Eddie Chaplin, Jane McCarthy, Karina Marshall-Tate, Salma Ali, Denise Harvey, Jessica Childs, Kiriakos Xenitidis, Samir Srivastava, Iain McKinnon, Louise Robinson, Clare S. Allely, Sally Hardy, Andrew Forrester
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.
{"title":"A realist evaluation of an enhanced court-based liaison and diversion service for defendants with neurodevelopmental disorders","authors":"Eddie Chaplin, Jane McCarthy, Karina Marshall-Tate, Salma Ali, Denise Harvey, Jessica Childs, Kiriakos Xenitidis, Samir Srivastava, Iain McKinnon, Louise Robinson, Clare S. Allely, Sally Hardy, Andrew Forrester","doi":"10.1002/cbm.2315","DOIUrl":"10.1002/cbm.2315","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47362,"journal":{"name":"Criminal Behaviour and Mental Health","volume":"34 2","pages":"117-133"},"PeriodicalIF":1.2,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cbm.2315","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71487379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Background</h3> <p>While there is empirical evidence to support associations between psychopathy scale ratings and offending or deviant behaviours, suggested as support for a unified theory of crime, evidence to date has been mainly from countries with high economic ratings and Western philosophies. In countries with a wide range of cultural groups and languages and a complex history of colonisation and apartheid, such scale ratings and correlations may differ.</p> </section> <section> <h3> Aims</h3> <p>To explore the psychometric properties of the Youth Psychopathic Traits Inventory-Short Version (YPI-S) and its applicability and relationship to deviant and actual or potential criminal behaviour among young adults in South Africa.</p> </section> <section> <h3> Methods</h3> <p>18- to 20-year-olds from poor socio-economic backgrounds were recruited by a fieldworker with an existing relationship with community-based youth centres. Consenting participants completed the Deviant Behaviour Variety Scale, reflecting criminal or similar behaviours in the 12 months prior to rating and the YPI-S. Reliability measurements, principal factor analysis, Spearman's Rho correlations, chi square and multiple regression were used to explore performance of the YPI-S in this sample and relationship of YPI-S scores to deviancy.</p> </section> <section> <h3> Results</h3> <p>Of the 213 participants recruited, 176 completed all data points and were entered into analyses. The YPI-S was found to have generally good psychometric properties; however, in factor analysis, while items mapped well into an emotional subscale and quite well into an interpersonal scale, as in the original, behavioural items did not. Emotional, interpersonal and total YPI-S scores were significantly associated with reported deviant behaviour scores.</p> </section> <section> <h3> Conclusion</h3> <p>The findings of this study suggest value in using the YPI-S with young people in South Africa to help identify those vulnerable to committing criminal acts. Among these disadvantaged young people, however, caution should be used in interpreting scores on its behavioural dimension. It is interesting that the emotional dimension, which incorporates perhaps the most personal features such as ‘callous and unemotional traits’ (albeit probably better considered as difficulty in recognising emotions in others), seemed most robust, suggesting that there may be core problems in a pathway to crime
{"title":"Evaluation of the psychometric properties of the Youth Psychopathic Traits Inventory-Short Version among young people in South Africa and the relationship of high scale scores to reported offending or similar deviant behaviour","authors":"Leon Holtzhausen, Emma Campbell","doi":"10.1002/cbm.2317","DOIUrl":"10.1002/cbm.2317","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>While there is empirical evidence to support associations between psychopathy scale ratings and offending or deviant behaviours, suggested as support for a unified theory of crime, evidence to date has been mainly from countries with high economic ratings and Western philosophies. In countries with a wide range of cultural groups and languages and a complex history of colonisation and apartheid, such scale ratings and correlations may differ.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To explore the psychometric properties of the Youth Psychopathic Traits Inventory-Short Version (YPI-S) and its applicability and relationship to deviant and actual or potential criminal behaviour among young adults in South Africa.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>18- to 20-year-olds from poor socio-economic backgrounds were recruited by a fieldworker with an existing relationship with community-based youth centres. Consenting participants completed the Deviant Behaviour Variety Scale, reflecting criminal or similar behaviours in the 12 months prior to rating and the YPI-S. Reliability measurements, principal factor analysis, Spearman's Rho correlations, chi square and multiple regression were used to explore performance of the YPI-S in this sample and relationship of YPI-S scores to deviancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 213 participants recruited, 176 completed all data points and were entered into analyses. The YPI-S was found to have generally good psychometric properties; however, in factor analysis, while items mapped well into an emotional subscale and quite well into an interpersonal scale, as in the original, behavioural items did not. Emotional, interpersonal and total YPI-S scores were significantly associated with reported deviant behaviour scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings of this study suggest value in using the YPI-S with young people in South Africa to help identify those vulnerable to committing criminal acts. Among these disadvantaged young people, however, caution should be used in interpreting scores on its behavioural dimension. It is interesting that the emotional dimension, which incorporates perhaps the most personal features such as ‘callous and unemotional traits’ (albeit probably better considered as difficulty in recognising emotions in others), seemed most robust, suggesting that there may be core problems in a pathway to crime","PeriodicalId":47362,"journal":{"name":"Criminal Behaviour and Mental Health","volume":"33 6","pages":"415-427"},"PeriodicalIF":1.