Forensic Nurses' Views Regarding: Medications for Inmates

Facilitating people living with severe and persistent mental illness to transition from prison to community: a qualitative exploration of staff experiences

Background

Transition from prison to community is a challenging time for all people who have been incarcerated. It is particularly challenging for those also living with serious and persistent mental illness. This study explored staff experiences and perspectives of what helped and hindered them in their work to support that transition.

Methods

Semi-structured interviews were conducted with 12 mental health staff working across three service sectors directly engaged in the process of supporting people with mental illness transitioning from prison to community; the forensic mental health provider Justice Health, Community Mental Health and a non-government delivered community-based service called Partners in Recovery. Data were analysed using constant comparative analysis.

Results

Five main themes were identified through the analysis. All five themes were key practices that, when occurring, supported staff to work in a way that they felt would maximise positive outcomes for people transitioning from prison to community. These included: housing secured before release; clearly defined and effective communication pathways; shared understanding of systems and roles; in-reach and continuity of contact, and consumers’ pre-release preparation and knowledge. All staff participants described barriers to good transition to community outcomes when some or all of these practices could not, or did not, occur.

Conclusions

Staff experiences highlight the complexity but importance of getting multi-sectorial partnerships and practices right for good prison to community transitions for people living with serious and persistent mental illness. Currently fragmented and disparate systems and practices need to align and clear expectations and understandings need to be shared across the whole. These changes, along with prioritised housing are likely to lead to better long-term outcomes for people.

Meeting the Health Needs of Postincarcerated Women: How Welcome Home Ministries Helps Bridge the Gap and Implications for Public Health Professionals

The marginalized population of newly released women inmates displays higher incidences of viral infections, mental illnesses, and chronic diseases (Wilper et al.). Current research has indicated that these health needs are not met during or after incarceration (Wilper et al.). Among other barriers, this gross health disparity increases the difficulty of reentry into society after release from incarceration. Welcome Home Ministries, a nonprofit organization that responds to the needs of postincarcerated women, helps facilitate the reentry process. Three Point Loma Nazarene University nursing students interning with Welcome Home Ministries created health outcome objectives for the organization to objectively measure their clients’ successes. The health outcome objectives explore the major needs of postincarcerated women and how they can be met. The many health issues of the newly released women provide significant implications for public and community health nurses in caring for these individuals.

Psychotropic medication adherence in correctional facilities: a review of the literature

Despite the high percentage of incarcerated persons with mental illness, surprisingly little is known about effective ways to increase psychotropic medication adherence in prison and upon release. Currently, there are limited definitive data regarding psychotropic medication adherence patterns among incarcerated persons, and the data that exist often miss specific information on changes in behaviour, symptom management and adherence patterns over the length of a person's sentence, which has implications for post-release ability to live in the community. This paper presents the current literature regarding psychotropic medication adherence among mentally ill persons who are incarcerated. The factors identified in support of medication adherence, future clinical research and care strategies are provided.

Binary construct analysis of forensic psychiatric nursing in the UK: high, medium, and low security services

The aim of this study was to identify if differences in perceptions of the role of forensic psychiatric nurses exist across the three levels of secure psychiatric provision: high, medium, and low. Any differences may reflect the type of clinical conditions found in different levels of security provision. An information-gathering schedule containing a validated 7-point Likert scale was distributed to 1200 forensic psychiatric nurses across the UK in 2005. A response rate of 34.6 was achieved, with 122 from high-security, 159 from medium-security, and 135 from low-security services. Differences in perceptions regarding role constructs were found across all three levels, with numerous differences being statistically significant using analysis of variance. The main implications are in relation to the development of skills and competencies, which should target specific clinical conditions in relation to effective interventions, the development of a specialist education and training curriculum focused on treatment outcomes, and the need for further research to draw together theory and practice. Finally, creative policy initiatives should be developed to cross-fertilize the levels of security provision in order that staff may acquire and deliver experiences in high-, medium-, and low-security psychiatric services.