1
|
Chaplin E, McCarthy J, Marshall-Tate K, Ali S, Harvey D, Childs J, Xenitidis K, Srivastava S, McKinnon I, Robinson L, Allely CS, Hardy S, Forrester A. A realist evaluation of an enhanced court-based liaison and diversion service for defendants with neurodevelopmental disorders. Crim Behav Ment Health 2024; 34:117-133. [PMID: 37930901 DOI: 10.1002/cbm.2315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 09/27/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND In England, court-based mental health liaison and diversion (L&D) services work across courts and police stations to support those with severe mental illness and other vulnerabilities. However, the evidence around how such services support those with neurodevelopmental disorders (NDs) is limited. AIMS This study aimed to evaluate, through the lens of court and clinical staff, the introduction of a L&D service for defendants with NDs, designed to complement the existing L&D service. METHODS A realist evaluation was undertaken involving multiple agencies based within an inner-city Magistrates' Court in London, England. We developed a logic model based on the initial programme theory focusing on component parts of the new enhanced service, specifically training, screening, signposting and interventions. We conducted semi-structured interviews with the court staff, judiciary and clinicians from the L&D service. RESULTS The L&D service for defendants with NDs was successful in identifying and supporting the needs of those defendants. Benefits of this service included knowledge sharing, awareness raising and promoting good practice such as making reasonable adjustments. However, there were challenges for the court practitioners and clinicians in finding and accessing local specialist community services. CONCLUSION A L&D service developed for defendants with NDs is feasible and beneficial to staff and clinicians who worked in the court setting leading to good practice being in place for the defendants. Going forward, a local care pathway would need to be agreed between commissioners and stakeholders including the judiciary to ensure timely and equitable access to local services by both defendants and practitioners working across diversion services for individuals with NDs.
Collapse
Affiliation(s)
- Eddie Chaplin
- Institute of Health and Social Care, London South Bank University, London, UK
| | - Jane McCarthy
- University of Auckland, Auckland, New Zealand
- King's College London, London, UK
| | | | | | - Denise Harvey
- Institute of Health and Social Care, London South Bank University, London, UK
| | | | | | | | | | - Louise Robinson
- Lancashire and South Cumbria NHS Foundation Trust, Preston, UK
- University of Manchester, Manchester, UK
| | | | - Sally Hardy
- NICHE Anchor Institute, University of East Anglia, East Anglia, UK
| | | |
Collapse
|
2
|
Kalebic N, Crole-Rees C, Tomlin J, Berrington C, Popovic I, Forrester A. Variations in services and intervention pathways for traumatic stress in Welsh prisons: A national survey. Med Leg J 2024; 92:50-53. [PMID: 38334710 PMCID: PMC10916347 DOI: 10.1177/00258172231214432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Both Post-Traumatic Stress Disorder and Complex Post-Traumatic Stress Disorder are prevalent in prison settings. Both often go undetected and untreated, while prisoners who already suffered previous trauma may be re-traumatised upon imprisonment. The current study aimed to conduct a national survey of all Welsh prisons to gather information about existing services and treatments for traumatic stress. The survey identified variation within Welsh prisons with regard to NICE-recommended evidence-based therapies. It is therefore recommended that there needs to be development of a pathway of Post-Traumatic Stress Disorder and Complex Post-Traumatic Stress Disorder in the prison system which should be achieved through a consensus process of both frontline staff and experts in the field.
Collapse
Affiliation(s)
- Natasha Kalebic
- Department of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Clare Crole-Rees
- Department of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Jack Tomlin
- School of Law and Criminology, University of Greenwich, London, UK
| | - Claudia Berrington
- Department of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Isidora Popovic
- Department of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Andrew Forrester
- Department of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| |
Collapse
|
3
|
Forrester A. Mental health care provision for segregated prisoners in England. Med Sci Law 2024:258024241236022. [PMID: 38414414 DOI: 10.1177/00258024241236022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
|
4
|
Bhui K, O'Brien A, Upthegrove R, Tsai AC, Soomro M, Newton-Howes G, Broome MR, Forrester A, Casey P, Doherty AM, Lee W, Kaufman KR. Protecting and promoting editorial independence. Br J Psychiatry 2024:1-3. [PMID: 38356355 DOI: 10.1192/bjp.2024.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
We argue that editorial independence, through robust practice of publication ethics and research integrity, promotes good science and prevents bad science. We elucidate the concept of research integrity, and then discuss the dimensions of editorial independence. Best practice guidelines exist, but compliance with these guidelines varies. Therefore, we make recommendations for protecting and strengthening editorial independence.
Collapse
Affiliation(s)
- Kamaldeep Bhui
- Department of Psychiatry, Nuffield Department of Primary Care Health Sciences, University of Oxford, UK; Oxford Health NHS Foundation Trust, UK; East London NHS Foundation Trust, UK; and World Psychiatric Association Collaborating Centre, Oxford, UK
| | - Aileen O'Brien
- Population Health Research Institute, St George's University of London, UK
| | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, UK; Birmingham Early Intervention Services, UK; and Birmingham Women's and Children's NHS Foundation Trust, UK
| | - Alexander C Tsai
- Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA; and Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | | | | | - Matthew R Broome
- Institute for Mental Health, University of Birmingham, UK; Birmingham Women's and Children's NHS Foundation Trust, UK; and Oxford Uehiro Centre for Practical Ethics, University of Oxford, UK
| | - Andrew Forrester
- Department of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, UK
| | - Patricia Casey
- Hermitage Medical Clinic, Dublin, Ireland; and University College Dublin, Ireland
| | | | | | - Kenneth R Kaufman
- Departments of Psychiatry and Neurology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA; and Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| |
Collapse
|
5
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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
| |
Collapse
|
6
|
Beigel L, Forrester A, Torales J, Aboaja A, Rivera Aroyo G, Roche MO, Opitz-Welke A, Mundt AP. Mental health intervention research in Latin American correctional settings: A scoping review. Int J Soc Psychiatry 2023; 69:1560-1577. [PMID: 37332202 DOI: 10.1177/00207640231174372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
BACKGROUND The Latin American prison population has grown faster than anywhere else globally over the past two decades, reaching a total of 1.7 million people at any given time. However, research on mental health prevention and treatment interventions in Latin American prisons remains scarce. AIMS This study aimed to systematically review and synthesize research on prison mental health interventions conducted in the region. METHODS We used a two-stage scoping review design guided by the JBI Manual for Evidence Synthesis. Searches took place in December 2021 in nine databases using descriptors and synonyms. First, all prison mental health research in Latin America was retained. Secondly, using title and abstract screening, all research possibly related to interventions was retained for full text evaluation. Studies reporting interventions were assessed by country, language, institution, population, intervention type, intervention focus and outcomes. RESULTS N = 34 studies were included in this review. These were 13 case reports, seven expert consensus papers and 14 quantitative studies (four randomized controlled trials, nine cohort studies, one quasi-experimental study). Fourteen interventions were targeted at promoting prosocial behavior, seven studies each aimed to improve mental health and to treat substance use disorders. Six studies involved the treatment of sexual offending behavior, and 3 focused on reducing criminal recidivism. Psychoeducation (n = 12) and motivational interviewing (n = 5) were the most frequent intervention types studied. Promising data from trials showed that anger management, depression, substance use and reoffending could be successfully addressed through interventions. CONCLUSIONS Implementation and effectiveness research of mental health interventions in Latin American prisons is scarce. Addressing mental health, substance use and prosocial behavior outcomes should be considered in future research. There is a particular dearth of controlled trials describing quantifiable outcomes.
