychiatry, University of Oxford, Oxford, UK.
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Amir Sariaslan
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Ebba Du Rietz
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Isabell Brikell
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Forrester A, Aboaja A, Beigel L, Mundt AP, Rivera G, Torales J. Mental health in prisons in Latin America: The effects of COVID-19. MEDICINE, SCIENCE, AND THE LAW 2023; 63:89-92. [PMID: 36628418 PMCID: PMC9836837 DOI: 10.1177/00258024221149932] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Affiliation(s)
| | | | | | - Adrian P. Mundt
- Universidad de Chile, Chile
- Universidad Diego Portales, Chile
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20
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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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21
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Miranda Seixas Einloft F, Kopittke L, Thais Guterres Dias M, Luana Veriato Schultz Á, Maria Dotta R, Maria Tannhauser Barros H. The use of benzodiazepines and the mental health of women in prison: a cross-sectional study. Sci Rep 2023; 13:4491. [PMID: 36934133 PMCID: PMC10024677 DOI: 10.1038/s41598-023-30604-0] [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: 05/15/2022] [Accepted: 02/27/2023] [Indexed: 03/20/2023] Open
Abstract
In this article we assessed the prevalence of benzodiazepine (BZD) use in women before and during imprisonment, as well as its related factors and association with symptoms of anxiety, depression, and posttraumatic stress disorder in a quantitative, cross-sectional, analytical study of regional scope. Two female prisons in the Brazilian Prison System were included. Seventy-four women participated by completing questionnaires about their sociodemographic data, BZD use and use of other substances. These questionnaires included the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C). Of the 46 women who reported no BZDs use before arrest, 29 (63%) began using BZDs during imprisonment (p < 0.001). Positive scores for PTSD, anxiety, and depression, as well as associations between BZD use during imprisonment and anxiety (p = 0.028), depression (p = 0.001) and comorbid anxiety and depression (p = 0.003) were found when a bivariate Poisson regression was performed. When a multivariate Poisson regression was performed for tobacco use, the PHQ-9 and GAD-7 scales, BZD use was associated with depression (p = p = 0.008), with tobacco use (p = 0.012), but not with anxiety (p = 0.325). Imprisonment increases the psychological suffering of women, consequently increasing BZD use. Nonpharmacological measures need to be considered in the health care of incarcerated women.
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Affiliation(s)
- Fernanda Miranda Seixas Einloft
- Programa de Pós-Gradução em Ciências da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA, Porto Alegre, Rio Grande do Sul, Brasil.
- Grupo Hospitalar Conceição - GHC, Porto Alegre, Rio Grande do Sul, Brasil.
| | - Luciane Kopittke
- Grupo Hospitalar Conceição - GHC, Porto Alegre, Rio Grande do Sul, Brasil
| | - Míriam Thais Guterres Dias
- Programa de Pós-Graduação em Política Social e Serviço Social, Universidade Federal do Rio Grande do Sul - UFRGS, Porto Alegre, Rio Grande do Sul, Brasil
| | - Águida Luana Veriato Schultz
- Programa de Pós-Graduação em Psicologia Social e Institucional, Universidade Federal do Rio Grande do Sul - UFRGS, Porto Alegre, Rio Grande do Sul, Brasil
| | | | - Helena Maria Tannhauser Barros
- Programa de Pós-Gradução em Ciências da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA, Porto Alegre, Rio Grande do Sul, Brasil
- Departamento de Farmacociências, Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA, Porto Alegre, Rio Grande do Sul, Brasil
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22
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Facer-Irwin E, Blackwood N, Bird A, MacManus D. Trauma, post-traumatic stress disorder and violence in the prison population: prospective cohort study of sentenced male prisoners in the UK. BJPsych Open 2023; 9:e47. [PMID: 36866723 PMCID: PMC10044336 DOI: 10.1192/bjo.2022.639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Violence is a common problem in prisons. Post-traumatic stress disorder (PTSD), a prevalent disorder in prison populations, has been identified as a risk factor for violent behaviour in community and military populations. Although cross-sectional associations between PTSD and prison violence have been documented, prospective cohort studies are required. AIMS To investigate whether PTSD is an independent risk factor for prison violence, and examine the potential role of PTSD symptoms and other trauma sequelae on the pathway from trauma exposure to violent behaviour in prison. METHOD A prospective cohort study was conducted in a large, medium security prison in London, UK. A random sample of sentenced prisoners arriving into custody (N = 223) took part in a clinical research interview, which assessed trauma histories, mental disorders including PTSD, and other potential sequelae of trauma (anger, emotion dysregulation). Incidents of violent behaviour were measured with prison records covering the 3 months after reception into custody. Stepped binary logistic regression and a series of binary mediation models were performed. RESULTS Prisoners who met current (past month) criteria for PTSD were more likely to engage in violent behaviour during the first 3 months of imprisonment, after adjusting for other independent risk factors. The relationship between lifetime exposure to interpersonal trauma and violent behaviour in custody was mediated by total PTSD symptom severity. Hyperarousal and negatively valenced cognitive and emotional appraisal symptoms were particularly implicated in this pathway. CONCLUSIONS The identification and treatment of PTSD has the potential to reduce violence in prison populations.
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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, UK
| | - Nigel Blackwood
- HMP Wandsworth, South London & Maudsley NHS Foundation Trust, UK; and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Annie Bird
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Deirdre MacManus
- HMP Wandsworth, South London and Maudsley NHS Trust, UK; Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and London and South East NHS Veterans' Mental Health Service, Camden and Islington NHS Trust, UK
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23
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Zielinski MJ, Allison MK, Smith MKS, Curran G, Kaysen D, Kirchner JE. Implementation of group cognitive processing therapy in correction centers: Anticipated determinants from formative evaluation. J Trauma Stress 2023; 36:193-204. [PMID: 36468175 PMCID: PMC10069158 DOI: 10.1002/jts.22898] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 10/20/2022] [Accepted: 10/20/2022] [Indexed: 12/07/2022]
Abstract
Nearly all people in prison have experienced trauma, and many meet the criteria for posttraumatic stress disorder (PTSD). Untreated PTSD increases the risk of substance use problems after release, contributing to a well-documented cycle of trauma, addiction, and incarceration. However, evidence-based, trauma-focused therapy for PTSD is rarely offered in prisons, and there is little research that can guide implementation efforts. In preparation for an effectiveness-implementation hybrid II pilot trial examining group-delivered cognitive processing therapy (CPT) in prisons, we conducted a formative evaluation using interviews structured according to the consolidated framework for implementation research (i.e., CFIR). Participants were correction center leadership, treatment staff, health care staff, and security staff (n = 22) and incarcerated persons (n = 14; 57.1% female). We found that CPT was highly compatible with residents' needs and the centers' available resources, culture, existing programs, and current workflow. CPT was also acceptable to all stakeholders. Potential barriers were the lower relative priority for CPT compared with programs that are reinforced at the system level, limited staff time to deliver CPT, limited staff knowledge about PTSD, and center features that could distract from CPT groups and/or training or be countertherapeutic. Taken together, CPT is a promising trauma-focused therapy for corrections, but these findings underscore the importance of identifying and matching potential barriers to effective implementation strategies a priori and work in the policy arena to promote sustainability.
