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Meijers J, Kuin NC, Scherder EJA, Harte JM. Characteristics of forensic psychiatric patients with a neurocognitive disorder. BJPsych Open 2024; 10:e117. [PMID: 38763914 DOI: 10.1192/bjo.2024.712] [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: 05/21/2024] Open
Abstract
BACKGROUND Emotional and behavioural disturbances accompanying neurocognitive disorders may sometimes lead to a criminal offence. Our knowledge of this specific forensic subpopulation is lagging behind the knowledge on, and attention for, 'classic' psychiatric disorders in forensic populations. AIMS To gain knowledge on the prevalence and characteristics of individuals with neurocognitive disorders in the forensic population. METHOD This retrospective database study uses an anonymised data-set of the National Database of penitentiary psychiatric centres (PPC) (N = 8391), which collects data on all patients admitted to one of the four PPCs (mental health clinics within the prison system) in The Netherlands since May 2013. Inclusion criterion for this study was the presence of a Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) or Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) diagnostic code belonging to the category of neurocognitive disorders. RESULTS A DSM-IV-TR or DSM-5 diagnostic code of a neurocognitive disorder was classified in 254 out of 8391 unique individuals, resulting in a prevalence of 3.0% in the total PPC population. The most prevalent diagnosis was unspecified neurocognitive disorder (59.1%). The neurocognitive disorder group significantly differed from a random control group from the database (n = 762) on demographic, clinical and criminological variables. CONCLUSIONS The prevalence of neurocognitive disorders in this real-world clinical sample is remarkably lower than in two earlier studies in similar populations. Also remarkable is the relatively high prevalence of an unspecified neurocognitive disorder. These findings lead us to hypothesise that neurocognitive disorders may be underdiagnosed in this population. Forensic psychiatric settings should evaluate whether they have sufficient expertise available in neuropsychological assessment.
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Affiliation(s)
- Jesse Meijers
- Willem Pompe Institute for Criminal Law and Criminology, Utrecht University, The Netherlands; and Judicial Complex Zaanstad, Dutch Custodial Institutions Agency, Ministry of Justice and Security, The Hague, The Netherlands
| | - Niki C Kuin
- Penitentiary Institution Vught, Dutch Custodial Institutions Agency, Ministry of Justice and Security, The Hague, The Netherlands; and Pieter Baan Centre, Netherlands Institute of Forensic Psychiatry and Psychology, Ministry of Justice and Security, The Hague, The Netherlands
| | - Erik J A Scherder
- Section of Clinical Neuropsychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, The Netherlands
| | - Joke M Harte
- Department of Criminology, Faculty of Law, Vrije Universiteit Amsterdam, The Netherlands
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Treacy S, Martin S, Samarutilake N, Phillips V, Underwood BR, Van Bortel T. Dementia care pathways in prisons - a comprehensive scoping review. HEALTH & JUSTICE 2024; 12:2. [PMID: 38244098 PMCID: PMC10799435 DOI: 10.1186/s40352-023-00252-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/16/2023] [Indexed: 01/22/2024]
Abstract
BACKGROUND The number of older people in prison is growing. As a result, there will also be more prisoners suffering from dementia. The support and management of this population is likely to present multiple challenges to the prison system. OBJECTIVES To examine the published literature on the care and supervision of people living in prison with dementia and on transitioning into the community; to identify good practice and recommendations that might inform the development of prison dementia care pathways. METHODS A scoping review methodology was adopted with reporting guided by the PRISMA extension for scoping reviews checklist and explanation. RESULTS Sixty-seven papers were included. Most of these were from high income countries, with the majority from the United Kingdom (n = 34), followed by the United States (n = 15), and Australia (n = 12). One further paper was from India. DISCUSSION The literature indicated that there were difficulties across the prison system for people with dementia along the pathway from reception to release and resettlement. These touched upon all aspects of prison life and its environment, including health and social care. A lack of resources and national and regional policies were identified as important barriers, although a number of solutions were also identified in the literature, including the development of locally tailored policies and increased collaboration with the voluntary sector. CONCLUSION To our knowledge, this is the most comprehensive and inclusive review of the literature on dementia care pathways in prison to date. It has identified a number of important areas of concern and opportunities for future research across the prison system, and its operations. This will hopefully lead to the identification or adaptation of interventions to be implemented and evaluated, and facilitate the development of dementia care pathways in prisons.
