Mental health expertise at prison reception

Brown, Kerry; Cullen, Alexis E.; Kooyman, Iain; Forrester, Andrew

doi:10.1080/14789949.2014.955810

Cited by 8 publications

(5 citation statements)

References 14 publications

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“…Ideally, nurses with mental health experience should administer the primary screen in adult institutions as this increases the validity of the screens by ensuring questions are understood and properly rated by the offenders [ 36 ]; however, this is usually not the case. Nurses in adult prisons and police stations tend to be physical health nurses without mental health experience.…”

Section: Identification and Assessmentmentioning

confidence: 99%

Identification and treatment of offenders with attention-deficit/hyperactivity disorder in the prison population: a practical approach based upon expert consensus

et al. 2018

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BackgroundAround 25% of prisoners meet diagnostic criteria for attention-deficit/hyperactivity disorder (ADHD). Because ADHD is associated with increased recidivism and other functional and behavioural problems, appropriate diagnosis and treatment can be a critical intervention to improve outcomes. While ADHD is a treatable condition, best managed by a combination of medication and psychological treatments, among individuals in the criminal justice system ADHD remains both mis- and under-diagnosed and consequently inadequately treated. We aimed to identify barriers within the prison system that prevent appropriate intervention, and provide a practical approach to identify and treat incarcerated offenders with ADHD.MethodsThe United Kingdom ADHD Partnership hosted a consensus meeting to discuss practical interventions for youth (< 18 years) and adult (≥18 years) offenders with ADHD. Experts at the meeting addressed prisoners’ needs for effective identification, treatment, and multiagency liaison, and considered the requirement of different approaches based on age or gender.ResultsThe authors developed a consensus statement that offers practical advice to anyone working with prison populations. We identified specific barriers within the prison and criminal justice system such as the lack of adequate: staff and offender awareness of ADHD symptoms and treatments; trained mental health staff; use of appropriate screening and diagnostic tools; appropriate multimodal interventions; care management; supportive services; multiagency liaison; and preparation for prison release. Through discussion, a consensus was reached regarding prisoners’ needs, effective identification, treatment and multiagency liaison and considered how this may differ for age and gender.ConclusionsThis practical approach based upon expert consensus will inform effective identification and treatment of offenders with ADHD. Appropriate intervention is expected to have a positive impact on the offender and society and lead to increased productivity, decreased resource utilization, and most importantly reduced rates of re-offending. Research is still needed, however, to identify optimal clinical operating models and to monitor their implementation and measure their success. Furthermore, government support will likely be required to effect change in criminal justice and mental health service policies.Electronic supplementary materialThe online version of this article (10.1186/s12888-018-1858-9) contains supplementary material, which is available to authorized users.

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Section: Identification and Assessmentmentioning

confidence: 99%

Identification and treatment of offenders with attention-deficit/hyperactivity disorder in the prison population: a practical approach based upon expert consensus

et al. 2018

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“…A key success was the adoption of an open referral system and a psychiatric nurse conducting screening assessments at reception. This was confirmed in an evaluation of this reception screening service which found significantly more suitable referrals to the in-reach team and little evidence of ‘mission creep’ whereby specialist services absorb primary care level mental health problems [ 19 ].…”

Section: Discussionmentioning

confidence: 89%

“…The scale of the problem has been further highlighted in a more recent study in which 23 % of the 3492 prisoners screened using research tools had a severe mental health problem; where 25 % with SMI, had been assessed by in-reach teams and only 13 % were then accepted onto their caseloads for further work [ 18 ]. In-reach teams are unlikely to be able to manage the high magnitude of mental health needs in prisons alone, which indicates a need to improve existing screening mechanisms [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Key successes and challenges in providing mental health care in an urban male remand prison: a qualitative study

Samele

Forrester

Urquía

et al. 2016

Soc Psychiatry Psychiatr Epidemiol

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PurposeThis study aimed to describe the workings of an urban male remand prison mental health service exploring the key challenges and successes, levels of integration and collaboration with other services.MethodA purposive sampling was used to recruit key prison and healthcare professionals for in-depth interviews. A thematic analysis was used to analyse transcripts based on an initial coding frame of several predefined themes. Other key themes were also identified.ResultsTwenty-eight interviews were conducted. Prisoners referred to the service had complex, sometimes acute mental illness requiring specialist assessment and treatment. Key successes of the in-reach service included the introduction of an open referral system, locating a mental health nurse at reception to screen all new prisoners and a zoning system to prioritise urgent or non-urgent cases. Achieving an integrated system of healthcare was challenging because of the numerous internal and external services operating across the prison, a highly transient population, limited time and space to deliver services and difficulties with providing inpatient care (e.g., establishing the criteria for admission and managing patient flow). Collaborative working between prison and healthcare staff was required to enable best care for prisoners.ConclusionsThe prison mental health in-reach service worked well in assessing and prioritising those who required specialist mental health care. Although the challenges of working within the prison context limited what the in-reach team could achieve. Further work was needed to improve the unit environment and how best to target and deliver inpatient care within the prison.

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“…In correctional facilities in England and Wales analogous systems have been implemented (Hopkin et al, 2017 ). Local adaptions to screening processes in-prison have shown to statistically significantly improve measures of depression, anxiety and psychological distress for people detained in prison at high-risk of psychosis (Evans et al, 2017 ) and be relatively inexpensive (Brown, Cullen, Kooyman, & Forrester, 2015 ).…”

Section: Discussionmentioning

confidence: 99%

The associations of poor psychiatric well-being among incarcerated men with injecting drug use histories in Victoria, Australia

et al. 2018

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BackgroundDual substance dependence and psychiatric and psychological morbidities are overrepresented in prison populations and associated with reoffending. In the context of an increasing prison population in Australia, investigating the needs of vulnerable people in prison with a dual diagnosis can help inform in-prison screening and treatment and improve prison and community service integration and continuation of care. In this study we quantified psychiatric well-being in a sample of people in prison with a history of injecting drug use in Victoria, Australia, and identified factors associated with this outcome.Methods and ResultsData for this paper come from baseline interviews undertaken in the weeks prior to release as part of a prospective cohort study of incarcerated men who reported regular injecting drug use prior to their current sentence. Eligible participants completed a researcher-administered structured questionnaire that canvassed a range of issues. Psychiatric well-being was assessed using the 12-item General Health Questionnaire (GHQ-12) and potential correlates were included based on a review of the literature. Of the 317 men included for analyses, 139 were classified as experiencing current poor psychiatric well-being. In the multivariate model using modified logistic regression, history of suicide attempt (aOR = 1.36, 95%CI 1.03–1.78), two or more medical conditions (aOR = 1.87, 95%CI 1.30–2.67) and use of crystal methamphetamine in the week prior to their current sentence (aOR = 1.52, 95%CI 1.05–2.22) were statistically significantly associated with current poor psychiatric well-being.ConclusionsComprehensively addressing the health-related needs for this vulnerable population will require a multidisciplinary approach and enhancing opportunities to screen and triage people in prison for mental health and other potential co-occurring health issues will provide opportunities to better address individual health needs and reoffending risk.

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Mental health expertise at prison reception

Cited by 8 publications

References 14 publications

Identification and treatment of offenders with attention-deficit/hyperactivity disorder in the prison population: a practical approach based upon expert consensus

Identification and treatment of offenders with attention-deficit/hyperactivity disorder in the prison population: a practical approach based upon expert consensus

Key successes and challenges in providing mental health care in an urban male remand prison: a qualitative study

The associations of poor psychiatric well-being among incarcerated men with injecting drug use histories in Victoria, Australia

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