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Affiliation(s)
- Melissa J. Zielinski
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Department of Psychological Science, University of Arkansas, Fayetteville, Arkansas, USA
| | - M. Kathryn Allison
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Mollee K. Steely Smith
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Geoffrey Curran
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Debra Kaysen
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California, USA
| | - JoAnn E. Kirchner
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Central Arkansas Veterans Healthcare System, Little Rock, Arkansas, USA
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24
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Brown LA, AlRabiah R, Terasse M, Aksianiuk V, Sisti D. Knowledge of evidence-based practices for PTSD among mental health court judges. MEDICINE, SCIENCE, AND THE LAW 2023; 63:42-52. [PMID: 35473423 DOI: 10.1177/00258024221096250] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Mental health courts offer access to community-based care for defendants with psychiatric disorders, including posttraumatic stress disorder (PTSD). However, limited information is available on how judges make treatment decisions about evidence-based practices. In this qualitative study, we interviewed mental health court judges to evaluate: (1) perspectives toward the role of PTSD in criminal behavior; (2) knowledge about evidence-based practice for PTSD; (3) treatment decisions for defendants with PTSD; and (4) treatment decisions for defendants at risk for suicide, a common comorbidity with PTSD. We hypothesized that mental health court judges would report low familiarity with evidence-based practices for PTSD despite wide recognition of the impact of trauma on criminal behavior. Methods: Mental health court judges (N = 11, 60% women, 60% between 50-59 years) were recruited from 7 states in the US and completed a demographics questionnaire and semi-structured qualitative interview that was transcribed and double-coded. Results: Judges in mental health court unanimously agreed that PTSD is highly prevalent among their defendants, but that they had not having received formal education about evidence-based practices for PTSD. They reported relying on their team members to provide recommendations for treatment planning and viewed their role as the enforcer of the treatment teams' suggestions. Finally, judges also reported that suicide prevention is an important consideration and that there is a need for universal suicide risk assessments. Conclusions: These findings have implications for continuing education among judges in mental health court, and we recommend mandated training to increase awareness of evidence-based practices for PTSD and suicide prevention.
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Affiliation(s)
- Lily A Brown
- Department of Psychiatry, 6572University of Pennsylvania, Philadelphia, PA, USA
| | - Reem AlRabiah
- Department of Psychiatry, 6572University of Pennsylvania, Philadelphia, PA, USA
| | - Melanie Terasse
- Department of Sociology, Princeton University, Princeton, NJ, USA
- Scattergood Program for Applied Ethics in Behavioral Health Care, 6572University of Pennsylvania, Philadelphia, PA, USA
| | - Valeryia Aksianiuk
- Scattergood Program for Applied Ethics in Behavioral Health Care, 6572University of Pennsylvania, Philadelphia, PA, USA
| | - Dominic Sisti
- Department of Psychiatry, 6572University of Pennsylvania, Philadelphia, PA, USA
- Scattergood Program for Applied Ethics in Behavioral Health Care, 6572University of Pennsylvania, Philadelphia, PA, USA
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25
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Fovet T, Wathelet M, Amad A, Horn M, Belet B, Roelandt JL, Thomas P, Vaiva G, D'Hondt F. PTSD in prison settings: the need for direct comparisons with the general population. Psychol Med 2023; 53:597-599. [PMID: 33634769 DOI: 10.1017/s0033291721000507] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Thomas Fovet
- University Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France
- Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France
| | - Marielle Wathelet
- University Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France
- Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France
- Fédération régionale de recherche en psychiatrie et santé mentale, Hauts-de-France, France
| | - Ali Amad
- University Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France
- Fédération régionale de recherche en psychiatrie et santé mentale, Hauts-de-France, France
| | - Mathilde Horn
- University Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France
| | - Bettina Belet
- University Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France
- Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France
| | - Jean-Luc Roelandt
- EPSM Lille Métropole, Centre Collaborateur de l'Organisation Mondiale de la Santé pour la recherche et la formation en santé mentale, Lille, France
- ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France
| | - Pierre Thomas
- University Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France
- Fédération régionale de recherche en psychiatrie et santé mentale, Hauts-de-France, France
| | - Guillaume Vaiva
- University Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France
- Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France
| | - Fabien D'Hondt
- University Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France
- Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France
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Sease TB, Cox CR, Knight K. Existential isolation and well-being in justice-involved populations. Front Psychol 2022; 13:1092313. [PMID: 36591099 PMCID: PMC9795838 DOI: 10.3389/fpsyg.2022.1092313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 11/22/2022] [Indexed: 12/15/2022] Open
Abstract
Much work in psychology has focused on feelings of social isolation and/or loneliness. Only recently have psychologists begun to explore the concept of existential isolation (EI). EI is the subjective sense that persons are alone in their experience and that others are unable to understand their perspective. EI thus occurs when people feel that they have a unique worldview unshared by others. Measured as either a state or trait, empirical studies have shown EI undermines life meaning and decreases well-being; people scoring high on EI report lower levels of need satisfaction, purpose in life, and meaningfulness and increased death-related concerns. There is also a positive correlation between EI and anxiety, depression, and suicidal ideation. The purpose of this perspective paper is to review literature on EI and discuss its relevance to people who have been involved with the justice system. Given their higher rates of substance use, mental health difficulties, and trauma, this traditionally underserved population is particularly susceptible to compromised well-being. We theorize that EI may impede the impact of therapeutic interventions in justice settings as more isolated individuals may feel disjointed from their counselors and peers, thereby decreasing levels of treatment engagement, participation, satisfaction, and perceived social support. Professionals may be able to mitigate issues related to EI by an enhanced focus on establishing authenticity within the therapist-client relationship (e.g., empathy, perspective taking, compassion), connecting with clients via I-sharing [i.e., matching on a shared experience(s)], and/or encouraging active participation in client's behavioral healthcare needs (e.g., self-reflection).
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Affiliation(s)
- Thomas B. Sease
- Institute of Behavioral Research, Texas Christian University, Fort Worth, TX, United States
| | - Cathy R. Cox
- Department of Psychology, Texas Christian University, Fort Worth, TX, United States
| | - Kevin Knight
- Institute of Behavioral Research, Texas Christian University, Fort Worth, TX, United States
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Irawan B, Yulia R. Emerging challenges to prisoners vaccination of covid-19: Historical, legal and humanitarian view. J Public Health Res 2022; 11:22799036221115769. [PMID: 36310829 PMCID: PMC9597029 DOI: 10.1177/22799036221115769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 07/09/2022] [Indexed: 11/06/2022] Open
Abstract
This research aims to present a legal history of the prisoners’ treatment in
global crises along with presenting an overview of prisoners’ treatment during
Covid-19 in view of International Humanitarian Laws. Using the formative
research method with a conceptual approach and statute approach, data was
gathered from various legal documents related to prisoners’ health laws linked
to legal purpose theories. This study further explains the need to treat old age
prisoners on a priority basis and to what extent international health
organizations are making efforts to establish criteria to vaccinate this
societal segment. The international regulatory framework was deeply analyzed to
draw conclusions and recommendations along with WHO efforts. It was revealed
that there exist adequate laws regarding priority health treatment of the
prisoners in crises times but existed an enormous need to highlight and address
the sensitive humanitarian issue. Additionally, WHO and other international
organizations have also revised the international laws during Covid-19 to treat
the prisoners. However, there is an immense need to devise explicit regulations
regarding the accessibility of the vaccine to all the groups of society,
including prisoners. The provision of a detailed overview of international laws
and treaties regarding prisoners’ priority health treatment is a major advance
of this research. Further recommendations for the developed and developing
nations and future research directions are suggested.