Collapse
Affiliation(s)
- Lukas Beigel
- Department of Psychiatry and Psychotherapy Charité Campus Mitte, Charité Universitätsmedizin Berlin, Germany
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Andrew Forrester
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, UK
| | - Julio Torales
- Department of Mental Health, Universidad Nacional de Asunción, Paraguay
| | - Anne Aboaja
- Mental Health and Addictions Research Group, University of York, UK
- Tees, Esk and Wear Valleys NHS Foundation Trust, Middlesbrough, UK
| | | | | | - Annette Opitz-Welke
- Department of Forensic Psychiatry, Charité Universitätsmedizin Berlin, Germany
| | - Adrian P Mundt
- Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| |
Collapse
|
7
|
McKenzie N, Forrester A. Editorial: Mental health in correctional and criminal justice systems (CCJS): exploring how diagnosis, treatment and cultural differences impact pathway through the CCJS. Front Psychiatry 2023; 14:1293060. [PMID: 38025446 PMCID: PMC10644784 DOI: 10.3389/fpsyt.2023.1293060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/02/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- Nigel McKenzie
- Division of Psychiatry, University College London, London, United Kingdom
| | - Andrew Forrester
- Department of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom
| |
Collapse
|
8
|
Sales CP, Forrester A, Tully J. Delays in transferring patients from prisons to secure psychiatric hospitals: An international systematic review. Crim Behav Ment Health 2023; 33:371-385. [PMID: 37667423 DOI: 10.1002/cbm.2309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 08/12/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Transfer to a psychiatric hospital of prisoners who need inpatient treatment for a mental disorder is an important part of prison healthcare in the UK. It is an essential factor in ensuring the principle of equivalence in the treatment of prisoners. In England and Wales, delays in transferring unwell prisoners to hospital were identified by the 2009 Bradley Report. There has been no subsequent systematic review of progress in so doing nor a corresponding appraisal of transfer arrangements in other parts of the world. AIM To conduct a systematic review of international literature about transfers of mentally unwell individuals from prison to hospital for the treatment of mental disorder since 2009. METHOD Eight databases were searched for data-based publications using terms for prison and transfer to hospital from 1 January 2009 to 4 August 2022. Inclusion criteria limited transfer to arrangements for pre-trial and sentenced prisoners going to a health service hospital, excluding hospital orders made on the conclusion of criminal hearing. RESULTS In England, four articles were identified, all showing that transfer times remain considerably longer than the national targets of 14 days (range, 14 days to >9 months); one study from Scotland found shorter mean transfer times, but more patients had been transferred to psychiatric intensive care units than to secure forensic hospitals. There were only two studies that investigated prison to hospital transfers for mental disorder from outside the UK and only one reported time-to-transfer data. CONCLUSIONS Findings from this literature review highlight failures to resolve transfer delays in England and provide little evidence about the problem elsewhere. Given the lack of data, it is unclear whether other countries do not have this problem or simply that there has been no research interest in it. A possible confounding factor here is that, in some countries, all treatment for prisoners' mental disorders occurs in prison. However, the principle that prisons are not hospitals seems important when people need inpatient care. Prospective, longitudinal cohort studies are urgently needed to map transfer times and outcomes.
Collapse
Affiliation(s)
| | - Andrew Forrester
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - John Tully
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
- Academic Unit of Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| |
Collapse
|
9
|
Arnell P, Lewis O, Kalocsányiová E, Forrester A. The UK's Illegal Migration Bill: Human rights violated. Med Sci Law 2023; 63:267-269. [PMID: 37487204 DOI: 10.1177/00258024231186736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
|
10
|
Dikoff B, Hassan R, Shankar R, Katona C, Chaplin L, Forrester A, Sen P. Supporting people with immigration issues in the context of the Mental Health Act 1983 and Mental Capacity Act 2005. Med Sci Law 2023:258024231171316. [PMID: 37161285 DOI: 10.1177/00258024231171316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Affiliation(s)
| | - Rukyya Hassan
- Greater Manchester Mental Health NHS Trust, Manchester, UK
| | - Rohit Shankar
- University of Plymouth Peninsula School of Medicine, Truro UK, Cornwall Partnership NHS Foundation Trust Truro UK
| | - Cornelius Katona
- Helen Bamber Foundation London UK and Division of Psychiatry, University College London UK
| | - Lucia Chaplin
- Cambridgeshire and Peterborough NHS Foundation Trust
| | | | - Piyal Sen
- Brunel University and Elysium Healthcare, UK
| |
Collapse
|
11
|
Forrester A, Aboaja A, Beigel L, Mundt AP, Rivera G, Torales J. Mental health in prisons in Latin America: The effects of COVID-19. Med Sci 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] [What about the content of this article? (0)] [Affiliation(s)] [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
| | | | | |
Collapse
|
12
|
Shafti M, Taylor P, Forrester A, Handerer F, Pratt D. A systematic review of the co-occurrence of self-harm and aggression: Is dual harm a unique behavioural construct? Front Psychiatry 2023; 14:1083271. [PMID: 36873217 PMCID: PMC9978485 DOI: 10.3389/fpsyt.2023.1083271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/23/2023] [Indexed: 02/18/2023] Open
Abstract
Introduction Dual harm is the co-occurrence of self-harm and aggression during an individual's lifetime. It is unclear whether sufficient evidence exists for dual harm as a unique clinical entity. This systematic review aimed to examine whether there are psychological factors that are uniquely associated with dual harm when compared to those who have engaged in sole harm (self-harm alone, aggression alone) and no harmful behaviours. Our secondary aim was to conduct a critical appraisal of the literature. Methods The review searched PsycINFO, PubMed, CINAHL, and EThOS on September 27, 2022, resulting in 31 eligible papers that represented 15,094 individuals. An adapted version of the Agency for Healthcare Research and Quality was used to assess risk of bias and a narrative synthesis was conducted. Results The included studies assessed differences in mental health problems, personality, and emotion related factors between the different behavioural groups. We found weak evidence that dual harm is an independent construct with unique psychological characteristics. Rather, our review suggests that dual harm results from the interaction of psychological risk factors that are associated with self-harm and aggression. Discussion The critical appraisal identified numerous limitations within the dual harm literature. Clinical implications and recommendations for future research are provided. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=197323, identifier CRD42020197323.
Collapse
Affiliation(s)
- Matina Shafti
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Peter Taylor
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Andrew Forrester
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Fritz Handerer
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Daniel Pratt
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| |
Collapse
|
13
|
Asherson P, Johansson L, Holland R, Bedding M, Forrester A, Giannulli L, Ginsberg Y, Howitt S, Kretzschmar I, Lawrie SM, Marsh C, Kelly C, Mansfield M, McCafferty C, Khan K, Muller-Sedgwick U, Strang J, Williamson G, Wilson L, Young S, Landau S, Thomson L. Randomised controlled trial of the short-term effects of osmotic-release oral system methylphenidate on symptoms and behavioural outcomes in young male prisoners with attention deficit hyperactivity disorder: CIAO-II study. Br J Psychiatry 2023; 222:7-17. [PMID: 35657651 PMCID: PMC7613969 DOI: 10.1192/bjp.2022.77] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Research has shown that 20-30% of prisoners meet the diagnostic criteria for attention-deficit hyperactivity disorder (ADHD). Methylphenidate reduces ADHD symptoms, but effects in prisoners are uncertain because of comorbid mental health and substance use disorders. AIMS To estimate the efficacy of an osmotic-release oral system methylphenidate (OROS-methylphenidate) in reducing ADHD symptoms in young adult prisoners with ADHD. METHOD We conducted an 8-week parallel-arm, double-blind, randomised placebo-controlled trial of OROS-methylphenidate versus placebo in male prisoners (aged 16-25 years) meeting the DSM-5 criteria for ADHD. Primary outcome was ADHD symptoms at 8 weeks, using the investigator-rated Connors Adult ADHD Rating Scale (CAARS-O). Thirteen secondary outcomes were measured, including emotional dysregulation, mind wandering, violent attitudes, mental health symptoms, and prison officer and educational staff ratings of behaviour and aggression. RESULTS In the OROS-methylphenidate arm, mean CAARS-O score at 8 weeks was estimated to be reduced by 0.57 points relative to the placebo arm (95% CI -2.41 to 3.56), and non-significant. The responder rate, defined as a 20% reduction in CAARS-O score, was 48.3% for the OROS-methylphenidate arm and 47.9% for the placebo arm. No statistically significant trial arm differences were detected for any of the secondary outcomes. Mean final titrated dose was 53.8 mg in the OROS-methylphenidate arm. CONCLUSIONS ADHD symptoms did not respond to OROS-methylphenidate in young adult prisoners. The findings do not support routine treatment with OROS-methylphenidate in this population. Further research is needed to evaluate effects of higher average dosing and adherence to treatment, multi-modal treatments and preventative interventions in the community.