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cbm.2317","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ellen van der Vorst, Niki C. Kuin, Vere van Koppen, Joke M. Harte
Background
In-prison violence by detainees is a problem worldwide, but despite evidence of a much higher prevalence of a range of psychiatric disorders than in the general population, little is known about psychopathology among violent detainees.
Aims
Our aim was to explore the psychopathology and mental healthcare history of Dutch detainees who were transferred to the highly restrictive facility for uncontrollably violent detainees following severe in-prison violence.
Methods
Anonymised data for all 253 male detainees incarcerated at any time between January 2016 and January 2020 in the specialist national facility for those seriously violent while in prison—‘the Violence Facility’—were obtained from the Dutch Ministry of Justice together with similarly recorded data for a matched comparison group of 253 detainees admitted to an in-prison psychiatric facility—‘the Psychiatric Facility’.
Results
There was no record of any psychiatric assessment for 29% of the Violence Facility men. Almost all of the detainees who had been assessed were classified with at least one disorder. Compared to detainees in the Psychiatric Facility, Violence Facility men were more likely to be diagnosed with attention deficit hyperactivity disorder (ADHD), anxiety, behavioural and personality disorders; Psychiatric Facility men were more likely to be diagnosed with psychosis or substance use disorder. Most men in both groups had previously used mental health services.
Conclusions
This first study of detainees in the Dutch in-prison facility for violent detainees raises questions about whether the extent of violence among these men may have masked mental healthcare needs and leads to questions about potential benefits from establishing more systematic mental health assessments for them, and a need for more specialist services.
{"title":"Psychopathology and history of mental healthcare among male detainees transferred to a facility for managing otherwise uncontrollable in-prison violence: An exploratory study","authors":"Ellen van der Vorst, Niki C. Kuin, Vere van Koppen, Joke M. Harte","doi":"10.1002/cbm.2316","DOIUrl":"10.1002/cbm.2316","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In-prison violence by detainees is a problem worldwide, but despite evidence of a much higher prevalence of a range of psychiatric disorders than in the general population, little is known about psychopathology among violent detainees.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Our aim was to explore the psychopathology and mental healthcare history of Dutch detainees who were transferred to the highly restrictive facility for uncontrollably violent detainees following severe in-prison violence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Anonymised data for all 253 male detainees incarcerated at any time between January 2016 and January 2020 in the specialist national facility for those seriously violent while in prison—‘the Violence Facility’—were obtained from the Dutch Ministry of Justice together with similarly recorded data for a matched comparison group of 253 detainees admitted to an in-prison psychiatric facility—‘the Psychiatric Facility’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was no record of any psychiatric assessment for 29% of the Violence Facility men. Almost all of the detainees who had been assessed were classified with at least one disorder. Compared to detainees in the Psychiatric Facility, Violence Facility men were more likely to be diagnosed with attention deficit hyperactivity disorder (ADHD), anxiety, behavioural and personality disorders; Psychiatric Facility men were more likely to be diagnosed with psychosis or substance use disorder. Most men in both groups had previously used mental health services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This first study of detainees in the Dutch in-prison facility for violent detainees raises questions about whether the extent of violence among these men may have masked mental healthcare needs and leads to questions about potential benefits from establishing more systematic mental health assessments for them, and a need for more specialist services.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47362,"journal":{"name":"Criminal Behaviour and Mental Health","volume":"33 6","pages":"428-440"},"PeriodicalIF":1.2,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cbm.2316","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although forensic psychiatry is recognised as a full medical speciality in the UK, training in it is not routinely offered to medical students. With growth both in forensic psychiatry and availability of medical school places, it is a good time to explore the nature and quality of experience already available.