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Affiliation(s)
| | - Rena Yulia
- Rena Yulia, Sultan Ageng Tirtayasa
University, Jl. Raya Palka No. Km 3, Panancangan, Kec. Cipocok Jaya, Kabupaten
Serang, Banten 42124, Indonesia.
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Ning M, Wen S, Zhou P, Zhang C. Ventral tegmental area dopaminergic action in music therapy for post-traumatic stress disorder: A literature review. Front Psychol 2022; 13:1014202. [PMID: 36300072 PMCID: PMC9589351 DOI: 10.3389/fpsyg.2022.1014202] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/21/2022] [Indexed: 11/24/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is a debilitating sequela of extraordinary traumatic sufferings that threaten personal health and dramatically attenuate the patient's quality of life. Accumulating lines of evidence suggest that functional disorders in the ventral tegmental area (VTA) dopaminergic system contribute substantially to PTSD symptomatology. Notably, music therapy has been shown to greatly ameliorate PTSD symptoms. In this literature review, we focused on whether music improved PTSD symptoms, based on VTA dopaminergic action, including the effects of music on dopamine (DA)-related gene expression, the promotion of DA release and metabolism, and the activation of VTA functional activities. In addition, the strengths and limitations of the studies concerning the results of music therapy on PTSD are discussed. Collectively, music therapy is an effective approach for PTSD intervention, in which the VTA dopaminergic system may hold an important position.
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Affiliation(s)
- Meng Ning
- School of Music, Huainan Normal University, Huainan, China
| | - Shizhe Wen
- School of Educational Sciences, Lingnan Normal University, Zhanjiang, China
| | - Peiling Zhou
- School of Educational Sciences, Lingnan Normal University, Zhanjiang, China
- Peiling Zhou
| | - Changzheng Zhang
- School of Educational Sciences, Lingnan Normal University, Zhanjiang, China
- *Correspondence: Changzheng Zhang
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Ray I, Fulham L, Simpson AI, Vogel T, Gerritsen C, Patel K, Jones RM. A comparison of men and women referred to provincial correctional mental health services in Ontario, Canada. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2022; 32:358-370. [PMID: 36209470 DOI: 10.1002/cbm.2263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Women comprise around 15% of admissions to provincial correctional institutions in Canada. Women in custody are known to have a high prevalence of mental health concerns, but little is known about how those referred to mental health services compare with referred men at a similar stage of imprisonment. AIMS Our aim was to describe and compare clinical, social and demographic characteristics of a complete cohort of custodially remanded men and women who were referred to mental health services while under custodial remand in two correctional institutions. METHODS We carried out retrospective analysis of data obtained from 4040 men and 1734 provincially detained women referred to mental health services in two correctional centres holding mainly pre-trial prisoners and serving a large mixed urban-rural catchment area in Toronto, Canada over a nearly five-year period. Men and women were first screened using the Brief Jail Mental Health Screen. Those who screened positive were assessed using the Jail Screening Assessment Tool the Brief Psychopathology Rating Scale-Expanded (BPRS-E) and the Clinical Global Impression-Corrections (CGI-C). RESULTS There were many similarities between men and women, but also some important differences. Women were more socioeconomically disadvantaged than men. More women than men reported having children, yet fewer reported having any form of employment or social supports, although men were more likely to report unstable housing. In addition, women were significantly more likely to have mood and anxiety problems and to be self-harming, but did not differ from men in current psychotic symptoms. We also found differences in patterns of substance use, with a higher proportion of women using heroin and methamphetamines but fewer women having accessed addiction services. CONCLUSIONS Our findings have implications for clinicians and service planners. They underscore the value of systematic screening for identifying need. More specifically, they suggest need for increased availability of addiction services for women as well as ensuring support for those women who have dependent-age children. Improvement in supports for entry into employment is particularly needed for women, while men are particularly likely to need access to stable housing.
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Affiliation(s)
- Ipsita Ray
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | | | - Alexander I Simpson
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Tobias Vogel
- Department of Forensic Psychiatry, University of Basel, Basel, Switzerland
| | - Cory Gerritsen
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Kiran Patel
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Roland M Jones
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
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Zielinski MJ, Smith MKS, Kaysen D, Selig JP, Zaller ND, Curran G, Kirchner JE. A participant-randomized pilot hybrid II trial of group cognitive processing therapy for incarcerated persons with posttraumatic stress and substance use disorder symptoms: study protocol and rationale. HEALTH & JUSTICE 2022; 10:30. [PMID: 36181587 PMCID: PMC9525924 DOI: 10.1186/s40352-022-00192-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 09/09/2022] [Indexed: 06/10/2023]
Abstract
BACKGROUND Trauma exposure and drug addiction go hand-in-hand for the 2.17 million people who are incarcerated in US prisons; prevalence of both exceed 80% among this population. This manuscript describes the rationale and methods for a participant-randomized effectiveness-implementation hybrid type II pilot trial designed to: 1) examine the effectiveness of Cognitive Processing Therapy group (CPT), an evidence-based psychotherapy for posttraumatic stress disorder (PTSD), for reducing post-release drug use and PTSD symptoms when adapted for and delivered in prisons; and 2) provide data on implementation outcomes associated with the use of implementation facilitation as a strategy for supporting uptake of CPT in prisons. METHOD Participants in the effectiveness portion of the trial (N = 120) will be incarcerated men and women who are randomly assigned to one of two group therapies: CPT or a control condition (PTSD coping skills group; PCS). Participants will complete assessment measures three times: pre-treatment, post-treatment, and 3 months following release from incarceration. CPT groups will be led by prison counselors who are receiving implementation facilitation to support their efforts. PCS groups will be led by trained clinicians on the research team. Implementation outcomes will include acceptability, appropriateness, adoption, feasibility, fidelity, and sustainability. After enrollment ends, the research team will monitor CPT sustainment and recidivism outcomes of study participants for one year. DISCUSSION This study will lay the groundwork for a larger study of interventions for co-occurring PTSD and SUD in prisons and, critically, inform the development of strategies (such as implementation facilitation) for supporting their uptake in routine practice. TRIAL REGISTRATION NCT04007666 , clinicaltrials.gov, 24 June 2019, 02 September 2021.
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Affiliation(s)
- Melissa J Zielinski
- University of Arkansas for Medical Sciences, Little Rock, AR, USA.