Collapse
|
14
|
Chaplin E, Lord Keith Bradley TRH, McCarthy J, Forrester A. Court liaison and diversion services for people with neurodevelopmental conditions: A House of Lords consensus meeting. Med Sci Law 2022; 62:252-253. [PMID: 35989653 DOI: 10.1177/00258024221121620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
| | | | | | - Andrew Forrester
- Cardiff University - Division of Psychological Medicine and Clinical Neurosciences, Cardiff, UK
| |
Collapse
|
15
|
Chaplin E, McCarthy J, Ali S, Marshall-Tate K, Xenitidis K, Harvey D, Childs J, Srivastava S, McKinnon I, Robinson L, Allely CS, Hardy S, Tolchard B, Forrester A. Severe mental illness, common mental disorders, and neurodevelopmental conditions amongst 9088 lower court attendees in London, UK. BMC Psychiatry 2022; 22:551. [PMID: 35962427 PMCID: PMC9373383 DOI: 10.1186/s12888-022-04150-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 07/19/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Court Mental Health Liaison and Diversion Services (CMHLDS) have developed in some countries as a response to the over-representation of mental illness and other vulnerabilities amongst defendants presenting to criminal justice (or correctional) systems. This study examined the characteristics and rates of mental disorder of 9088 defendants referred to CMHLDS. METHOD The study analysed service level data, obtained from the National Health Service's mental health data set, to examine characteristics relating to gender, ethnicity and comorbidity of common mental and neurodevelopmental disorders at five CMHLDS across London between September 2015 and April 2017. RESULTS The sample included 7186 males (79.1%) and 1719 females (18.9%), the gender of 183 (2%) were not recorded. Of those referred, 6616 (72.8%) presented with an identifiable mental disorder and 503 (5.5%) with a neurodevelopmental disorder (NDD). Significantly higher rates of schizophrenia were reported amongst Black defendants (n = 681; 37.2%) and Asian defendants (n = 315; 29%), while higher rates of depression were found amongst White defendants (n = 1007; 22.1%). Substance misuse was reported amongst 2813 defendants (31%), and alcohol misuse amongst 2111 (23.2%), with significantly high rates of substance and alcohol misuse amongst defendants presenting with schizophrenia or personality disorder. CONCLUSIONS This is one of the largest studies to examine mental health needs and vulnerabilities amongst defendants presenting to CMHLDS. It will enable an improved understanding of the required service designs and resources required to manage the healthcare pathways for people attending CMHLDS.
Collapse
Affiliation(s)
- Eddie Chaplin
- Institute of Health and Social Care, London South Bank University, London, UK.
| | - Jane McCarthy
- grid.13097.3c0000 0001 2322 6764University of Auckland, New Zealand & Visiting Senior Lecturer, King’s College London, London, UK
| | - Salma Ali
- grid.4756.00000 0001 2112 2291Institute of Health and Social Care, London South Bank University, London, UK
| | - Karina Marshall-Tate
- grid.4756.00000 0001 2112 2291Institute of Health and Social Care, London South Bank University, London, UK ,South London and Maudsley NHS Foundation Trust, London, UK
| | | | - Denise Harvey
- grid.4756.00000 0001 2112 2291Institute of Health and Social Care, London South Bank University, London, UK
| | - Jessica Childs
- grid.4756.00000 0001 2112 2291Institute of Health and Social Care, London South Bank University, London, UK ,Together for Mental Wellbeing, London, UK
| | | | - Iain McKinnon
- grid.1006.70000 0001 0462 7212Newcastle University, Newcastle upon Tyne, UK
| | - Louise Robinson
- grid.5379.80000000121662407Manchester University, Manchester, UK
| | - Clare S. Allely
- grid.8752.80000 0004 0460 5971Reader in Forensic Psychology at the University of Salford, Manchester, UK ,grid.8761.80000 0000 9919 9582Affiliate member of the Gillberg Neuropsychiatry Centre at Gothenburg University, Gothenburg, Sweden ,grid.8756.c0000 0001 2193 314XHonorary Research Fellow in the College of Medical, Veterinary and Life Sciences affiliated to the Institute of Health and Wellbeing at the University of Glasgow, Glasgow, UK
| | - Sally Hardy
- grid.8273.e0000 0001 1092 7967University of East Anglia, Norwich, UK
| | - Barry Tolchard
- grid.26597.3f0000 0001 2325 1783Teesside University, Middlesbrough, UK
| | - Andrew Forrester
- grid.5600.30000 0001 0807 5670Forensic Psychiatry, Cardiff University, Cardiff, UK
| |
Collapse
|
16
|
Sen P, Crowley G, Arnell P, Katona C, Pillay M, Waterman LZ, Forrester A. The UK's exportation of asylum obligations to Rwanda: A challenge to mental health, ethics and the law. Med Sci Law 2022; 62:165-167. [PMID: 35699690 DOI: 10.1177/00258024221104163] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Piyal Sen
- Brunel University College of Health, Medicine and Life Sciences, UK
| | | | | | | | - Mishka Pillay
- One Strong Voice Network, and Trustee of Freedom from Torture, UK
| | | | | |
Collapse
|
17
|
Kalebic N, Argent S, Austin H, Bramley L, O'Connor G, Hoskins C, Willis A, Withecomb J, Forrester A, Morgan P, Taylor PJ. The all-Wales forensic adolescent consultation and treatment service (FACTS): A 5-year referral cohort study. Crim Behav Ment Health 2022; 32:159-174. [PMID: 35709314 DOI: 10.1002/cbm.2244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/04/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND FACTS is a Wales-wide mental health service for 10-17-year-olds with needs beyond the remit of mainstream child and adolescent mental health services (CAMHS). As a purely consultation-liaison service, it differs from other UK services in the field. AIMS To describe a complete cohort of referrals to FACTS 2013-2017 with service exit by June 2018. METHODS Clinical, social and offending data were extracted from FACTS records. RESULTS 80 young people completed a FACTS episode, averaging nearly a year (309 days; range 13-859 days). Mostly boys (65, 81%) of mean age 15.4 years (range 9-18), two-thirds (n = 53) had three or more referral reasons, one invariably being threatened/actual harm to others; only half were criminal-justice involved. Half (41, 51%) were committing sexually harmful acts. Half were self-harming (41, 51%). All but seven had had at least one adverse childhood experience (ACE), nearly half (35, 44%) four or more. Nevertheless, post-traumatic stress disorder (PTSD) was rarely diagnosed (7, 9%); just over one-quarter (23, 29%) had no diagnosis at all. Correspondence analyses endorsed two distinct Attention deficit hyperactivity disorder groups, distinguished by presence/absence of evidenced brain damage or dysfunction. Suicide-related behaviours clustered with the other diagnoses, flashbacks and psychotic symptoms with no diagnosis. Change in home circumstances during a FACTS episode was slight. CONCLUSIONS The complexity of presenting problems and service involvement evidences need for FACTS. The extent of persistently harmful sexual behaviours is a novel finding, suggesting need for more expert input for this at other service levels. Rarity of PTSD diagnoses was surprising given the extent of ACEs. This raises concerns that services focus on disorder signs rather than the child's inner life. Given the extent of problems, minimal change may be a positive outcome - especially when remaining in the community. Further development of this service should include explicit case-by-case goals and indicative outcome markers.
Collapse
Affiliation(s)
| | - Sarah Argent
- Cardiff University, Cardiff, UK
- FACTS, Cwm Taf Morgannwg University Health Board, Bridgend, UK
| | | | | | - Gwen O'Connor
- FACTS, Cwm Taf Morgannwg University Health Board, Bridgend, UK
| | | | | | - Julie Withecomb
- FACTS, Cwm Taf Morgannwg University Health Board, Bridgend, UK
| | | | | | | |
Collapse
|
18
|
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] [What about the content of this article? (0)] [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.
