Previous meta-analyses may have overestimated the prevalence of attention-deficit hyperactivity disorder (ADHD) in prisoners by including data from selected samples.
To estimate the prevalence of ADHD in unselected samples of adults in prison and examine potential sources of heterogeneity by meta-regression and subgroup analyses.
We assessed all studies included in a 2018 systematic review for eligibility and updated the literature search to include studies published up to September 2023.
A total of 11 studies reporting robust diagnostic data on ADHD in 3919 unselected adults in prison were included. In meta-regression, ADHD prevalence did not differ between men and women but it was significantly higher in studies using a two-phase design. In random sampling studies, the pooled prevalence of ADHD was 8.3% (95% CI: 3.8–12.8) which was further halved after the removal of an outlier.
One in 12 adults in prison have been diagnosed with ADHD. Our findings highlight the importance of using clear and consistent inclusion criteria in meta-analyses of prevalence.
Both police shootings and violent crime remain high in the United States of America compared to other developed nations but debates continue about whether race, mental health or other social factors are related to them.
Our aim was to test relationships between community factors indicative of socio-economic status, racial demographics, police shootings, and violent crime.
Data on police shootings, violent crime and community sociodemographic factors were drawn from two publicly accessible datasets: health and police records of 100 US municipalities and relationships between them explored using regression analyses.
Data were from the 100 largest US municipalities as designated by the mapping police violence database. The median per capital violent crime rate was 5.94 and median killings by police per 10 thousand arrests was 13.7. Violent crime was found to be related mainly to income inequality and lower academic achievement in the community. Race was unrelated to violent crime after controlling for other factors. Police shootings were found to be related to community level mental health concerns, food insecurity and the municipality's violent crime rate.
The evidence suggests that socio-economic factors are the primary drivers of both violent crime perpetration and police shootings. Policy approaches aimed at improving education and reducing poverty are likely to mitigate both violent crime and police shootings. However, it is important to recognise that being Black is an indicator of particular disadvantage within this context. This underscores the need for comprehensive strategies that address the systemic issues of racial disparities and socio-economic inequality, while also acknowledging the complex interplay of race, poverty and policing in the context of violent crime and police shootings.
Visits present an opportunity for prisoners to preserve family ties and reduce isolation, but not all receive visits from family or friends whilst incarcerated.
To locate, appraise and synthesise qualitative data on the experiences of adult male prisoners (aged 18 years+) who do not receive prison visits from family or friends.
Nine electronic databases were searched from the date of their inception until March 2023. The quality of included studies was assessed using the Critical Appraisal Skills Programme checklist for qualitative studies, and data from the studies were synthesised using the thematic synthesis method.
Eighteen studies from seven countries (the USA, the UK [England, Northern Ireland & Scotland], Canada, Netherlands and the Philippines) were eligible for inclusion. Three main themes emerged: (1) reasons for not receiving visits, (2) harmful effects of not receiving visits and (3) the value of volunteer visitor programmes. Practical problems were cited as interfering with visiting opportunities, but also some prisoners or families chose not to meet in prison. Loneliness and depression were extensively described as effects of not receiving visits. Qualities associated with volunteer visitors included raised self-esteem, improved mood and personal growth.
Narratives of the experiences of adult men in prison without visits from family or friends suggest that not only the practical difficulties of imprisonment affect visiting; barriers that prisoners themselves impose would merit further exploration, as would family and relationship dynamics during incarceration and the emotional impact of prison visits, for both prisoners and their families. There are suggestions of therapeutic as well as humanitarian benefits from volunteer visiting programmes. There is a gap in the literature about any specific effect on rebuilding family relationships.
To date, there is no evidence supporting the existence of an association between Autism Spectrum Disorder (ASD) and extremism in the general population. However, there is increasing recognition that several features of ASD may provide the context of vulnerability to engage in extremist behaviour.
This paper sets out the case for a dedicated clinical approach to better integrate clinical risk appraisal processes with an assessment of ASD individuals' vulnerabilities within the Criminal Justice System.
In this paper the Framework for the Assessment of Risk & Protection in Offenders on the Autistic Spectrum (FARAS): A Guide for Risk Assessors Working with Offenders on the Autistic Spectrum is explored. In developing the FARAS, Al-Attar proposed seven facets of ASD that ‘may have different functional links with push and pull factors to terrorism’ (p. 928), which include circumscribed interests; rich vivid fantasy and impaired social imagination; need for order, rules, rituals, routine and predictability; obsessionality, repetition and collecting; social interaction and communication difficulties; cognitive styles and Sensory processing.
We describe the FARAS within the context of the most widely used clinical risk appraisal ‘aide memoire’ instruments integral to the Structured Professional Judgement of risk process, namely the HCR20v3.
Changes to policy around inpatient services for people with intellectual and developmental disability (IDD) who offend, have led to a need for services to reconsider their models of care. This has led to calls for more tailored, patient-centred care models, with less reliance solely on offence-related treatment programmes which can be unsuitable for a growing proportion of patients with more complex cognitive and behavioural difficulties. In response, the Walkway to Wellness (W2W) was developed at one National Health Service Trust providing secure services to people with IDD, with the intention of delivering a more collaborative, co-produced and goal-oriented care model that was better understood by staff and patient stakeholders.
To evaluate the implementation of the W2W using Normalisation Process Theory (NPT), an evidence-based theoretical approach is used across a number of health settings.
Staff were invited to complete a short questionnaire, using the NPT informed Normalisation Measure Development questionnaire, at two time points along the implementation process. Patients were invited to complete a simplified questionnaire. Both groups were asked for their views on the W2W and the process of its implementation.
Although the W2W was more familiar to staff at the second time point, scores on the four NPT constructs showed a trend for it being less embedded in practice, with significant results concerning the ongoing appraisal of the new model. Patient views were mixed; some saw the benefit of more goal-oriented processes, but others considered it an additional chore hindering their own perceived goals.
Early involvement of all stakeholders is required to enhance the understanding of changes to models of care. Live feedback should be used to refine and revise the model to meet the needs of patients, carers and staff members.
International studies show that adults with intellectual and developmental disabilities (IDD) are disproportionately represented in the criminal justice and forensic mental health systems; however, it is difficult to capture their involvement across systems in any one jurisdiction.
The current study aimed to estimate the prevalence of IDD across different parts of the criminal justice and forensic mental health systems in Ontario and to describe the demographic and clinical profiles of these individuals relative to their counterparts without IDD.
This project utilised administrative data to identify and describe the demographic and clinical characteristics of adults with IDD and criminal justice or forensic involvement across four sectors: federal correctional facilities, provincial correctional facilities, forensic inpatient mental health care and community mental health programmes. Questions were driven by and results were contextualised by a project advisory group and people with lived experience from the different sectors studied, resulting in a series of recommendations.
Adults with IDD were over-represented in each of the four settings, ranging from 2.1% in federal corrections to 16.7% in forensic inpatient care. Between 20% (forensic inpatient) and 38.4% (provincial corrections) were under the age of 25 and between 34.5% (forensic inpatient) and 41.8% (provincial corrections) resided in the lowest income neighbourhoods. Medical complexity and rates of co-occurring mental health conditions were higher for people with IDD than those without IDD in federal and provincial corrections.
Establishing a population-based understanding of people with IDD within these sectors is an essential first step towards understanding and addressing service and care needs. Building on the perspectives of people who work in and use these systems, this paper concludes with intervention recommendations before, during and after justice involvement.
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