- University of Arkansas, Fayetteville, USA.
| | | | | | - James P Selig
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Geoffrey Curran
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - JoAnn E Kirchner
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Central Arkansas Veterans Healthcare System, North Little Rock, USA
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31
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Fovet T, Eck M, Bouchard JP. De quels troubles psychiatriques souffrent les personnes détenues en France ? ANNALES MÉDICO-PSYCHOLOGIQUES, REVUE PSYCHIATRIQUE 2022. [DOI: 10.1016/j.amp.2022.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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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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Mundt AP, Langerfeldt SD, Maphisa JM, Sourabié O, Yongsi BN, Serri ER, Bukasa Tshilonda JC, Te JH, Bitta MA, Mathe L, Liwimbi O, Dos Santos PF, Atilola O, Jansen S, Diegane Tine JA, Akran C, Jalloh A, Kagee A, Van Wyk ES, Forry JB, Imasiku ML, Chigiji H, Priebe S. Changes in rates of psychiatric beds and prison populations in sub-Saharan Africa from 1990 to 2020. J Glob Health 2022; 12:04054. [PMID: 36056592 PMCID: PMC9440375 DOI: 10.7189/jogh.12.04054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Psychiatric bed numbers (general, forensic, and residential) and prison populations have been considered indicators of institutionalization. The present study aimed to assess changes of those indicators across sub-Saharan Africa (SSA) from 1990 to 2020. Methods We retrospectively obtained data on psychiatric bed numbers and prison populations from 46 countries in SSA between 1990 and 2020. Mean and median rates, as well as percentage changes between first and last data points were calculated for all of SSA and for groups of countries based on income levels. Results Primary data were retrieved from 17 out of 48 countries. Data from secondary sources were used for 29 countries. From two countries, data were unavailable. The median rate of psychiatric beds decreased from 3.0 to 2.2 per 100 000 population (median percentage change = -16.1%) between 1990 and 2020. Beds in forensic and residential facilities were nonexistent in most countries of SSA in 2020, and no trend for building those capacities was detected. The median prison population rate also decreased from 77.8 to 71.0 per 100 000 population (-7.8%). There were lower rates of psychiatric beds and prison populations in low-income and lower-middle income countries compared with upper-middle income countries. Conclusions SSA countries showed, on average, a reduction of psychiatric bed rates from already very low levels, which may correspond to a crisis in acute psychiatric care. Psychiatric bed rates were, on average, about one twenty-fifth of countries in the Organization for Economic Co-operation and Development (OECD), while prison population rates were similar. The heterogeneity of trends among SSA countries over the last three decades indicates that developments in the region may not have been based on coordinated policies and reflects unique circumstances faced by the individual countries.
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Affiliation(s)
- Adrian P Mundt
- Medical Faculty, Universidad Diego Portales, Santiago, Chile.,Departamento de Neurología y Psiquiatría, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | | | - J Maphisa Maphisa
- Department of Psychology, University of Botswana, Gaborone, Botswana
| | - Oumar Sourabié
- Psychiatrist, Regional Center Hospital of Fada N'gourma, Fada N'gourma, Burkina Faso
| | - Blaise Nguendo Yongsi
- Institute for Training & Research in Population Studies, University of Yaoundé, Yaoundé, Cameroon
| | - Enzo Rozas Serri
- Departamento de Neurología y Psiquiatría, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.,Department of Psychiatry and Mental Health, Hospital Clínico Universidad de Chile, Santiago, Chile
| | | | - Jeronimo H Te
- West African Epidemiology Network on Drug Use (WENDU), Bissau, Guinea-Bissau
| | - Mary A Bitta
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom.,KEMRI-Welcome Trust Research Program, Kilifi, Kenya
| | | | - Olive Liwimbi
- Zomba Mental Hospital, Ministry of Health, Zomba, Malawi
| | | | - Olayinka Atilola
- Lagos State University College of Medicine (LASUCOM), Lagos, Nigeria
| | - Stefan Jansen
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Jean A Diegane Tine
- Institute of Health and Development, Cheikh Anta Diop University, Dakar, Senegal
| | | | - Abdul Jalloh
- Sierra Leone Psychiatric Teaching Hospital, Freetown, Sierra Leone.,College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Ashraf Kagee
- Alan Fisher Centre for Public Mental Health, University of Cape Town, Cape Town.,Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Elizabeth S Van Wyk
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Jimmy B Forry
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.,Department of Mental Health and Psychiatry, Faculty of Clinical Medicine and Dentistry, Kampala, International University-Western Campus, Bushenyi, Uganda.,Department of Psychiatry, Mubende Regional Referral Hospital, Mubende, Uganda
| | | | | | - Stefan Priebe
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
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Morgan-López AA, Hien DA, Saraiya TC, Saavedra LM, Norman SB, Killeen TK, Simpson TL, Fitzpatrick S, Mills KL, Ruglass LM, Back SE, López-Castro T. Estimating posttraumatic stress disorder severity in the presence of differential item functioning across populations, comorbidities, and interview measures: Introduction to Project Harmony. J Trauma Stress 2022; 35:926-940. [PMID: 35124864 PMCID: PMC9844237 DOI: 10.1002/jts.22800] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 12/03/2021] [Accepted: 12/04/2021] [Indexed: 01/19/2023]
Abstract
Multiple factor analytic and item response theory studies have shown that items/symptoms vary in their relative clinical weights in structured interview measures for posttraumatic stress disorder (PTSD). Despite these findings, the use of total scores, which treat symptoms as though they are equally weighted, predominates in practice, with the consequence of undermining the precision of clinical decision-making. We conducted an integrative data analysis (IDA) study to harmonize PTSD structured interview data (i.e., recoding of items to a common symptom metric) from 25 studies (total N = 2,568). We aimed to identify (a) measurement noninvariance/differential item functioning (MNI/DIF) across multiple populations, psychiatric comorbidities, and interview measures simultaneously and (b) differences in inferences regarding underlying PTSD severity between scale scores estimated using moderated nonlinear factor analysis (MNLFA) and a total score analog model (TSA). Several predictors of MNI/DIF impacted effect size differences in underlying severity across scale scoring methods. Notably, we observed MNI/DIF substantial enough to bias inferences on underlying PTSD severity for two groups: African Americans and incarcerated women. The findings highlight two issues raised elsewhere in the PTSD psychometrics literature: (a) bias in characterizing underlying PTSD severity and individual-level treatment outcomes when the psychometric model underlying total scores fails to fit the data and (b) higher latent severity scores, on average, when using DSM-5 (net of MNI/DIF) criteria, by which multiple factors (e.g., Criterion A discordance across DSM editions, changes to the number/type of symptom clusters, changes to the symptoms themselves) may have impacted severity scoring for some patients.
