Psychological screening service for men newly admitted to an Italian prison: Preliminary clinical outcome analysis after 1 year of clinical activity

IF 1.1 4区医学 Q3 CRIMINOLOGY & PENOLOGY Criminal Behaviour and Mental Health Pub Date : 2023-09-11 DOI:10.1002/cbm.2310

Lorenzo Pelizza, Enrico Rossi, Ursula Zambelli, Elisa Violante, Melania Scarci, Elena Mammone, Adriana Adriani, Simona Pupo, Giuseppina Paulillo, Pietro Pellegrini

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Abstract

Background

Screening for mental disorders among prisoners is crucial for early detection and intervention of psychopathology and substance use disorders. In Italy, only a minority of prisons have implemented a structured screening process, and there is not yet a standard approach to this worldwide.

Aims

First, to describe a systematic psychological screening for early identification of mental disorder, including drug use disorders, and suicide risk among men on reception into one Italian prison, designed to inform management and, secondly, to describe mental health outcomes among those prisoners accepted into the in-reach mental health service as a result of the assessment.

Methods

All prisoners newly received in the Parma Penitentiary Institute at any time in 2020 were screened using the Jail Screening Assessment Tool. Those who screened positive for any mental disorder, including substance use disorders and suicide indicators, were asked to complete the Parma Scale for the treatment evaluation of offenders with psychiatric disorders (Pr-Scale), a locally developed tool that allows for the measurement of mental state change as well as changes in treatment and management. Scores on this scale soon after reception were compared with scores after 1 year of work with the in-reach team.

Results

Among 303 newly admitted male prisoners in 2020, 167 (55%) screened positive for substance use disorder and 30 (10%) for other primary mental disorders. Most of these (n = 151) were offered and accepted care by the mental health in-reach service. After 1 year, those who had been treated by this service showed significant improvement in all Pr-Scale clinical variables.

Conclusions

Our findings support the extension of a psychological screening into a service for new receptions to Italian prisons. They add evidence for the utility of the Pr-Scale for detecting those newly admitted prisoners likely to benefit from early mental health interventions provided by in-reach services and for evidencing resultant change. Future studies are needed to replicate our results in other Italian prisons as a precursor to systems improvement, while other countries might also benefit from using similar evaluation and reevaluation routinely.

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意大利监狱新收监男子的心理筛查服务：临床活动一年后的初步临床结果分析。

背景：对囚犯进行精神障碍筛查对于早期发现和干预精神病理学和物质使用障碍至关重要。在意大利，只有少数监狱实施了结构化的筛查程序，而全世界还没有一个标准的方法。目的：首先，描述一项系统的心理筛查，以早期识别意大利一所监狱接收的男性的精神障碍，包括药物使用障碍和自杀风险，旨在为管理层提供信息；其次，描述评估结果显示，接受可及精神健康服务的囚犯的心理健康结果。方法：使用监狱筛查评估工具对2020年任何时候新入住帕尔马监狱的所有囚犯进行筛查。那些对任何精神障碍（包括物质使用障碍和自杀指标）筛查呈阳性的人被要求完成帕尔马量表，用于对精神障碍罪犯的治疗评估（Pr量表），这是一种当地开发的工具，可以测量精神状态的变化以及治疗和管理的变化。接收后不久，将该量表上的分数与在触手可及团队工作一年后的分数进行比较。结果：在2020年新入院的303名男性囚犯中，167人（55%）的物质使用障碍筛查呈阳性，30人（10%）的其他原发性精神障碍筛查呈阴性。其中大多数（n=151）由心理健康服务机构提供并接受护理。1年后，接受该服务的患者在所有Pr量表临床变量方面都有显著改善。结论：我们的研究结果支持将心理筛查扩展到意大利监狱的新接待服务中。他们补充了Pr量表的实用性证据，用于检测那些可能受益于外展服务提供的早期心理健康干预的新入院囚犯，并证明由此产生的变化。未来的研究需要在其他意大利监狱中复制我们的结果，作为系统改进的前兆，而其他国家也可能从常规使用类似的评估和重新评估中受益。

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来源期刊

Criminal Behaviour and Mental Health Multiple-

CiteScore

1.60

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0.00%

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期刊介绍： Criminal Behaviour & Mental Health – CBMH – aims to publish original material on any aspect of the relationship between mental state and criminal behaviour. Thus, we are interested in mental mechanisms associated with offending, regardless of whether the individual concerned has a mental disorder or not. We are interested in factors that influence such relationships, and particularly welcome studies about pathways into and out of crime. These will include studies of normal and abnormal development, of mental disorder and how that may lead to offending for a subgroup of sufferers, together with information about factors which mediate such a relationship.