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Affiliation(s)
- Samantha Treacy
- Faculty of Humanities and Social Sciences, Department of Criminology, Sociology & Social Policy, Swansea University, Swansea, UK
| | - Steven Martin
- Leicester School of Allied Health Sciences, De Montfort University, Leicester, UK
| | - Nelum Samarutilake
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Veronica Phillips
- Cambridge Medical Library, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Ben R Underwood
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Tine Van Bortel
- Leicester School of Allied Health Sciences, De Montfort University, Leicester, UK.
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
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Mantell R, Withall A, Radford K, Kasumovic M, Monds L, Hwang YIJ. The Design Preferences for a Serious Game-based Cognitive Assessment of Older People in Prison: Thematic Analysis (Preprint). JMIR Serious Games 2023; 11:e45467. [PMID: 37067850 PMCID: PMC10152383 DOI: 10.2196/45467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 01/24/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Serious games have the potential to transform the field of cognitive assessment. The use of serious game-based cognitive assessments in prison environments is particularly exciting. This is because interventions are urgently needed to address the rapid increase in the number of currently incarcerated older adults globally and because of the heightened risks of dementia and cognitive decline present in this population. Game-based assessments are assumed to be fun, engaging, and suitable alternatives to traditional cognitive testing, but these assumptions remain mostly untested in older adults. This is especially true for older adults in prison, whose preferences and needs are seldom heard and may deviate from those previously captured in studies on cognition and serious games. OBJECTIVE This study aimed to understand the design preferences of older adults in prison for a game-based cognitive assessment. METHODS This study used reflexive thematic analysis, underpinned by critical realism, and applied the technique of abduction. Overall, 4 focus groups with a total of 20 participants were conducted with older adults (aged ≥50 years; aged ≥45 years for Aboriginal and Torres Strait Islander people) across 3 distinct prison environments in Australia. RESULTS Self-determination theory was used as a theoretical foundation to interpret the results. Overall, 3 themes were generated: Goldilocks-getting gameplay difficulty just right through optimal challenge (the first theme emphasizes the participants' collective desire for an individualized optimal level of difficulty in serious gameplay), Avoiding Childish Graphics-gimmicky gameplay can be condescending (the second theme raises the importance of avoiding immature and childlike gameplay features, as some older end users in prison felt that these can be condescending), and A Balanced Diet-meaningful choice and variety keeps game-based assessments fun (the third theme highlights the strong user preference for meaningful choice and variety in any serious game-based cognitive assessment to maximize in-game autonomy). CONCLUSIONS The collection of these themes provides novel insights into key game design preferences of marginalized older adults.
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Affiliation(s)
- Rhys Mantell
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Adrienne Withall
- School of Population Health, University of New South Wales, Sydney, Australia
- Ageing Futures Institute, University of New South Wales, Sydney, Australia
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Kylie Radford
- Ageing Futures Institute, University of New South Wales, Sydney, Australia
- School of Psychology, University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| | - Michael Kasumovic
- School of Biological, Earth & Environmental Sciences, University of New South Wales, Sydney, Australia
- Arludo, Sydney, Australia
| | - Lauren Monds
- Addiction Medicine, Central Clinical School, The University of Sydney, Sydney, Australia
| | - Ye In Jane Hwang
- School of Population Health, University of New South Wales, Sydney, Australia
- Ageing Futures Institute, University of New South Wales, Sydney, Australia
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Washington L. Dementia and the aging population: cognitive screening within correctional health. Int J Prison Health 2022; 19:10.1108/IJPH-08-2021-0070. [PMID: 35759397 PMCID: PMC10231416 DOI: 10.1108/ijph-08-2021-0070] [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 purpose of this study was to examine the literature surrounding dementia in the aging correctional population and assess the role of cognitive screening related to dementia detection within corrections. The literature regarding the role of dementia within the justice continuum is scant. Furthermore, correctional health researchers have not reached a consensus on the best age to administer cognitive screening in older persons or prioritizes a screening tool for the early detection of dementia. DESIGN/METHODOLOGY/APPROACH A key search term list including dementia screening and was developed to review the literature surrounding dementia and the aging correctional population. PubMed, Criminal Justice Abstracts (Ebsco) and the National Criminal Justice Reference Service were used within the academic search. A gray literature search using these same search terms was conducted reviewing criminal justice federal agencies and organizations for additional information on the dementia experience within correctional settings. Snowballing was used to capture relevant theoretical and empirical knowledge. FINDINGS Shortages in aging specialized health-care staffing presents a barrier for the clinical interpretation of Montreal Cognitive Assessment (MoCA) results. Correctional officers are also identified as useful candidates within the administration of cognitive screening with proper training. The MoCA may be the optimal cognitive screening tool for dementia, until an original cognitive screening tool is created specific to the correctional population. An age of 55 years or older may serve as the best cutoff score for classifying incarcerated individuals as older persons, and screening should be prioritized for these individuals. Finally, new specialized programs related to dementia within correctional settings are identified. RESEARCH LIMITATIONS/IMPLICATIONS A limitation of this research is the conflicting opinions among researchers regarding the use of general cognitive screening tools within the correctional setting. ORIGINALITY/VALUE This research can inform correctional organizational policy and practices regarding the screening of older persons suspected of dementia. Most notably, this research proposes that correctional settings should incorporate the MoCA within initial screening of all individuals 55 years of age or older, enriching the job design of correctional officer's job positions to include cognitive testing, and for correctional settings to provide dementia and age-associated training for correctional officers. Finally, this paper informs future research in the development of a cognitive assessment tool specific to the correctional population.