Aims
1. To map the literature against the guideline for reporting evidence-based practice educational interventions and teaching checklist. 2. To critically review research and scholarship. 3. To identify gaps in evidence-based education for medical students in forensic psychiatry.
Method
A systematic search of three bibliographic databases from inception to December 2021 was undertaken using keywords related to medical students and forensic psychiatry between December 2021 and March 2022. The search was supplemented by citation and hand searching.
Results
Eight articles were identified. Collectively, they suggest that education and teaching were implemented at a local level and not linked to theories of learning. Exposure to forensic psychiatry stimulated positive attitudes, which amplified interest in psychiatry. There was insufficient evidence to determine optimal undergraduate education and teaching practice in forensic psychiatry.
Conclusions
Forensic psychiatry appears to have much to offer the medical undergraduate as part of core learning in psychiatry, including universal skills and knowledge such as ethical decision-making and handling emotions. There appears to be considerable opportunity for education, teaching and research innovation in undergraduate education and teaching in forensic psychiatry. Interesting areas for development include simulated and coproduced education.
{"title":"A critical review of undergraduate education and teaching in forensic psychiatry","authors":"Leila Sharda, Karen Wright","doi":"10.1002/cbm.2314","DOIUrl":"10.1002/cbm.2314","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although forensic psychiatry is recognised as a full medical speciality in the UK, training in it is not routinely offered to medical students. With growth both in forensic psychiatry and availability of medical school places, it is a good time to explore the nature and quality of experience already available.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>1. To map the literature against the guideline for reporting evidence-based practice educational interventions and teaching checklist. 2. To critically review research and scholarship. 3. To identify gaps in evidence-based education for medical students in forensic psychiatry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A systematic search of three bibliographic databases from inception to December 2021 was undertaken using keywords related to medical students and forensic psychiatry between December 2021 and March 2022. The search was supplemented by citation and hand searching.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight articles were identified. Collectively, they suggest that education and teaching were implemented at a local level and not linked to theories of learning. Exposure to forensic psychiatry stimulated positive attitudes, which amplified interest in psychiatry. There was insufficient evidence to determine optimal undergraduate education and teaching practice in forensic psychiatry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Forensic psychiatry appears to have much to offer the medical undergraduate as part of core learning in psychiatry, including universal skills and knowledge such as ethical decision-making and handling emotions. There appears to be considerable opportunity for education, teaching and research innovation in undergraduate education and teaching in forensic psychiatry. Interesting areas for development include simulated and coproduced education.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47362,"journal":{"name":"Criminal Behaviour and Mental Health","volume":"33 6","pages":"401-414"},"PeriodicalIF":1.2,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41215931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matthew Callender, Greta Arancia Sanna, Kathryn Cahalin
Background
Growing evidence of mental disorders among people going through the criminal justice system suggests the potential benefit of courts adding a Mental Health Treatment Requirement (MHTR) when sentencing an offender to a Community Order (sentence) in England and Wales. Although available since 2003, MHTRs have not been widely used, and there is little evidence on outcomes.
Aim
To conduct the first large-scale evaluation of mental health outcomes of people with an MHTR as part of their community sentence across multiple sites in England and Wales.
Methods
Data were collected from 14 sites in England and Wales about individuals who were given an MHTR as part of a community sentence. They were assessed before and after this. During the MHTR, they received a psychotherapeutic intervention by assistant psychologists in a primary care framework. Measures of psychological distress (Clinical Outcomes in Routine Evaluation—Outcome Measure), anxiety (Generalised Anxiety Disorder-7) and depression (Patient Health Questionnaire) were completed before the MHTR was implemented and after completion.