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Affiliation(s)
| | - Denise A. Hien
- Center for Alcohol Studies, Rutgers University–Piscataway, Piscataway, New Jersey, USA
| | - Tanya C. Saraiya
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | | | - Sonya B. Norman
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California–San Diego, San Diego, California, USA
| | - Therese K. Killeen
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
- Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA
| | - Tracy L. Simpson
- Veterans Affairs Puget Sound Healthcare System, Seattle, Washington, USA
| | | | | | - Lesia M. Ruglass
- Department of Psychology, City College of New York, New York, New York, USA
| | - Sudie E. Back
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
- Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA
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Caravaca-Sánchez F, Vidovic KR, Fearn NE, Vaughn MG. Incarcerated Women in Spain: The Salience of Traumatic Exposure. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP10126-NP10147. [PMID: 33435810 DOI: 10.1177/0886260520985483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Incarcerated women are at high risk of exposure to traumatic events with subsequent development of post-traumatic stress disorder (PTSD). The present study builds on prior research by adding new findings from Spain on the association between childhood and prison victimization, and negative emotional states with PTSD symptoms during incarceration among women. The study sample (N = 174) included female prison inmates enrolled from two prisons located in Southeast Spain. Participants completed self-report questionnaires including demographic and criminal variables, childhood and prison victimization (including emotional, physical and sexual victimization), negative emotional states (including depression, anxiety, and stress symptoms) and PTSD symptoms. Logistic regression analysis revealed that women screening positive for trauma had significantly greater odds for the assortment of childhood victimization, prison victimization (specifically physical victimization) and depression, anxiety, and stress. Current findings suggest a need to include these construct assessments in the screening and identification of PTSD among incarcerated women in Spain.
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McKinnon I, Moore J, Lyall A, Forrester A. Screening for mental disorders in police custody settings. BJPSYCH ADVANCES 2022. [DOI: 10.1192/bja.2022.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Mental disorders are overrepresented in the criminal justice system, and this applies equally to police custody. These environments are complex and often pressured, and the acuity of the situation, combined with underlying mental disorders, comorbid medical problems and substance misuse, can lead to behavioural disturbance and increased psychiatric risk. Police custody may also present an opportunity to identify and signpost people with mental disorders and vulnerabilities who are ordinarily hard to reach by standard health services. This article considers the purposes of mental health screening of detainees in police custody. It gives an overview of research into screening for a range of psychiatric disorders and vulnerabilities (including substance misuse and traumatic brain injury) and summarises data on deaths in and immediately following release from custody. Given the inadequacy of statutory screening procedures in some jurisdictions, the authors offer a pragmatic evidence-based protocol to guide screening for mental disorders in custody detainees.
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Bianchini V, Paoletti G, Ortenzi R, Lagrotteria B, Roncone R, Cofini V, Nicolò G. The Prevalence of PTSD in a Forensic Psychiatric Setting: The Impact of Traumatic Lifetime Experiences. Front Psychiatry 2022; 13:843730. [PMID: 35573371 PMCID: PMC9091818 DOI: 10.3389/fpsyt.2022.843730] [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: 12/26/2021] [Accepted: 03/01/2022] [Indexed: 11/13/2022] Open
Abstract
Background Several studies have identified traumatic history among forensic patients and its association with criminal behaviors and psychiatric diagnoses. Post-traumatic stress disorder (PTSD) is highly prevalent in forensic settings causing a serious deterioration of the primary psychiatric disorder. Aims Our study aims to evaluate the prevalence of PTSD and the role of traumatic experiences and abuse in the development of severe psychiatric disorders in a sample of psychiatric offenders. Methods Fifty-three patients admitted in Italian high intensity therapeutic facilities-the Residenze per l'Esecuzione delle Misure di Sicurezza (REMS)-were evaluated with the Trauma Experience Checklist (TEC) and the Millon Clinical Multiaxal Inventory (MCMI-III) to study lifetime traumatic memories and general psychopathology, respectively. Results Preliminary findings show that about 41% (N = 22) of psychiatric offenders were affected by PTSD, often not due to a single episode but to multiple lifetime traumas. Therefore, lifetime traumatic experiences and specifically sexual abuse are significant risk factors for the development of a personality disorder, which is present in the 38% (N = 20) of the sample. Conclusions The high PTSD prevalence and the strong association found between trauma and abuse with the development of a personality disorder emphasizes the importance of an early evaluation and intervention on traumatic experiences in this difficult population of psychiatric patients; in fact, the treatment of psychiatric offenders is actually vague and devoid of scientific evidence. Our results open up the perspective on the use of known and specific interventions for trauma, such as EMDR and Mindfulness.
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Affiliation(s)
- Valeria Bianchini
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Terzo Centro di Psicoterapia, Rome, Italy
| | - Giovanna Paoletti
- DSMDP Asl Roma 5, REMS Castore, Contrada Colle Cisterna, Subiaco, Italy
| | - Roberta Ortenzi
- DSMDP Asl Roma 5, REMS Castore, Contrada Colle Cisterna, Subiaco, Italy
- Scuola di Terapia Cognitiva—APC, Rome, Italy
| | - Brunella Lagrotteria
- Terzo Centro di Psicoterapia, Rome, Italy
- DSMDP Asl Roma 5, REMS Castore, Contrada Colle Cisterna, Subiaco, Italy
- Scuola di Psicoterapia Cognitiva—SPC, Rome, Italy
| | - Rita Roncone
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Vincenza Cofini
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Giuseppe Nicolò
- Terzo Centro di Psicoterapia, Rome, Italy
- DSMDP Asl Roma 5, REMS Castore, Contrada Colle Cisterna, Subiaco, Italy
- Scuola Italiana Cognitivismo Clinico—SICC, Rome, Italy
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Prost SG, Golembeski C, Periyakoil VS, Arias J, Knittel AK, Ballin J, Oliver HD, Tran NT. Standardized outcome measures of mental health in research with older adults who are incarcerated. Int J Prison Health 2022; ahead-of-print:10.1108/IJPH-08-2021-0085. [PMID: 35362688 PMCID: PMC9328480 DOI: 10.1108/ijph-08-2021-0085] [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] [Indexed: 11/17/2022]
Abstract
PURPOSE The targeted use of standardized outcome measures (SOMs) of mental health in research with older adults who are incarcerated promotes a common language that enables interdisciplinary dialogue, contributes to the identification of disparities and supports data harmonization and subsequent synthesis. This paper aims to provide researchers with rationale for using "gold-standard" measures used in research with community-dwelling older adults, reporting associated study sample psychometric indexes, and detailing alterations in the approach or measure. DESIGN/METHODOLOGY/APPROACH The authors highlight the mental health of older adults who are incarcerated. They also discuss the benefits of SOMs in practice and research and then identify gold-standard measures of mental health used in research with community-dwelling older adults and measures used in research with older adults who are incarcerated. Finally, the authors provide several recommendations related to the use of SOMs of mental health in research with this population. FINDINGS Depression, anxiety and post-traumatic stress disorder are common among older adults who are incarcerated. Researchers have used a variety of measures to capture these mental health problems, some parallel to those used with community-dwelling samples. However, a more targeted use of SOMs of mental health in research with this population will contribute to important strides in this burgeoning field. ORIGINALITY/VALUE This review offers several practical recommendations related to SOMs of mental health in research with older adults who are incarcerated to contribute to a rigorous evidence base and thus inform practice and potentially improve the health and well-being of this population.