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Affiliation(s)
- Lance Washington
- Department of Research and Consulting, National Association of State Mental Health Program Directors Research Institute, Falls Church, Virginia, USA
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Niedens M, Yeager A, Vidoni ED, Barton K, Perales-Puchalt J, Dealey RP, Quinn D, Gage LA. A Collaborative Approach to Dementia Inclusion in Social Work Education: The Dementia Intensive. JOURNAL OF SOCIAL WORK EDUCATION 2022; 59:493-505. [PMID: 37397072 PMCID: PMC10309142 DOI: 10.1080/10437797.2022.2039820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/11/2021] [Indexed: 07/04/2023]
Abstract
There are 5.8 million Americans with Alzheimer's disease and this number is rising. Social Work can play a key role. Yet, like other disciplines, the field is ill prepared for the growing number of individuals and family members who are impacted physically, emotionally and financially. Compounding the challenge, the number of social work students identifying interest in the field is low. This mixed methods concurrent study assessed the preliminary efficacy of a day-long education event among social work students from eight social work programs. Pre- post-training survey included: 1) dementia knowledge, assessed with the Dementia Knowledge Assessment Scale, and 2) negative attitudes towards dementia, assessed by asking students to identify three words that reflected their thoughts on dementia, which were later rated as positive, negative or neutral by three external raters. Bivariate analyses showed that dementia knowledge (mean difference= 9.9) and attitudes (10% lower) improved from pre- to post-training (p<0.05). Collaboration between social work programs can increase student access to strength-based dementia education. Such programs hold the potential of improving dementia capability within the field of Social Work.
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Affiliation(s)
| | - Amy Yeager
- KU Alzheimer's Disease Research Center, Department of Neurology
| | - Eric D Vidoni
- KU Alzheimer's Disease Research Center, Department of Neurology
| | | | | | | | - Dory Quinn
- Pittsburg State University, Department of History, Philosophy & Social Sciences
| | - L Ashley Gage
- University of Central Missouri, Department of Social Work
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Stoliker BE, Kerodal AG, Jewell LM, Brown K, Kent-Wilkinson A, Peacock S, O'Connell ME, Wormith JS. Older people in custody in a forensic psychiatric facility, prevalence of dementia, and community reintegration needs: an exploratory analysis. HEALTH & JUSTICE 2022; 10:3. [PMID: 35072844 PMCID: PMC8785542 DOI: 10.1186/s40352-022-00168-8] [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: 03/10/2021] [Accepted: 01/11/2022] [Indexed: 05/23/2023]
Abstract
BACKGROUND Across much of the developed world, the number of older people in custody has been increasing, which presents challenges for correctional systems due to the complex social, medical and mental health needs of this subgroup, especially those living with dementia. The present study therefore aimed to increase insight into the extent to which older people in custody are (a) potentially living with dementia and (b) receiving appropriate supports/services (particularly, with respect to community reintegration). RESULTS Cross-sectional data were drawn from a sample of 29 older people in custody and 20 correctional health care professionals at a regional forensic psychiatric hospital in a medium-sized Canadian city. In general, analyses revealed that: (a) scores from a modified version of the Community Screening Instrument for Dementia (CSI'D') suggest that 45% of older individuals screened positive for dementia; (b) 35% of Social Workers and 25% of Primary Nurses (i.e., RNs/RPNs) suspected that at least one older individual on their caseload has dementia, and there was adequate agreement between health staffs' perception of the presence or absence of dementia and the CSI'D' assessment; (c) varying supports/services may be required for older individuals' successful community reintegration and living; and (d) Social Workers and Primary Nurses generally lack training/education to adequately support older people in custody. CONCLUSIONS A substantial number of older people in custody may experience age-related challenges, including dementia. This necessitates the development and implementation of programming to effectively address older individuals' needs during incarceration and community reintegration and living.