Results
Where paired sample t-tests and Wilcoxon signed ranked tests were used, with samples ranging between 309 and 447 individuals, clinically significant changes were obtained for all measures. Most individuals (63%) were identified as experiencing a reliable change in at least two out of the three scales. Finally, a negative linear relationship, between measures at the start of the intervention and reliable change, was identified with higher pre-measures, indicating that more initial distress, anxiety and/or depression were associated with more sizeable changes.
Conclusions
This paper provides the first substantial evidence in support of the MHTR within a primary mental healthcare framework as an effective pathway to reduce mental health problems among individuals under probation supervision as part of a sentence after conviction for a criminal offence. This supports the expansion of the provision across England and Wales. Future research should take account of the non-completers and explore the relationship between the MHTR, mental health improvements and reoffending.
{"title":"Mental health outcomes for those who have offended and have been given a Mental Health Treatment Requirement as part of a Community Order in England and Wales","authors":"Matthew Callender, Greta Arancia Sanna, Kathryn Cahalin","doi":"10.1002/cbm.2312","DOIUrl":"10.1002/cbm.2312","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Growing evidence of mental disorders among people going through the criminal justice system suggests the potential benefit of courts adding a Mental Health Treatment Requirement (MHTR) when sentencing an offender to a Community Order (sentence) in England and Wales. Although available since 2003, MHTRs have not been widely used, and there is little evidence on outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To conduct the first large-scale evaluation of mental health outcomes of people with an MHTR as part of their community sentence across multiple sites in England and Wales.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were collected from 14 sites in England and Wales about individuals who were given an MHTR as part of a community sentence. They were assessed before and after this. During the MHTR, they received a psychotherapeutic intervention by assistant psychologists in a primary care framework. Measures of psychological distress (Clinical Outcomes in Routine Evaluation—Outcome Measure), anxiety (Generalised Anxiety Disorder-7) and depression (Patient Health Questionnaire) were completed before the MHTR was implemented and after completion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Where paired sample <i>t</i>-tests and Wilcoxon signed ranked tests were used, with samples ranging between 309 and 447 individuals, clinically significant changes were obtained for all measures. Most individuals (63%) were identified as experiencing a reliable change in at least two out of the three scales. Finally, a negative linear relationship, between measures at the start of the intervention and reliable change, was identified with higher pre-measures, indicating that more initial distress, anxiety and/or depression were associated with more sizeable changes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This paper provides the first substantial evidence in support of the MHTR within a primary mental healthcare framework as an effective pathway to reduce mental health problems among individuals under probation supervision as part of a sentence after conviction for a criminal offence. This supports the expansion of the provision across England and Wales. Future research should take account of the non-completers and explore the relationship between the MHTR, mental health improvements and reoffending.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47362,"journal":{"name":"Criminal Behaviour and Mental Health","volume":"33 5","pages":"386-396"},"PeriodicalIF":1.2,"publicationDate":"2023-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cbm.2312","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41172580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Response to Donnir, G. M., & Asare-Doku, W. (2023). Prevalence of psychiatric disorders among sentenced prisoners in a medium security prison in Ghana: Implications for mental health assessment and service","authors":"LienChung Wei","doi":"10.1002/cbm.2311","DOIUrl":"10.1002/cbm.2311","url":null,"abstract":"","PeriodicalId":47362,"journal":{"name":"Criminal Behaviour and Mental Health","volume":"33 5","pages":"369-370"},"PeriodicalIF":1.2,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10564298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lorenzo Pelizza, Enrico Rossi, Ursula Zambelli, Elisa Violante, Melania Scarci, Elena Mammone, Adriana Adriani, Simona Pupo, Giuseppina Paulillo, Pietro Pellegrini
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.