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Affiliation(s)
- Stephanie Grace Prost
- Raymond A. Kent School of Social Work, University of Louisville, Louisville, Kentucky, USA
| | - Cynthia Golembeski
- Milano School of Policy, Management, and Environment, The New School, New York, New York, USA
| | | | - Jalayne Arias
- University of California San Francisco, San Francisco, California, USA
| | - Andrea K Knittel
- Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Jessica Ballin
- Department of Health Promotion and Sports Medicine, Oregon Health and Science University, Portland, Oregon, USA
| | - Heather D Oliver
- Raymond A. Kent School of Social Work, University of Louisville, Louisville, Kentucky, USA
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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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Carter A, Butler A, Willoughby M, Janca E, Kinner SA, Southalan L, Fazel S, Borschmann R. Interventions to reduce suicidal thoughts and behaviours among people in contact with the criminal justice system: A global systematic review. EClinicalMedicine 2022; 44:101266. [PMID: 35072018 PMCID: PMC8763634 DOI: 10.1016/j.eclinm.2021.101266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/15/2021] [Accepted: 12/20/2021] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND People who experience incarceration die by suicide at a higher rate than those who have no prior criminal justice system contact, but little is known about the effectiveness of interventions in other criminal justice settings. We aimed to synthesise evidence regarding the effectiveness of interventions to reduce suicide and suicide-related behaviours among people in contact with the criminal justice system. METHODS We searched Embase, PsycINFO, MEDLINE, and grey literature databases for articles published between 1 January 2000 and 1 June 2021. The protocol was registered with PROSPERO (CRD42020185989). FINDINGS Thirty-eight studies (36 primary research articles, two grey literature reports) met our inclusion criteria, 23 of which were conducted in adult custodial settings in high-income, Western countries. Four studies were randomised controlled trials. Two-thirds of studies (n=26, 68%) were assessed as medium quality, 11 (29%) were assessed as high quality, and one (3%) was assessed as low quality. Most had considerable methodological limitations and very few interventions had been rigorously evaluated; as such, drawing robust conclusions about the efficacy of interventions was difficult. INTERPRETATION More high-quality evidence from criminal justice settings other than adult prisons, particularly from low- and middle-income countries, should be considered a priority for future research. FUNDING This work was funded by the Australian government's National Suicide Prevention Taskforce. RB is supported by a National Health and Medical Research Council (NHMRC) Emerging Leader Investigator Grant (EL2; GNT2008073). MW is supported by a NHMRC Postgraduate Scholarship (GNT1151103). SF was funded by the NIHR HTA Programme (HTA Project:16/159/09).
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Affiliation(s)
- Annie Carter
- Justice Health Unit, Centre for Health Equity; Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Amanda Butler
- Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
| | - Melissa Willoughby
- Justice Health Unit, Centre for Health Equity; Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
- Centre for Adolescent Health; Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Emilia Janca
- Justice Health Unit, Centre for Health Equity; Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Stuart A. Kinner
- Justice Health Unit, Centre for Health Equity; Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
- Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
- Mater Research Institute-UQ, University of Queensland, Brisbane, Queensland, Australia
- Griffith Criminology Institute, Griffith University, Brisbane, Queensland, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Louise Southalan
- Justice Health Unit, Centre for Health Equity; Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Seena Fazel
- Department of Psychiatry, University of Oxford; Oxford Health NHS Foundation Trust, Oxford, UK
| | - Rohan Borschmann
- Justice Health Unit, Centre for Health Equity; Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
- Centre for Adolescent Health; Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Psychiatry, University of Oxford; Oxford Health NHS Foundation Trust, Oxford, UK
- Melbourne School of Psychological Sciences; The University of Melbourne, Parkville, Victoria, Australia
- Corresponding Author: A/Prof. Rohan Borschmann, PhD DClinPsych BBSc PG-Dip (Psych) MAPS, Dame Kate Campbell Senior Research Fellow / Psychologist, Justice Health Unit, Centre for Health Equity; Melbourne School of Population and Global Health, The University of Melbourne, Level 4, 207 Bouverie street, Carlton, 3010, VIC Australia. Tel: +61 3 8344 0093; Fax: +61 3 8341 6212.
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Travers Á, McDonagh T, Cunningham T, Dalsklev M, Armour C, Hansen M. Trauma Exposure and Domestic Violence Offending Severity in a Probation Sample From Post-conflict Northern Ireland. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:1566-1587. [PMID: 32484389 DOI: 10.1177/0886260520922355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Domestic violence is more common in post-conflict settings such as Northern Ireland. However, the extent to which trauma and related mental health problems are associated with domestic violence perpetration in the region has not yet been quantitatively assessed. The present study examines relationships between multiple traumas, mental health problems, and five indicators of domestic violence perpetration severity (causing injury, use of a weapon, breach of nonmolestation order, sexual violence, and previous police involvement). The unique risk associated with distinct types of trauma (i.e., childhood maltreatment or conflict related) was also investigated. Perpetrators' case file data (n = 405) were analyzed using hierarchical logistic regression. The rates of recorded trauma exposure and mental health difficulties were 72.3% and 63.5%, respectively. The first logistic regression analyses showed that exposure to multiple traumas was associated with increased likelihood of perpetrating injurious and sexual violence, when controlling for the covariates (odds ratios [ORs] = 1.24-1.28). The second logistic regression analyses showed that childhood maltreatment was the only trauma type to confer unique risk, a relationship that was significant only for the outcome of perpetrating injurious violence (OR = 3.06). Substance misuse was also significantly associated with perpetration of injurious violence, use of weapons, and having past police involvement (ORs = 2.49-3.50). The accumulation of traumatic experiences and substance abuse appear to act as risk factors for some indicators of offending severity. Childhood maltreatment appears to confer particularly strong risk. The findings may support a focus on trauma and substance abuse as intervention targets in post-conflict settings.
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Affiliation(s)
| | | | | | | | | | - Maj Hansen
- University of Southern Denmark, Odense, Denmark
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Naidoo S, Subramaney U, Paruk S, Ferreira L. Mental illness and HIV amongst female inmates in Durban, South Africa. S Afr J Psychiatr 2022; 28:1628. [PMID: 35169507 PMCID: PMC8832006 DOI: 10.4102/sajpsychiatry.v28i0.1628] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 07/27/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND There is limited data regarding the prevalence of mental illness and human immunodeficiency virus (HIV) amongst female inmates in South Africa. Rehabilitation programmes can only be formulated once the needs of this population have been identified. AIM This study aimed to measure the prevalence of mental illnesses, borderline and antisocial personality disorders and HIV amongst female inmates. SETTING The study was based at a correctional centre in Durban, KwaZulu-Natal, South Africa. METHODS This study forms part of a larger two-phased, mixed methods, sequential, explanatory design study. In phase one, 126 female inmates were interviewed using a clinical questionnaire and the Structured Clinical Interview for Diagnostics and Statistical Manual (DSM)-5 diagnoses - Research Version. RESULTS The following lifetime prevalence rates were found: depressive disorder 70.6%, alcohol use disorder 48.4%, post-traumatic stress disorder (PTSD) 46.8%, borderline personality disorder 33.3%, substance use disorder 31.7%, antisocial personality disorder 15.1% and psychotic disorder 4.8%. The prevalence of current adult attention-deficit and hyperactivity disorder was 9.5%. A total of 39% of the participants admitted to past suicide attempts, whilst 64.3% reported past suicidal ideation and 36.5% had a current episode of a psychiatric disorder. A total of 64.3% of the participants were living with HIV. Although 90.4% had a lifetime psychiatric disorder, only 16.7% were previously diagnosed with a mental illness. The majority of inmates with lifetime disorders had psychiatric comorbidities. CONCLUSION The high prevalence of mental illness and HIV amongst female inmates, and the fact that most with mental illness remain undiagnosed, is concerning. Improved screening, identification and treatment of mental illnesses in this population is needed to ensure optimal mental health outcomes and decreased recidivism.
