Best Practices: Disseminating Best Practices for Bipolar Disorder Treatment in a Correctional Population

Kamath, Jayesh; Temporini, H; Quarti, Susan; Zhang, Wanli; Kesten, Karen; Wakai, Sara; Shelton, Dinah; Trestman, Robert L.

doi:10.1176/ps.2010.61.9.865

Cited by 7 publications

(5 citation statements)

References 11 publications

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“…Our knowledge is relatively limited even with respect to the practice of polypharmacy in BD inmates. Two longitudinal 12-week studies by Kamath et al documented strikingly high prevalence rates for polypharmacy (use of three or more psychotropic medications at one) in 84% of the cases (out of a total sample of 40 BD-I or BD-II cases, equal ratios for males and females) 43 urging the need for standard medication algorithms to reduce the polypharmacy in the correctional setting, with a special reference to antidepressant and antipsychotic drugs. 70 Similarly, despite the acknowledgment that pharmacological treatments for BD have historically been associated with neurocognitive side effects, especially in elderly subjects or otherwise possibly cognitively vulnerable subjects who would be particularly sensitive to polypharmacy, 71 , 72 very little is known about these subjects, including bipolar subjects with intellectual disabilities (IDs).…”

Section: Resultsmentioning

confidence: 99%

Prevalence and clinical features associated with bipolar disorder polypharmacy: a systematic review

Fornaro¹,

Berardis²,

Koshy³

et al. 2016

NDT

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BackgroundUncertainty exists regarding the prevalence and clinical features associated with the practice of polypharmacy in bipolar disorder (BD), warranting a systematic review on the matter.MethodsThree authors independently searched major electronic databases from inception till September 2015. Articles were included that reported either qualitative or quantitative data about the prevalence and clinical features associated with polypharmacy in adult cases of BD.ResultsThe operative definitions of polypharmacy adopted across varying studies varied, with concomitant use of two or more psychotropic medications or use of four or more psychotropic medications at once being the most common and the most reliable, respectively. Regardless of type or current mood episode polarity of BD, prevalence rates up to 85% and 36% were found using the most permissive (two or more medications at once) and the most conservative (four or more) operative definitions for polypharmacy, respectively. Point prevalence prescription rates of one or more antidepressant or antipsychotic as part of a polypharmacy regimen occurred in up to 45% or 80% of the cases, respectively, according to the most permissive definition of polypharmacy. In contrast, lithium prescription rates ranged from 13% to 33% in BD patients receiving polypharmacy according to conservative and permissive definitions, possibly suggesting a reduced need for augmentation of combination strategies for those cases of BD with a favorable lifetime lithium response and/or long-lasting treatment as well as less likelihood of lithium response over the time most severe cases possibly exposed to a more complex polypharmacy overall.Limitations“Apples and oranges” bias; publication bias for most recently introduced compounds.ConclusionPolypharmacy is common among people with BD across varying type and mood episode phases of illness. Special population, including BD patients at high risk of familial load for suicidal behavior, solicit further research as well as the plausible “protective” role of lithium toward polypharmacy in BD. The PROSPERO registration number is CRD42014015084.

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Section: Resultsmentioning

confidence: 99%

Prevalence and clinical features associated with bipolar disorder polypharmacy: a systematic review

Fornaro¹,

Berardis²,

Koshy³

et al. 2016

NDT

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“…There was a great variation in types of interventions reported in the included studies. These include clinician-delivered individual or group psychotherapy [ 39 , 40 , 45 , 46 ]; group-based module curriculum with components on discharge planning and release safety planning and coping, courtroom behavior, treatment compliance, mental health and substance abuse, anger management and conflict, effective communication skills [ 37 ]; adaptation of evidence-based treatment algorithms to improve clinical outcomes [ 36 ]; citizenship project including peer support, citizenship classes [ 43 ]; intermediate care programs to ease transitions from prison to the community [ 47 ]; a new model of care for broadened triggers for mental health referral [ 33 ]; wraparound case management and peer support services [ 35 ]; art brut therapy [ 42 ]; jail and court based diversion programs [ 41 ]; and mental health court [ 44 ]. All of these interventions were delivered at intercepts 3 and 4 (jail/court-based and during community reentry) in the sequential intercept model (see Table 3 ) [ 48 ].…”

Section: Resultsmentioning

confidence: 99%

“…Due to methodological heterogeneity, not all studies reported effect sizes. However, for those studies that reported effect sizes, the effect sizes ranged from ( p < 0.001) [ 36 ] to ( p < 0.0001) [ 37 ].…”

Section: Resultsmentioning

confidence: 99%

“…Of the 13 articles included in this systematic review, 31% ( n = 4) reported at least one barrier to implementing the intervention in criminal justice ( n = 2) or community-based rehabilitation settings ( n = 2). The reported barriers included lack of external policy and incentives (e.g., correctional/administrative policy, clinical culture in the correctional institutions [ 36 , 46 ], patient needs and resources, design quality and packaging, personal attributes of the study participants, implementation climate, and available resources. See Table 4 .…”