Collapse
|
19
|
Ryland H, Exworthy T, Forrester A. Over 30 years of liaison and diversion in England and Wales: How far have we come, and what is now needed? Med Sci Law 2022; 62:85-87. [PMID: 35373643 DOI: 10.1177/00258024221092711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Howard Ryland
- Senior Clinical Researcher, Department of Psychiatry, University of Oxford, Warneford Lane, Oxford OX3 7JX, UK
| | - Tim Exworthy
- Visiting Senior Lecturer, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, London SE5 8AF
- Consultant Forensic Psychiatrist, Cygnet Hospital Stevenage, Stevenage, Hertfordshire, SG1 4YS
| | - Andrew Forrester
- Professor of Forensic Psychiatry, Department of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Haydn Ellis Building, Maindy Road, Cardiff CF244HQ
| |
Collapse
|
20
|
Affiliation(s)
- Piyal Sen
- College of Health, Medicine and Life Sciences, Brunel University, Uxbridge, UK
| | - Andrew Forrester
- Department of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Megan Georgiou
- Department of Sociology, University of Surrey, Guildford, UK
| | | | - Nasrul Ismail
- School for Policy Studies, University of Bristol, Bristol, UK
| | | |
Collapse
|
21
|
Waterman LZ, Pillay M, Sen P, Crowley G, Forrester A, Katona C. It is time to expand community alternatives to immigration detention. BMJ 2022; 376:o458. [PMID: 35210260 DOI: 10.1136/bmj.o458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Lauren Z Waterman
- South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London, UK
| | | | - Piyal Sen
- Chadwick Lodge and Eaglestone View, Elysium Healthcare, Milton Keynes, UK
| | - Grace Crowley
- South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London, UK
| | - Andrew Forrester
- Department of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | | |
Collapse
|
22
|
Morgan L, Forrester A, Burns M, Nixon T, Hopkins E. A review of services for vulnerable people detained in Northern Ireland prisons: The impact of underfunding. Crim Behav Ment Health 2022; 32:1-4. [PMID: 35253298 DOI: 10.1002/cbm.2227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Leanne Morgan
- Regulation and Quality Improvement Authority, Belfast, UK
| | | | - Mick Burns
- NHS England and NHS Improvement, Leeds, UK
| | - Theresa Nixon
- Regulation and Quality Improvement Authority, Belfast, UK
| | - Emer Hopkins
- Regulation and Quality Improvement Authority, Belfast, UK
| |
Collapse
|
23
|
Crole-Rees C, Forrester A. Developing a clinical pathway for traumatic stress in prisons. Med Sci Law 2022; 62:4-7. [PMID: 35006013 DOI: 10.1177/00258024211072770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Clare Crole-Rees
- Cardiff University and Cwm Taf Morgannwg University Health Board, Pontypridd, UK
| | - Andrew Forrester
- Forensic Psychiatry, Department of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| |
Collapse
|
24
|
McCarthy J, Chaplin E, Hayes S, Søndenaa E, Chester V, Morrissey C, Allely CS, Forrester A. Defendants with intellectual disability and autism spectrum conditions: the perspective of clinicians working across three jurisdictions. Psychiatr Psychol Law 2022; 29:698-717. [PMID: 36148388 PMCID: PMC9487969 DOI: 10.1080/13218719.2021.1976297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The treatment of vulnerable defendants by criminal justice systems or correctional systems varies within and between countries. The purpose of this paper is to examine three legal jurisdictions - New South Wales in Australia; Norway; England and Wales - to understand the extent of variation in practice within the court systems for defendants with intellectual disabilities (ID) and/or autism spectrum conditions (ASC). Two of the jurisdictions had a process for screening in place, either in police custody or at court, but this was not universally implemented across each jurisdiction. All three jurisdictions had a process for supporting vulnerable defendants through the legal system. Across the three jurisdictions, there was variation in disposal options from a mandatory care setting to hospital treatment to a custodial sentence for serious offences. This variation requires further international exploration to ensure the rights of defendants with ID or ASC are understood and safeguarded.
Collapse
Affiliation(s)
- Jane McCarthy
- Institute of Psychiatry, Psychology & Neuroscience King’s College London, London, UK
- Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand
| | - Eddie Chaplin
- Institute of Health and Social Care, London South Bank University, London, UK
- Correspondence: Eddie Chaplin, Institute of Health and Social Care, London South Bank University, 103 Borough Road, LondonSE1 0AA, UK.
| | - Susan Hayes
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Erik Søndenaa
- Faculty of Medicine, Institute of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
- Forensic Department, St.Olavs Hospital, Trondheim, Norway
| | - Verity Chester
- Hertfordshire Partnership University NHS Foundation Trust, Little Plumstead Hospital, Hospital Road, Norwich, UK
| | - Catrin Morrissey
- Lincolnshire Partnership NHS Foundation Trust and University of Nottingham, Nottingham, UK
| | - Clare S. Allely
- School of Health and Society, Salford University, Salford, UK and affiliate member of the Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Andrew Forrester
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| |
Collapse
|
25
|
Shafti M, Steeg S, de Beurs D, Pratt D, Forrester A, Webb RT, Taylor PJ. The inter-connections between self-harm and aggressive behaviours: A general network analysis study of dual harm. Front Psychiatry 2022; 13:953764. [PMID: 35935416 PMCID: PMC9354883 DOI: 10.3389/fpsyt.2022.953764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
Dual harm is the co-occurrence of self-harm and aggression during an individual's lifetime. This behaviour is especially prevalent within criminal justice and forensic settings. The forms of aggression that should be included in the definition of dual harm have not yet been established. This study aimed to use network analysis to inform an evidence-based definition of dual harm by assessing the relationship between self-harm and different forms of aggressive behaviour in young people (N = 3,579). We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC). Results revealed low correlations between the variables, leading to sparse network models with weak connections. We found that when separated into their distinct forms, aggressive acts and self-harm are only weakly correlated. Our work provides preliminary evidence to assist in understanding and managing dual harm within clinical and forensic settings and informs recommendations for future research.
Collapse
Affiliation(s)
- Matina Shafti
- Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom.,Division of Psychology and Mental Health, Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Sarah Steeg
- Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom.,Centre for New Treatments and Understanding in Mental Health (CeNTrUM), University of Manchester, Manchester, United Kingdom
| | - Derek de Beurs
- Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, Netherlands
| | - Daniel Pratt
- Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom.,Division of Psychology and Mental Health, Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, United Kingdom.,Centre for New Treatments and Understanding in Mental Health (CeNTrUM), University of Manchester, Manchester, United Kingdom
| | - Andrew Forrester
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Roger T Webb
- Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom.,Division of Psychology and Mental Health, Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, United Kingdom.,National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, University of Manchester and Northern Care Alliance NHS Foundation Trust, Manchester, United Kingdom
| | - Peter James Taylor
- Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom.,Division of Psychology and Mental Health, Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| |
Collapse
|
26
|
Chaplin E, McCarthy J, Marshall-Tate K, Ali S, Xenitidis K, Childs J, Harvey D, McKinnon I, Robinson L, Hardy S, Srivastava S, Allely CS, Tolchard B, Forrester A. Evaluation of a liaison and diversion Court Mental Health Service for defendants with neurodevelopmental disorders. Res Dev Disabil 2021; 119:104103. [PMID: 34628339 DOI: 10.1016/j.ridd.2021.104103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/31/2021] [Accepted: 09/29/2021] [Indexed: 06/13/2023]
Abstract
AIM Neurodevelopmental disorders (NDD) may present as neuropsychiatric problems as well as impairments of motor, cognitive, social and communication functioning. This study describes the introduction of a specialist service with expertise in NDD into an existing court mental health liaison and diversion service to determine if the service would impact on the health needs or disposal outcomes of defendants. METHODS We examined referrals of defendants with NDD disorders over 30-months at a London Magistrates' Court. The pre-existing Court Mental Health (CMH) service was enhanced to provide additional expertise and hereafter referred to as the CMH + NDD Service. Baseline data including gender, ethnicity, remands and the rates of mental disorders was collected from the CMH Service using the existing minimum mental health service dataset. This was compared with data collected from the CMH + NDD Service. RESULTS We found the following rates of NDD 9.5 % (n = 43) for the CMH service, and 9.5 % (n = 79) for the CMH + NDD service. Although overall the rates were the same the number of defendants with a single NDD diagnosis was increased in the CMH + NDD service with ADHD 10 %, ASD and ID 4% higher, the rates of comorbid NDD decreased in the CMH + NDD service compared to baseline. Specific disorders such as depression were recorded at higher rates for NDD defendants in both phases, however, this did not reach significance. In contrast, schizophrenia and delusional disorders, alcohol and substance use were observed at much higher in the non-NDD defendants during both phases of the study. The rates of diagnosis of schizophrenia and delusional disorders increased for the NDD group within the CMH + NDD service. Following the first court appearance, there was a 10 % reduction in custodial remands for defendants with NDD who were seen by the CMH + NDD service (34.2 %, n = 25 in the CMH + NDD service vs 43.8 %, n = 14 in the CMH service). CONCLUSION The study found it is possible to successfully integrate practitioners with expertise of NDD into existing liaison and diversion services. This service enhancement demonstrated modest evidence of service effectiveness, including an increase in the detection of comorbid mental illness and a reduction in custodial remands for defendants with NDD. Further work needs to be completed to examine how this model can be rolled out across multiple courts and in particular, a cost-benefit analysis is required to understand whether an approach involving a cluster of Courts, as opposed to a single site is the most effective approach for this group of defendants.
Collapse
Affiliation(s)
- Eddie Chaplin
- London South Bank University Institute of Health and Social Care, United Kingdom.
| | - Jane McCarthy
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Karina Marshall-Tate
- London South Bank University Institute of Health and Social Care, United Kingdom; South London and Maudsley NHS Foundation Trust, United Kingdom
| | - Salma Ali
- Newcastle University, United Kingdom
| | | | - Jessica Childs
- London South Bank University Institute of Health and Social Care, United Kingdom
| | - Denise Harvey
- London South Bank University Institute of Health and Social Care, United Kingdom
| | | | | | | | | | | | | | | |
Collapse
|
27
|
Khan AA, Ryland H, Pathan T, Ahmed HU, Hussain A, Forrester A. Mental health services in the prisons of Bangladesh. BJPsych Int 2021; 18:88-91. [PMID: 34747941 PMCID: PMC8554923 DOI: 10.1192/bji.2021.34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 01/16/2023] Open
Abstract
In this narrative review we consider what is known about mental health conditions in the prison system in Bangladesh and describe the current provision of mental health services for prisoners with mental health needs. We contextualise this within the literature on mental health conditions in correctional settings in the wider sub-continental region and low- and middle-income countries (LMICs) more broadly. We augment findings from the literature with information from unstructured interviews with local experts, and offer recommendations for research, policy and practice.