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Affiliation(s)
- Samantha Naidoo
- Department of Psychiatry, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ugasvaree Subramaney
- Department of Psychiatry, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Saeeda Paruk
- Discipline of Psychiatry, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Liezel Ferreira
- Department of Psychiatry, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Tadros E, Ansell A. Romantic attachment, childhood stability, depression, and PTSD in couples with an incarcerated partner. J Forensic Sci 2022; 67:619-629. [PMID: 34985138 DOI: 10.1111/1556-4029.14976] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 12/08/2021] [Accepted: 12/21/2021] [Indexed: 12/29/2022]
Abstract
Incarceration has a multitude of effects on prisoners' finances, health, education, employment, and family relationships. Incarceration complicates the maintenance of attachment bonds between romantic partners. Data from the Multi-site Family Study on Incarceration, Parenting, and Partnering were analyzed to examine the effects of childhood stability on adult romantic attachment while controlling for the effects of PTSD and depression within the carceral population. Findings indicate that posttraumatic stress disorder (PTSD) and depression have statistically significant effects on adult romantic attachment. PTSD on romantic attachment for men is statistically significant (p < 0.05) at -0.193 with an overall standardized effect of -0.086. For women, the effect is statistically significant (p < 0.01) at -0.235 with an overall standardized effect of -0.1. Effects of depression on romantic attachment for men is statistically significant (p < 0.001) -0.129 with an overall standardized effect of -0.229. For women, depression is also statistically significant (p < 0.001) at -0.153 with a standardized effect of -0.265. We examined the effects of childhood stability on adult romantic attachment while controlling for the effects of PTSD and depression within the carceral population. Findings supported our hypothesis that individuals with better childhood stability will experience better romantic attachments. Findings related to our hypothesis that having a partner with better childhood stability is positively associated with better romantic attachment produced mixed results. Clinical implications are discussed, and future directions call for research, practice, and training to improve outcomes for justice-involved romantic partners, their attachment, and consideration of covariates of depression and PTSD.
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Affiliation(s)
- Eman Tadros
- Governors State University, University Park, Illinois, USA
| | - Andrew Ansell
- Governors State University, University Park, Illinois, USA
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Kherabi Y, Mollo B, Gerard S, Lescure FX, Rioux C, Yazdanpanah Y. Patient-centered approach to the management of drug-resistant tuberculosis in France: How far off the mark are we? PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000313. [PMID: 36962203 PMCID: PMC10021739 DOI: 10.1371/journal.pgph.0000313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 03/09/2022] [Indexed: 11/18/2022]
Abstract
Drug-resistant tuberculosis (DR-TB) is a major public health concern worldwide. The prolonged isolation required is a source of challenges for both healthcare workers and patients, especially in high-income countries where DR-TB patients are frequently migrants with vulnerabilities. However, data on the needs of these vulnerable patients are scarce. Our objective was to identify and quantify conflict or inappropriate care situations experienced by both DR-TB patients and healthcare workers. This 10-year retrospective observational study (01/2008 to 10/2018) was conducted in a referral center for resistant tuberculosis management in Paris, France. Sixty-five DR-TB patients were hospitalized during the study period. Their demographic, clinical and social characteristics and any conflict or inappropriate care situations they experienced with healthcare workers while hospitalized were analyzed. Conflict or inappropriate care situations with healthcare workers were reported for 24 patients during their stay (36.9%). Eleven patients (16.9%) had difficulty adhering to respiratory isolation rules, 15 (23.1%) were discharged against medical advice, 9 (13.8%) were excluded from hospital for disciplinary reasons, verbal or physical violence was reported for 7 patients (10.8%), and 4 arrests (6.2%) were made by the police. Conflict situations were reported more often when there was a language barrier (70.8%, p<0.0001). More than one-third of patients with DR-TB in this referral center experienced at least one inappropriate care situation with healthcare workers. This study illustrates the urgent need to promote a patient-centered approach and to respond to the challenges of its practical implementation.
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Affiliation(s)
- Yousra Kherabi
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire Bichat-Claude Bernard, Paris, France
- Inserm U1137, IAME, Université de Paris, Paris, France
| | - Bastien Mollo
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire Bichat-Claude Bernard, Paris, France
- Inserm U1137, IAME, Université de Paris, Paris, France
| | - Sandrine Gerard
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire Bichat-Claude Bernard, Paris, France
| | - François-Xavier Lescure
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire Bichat-Claude Bernard, Paris, France
- Inserm U1137, IAME, Université de Paris, Paris, France
| | - Christophe Rioux
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire Bichat-Claude Bernard, Paris, France
- Inserm U1137, IAME, Université de Paris, Paris, France
| | - Yazdan Yazdanpanah
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire Bichat-Claude Bernard, Paris, France
- Inserm U1137, IAME, Université de Paris, Paris, France
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Dueweke AR, Higuera DE, Zielinski MJ, Karlsson ME, Bridges AJ. Does Group Size Matter? Group Size and Symptom Reduction Among Incarcerated Women Receiving Psychotherapy Following Sexual Violence Victimization. Int J Group Psychother 2022; 72:1-33. [PMID: 36249160 PMCID: PMC9555233 DOI: 10.1080/00207284.2021.2015601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Survivors Healing from Abuse: Recovery through Exposure (SHARE) is an eight-week therapy group for incarcerated women who have experienced sexual violence victimization. SHARE requires each member to complete an imaginal exposure and to listen when others share their experiences of victimization. While trauma-focused group interventions including SHARE are associated with reductions in internalizing symptoms, little work has examined how group characteristics predict symptom decreases. The purpose of this study was to examine whether group size was associated with symptom changes pre- to post-treatment. Participants (n=140 across 29 groups) completed self-report measures of posttraumatic stress symptoms before and after completing SHARE. Multilevel modeling revealed the majority of the variance in post-treatment symptoms was attributed to individual factors rather than group factors. Symptom change was comparable for groups of two to eight women; declines in symptom improvement were observed at a group size of ten participants.