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Affiliation(s)
- Bryce E Stoliker
- Centre for Forensic Behavioural Science and Justice Studies, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 5A5, Canada.
| | - Ashmini G Kerodal
- Centre for Forensic Behavioural Science and Justice Studies, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 5A5, Canada
| | - Lisa M Jewell
- Centre for Forensic Behavioural Science and Justice Studies, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 5A5, Canada
| | - Kelsey Brown
- Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 5A5, Canada
| | - Arlene Kent-Wilkinson
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 5E5, Canada
| | - Shelley Peacock
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 5E5, Canada
| | - Megan E O'Connell
- Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 5A5, Canada
| | - J Stephen Wormith
- Centre for Forensic Behavioural Science and Justice Studies, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 5A5, Canada
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du Toit S, Ng S. Improving Care for Older Prisoners Living With Dementia in Australian Prisons: Perspectives of External Organizations. THE GERONTOLOGIST 2021; 62:543-555. [PMID: 34570214 DOI: 10.1093/geront/gnab077] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The care and well-being of an increasing number of older prisoners living with dementia require an adequate care continuum. Longstanding barriers, including limited resources and relevant expertise, necessitate an interdisciplinary approach and incorporation of external organizations in supporting prisoners with dementia. However, little is known about their perspectives and experiences. This study aimed to explore the role of external organizations in providing care for prisoners with dementia in Australia. RESEARCH DESIGN AND METHODS In this qualitative descriptive study, 27 participants from legal, health, and social services rendering services in Australian prisons were recruited. Qualitative data were generated by applying the Nominal Group Technique in research group discussions. Demographic/background data were used to generate descriptive statistics through Qualtrics. RESULTS Inductive thematic analysis of qualitative data revealed challenges and opportunities for future dementia care in Australian prisons. Six research discussion groups represented participants from Victoria, Queensland, New South Wales, Western Australia, and Tasmania. Identified themes included (a) possible models of care for prisoners with dementia, (b) uncovering the invisible issues of dementia care in prisons, and (c) proposed next steps for improved care of prisoners with dementia. DISCUSSION AND IMPLICATIONS This study provided recommendations for multiple stakeholders to overcome barriers in providing dementia care to prisoners. Increased collaboration between corrective services and external organizations was recommended, with a clear delineation of custodial and care priorities. External organizations highlighted the wider community's responsibility to care for older prisoners and the need to explore emerging areas of practice in this regard.
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Affiliation(s)
- Sanetta du Toit
- Discipline of Occupational Therapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Shermaine Ng
- Discipline of Occupational Therapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
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Pandey P, Varshney P, Gajera GV, Nirisha PL, Malathesh BC, Manjunatha N, Sivakumar PT, Kumar CN, Math SB. Criminal Responsibility in Geropsychiatry: Competence, Culpability, and Care. Indian J Psychol Med 2021; 43:S97-S106. [PMID: 34732961 PMCID: PMC8543614 DOI: 10.1177/02537176211030993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Elderly persons can get involved in the criminal justice system as victims or as perpetrators. The interaction of elderly persons with mental illness at various cross-sections of the judicial process needs thoughtful consideration. Through this review, the authors approach this less studied aspect of forensic psychiatry. Concerning the evaluation of a prisoner, three scenarios need focused consideration: evaluation for fitness to stand trial before a competent court, evaluations for an insanity defense, and fitness for sentencing. At the same time, incarcerated elderly who developed dementia or a severe mental illness at any point of time during the trial or in prison need specific approaches. In this article, the authors discuss the acts and case laws relevant to navigating these legal scenarios. We discuss existing mental health care provisions for protecting the health interests of elderly care in prison.
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Affiliation(s)
- Praveen Pandey
- Dept. of Psychiatry, Tele-medicine Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Prateek Varshney
- Dept. of Psychiatry, Community Psychiatry Unit, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Gopi V Gajera
- Dept. of Psychiatry, Tele-medicine Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - P Lakshmi Nirisha
- Dept. of Psychiatry, Tele-medicine Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Barikar C Malathesh
- Dept. of Psychiatry, Tele-medicine Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Narayana Manjunatha
- Dept. of Psychiatry, Community Psychiatry Unit, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Palanimuthu T Sivakumar
- Dept. of Psychiatry, Geriatric Psychiatry Unit, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - C Naveen Kumar
- Dept. of Psychiatry, Community Psychiatry Unit, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Suresh Bada Math
- Dept. of Psychiatry, Forensic Psychiatry Services, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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