Collapse
Affiliation(s)
- Al Aditya Khan
- FRCPsych, Consultant Forensic Psychiatrist, Oxleas NHS Foundation Trust, London, UK.
| | - Howard Ryland
- MRCPsych, NIHR Doctoral Research Fellow, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Tayeem Pathan
- MRCPsych, Consultant Psychiatrist, Surrey and Border NHS Foundation Trust, Farnham, UK
| | - Helal Uddin Ahmed
- MD (Psychiatry), Associate Professor, Child, Adolescent and Family Psychiatry, National Institute of Mental Health, Dhaka, Bangladesh
| | - Amir Hussain
- MPhil, General Member, Bangladesh Clinical Psychology Society, Dhaka, Bangladesh
| | - Andrew Forrester
- MD (Res), Professor of Forensic Psychiatry, Department of Psychological Medicine and Clinical Neurosciences, University of Cardiff, Cardiff, UK
| |
Collapse
|
28
|
Carthy E, Hillier B, Tracy DK, Pakianathan M, Morris S, Shell Y, Forrester A. Chemsex-related crime and vulnerability: A public health and criminal justice priority. Med Sci Law 2021; 61:247-249. [PMID: 34558363 DOI: 10.1177/00258024211049490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Elliott Carthy
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Bradley Hillier
- West London Forensic Service, St Bernard's Hospital, West London NHS Trust, UK
| | - Derek K Tracy
- West London NHS Trust, UK
- Department of Psychosis Studies, the Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
- Division of Psychiatry, University College London, UK
| | | | - Stephen Morris
- Her Majesty's Prison & Probation Service (HMPPS), London, UK
| | - Yvonne Shell
- Department of Psychology, Bournemouth University
| | - Andrew Forrester
- Department of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| |
Collapse
|
29
|
Chaplin E, Rawat A, Perera B, McCarthy J, Courtenay K, Forrester A, Young S, Hayward H, Sabet J, Underwood L, Mills R, Asherson P, Murphy D. Prisoners with Attention Deficit Hyperactivity Disorder: co-morbidities and service pathways. Int J Prison Health 2021. [DOI: 10.1108/ijph-03-2021-0020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This paper aims to examine effective diagnostic and treatment pathways for attention deficit hyperactivity disorder (ADHD) in prison settings given the high prevalence of ADHD and comorbidities in the prison population.
Design/methodology/approach
Two studies were carried out in two separate prisons in London. Firstly, data were collected to understand the prevalence of ADHD and the comorbidities. The second study used quality improvement (QI) methodology to assess the impact of a diagnostic and treatment pathway for prisoners with ADHD.
Findings
Of the prisoners, 22.5% met the diagnostic criteria for ADHD. Nearly half of them were screened positive for autistic traits, with a higher prevalence of mental disorders among prisoners with ADHD compared to those without. The QI project led to a significant increase in the number of prisoners identified as requiring ADHD assessment but a modest increase in the number of prisoners diagnosed or treated for ADHD.
Originality/value
Despite various challenges, an ADHD diagnostic and treatment pathway was set up in a prison using adapted QI methodology. Further research is needed to explore the feasibility of routine screening for ADHD in prison and examine at a national level the effectiveness of current ADHD prison pathways.
Collapse
|
30
|
Sen P, Crowley G, Moro C, Slade K, Khan AA, Katona C, Forrester A. Mental health in immigration detention: A comparison of foreign national ex-prisoners and other detainees. Crim Behav Ment Health 2021; 31:275-287. [PMID: 34392577 DOI: 10.1002/cbm.2207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 03/05/2021] [Accepted: 07/08/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND People held in immigration removal centres have a range of vulnerabilities relating both to disappointment at imminent removal from the country of hoped-for residence and various antecedent difficulties. An important subgroup in the UK is of foreign national ex-prisoners who have served a period of incarceration there. Prisoners generally have higher rates of mental disorders than the general population. It is, however, not clear whether foreign national ex-prisoners in UK immigration removal centres have higher rates of mental disorders than other detainees. AIMS To compare the screened prevalence of mental disorders, levels of unmet needs and time in detention between foreign national ex-prisoners and others in Immigration Removal Centres in England. METHODS We conducted a secondary analysis of cross-sectional survey data from a previously published study in one Immigration Removal Centre. RESULTS The 28 foreign national ex-prisoners had been in immigration detention for longer and reported greater levels of unmet needs than the other 66 detainees. The highest levels of unmet needs among the foreign national ex-prisoners were in the areas of psychological distress and intimate relationships. After adjusting for time spent in detention, there was evidence to suggest that foreign national ex-prisoners had a higher screened prevalence of substance use disorders, autism spectrum disorders and attention-deficit hyperactivity disorder than the other detainees. CONCLUSIONS/IMPLICATIONS FOR CLINICAL PRACTICE This study supports the view that foreign national ex-prisoners are a vulnerable group within immigration detention who have needs for enhanced and specialist service provision, including appropriate arrangements for health screening and active consideration to alternatives to their detention.
Collapse
Affiliation(s)
- Piyal Sen
- Department of Life Sciences, Brunel University, London, UK
| | - Grace Crowley
- Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - Claira Moro
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Karen Slade
- Division of Psychology, Nottingham Trent University, Nottingham, UK
| | - Al Aditya Khan
- The Bracton Centre, Oxleas NHS Foundation Trust, Dartford, UK
| | | | | |
Collapse
|
31
|
Ryland H, Forrester A, Exworthy T, Gallagher S, Ramsay L, Khan AA. Liaison and diversion services in South East London: Referral patterns over a 25-year period. Med Leg J 2021; 89:166-172. [PMID: 34219537 DOI: 10.1177/00258172211010558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Criminal justice liaison and diversion services identify people with mental health needs and ensure they receive appropriate support. We describe a 25-year period of one such service that deals with a population of 864,540 in South East London that was set up in 1991. We used data from three time periods. A diagnosis of a mental illness was recorded in 70.0-80.3% of court liaison and diversion referrals. The proportion receiving a hospital order declined from 15.4% in 1991/1992 to 1.1% in 2015/2016; 54/199 (27.1%) of referrals to the police liaison and diversion service were detained in hospital. Although the service is designed to support any individual with a mental health issue, these results suggest that it has dealt mainly with people who have severe mental illness. Further research is required to understand how best to benefit a wider range of people with mental health issues who attend the lower (Magistrates') courts, and whether screening for mental disorders can be applied in liaison and diversion settings to aid the implementation of national policy. We also need to understand how disposal decisions are made, and which are most effective.
Collapse
Affiliation(s)
- Howard Ryland
- Bracton Centre, Oxleas NHS Foundation Trust, London, UK
| | - Andrew Forrester
- Greater Manchester Mental Health NHS Foundation Trust, Prestwich, UK.,University of Manchester, Manchester, UK
| | - Tim Exworthy
- Cygnet Hospital Stevenage, Stevenage, UK.,Department of Forensic and Developmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | | | | |
Collapse
|
32
|
Chaplin E, McCarthy J, Allely CS, Forrester A, Underwood L, Hayward H, Sabet J, Young S, Mills R, Asherson P, Murphy D. Self-harm and Mental Health Characteristics of Prisoners with elevated rates of autistic traits. Res Dev Disabil 2021; 114:103987. [PMID: 34004498 DOI: 10.1016/j.ridd.2021.103987] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 05/09/2021] [Accepted: 05/09/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Prevalence studies among prisoners have found rates of 1-4% for autism spectrum disorder (ASD) or autistic traits. However, little is known about those prisoners with high levels of autistic traits. AIM This aim of this study was to compare the mental health characteristics of prisoners with autistic traits with neurotypical prisoners not screening positive for neurodevelopmental disorders. METHOD The study recruited 240 male prisoners from a London prison and screened for autism spectrum disorder using the Autism Quotient (AQ) 20 and 10, and Autism Diagnostic Observation Schedule (ADOS). The Mini International Neuropsychiatric Interview was used to assess for depression, anxiety, self-harm behavior and suicide. RESULTS Screening using the AQ identified 46 prisoners with significant autistic traits, with 12 meeting the diagnostic threshold for ASD using the ADOS. Those screening positive with autistic traits were significantly more likely to have thought about self-harm and suicide in the past month than neurotypical prisoners and have a comorbid mental disorder. They were also significantly more likely to report having attempted suicide during their lifetime compared to neurotypical peers at a rate of 64.9 % compared to 11.6 % for the neurotypical prisoners. CONCLUSION Prisoners with elevated levels of autistic traits were more likely to report self-harm, suicidal thoughts and were more vulnerable to a range of mental disorders than neurotypical prisoners. There is a need for more evidence on the experience of autistic prisoners to inform how pathways should work to improve health outcomes through increased awareness and access to screening and subsequent diagnosis which currently prisons are currently not set up for.