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Affiliation(s)
- Aubrey R. Dueweke
- Department of Psychological Science, University of Arkansas, 216 Memorial Hall, Fayetteville, AR 72701, USA
| | - Danielle E. Higuera
- Department of Psychological Science, University of Arkansas, 216 Memorial Hall, Fayetteville, AR 72701, USA
| | - Melissa J. Zielinski
- Department of Psychological Science, University of Arkansas, 216 Memorial Hall, Fayetteville, AR 72701, USA.,Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR 72205, USA
| | - Marie E. Karlsson
- Department of Psychology, Murray State University, 212 Wells Hall, Murray, KY 42071, USA
| | - Ana J. Bridges
- Department of Psychological Science, University of Arkansas, 216 Memorial Hall, Fayetteville, AR 72701, USA
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Fovet T, Wathelet M, Amad A, Horn M, Belet B, Benradia I, Roelandt JL, Thomas P, Vaiva G, D'Hondt F. Trauma exposure and PTSD among men entering jail: A comparative study with the general population. J Psychiatr Res 2021; 145:205-212. [PMID: 34929470 DOI: 10.1016/j.jpsychires.2021.12.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/27/2021] [Accepted: 12/10/2021] [Indexed: 12/17/2022]
Abstract
Research has consistently shown high levels of post-traumatic stress disorder (PTSD) in correctional settings. We aimed to compare the prevalences of trauma exposure, subthreshold PTSD, and full PTSD in incarcerated people with those observed in the general population. We used the Mini-International Neuropsychiatric Interview to screen for psychiatric disorders among men upon admission to jail (N = 630) and non-incarcerated men living in the same geographic area (the northern district of France; N = 5793). We utilized a multinomial regression model to assess the association between admission to jail and the prevalences of trauma exposure, subthreshold PTSD, and full PTSD. We employed logistic regression models to verify the interaction between admission to jail and PTSD status on the presence of psychiatric comorbidities. Full PTSD was overrepresented among men in jail after adjustment for all covariates (OR [95% CI] = 3.49 [1.55-7.85], p = 0.002). The association between PTSD status and the presence of at least one psychiatric comorbidity was also more important upon admission to jail than in the general population. Admission to jail was not associated with a higher prevalence of trauma exposure (OR [95% CI] = 1.12 [0.85-1.46], p = 0.419) or subthreshold PTSD (OR [95% CI] = 1.17 [0.81-1.68], p = 0.413). These results suggest higher prevalence rates of full PTSD and psychiatric comorbidities associated with PTSD symptoms in incarcerated people than in the general population. The provision of trauma-focused interventions tailored to these clinical specificities should be considered for the jail population.
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Affiliation(s)
- Thomas Fovet
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France.
| | - Marielle Wathelet
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France; Fédération régionale de recherche en psychiatrie et santé mentale, Hauts-de, France
| | - Ali Amad
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Fédération régionale de recherche en psychiatrie et santé mentale, Hauts-de, France
| | - Mathilde Horn
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France
| | - Bettina Belet
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France
| | - Imane Benradia
- EPSM Lille Métropole, Centre Collaborateur de l'Organisation Mondiale de la Santé pour la recherche et la formation en santé mentale, Lille, France
| | - Jean-Luc Roelandt
- EPSM Lille Métropole, Centre Collaborateur de l'Organisation Mondiale de la Santé pour la recherche et la formation en santé mentale, Lille, France; ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France
| | - Pierre Thomas
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Fédération régionale de recherche en psychiatrie et santé mentale, Hauts-de, France
| | - Guillaume Vaiva
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France
| | - Fabien D'Hondt
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France
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PTSD: equity in diagnostic practice. Lancet Psychiatry 2021; 8:1024-1026. [PMID: 34801116 DOI: 10.1016/s2215-0366(21)00366-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 08/22/2021] [Accepted: 08/23/2021] [Indexed: 11/22/2022]
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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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Bebbington PE, McManus S, Coid JW, Garside R, Brugha T. The mental health of ex-prisoners: analysis of the 2014 English National Survey of Psychiatric Morbidity. Soc Psychiatry Psychiatr Epidemiol 2021; 56:2083-2093. [PMID: 33751153 PMCID: PMC8519824 DOI: 10.1007/s00127-021-02066-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 03/10/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE Prisoners experience extremely high rates of psychiatric disturbance. However, ex-prisoners have never previously been identified in representative population surveys to establish how far this excess persists after release. Our purpose was to provide the first community-based estimate of ex-prisoners' mental health in England using the data from the 2014 Adult Psychiatric Morbidity Survey (APMS). METHODS APMS 2014 provides cross-sectional data from a random sample (N = 7546) of England's household population aged 16 or above. Standardised instruments categorised psychiatric disorders and social circumstances. Participants who had been in prison were compared with the rest of the sample. RESULTS One participant in seventy had been in prison (1.4%; 95% CI 1.1-1.7; n = 103). Ex-prisoners suffered an excess of current psychiatric problems, including common mental disorders (CMDs), psychosis, post-traumatic disorder, substance dependence, and suicide attempts. They were more likely to screen positive for attention-deficit/hyperactivity disorder and autistic traits, to have low verbal IQ, and to lack qualifications. They disclosed higher rates of childhood adversity, including physical and sexual abuse and local authority care. The odds (1.88; 95% CI 1.02-3.47) of CMDs were nearly doubled in ex-prisoners, even after adjusting for trauma and current socioeconomic adversity. CONCLUSIONS Prison experience is a marker of enduring psychiatric vulnerability, identifying an important target population for intervention and support. Moreover, the psychiatric attributes of ex-prisoners provide the context for recidivism. Without effective liaison between the criminal justice system and mental health services, the vulnerability of ex-prisoners to relapse and to reoffending will continue, with consequent personal and societal costs.
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Affiliation(s)
- Paul E Bebbington
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK.
| | - Sally McManus
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
- National Centre for Social Research, London, UK
- Violence and Society Centre, City, University of London, London, UK
| | - Jeremy W Coid
- Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary, University of London, London, UK
| | | | - Terry Brugha
- Department of Health Sciences, Leicester University, Leicester, UK
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Givens A, Cuddeback GS. Traumatic experiences among individuals with severe mental illnesses on probation. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2021; 31:310-320. [PMID: 34498309 DOI: 10.1002/cbm.2212] [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: 09/30/2020] [Accepted: 08/23/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The large and growing number of individuals with severe mental illnesses who are on probation presents challenges to both mental health and criminal justice authorities. The clinical and mental health service needs of probationers with severe mental illnesses have however, been insufficiently researched, particularly with respect to trauma and the need for trauma-informed services. AIMS To explore the lifetime prevalence of post-traumatic stress disorder (PTSD) among people on probation who also have other serious mental illnesses and their demographic characteristics. METHODS Individuals on probation in six counties in one southeastern state who had been diagnosed with severe mental illnesses were assessed for PTSD; they were also asked whether they had experienced any of 14 traumatic events of interest over their lifetimes. RESULTS Of 207 participants, about half had clinically diagnosable PTSD. Nearly two-thirds had experienced more than five traumatic events during their lifetimes: 86% experienced at least one non-interpersonal traumatic event, such as a car accident, and 90% experienced at least one interpersonal traumatic event, such as a physical assault. The latter was the single most frequently reported traumatic event (80%, n = 160). PTSD was, on average, associated with a higher number of prior traumatic experiences overall. CONCLUSIONS In one state in the USA, rates of trauma experiences and PTSD among probationers with other mental illnesses are high. Relative to prisoners, little is known about the mental health needs among probationers, so replication in a larger sample across jurisdictions would be useful. Findings are likely to have implications for form of service delivery as well as treatment needs.
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Affiliation(s)
| | - Gary S Cuddeback
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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