Section: Resultsmentioning

confidence: 99%

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Mental health interventions for individuals with serious mental illness in the criminal legal system: a systematic review

Hailemariam,

Bustos,

Montgomery

et al. 2024

BMC Psychiatry

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Background Globally, individuals with mental illness get in contact with the law at a greater rate than the general population. The goal of this review was to identify and describe: (1) effectiveness of mental health interventions for individuals with serious mental illness (SMI) who have criminal legal involvement; (2) additional outcomes targeted by these interventions; (3) settings/contexts where interventions were delivered; and (4) barriers and facilitating factors for implementing these interventions. Methods A systematic review was conducted to summarize the mental health treatment literature for individuals with serious mental illness with criminal legal involvement (i.e., bipolar disorder, schizophrenia, major depressive disorder). Searches were conducted using PsychINFO, Embase, ProQuest, PubMed, and Web of Science. Articles were eligible if they were intervention studies among criminal legal involved populations with a mental health primary outcome and provided description of the intervention. Results A total of 13 eligible studies were identified. Tested interventions were categorized as cognitive/behavioral, community-based, interpersonal (IPT), psychoeducational, or court-based. Studies that used IPT-based interventions reported clinically significant improvements in mental health symptoms and were also feasible and acceptable. Other interventions demonstrated positive trends favoring the mental health outcomes but did not show statistically and clinically significant changes. All studies reported treatment outcomes, with only 8 studies reporting both treatment and implementation outcomes. Conclusion Our findings highlight a need for more mental health research in this population. Studies with randomized design, larger sample size and studies that utilize non-clinicians are needed.

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“…Most existing jail health care studies focus on a single jail or are limited to specific elements of care (e.g., screening) or disease entities (e.g., HIV). [18][19][20][21][22][23] In response, our objective for this study was to generate a comprehensive description of jails' health care structures, resources, and delivery across the entire incarceration experience, from jail entry to release. We undertook this effort in the Southeast, which has some of the highest rates of incarceration of any region in the United States and relatively high levels of community need stemming from low rates of state Medicaid expansion and substantial shortages of community health professionals.…”

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confidence: 99%

Jail Health Care in the Southeastern United States From Entry to Release

et al. 2022

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As a consequence of mass incarceration and related social inequities in the United States, jails annually incarcerate millions of people who have profound and expensive health care needs. Resources allocated for jail health care are scarce, likely resulting in treatment delays, limited access to care, lower‐quality care, unnecessary use of emergency medical services (EMS) and emergency departments (EDs), and limited services to support continuity of care upon release. Potential policy solutions include alternative models for jail health care oversight and financing, and providing alternatives to incarceration, particularly for those with mental illness and substance use disorders. Context Millions of people are incarcerated in US jails annually. These individuals commonly have ongoing medical needs, and most are released back to their communities within days or weeks. Jails are required to provide health care but have substantial discretion in how they provide care, and a thorough overview of jail health care is lacking. In response, we sought to generate a comprehensive description of jails’ health care structures, resources, and delivery across the entire incarceration experience from jail entry to release. Methods We conducted in‐depth interviews with jail personnel in five southeastern states from August 2018 to February 2019. We purposefully targeted recruitment from 34 jails reflecting a diversity of sizes, rurality, and locations, and we interviewed personnel most knowledgeable about health care delivery within each facility. We coded transcripts for salient themes and summarized content by and across participants. Domains included staffing, prebooking clearance, intake screening and care initiation, withdrawal management, history and physicals, sick calls, urgent care, external health care resources, and transitional care at release. Findings Ninety percent of jails contracted with private companies to provide health care. We identified two broad staffing models and four variations of the medical intake process. Detention officers often had medical duties, and jails routinely used community resources (e.g., emergency departments) to fill gaps in on‐site care. Reentry transitional services were uncommon. Conclusions Jails’ strategies for delivering health care were often influenced by a scarcity of on‐site resources, particularly in the smaller facilities. Some strategies (e.g., officers performing medical duties) have not been well documented previously and raise immediate questions about safety and effectiveness, and broader questions about the adequacy of jail funding and impact of contracting with private health care companies. Beyond these findings, our description of jail health care newly provides researchers and policymakers a common foundation from which to understand and study the delivery of jail health care.

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Best Practices: Disseminating Best Practices for Bipolar Disorder Treatment in a Correctional Population

Cited by 7 publications

References 11 publications

Prevalence and clinical features associated with bipolar disorder polypharmacy: a systematic review

Prevalence and clinical features associated with bipolar disorder polypharmacy: a systematic review

Mental health interventions for individuals with serious mental illness in the criminal legal system: a systematic review

Jail Health Care in the Southeastern United States From Entry to Release

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