Collapse
Affiliation(s)
- Eddie Chaplin
- London South Bank University Institute of Health and Social Care, United Kingdom.
| | - Jane McCarthy
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | | | | | - Lisa Underwood
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | | | | | | | | | | | | |
Collapse
|
33
|
Arnell P, Forrester A. Extradition and mental health in the spotlight - The case of Julian Assange. Crim Behav Ment Health 2021; 31:77-79. [PMID: 33848028 DOI: 10.1002/cbm.2195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 03/26/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Paul Arnell
- Law School, Robert Gordon University, Aberdeen, UK
| | - Andrew Forrester
- Department of Psychiatry, Cardiff University, Cardiff, Wales, UK
| |
Collapse
|
34
|
Samele C, McKinnon I, Brown P, Srivastava S, Arnold A, Hallett N, Forrester A. The prevalence of mental illness and unmet needs of police custody detainees. Crim Behav Ment Health 2021; 31:80-95. [PMID: 33818834 DOI: 10.1002/cbm.2193] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 12/23/2020] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Internationally, there is evidence of high rates of mental disorders amongst police custody detainees but this literature is limited, and there has been little research into the unmet needs of police detainees in the UK, or elsewhere. Such research could support better focussed interventions for improving health and recidivism outcomes. AIM To examine psychiatric and developmental morbidity amongst police detainees, and ascertain differences in need between morbidity categories. METHOD We used a cross-sectional study design and interviewed a 40% sample of people entering police custody in one South London police station over a 2-week period. A series of standardised measures was administered to screen for the presence of mental illness, general health and social care needs. RESULTS A cohort of 134 people was generated, of whom nearly one-third (39, 29%) had current mental illness (major depression and/or psychosis); more had a lifetime diagnosis (54, 40%). Just under a fifth met the threshold for post-traumatic stress disorder (11, 8%). Clinically relevant alcohol or daily cannabis use affected about one quarter of the sample. Twenty-one percent (or 28) screened positive for personality disorder, 11% (or 15) for attention deficit hyperactivity disorder and 4% (6) for intellectual disability. Nearly one-fifth (24, 18%) were at risk for suicide. Those with psychosis, and those deemed at risk for suicide, had the highest levels of unmet need and, indeed, overall need. The most frequent unmet need was for accommodation. CONCLUSION Our findings not only confirm high rates of mental health problems amongst police detainees but also demonstrate their high risk of suicide and high levels of unmet need, especially as regards accommodation. This underscores the need to provide mental health services in police stations, to help identify and resolve these issues at this early stage in the criminal justice system. Extending accommodation capacity to help some arrestees may help to save lives and interrupt cycling through the criminal justice system.
Collapse
Affiliation(s)
- Chiara Samele
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Informed Thinking, London, UK
| | - Iain McKinnon
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Northgate Hospital, Morpeth and Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Penelope Brown
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London and South London and Maudsley NHS Foundation Trust, London, UK
| | | | | | | | - Andrew Forrester
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| |
Collapse
|
35
|
Arnell P, Forrester A. Extradition and mental health: The need for multidisciplinary review and research. Med Sci Law 2021; 61:83-85. [PMID: 33554757 DOI: 10.1177/0025802421993370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
|
36
|
Shafti M, Taylor PJ, Forrester A, Pratt D. The Co-occurrence of Self-Harm and Aggression: A Cognitive-Emotional Model of Dual-Harm. Front Psychol 2021; 12:586135. [PMID: 33716854 PMCID: PMC7946988 DOI: 10.3389/fpsyg.2021.586135] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 01/29/2021] [Indexed: 11/29/2022] Open
Abstract
There is growing evidence that some individuals engage in both self-harm and aggression during the course of their lifetime. The co-occurrence of self-harm and aggression is termed dual-harm. Individuals who engage in dual-harm may represent a high-risk group with unique characteristics and pattern of harmful behaviours. Nevertheless, there is an absence of clinical guidelines for the treatment and prevention of dual-harm and a lack of agreed theoretical framework that accounts for why people may engage in this behaviour. The present work aimed to address this gap in the literature by providing a narrative review of previous research of self-harm, aggression and dual-harm, and through doing so, presenting an evidence-based theory of dual-harm – the cognitive-emotional model of dual-harm. This model draws from previous studies and theories, including the General Aggression Model, diathesis-stress models and emotional dysregulation theories. The cognitive-emotional model highlights the potential distal, proximal and feedback processes of dual-harm, the role of personality style and the possible emotional regulation and interpersonal functions of this behaviour. In line with our theory, various clinical and research implications for dual-harm are suggested, including hypotheses to be tested by future studies.
Collapse
Affiliation(s)
- Matina Shafti
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Peter James Taylor
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Andrew Forrester
- Division of Psychological Medicine and Clinical Neuroscienecs, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Daniel Pratt
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| |
Collapse
|
37
|
McKenna B, Skipworth J, Forrester A, Shaw J. Prison mental health in-reach teams in Aotearoa New Zealand: A national survey. Psychiatr Psychol Law 2021; 28:774-784. [PMID: 35571595 PMCID: PMC9103505 DOI: 10.1080/13218719.2020.1855269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The STAIR in-reach model of care for prisoners with serious mental illness focuses on screening, triage, assessment, interventions and reintegration by using the principles of assertive community treatment. An evidence base exists for the efficacy for its use in Aotearoa New Zealand. However, little is known about its adoption throughout the country. This national survey of managers of in-reach teams to all prisons (N = 19) aimed to determine the pattern of in-reach service delivery. It compared STAIR in-reach teams with other teams regarding service structure, staffing, interventions, reintegration strategies and training needs. This study signals gains made by adopting the STAIR model (multi-disciplinary team service delivery, 'through the wire' support and use of technologies to assist discharge planning) and potential areas of improvement (further use of psychosocial interventions and training needs). To assist national adoption of STAIR, a review is required to consider the cultural responsivity, gender-responsivity and recovery-orientated characteristics of the model.
Collapse
Affiliation(s)
- Brian McKenna
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
- Auckland Regional Forensic Psychiatry Services, Waitemata District Health Board, Auckland, New Zealand
- Centre for Forensic Behavioural Science, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Jeremy Skipworth
- Auckland Regional Forensic Psychiatry Services, Waitemata District Health Board, Auckland, New Zealand
| | - Andrew Forrester
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- Offender Health Research Network, University of Manchester, Manchester, UK
| | - Jenny Shaw
- Offender Health Research Network, University of Manchester, Manchester, UK
| |
Collapse
|
38
|
Simpson AIF, Gerritsen C, Maheandiran M, Adamo V, Vogel T, Fulham L, Kitt T, Forrester A, Jones RM. A Systematic Review of Reviews of Correctional Mental Health Services Using the STAIR Framework. Front Psychiatry 2021; 12:747202. [PMID: 35115956 PMCID: PMC8806032 DOI: 10.3389/fpsyt.2021.747202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 12/13/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Rising demand for correctional mental health services (CMHS) in recent decades has been a global phenomenon. Despite increasing research, there are major gaps in understanding the best models for CMHS and how to measure their effectiveness, particularly studies that consider the overall care pathways and effectiveness of service responses. The STAIR (Screening, Triage, Assessment, Intervention, and Re-integration) model is an evidence-based framework that defines and measures CMHS as a clinical pathway with a series of measurable, and linked functions. METHOD We conducted a systematic review of the reviews of CMHS elements employing PRISMA guidelines, organized according to STAIR pillars. We assessed the quality of included studies using the AMSTAR-2 criteria. Narrative reviews were read and results synthesized. RESULTS We included 26 review articles of which 12 were systematic, metaanalyses, and 14 narrative reviews. Two systematic reviews and seven narrative reviews addressed screening and triage with strong evidence to support specific screening and triage systems. There was no evidence for standardised assessment approaches. Eight systematic reviews and seven narrative reviews addressed interventions providing some evidence to support specific psychosocial interventions. Three systematic reviews and six narrative reviews addressed reintegration themes finding relatively weak evidence to support reintegration methods, with interventions often being jurisdictionally specific and lacking generalizability. CONCLUSIONS The STAIR framework is a useful way to organize the extant literature. More research is needed on interventions, assessment systems, care pathway evaluations, and reintegration models.
