An economic analysis of the in-prison therapeutic community model on prison management costs

Zhang, Sheldon X.; Roberts, Robert E.; McCollister, Kathryn E.

doi:10.1016/j.jcrimjus.2009.06.006

Cited by 14 publications

(15 citation statements)

References 33 publications

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“…171 TCs are 'typically drug free settings that rely heavily on peer influence and mentoring activities' (p. 389); 171 indeed, the aim of this study was to assess the impact on management costs (these included inmate infractions, inmate grievances and major incidents) in a prison-based substance abuse programme. The analysis uses a group of similar inmates housed in a non-TC yard as the comparator.…”

Section: Study Characteristics and Populationmentioning

confidence: 99%

“…Although the study does not explicitly refer to health outcomes, this is implicit in both the raison d'être of the TC and the body of evidence cited by the authors, which points to reduced drug use among TC participants together with potential costs savings that could offset the cost of the TC programme. Zhang and colleagues 171 are interested in the shorter-term benefits -the impact on disruptive behaviour, prisoner-staff conflict and management costs -which appear to be a more neglected area of research. They highlight a previous study 176 which found that a TC environment was thought to promote fewer inmate disciplinary problems.…”

Section: Commentarymentioning

confidence: 99%

“…The model would draw on evidence from a range of sources including papers identified in the effectiveness and cost-effectiveness reviews, other clinical evidence and professional opinion when data/evidence are not available. However, as only one paper was identified in the cost-effectiveness review, 171 and this paper was unlikely to be generalisable to the UK, we focused our attention on evidence from the effectiveness review.…”

Section: Introductionmentioning

confidence: 99%

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A systematic review of the effectiveness and cost-effectiveness of peer-based interventions to maintain and improve offender health in prison settings

South

Bagnall

Hulme

et al. 2014

Health Services and Delivery Research

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BackgroundOffender health is deemed a priority issue by the Department of Health. Peer support is an established feature of prison life in England and Wales; however, more needs to be known about the effectiveness of peer-based interventions to maintain and improve health in prison settings.ObjectivesThe study aimed to synthesise the evidence on peer-based interventions in prison settings by carrying out a systematic review and holding an expert symposium. Review questions were (1) what are the effects of peer-based interventions on prisoner health and the determinants of prisoner health?, (2) what are the positive and negative impacts on health services within prison settings of delivering peer-based interventions?, (3) how do the effects of peer-based approaches compare with those of professionally led approaches? and (4) what are the costs and cost-effectiveness of peer-based interventions in prison settings?Data sourcesFor the systematic review, 20 electronic databases including MEDLINE, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature and EMBASE were searched from 1985. Grey literature and relevant websites were also searched. To supplement the review findings 58 delegates, representing a variety of organisations, attended an expert symposium, which provided contextual information.Review methodsTwo reviewers independently selected studies using the following inclusion criteria: population – prisoners resident in prisons and young offender institutions; intervention – peer-based interventions; comparators: review questions 3 and 4 compared peer-led and professionally led approaches; outcomes – prisoner health or determinants of health, organisational/process outcomes or views of prison populations; study design: quantitative, qualitative and mixed-methods evaluations. Two reviewers extracted data and assessed validity using piloted electronic forms and validity assessment criteria based on published checklists. Results from quantitative studies were combined using narrative summary and meta-analysis when appropriate; results from qualitative studies were combined using thematic synthesis.ResultsA total of 15,320 potentially relevant papers were identified of which 57 studies were included in the effectiveness review and one study was included in the cost-effectiveness review; most were of poor methodological quality. A typology of peer-based interventions was developed. Evidence suggested that peer education interventions are effective at reducing risky behaviours and that peer support services provide an acceptable source of help within the prison environment and have a positive effect on recipients; the strongest evidence came from the Listener scheme. Consistent evidence from many predominantly qualitative studies suggested that being a peer deliverer was associated with positive effects across all intervention types. There was limited evidence about recruitment of peer deliverers. Recurring themes were the importance of prison managerial and staff support for schemes to operate successfully, and risk management. There was little evidence on the cost-effectiveness of peer-based interventions. An economic model, developed from the results of the effectiveness review, although based on data of variable quality and a number of assumptions, showed the cost-effectiveness of peer-led over professionally led education in prison for the prevention of human immunodeficiency virus (HIV) infection.LimitationsThe 58 included studies were, on the whole, of poor methodological quality.ConclusionsThere is consistent evidence from a large number of studies that being a peer worker is associated with positive health. Peer support services can also provide an acceptable source of help within the prison environment and can have a positive effect on recipients. This was confirmed by expert evidence. Research into cost-effectiveness is sparse but a limited HIV-specific economic model, although based on a number of assumptions and evidence of variable quality, showed that peer interventions were cost-effective compared with professionally led interventions. Well-designed intervention studies are needed to provide robust evidence including assessing outcomes for the target population, economic analysis of cost-effectiveness and impacts on prison health services. More research is needed to examine issues of reach, utilisation and acceptability from the perspective of recipients and those who choose not to receive peer support.Study registrationThis study was registered as PROSPERO CRD42012002349.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Section: Study Characteristics and Populationmentioning

confidence: 99%

Section: Commentarymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A systematic review of the effectiveness and cost-effectiveness of peer-based interventions to maintain and improve offender health in prison settings

South

Bagnall

Hulme

et al. 2014

Health Services and Delivery Research

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show abstract

“…Misbehavior in prison raises concerns about the safety of other inmates and staff, appropriate methods of management, costs, and reentry in the community upon release (Flanagan, 1982(Flanagan, , 1983Goetting & Howsen, 1986;Gottfredson, 1979;Welsh, McGrain, Salamatin, & Zajac, 2007;Wolff & Shi, 2009;Zhang, Roberts, & McCollister, 2009). A socially disruptive prison environment creates general unrest, which makes inmate adjustment difficult (Adams, 1983).…”

Section: The Problem Of Prison Misconductmentioning

confidence: 99%

The Effects of Mental Health and Substance Abuse Disorders on Institutional Misconduct Among Female Inmates

Houser¹,

Belenko²,

Brennan³

2011

Justice Quarterly

127

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“…A recent evaluation of the Life Connections Program using federal prisoner data and a propensity score matching design found that inmates involved in the Life Connections Program were significantly less likely to engage in serious forms of misconduct (Camp, Daggett, Kwon, & Klein-Saffran, 2008). More generally, recent evaluation evidence suggests that therapeutic community-based yards have fewer infractions, grievances, and major incidents of misconduct than traditional prison yards in addition to the therapy focus of the former (Zhang, Roberts, & McCollister, 2009). Similarly positive effects were found for therapeutic community approaches on work release clients (Butzin, O'Connell, Martin, & Inciardi, 2006).…”

Section: Contents Lists Available At Sciencedirectmentioning

confidence: 99%

The criminal justice system works!

DeLisi

2010

Journal of Criminal Justice

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An economic analysis of the in-prison therapeutic community model on prison management costs

Cited by 14 publications

References 33 publications

A systematic review of the effectiveness and cost-effectiveness of peer-based interventions to maintain and improve offender health in prison settings

A systematic review of the effectiveness and cost-effectiveness of peer-based interventions to maintain and improve offender health in prison settings

The Effects of Mental Health and Substance Abuse Disorders on Institutional Misconduct Among Female Inmates

The criminal justice system works!

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