{"title":"Psychological screening service for men newly admitted to an Italian prison: Preliminary clinical outcome analysis after 1 year of clinical activity","authors":"Lorenzo Pelizza, Enrico Rossi, Ursula Zambelli, Elisa Violante, Melania Scarci, Elena Mammone, Adriana Adriani, Simona Pupo, Giuseppina Paulillo, Pietro Pellegrini","doi":"10.1002/cbm.2310","DOIUrl":"10.1002/cbm.2310","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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 <i>Parma Scale for the treatment evaluation of offenders with psychiatric disorders</i> (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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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 (<i>n</i> = 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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47362,"journal":{"name":"Criminal Behaviour and Mental Health","volume":"33 5","pages":"342-353"},"PeriodicalIF":1.2,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10204392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Delays in transferring patients from prisons to secure psychiatric hospitals: An international systematic review","authors":"Christian P. Sales, Andrew Forrester, John Tully","doi":"10.1002/cbm.2309","DOIUrl":"10.1002/cbm.2309","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47362,"journal":{"name":"Criminal Behaviour and Mental Health","volume":"33 5","pages":"371-385"},"PeriodicalIF":1.2,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10155291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrew Allen, Mary Katsikitis, Prudence Millear, Nadine McKillop
Background
Sexual fantasies and memories are aetiological considerations in the perpetration of sexual violence, but fantasy–memory–behaviour relationships may be influenced by various factors, including sexual fantasy and memory phenomenology, that are the properties of mental imagery.
Aims
To investigate differences in sexual fantasy phenomenology and sexual memory intensity in men who report a history of harmful sexual behaviour compared to those who do not. We also investigated whether the likelihood of reporting harmful sexual intent was related to sexual memory intensity, independently of age and harmful sexual behaviour history.
Methods
An online cross-sectional survey design was used, focusing on men aged ≥18 years who were recruited from the general population via social media. The survey prompted participants to envisage a favoured sexual fantasy, then obtained data on fantasy phenomenology, including vividness and sensations, and arousal level. In addition, information was requested about sexual memory intensity and harmful sexual behaviour history and intent.
Results
A total of 322 men completed the survey. Multiple Welch's t-tests showed that men self-reporting one or more harmful sexual behaviours, such as rape or child sexual abuse, gave significantly higher ratings of sexual fantasy phenomenology but not fantasy frequency or masturbation. They were also more likely to report higher sexual memory intensity. Although the significance of fantasy phenomenology varied between subgroups, binary logistic regression indicated that age, history of harmful sexual behaviour and sexual memory intensity were each independently associated with harmful sexual intent.
Conclusions
Our findings provide new insights into the importance of fantasy phenomenology, demonstrating nuanced differences between those with and without a history of harmful sexual behaviour and illustrating that memory intensity is associated with harmful sexual behaviour intent. Further research into these differences in the context of assessment and intervention for sexual violence perpetration is warranted.
{"title":"Implications of sexual fantasy characteristics and memory intensity for harmful sexual behaviour","authors":"Andrew Allen, Mary Katsikitis, Prudence Millear, Nadine McKillop","doi":"10.1002/cbm.2308","DOIUrl":"10.1002/cbm.2308","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sexual fantasies and memories are aetiological considerations in the perpetration of sexual violence, but fantasy–memory–behaviour relationships may be influenced by various factors, including sexual fantasy and memory phenomenology, that are the properties of mental imagery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To investigate differences in sexual fantasy phenomenology and sexual memory intensity in men who report a history of harmful sexual behaviour compared to those who do not. We also investigated whether the likelihood of reporting harmful sexual intent was related to sexual memory intensity, independently of age and harmful sexual behaviour history.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An online cross-sectional survey design was used, focusing on men aged ≥18 years who were recruited from the general population via social media. The survey prompted participants to envisage a favoured sexual fantasy, then obtained data on fantasy phenomenology, including vividness and sensations, and arousal level. In addition, information was requested about sexual memory intensity and harmful sexual behaviour history and intent.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 322 men completed the survey. Multiple Welch's <i>t</i>-tests showed that men self-reporting one or more harmful sexual behaviours, such as rape or child sexual abuse, gave significantly higher ratings of sexual fantasy phenomenology but not fantasy frequency or masturbation. They were also more likely to report higher sexual memory intensity. Although the significance of fantasy phenomenology varied between subgroups, binary logistic regression indicated that age, history of harmful sexual behaviour and sexual memory intensity were each independently associated with harmful sexual intent.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings provide new insights into the importance of fantasy phenomenology, demonstrating nuanced differences between those with and without a history of harmful sexual behaviour and illustrating that memory intensity is associated with harmful sexual behaviour intent. Further research into these differences in the context of assessment and intervention for sexual violence perpetration is warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47362,"journal":{"name":"Criminal Behaviour and Mental Health","volume":"33 5","pages":"317-329"},"PeriodicalIF":1.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cbm.2308","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10492457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}