Collapse
Affiliation(s)
- Alexander I F Simpson
- Forensic Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Cory Gerritsen
- Department of Forensic Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | | | - Vito Adamo
- Department of Forensic Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Tobias Vogel
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Lindsay Fulham
- Department of Forensic Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Tamsen Kitt
- Department of Psychology, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Andrew Forrester
- Forensic Psychiatry, Department of Psychological Medicine and Clinical Neursciences, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Roland M Jones
- Department of Forensic Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
39
|
Craster L, Forrester A. The early identification of people with personality disorder in the criminal justice system. Med Sci Law 2020; 60:294-300. [PMID: 32299295 DOI: 10.1177/0025802420917837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The prevalence of personality disorder is very high among criminal justice (correctional) populations, yet our understanding of this condition as it arises in police custody is presently limited. Although healthcare screening has a well-described role within criminal justice settings, including police custody, specific screening for personality disorders has hardly been considered. Yet such screening is broadly in keeping with the aims of liaison and diversion services and the general healthcare principle of early identification, has the potential to inform future care pathways and ameliorate risk and could in some cases inform future sentencing arrangements including community alternatives. Therefore, there is a need for research to consider the design and implementation of a suitable screening tool for application as early as possible in the criminal justice pathway, either as a stand-alone instrument, or as part of a wider package of healthcare screens. It will be important to consider the feasibility of any such design, given environmental and time limitations within police custody and the high levels of substance misuse, with issues relating to intoxication and withdrawal.
Collapse
Affiliation(s)
- Laura Craster
- Barnet, Enfield and Haringey Mental Health NHS Trust, UK
| | | |
Collapse
|
40
|
Hopkin G, Chaplin L, Slade K, Craster L, Valmaggia L, Samele C, Forrester A. Differences between homeless and non-homeless people in a matched sample referred for mental health reasons in police custody. Int J Soc Psychiatry 2020; 66:576-583. [PMID: 32438844 DOI: 10.1177/0020764020920904] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Homelessness has risen across high-income countries in the last decade, and in the United Kingdom, there has been a drastic increase in people living on the streets. Due to these increases, policy responses from public services are required to address the needs of this group. The risk factors for homelessness and conditions that this group live in mean they are at elevated risk of both mental health problems and contact with the criminal justice system. Despite this, there is little previous research on the homeless in police custody. METHODS Our study used a matched sample of homeless (n = 77) and non-homeless (n = 77) individuals to examine whether there were different needs across this group and whether the responses of a criminal justice mental health service differ for this group. This study is a secondary data analysis of a more extensive study. RESULTS Homeless and non-homeless detainees referred to the mental health service were broadly similar. However, differences in some variables show that homeless detainees had higher rates and frequency of substance misuse as well as some suggestion of more acute immediate need. Onward referrals were lower for homeless people, and it is not clear why this is the case. In addition, for those referred contact with services over time was reduced compared to the non-homeless group. DISCUSSION Our findings indicate that mental health services in police custody may need adaptations to ensure homeless individuals' higher level of need is addressed and that they receive appropriate care both during and after detention. Further quantitative and qualitative research is needed to confirm why responses differ and to assess what can be done to address this issue.
Collapse
Affiliation(s)
- Gareth Hopkin
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | | | - Karen Slade
- Department of Psychology, Nottingham Trent University, Nottingham, UK
| | - Laura Craster
- Barnet, Enfield and Haringey Mental Health NHS Trust, London, UK
| | - Lucia Valmaggia
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | | | - Andrew Forrester
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| |
Collapse
|
41
|
Ismail N, Forrester A. The state of English prisons and the urgent need for reform. Lancet Public Health 2020; 5:e368-e369. [PMID: 32619537 PMCID: PMC7326388 DOI: 10.1016/s2468-2667(20)30142-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 05/18/2020] [Indexed: 10/25/2022]
Affiliation(s)
- Nasrul Ismail
- Centre for Public Health and Wellbeing, University of the West of England, Bristol BS16 1QY, UK.
| | - Andrew Forrester
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK; Offender Health Research Network, University of Manchester, Manchester, UK
| |
Collapse
|
42
|
Kothari R, Forrester A, Greenberg N, Sarkissian N, Tracy DK. COVID-19 and prisons: Providing mental health care for people in prison, minimising moral injury and psychological distress in mental health staff. Med Sci Law 2020; 60:165-168. [PMID: 32462971 DOI: 10.1177/0025802420929799] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Radha Kothari
- North London Forensic Services, Barnet, Enfield and Haringey Mental Health Trust, HMP/YOI Pentonville, UK
| | - Andrew Forrester
- Greater Manchester Mental Health NHS Foundation Trust, UK
- University of Manchester, UK
| | - Neil Greenberg
- Health Protection Research Unit in Emergency Preparedness and Respsonse, King's College London, UK
| | - Natasha Sarkissian
- North London Forensic Services, Barnet, Enfield and Haringey Mental Health Trust, HMP/YOI Pentonville, UK
| | - Derek K Tracy
- Cognition, Schizophrenia and Imaging Laboratory, Department of Psychosis Studies, the Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
- Oxleas NHS Foundation Trust, UK
| |
Collapse
|
43
|
Forrester A, Hopkin G, Bryant L, Slade K, Samele C. Alternatives to custodial remand for women in the criminal justice system: A multi-sector approach. Crim Behav Ment Health 2020; 30:68-78. [PMID: 32212284 DOI: 10.1002/cbm.2144] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 03/01/2020] [Indexed: 05/26/2023]
Abstract
Throughout the world, women involved in criminal justice systems often present with substantial needs and vulnerabilities. Diverting vulnerable people away from prison is government policy in England and Wales, but full psychiatric and social assessments are expensive and hard to access. A screening and quick response initiative - alternatives to custodial remand for women (ACRW) - was implemented across three areas of London (West, South and East) to supplement existing court liaison and diversion services, to assess the feasibility of a supplementary custodial remand service as part of a women's specialist service pathway in the criminal justice system in England. Three mental health trusts and two voluntary sector providers offered this service enhancement - a screening and service link provision in three London boroughs between 2012 and 2014. We conducted a service evaluation using routinely collected service use record data. The service made 809 contacts, of whom 104 had contact on multiple occasions. Many were identified as at risk of self-harm (46%) or had histories of hospital admission for mental disorder (36%), but few were referred either to the liaison and diversion service or specialist mental health services. The largest group of referrals was to women's community services outside the health service (e.g. counselling, domestic violence or sexual abuse services). 180 women had dependent children and 22 were pregnant, increasing the urgency to find non-custodial alternatives. As well as confirming high levels of need amongst women entering the criminal justice system, this evaluation confirms the feasibility of working across sectors in this field, providing an extra layer of service that can complement existing liaison and diversion service provision. The service was responsive and most women using it were kept out of custody. Research is now required to understand the appropriateness of the referrals, the extent to which women follow them through and the impact on their mental health and desistance from offending.
Collapse
Affiliation(s)
- Andrew Forrester
- Health and Justice, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- Offender Health Research Network, University of Manchester, Manchester, UK
| | - Gareth Hopkin
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | | | - Karen Slade
- School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | - Chiara Samele
- Informed Thinking, London, UK
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| |
Collapse
|
44
|
Gunn J, Taylor PJ, Forrester A, Parrott J, Grounds A. Telemedicine in prisons: A Crime in Mind perspective. Crim Behav Ment Health 2020; 30:65-67. [PMID: 32589331 DOI: 10.1002/cbm.2160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 05/27/2020] [Indexed: 06/11/2023]
Affiliation(s)
- John Gunn
- Forensic Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - Pamela J Taylor
- Department of Psychological Medicine & Neurology, School of Medicine, Cardiff University, Cardiff, UK
| | - Andrew Forrester
- Greater Manchester Mental Health NHS Foundation Trust, University of Manchester, Manchester, UK
| | | | | |
Collapse
|
45
|
Abstract
This paper summarises a joint meeting, organised by the British Academy of Forensic Sciences (BAFS) and the Clinical Forensic and Legal Medicine Section of the Royal Society of Medicine (RSM), which took place at the RSM, London, on 18 January 2020. It featured six speakers from different fields within medicine, science and the law – in keeping with the core aims of BAFS and Medicine, Science and the Law – and was concluded by a view from the judicial bench. The wide-ranging discussion included descriptions of cases of bias – both conscious and unconscious – and confirmed that while no professional group is exempt from the potential intrusion of bias, the phenomenon should be more clearly recognised, discussed and guarded against by individuals, peers and wider professional networks and bodies.
Collapse
Affiliation(s)
- Andrew Forrester
- Consultant and Honorary Senior Lecturer in Forensic Psychiatry, Greater Manchester Mental Health NHS Foundation Trust and University of Manchester, Manchester, UK
| |
Collapse
|
46
|
Metcalf CD, Phillips C, Forrester A, Glodowski J, Simpson K, Everitt C, Darekar A, King L, Warwick D, Dickinson AS. Quantifying Soft Tissue Artefacts and Imaging Variability in Motion Capture of the Fingers. Ann Biomed Eng 2020; 48:1551-1561. [PMID: 32076882 PMCID: PMC7154021 DOI: 10.1007/s10439-020-02476-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 02/05/2020] [Indexed: 10/29/2022]
Abstract
This study assessed the accuracy of marker-based kinematic analysis of the fingers, considering soft tissue artefacts (STA) and marker imaging uncertainty. We collected CT images of the hand from healthy volunteers with fingers in full extension, mid- and full-flexion, including motion capture markers. Bones and markers were segmented and meshed. The bone meshes for each volunteer's scans were aligned using the proximal phalanx to study the proximal interphalangeal joint (PIP), and using the middle phalanx to study the distal interphalangeal joint (DIP). The angle changes between positions were extracted. The HAWK protocol was used to calculate PIP and DIP joint flexion angles in each position based on the marker centroids. Finally the marker locations were 'corrected' relative to the underlying bones, and the flexion angles recalculated. Static and dynamic marker imaging uncertainty was evaluated using a wand. A strong positive correlation was observed between marker- and CT-based joint angle changes with 0.980 and 0.892 regression slopes for PIP and DIP, respectively, and Root Mean Squared Errors below 4°. Notably for the PIP joint, correlation was worsened by STA correction. The 95% imaging uncertainty interval was < ± 1° for joints, and < ± 0.25 mm for segment lengths. In summary, the HAWK marker set's accuracy was characterised for finger joint flexion angle changes in a small group of healthy individuals and static poses, and was found to benefit from skin movements during flexion.
Collapse
Affiliation(s)
- C D Metcalf
- Faculty of Environmental & Life Sciences, University of Southampton, Southampton, UK
| | - C Phillips
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK
| | - A Forrester
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK
| | - J Glodowski
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK
| | - K Simpson
- Faculty of Environmental & Life Sciences, University of Southampton, Southampton, UK
| | - C Everitt
- University Hospital Southampton, Southampton, UK
| | - A Darekar
- University Hospital Southampton, Southampton, UK
| | - L King
- University Hospital Southampton, Southampton, UK
| | - D Warwick
- University Hospital Southampton, Southampton, UK
| | - A S Dickinson
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK.
| |
Collapse
|
47
|
Affiliation(s)
- Andrew Forrester
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- University of Manchester, Manchester, UK
| | - Mary Piper
- University of Manchester, Manchester, UK
| |
Collapse
|
48
|
Abstract
Vortex-loop renormalization is used to compute the specific heat of superfluid ^{4}He near the lambda point at various pressures up to 26 bars. The input parameters are the pressure dependence of T_{λ} and the superfluid density, which determine the nonuniversal parameters of the vortex core energy and core size. The results for the specific heat are found to be in good agreement with experimental data, matching the expected universal pressure dependence to within about 5%. The nonuniversal critical amplitude of the specific heat is found to be in reasonable agreement, a factor of four larger than the experiments. We point out problems with recent Gross-Pitaevskii simulations that claimed the vortex-loop percolation temperature did not match the critical temperature of the superfluid phase transition.
Collapse
Affiliation(s)
- Andrew Forrester
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - Gary A Williams
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| |
Collapse
|
49
|
McCarthy J, Chaplin E, Forrester A, Underwood L, Hayward H, Sabet J, Young S, Mills R, Asherson P, Murphy D. Prisoners with neurodevelopmental difficulties: Vulnerabilities for mental illness and self-harm. Crim Behav Ment Health 2019; 29:308-320. [PMID: 31912971 DOI: 10.1002/cbm.2132] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 12/28/2018] [Accepted: 10/03/2019] [Indexed: 05/26/2023]
Abstract
BACKGROUND Research into neurodevelopmental disorders in adult offenders has tended to be disorder specific, so hindering service planning for a group of offenders with similar vulnerabilities. AIM To examine vulnerabilities for mental illness and self-harming behaviours among male prisoners screening positive for a range of neurodevelopmental difficulties-including but not confined to disorders of intellectual ability, attention deficit hyperactivity, and in the autistic spectrum. METHOD In a cross-sectional study, prisoners who screened positive for neurodevelopmental difficulties were compared to prisoners who screened negative for the same on indicators of suicide-related and self-harm behaviours, mental illness, and substance misuse using the Mini International Neuropsychiatric Interview (MINI). RESULTS Of 87 prisoners who screened positive for neurodevelopmental difficulties, 69 had full MINI mental health data. In comparison with 69 neurotypical men in the same prison, the neurodevelopmental difficulties group was significantly more likely to have thought about self-harm and suicide in the last month and to have significantly higher rates of concurrent mental disorders including psychosis, anxiety, depression, personality disorder, and substance dependency disorders. CONCLUSIONS This is one of the first studies to examine the mental health of adults with neurodevelopmental difficulties in a prison setting. This group, unlike those who meet diagnostic threshold, is not routinely considered by mental health or correctional services. The study found prisoners with neurodevelopmental difficulties showed greater vulnerability to mental disorder and thoughts of suicide and suicide-related behaviours than other prisoners. Accordingly, we recommend routine early screening across the criminal justice system for any neurodevelopmental difficulties to inform decision-making on the most appropriate disposal and support.
Collapse
Affiliation(s)
- Jane McCarthy
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Eddie Chaplin
- London South Bank University School of Health and Social Care, Ringgold Standard Institution, 103 Borough Road, London, SE1 0AA, United Kingdom of Great Britain and Northern Ireland
| | - Andrew Forrester
- Greater Manchester Mental Health NHS Foundation Trust and South London and Maudsley NHS Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland
- King's College London, London, United Kingdom of Great Britain and Northern Ireland
| | | | - Hannah Hayward
- King's College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Jess Sabet
- King's College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Susan Young
- Institute of Psychiatry, De Crespigny Park, London, SE5 8AF, United Kingdom of Great Britain and Northern Ireland
- Broadmoor Hospital West London Mental Health Trust, London, RG45 7EG, United Kingdom of Great Britain and Northern Ireland
| | - Richard Mills
- Research Autism, London, United Kingdom of Great Britain and Northern Ireland
| | - Philip Asherson
- King's College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Declan Murphy
- King's College London, London, United Kingdom of Great Britain and Northern Ireland
| |
Collapse
|
50
|
Forrester A, Hopkin G. Mental health in the criminal justice system: A pathways approach to service and research design. Crim Behav Ment Health 2019; 29:207-217. [PMID: 31478274 DOI: 10.1002/cbm.2128] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 08/01/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Care pathway approaches were introduced into health care in the 1980s and have become standard international practice. They are now being introduced more specifically for health care in the criminal justice system. Care pathway delivery has the theoretical advantage of encouraging a whole-systems approach for health and social care within the criminal justice system, but how well is it supported by empirical evidence? AIMS The aim of this study is to review the nature and extent of evidence streams supporting health care delivery within interagency pathway developments since 2000. METHOD We used an exploratory narrative method to review the nature and extent of evidence streams supporting health care delivery within interagency pathway developments since 2000. The available literature was reviewed using a keyword search approach with three databases: PubMed, Medline, and Google Scholar. FINDINGS Research in this field has covered police custody, courts, prisons, and the wider community, but there is little that follows the entire career through all these elements of offender placement. Main themes in the research to date, regardless of where the research was conducted, have been counting the disorder or the need, development and evaluation of screening tools, and evaluation of clinical intervention styles. Most evidence to date is simply observational, although the possibility of conducting randomised controlled trials of interventions within parts of the criminal justice system, especially prisons, is now well established. CONCLUSIONS Access to health care while passing through the criminal justice system is essential because of the disproportionately high rates of mental disorder among offenders, and the concept of structured pathways to ensure this theoretically satisfying, but as yet empirically unsupported. Further, substantial cuts in services, generally following government economies, are largely unresearched. Considerable investment in new possibilities, driven by both pressure groups and government, tend to be informed by good will and theory rather than hard evidence and are often not evaluated even after introduction. This must change.
Collapse
Affiliation(s)
- Andrew Forrester
- Edenfield Centre, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- Offender Health Research Network, University of Manchester, Manchester, UK
| | - Gareth Hopkin
- Department of Health Policy, London School of Economics and Political Science, London, UK
| |
Collapse
|