The management of released prisoners with severe and enduring mental illness

Lennox, Charlotte; Senior, Jane; King, Carlene; Hassan, Lamiece; Clayton, Ruth; Thornicroft, Graham; Shaw, Jenny

doi:10.1080/14789949.2011.634921

Cited by 37 publications

(41 citation statements)

References 10 publications

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“…This percentage is lower than in the Hayes et al 20 study and may reflect older prisoners prioritising other issues, rather than their physical health, immediately on entry into prison. Note review ≥ 60 100 n/a n/a n/a n/a 38 n/a 33 19 3 Self-report [65][66][67][68][69][70][71][72][73][74] 16,443 n/a n/a 1 n/a 29 25 12 9 n/a n/a, not applicable; SF-12, Short Form questionnaire-12 items. a For the Kingston et al 32 study self-reported findings are presented in brackets and findings from inmate records are present outside the brackets.…”

Section: Physical Health Needsmentioning

confidence: 99%

“…66 Consequently, it is essential that contact with care services is maintained on release from prison. 67,68 The National Association for the Care and Resettlement of Offenders recommends that the resettlement needs of every offender should be considered from the start of their prison sentence, 69 although little is known regarding the extent to which this is realised because there is a paucity of research concerning discharge planning for prisoners. The UK government has argued that effective release planning is a key priority to reduce barriers to resettlement.…”

Section: Introductionmentioning

confidence: 99%

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The effectiveness of the Older prisoner Health and Social Care Assessment and Plan (OHSCAP): a randomised controlled trial

Forsyth

Archer-Power

Senior

et al. 2017

Health Serv Deliv Res

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Background Older people are the fastest-growing group in prisons in England and Wales and have complex health and social care needs that often remain unmet. Objectives (1) Evaluate the efficacy of the Older prisoner Health and Social Care Assessment and Plan (OHSCAP) in improving (i) the ability to meet older male prisoners’ health and social care needs, (ii) health-related quality of life (HRQoL), (iii) depressive symptoms and (iv) functional health and well-being and activities of daily living; (2) assess the quality of care plans produced; (3) explore the experiences of older prisoners receiving, and staff conducting, the OHSCAP; and (4) evaluate the cost-effectiveness of the OHSCAP compared with treatment as usual (TAU). Design Multicentre, parallel-group randomised controlled trial (RCT) with follow-up at 3 months, with a nested qualitative study and quality audit of care plans (n = 150, 68%). Setting Ten English prisons. Participants Four hundred and ninety-seven newly arrived male prisoners aged ≥ 50 years with a discharge date at least 3 months from recruitment. A total of 14 prisoners and 11 staff participated in qualitative interviews. Intervention Randomisation to OHSCAP or TAU. The OHSCAP group had health and social needs assessed by a trained health-care worker or prison officer. Care plans were devised and subsequent actions included professional support and appropriate referrals. Main outcome measures Primary outcome measure – mean number of unmet health and social care needs as measured by the Camberwell Assessment of Need – Short Forensic Version. Secondary outcome measures – measures of functional health and well-being, depressive symptoms and HRQoL. A health economic evaluation was undertaken using service contact between baseline and follow-up and appropriate unit cost information. Results A total of 497 prisoners were recruited (248 to OHSCAP and 249 to TAU). The 404 completed follow-ups were split evenly between the trial arms. No significant differences were observed between the intervention and TAU groups in relation to the primary outcome measure. The OHSCAP did not demonstrate convincing benefits in HRQoL over TAU, and there were no significant differences in relation to costs. Audit and qualitative data suggest that the intervention was not implemented as planned. Limitations As a result of the limited follow-up period, potential long-term gains of the intervention were not measured. Some of the standardised tools had limited applicability in prison settings. Cost-effectiveness data were limited by unavailability of relevant unit cost data. Conclusions The OHSCAP failed in its primary objective but, fundamentally, was not implemented as planned. This appears to have been attributable, in some part, to wider difficulties currently affecting the prison landscape, including reduced levels of staffing, the loss of specialist support roles for such initiatives and increased prevalence of regime disruption. Future work Partnership working and information sharing across disciplines within prison settings require improvement. Research should explore the potential involvement of other prisoners and third-sector organisations in identifying and addressing older prisoners’ health and social care needs to better match community provision. Further examination should be undertaken of how the prison regime and system affects the well-being of older prisoners. Future prison-based RCTs should carefully balance the fidelity of initiatives being evaluated and testing in a ‘real-life’ setting. Trial registration Current Controlled Trials ISRCTN11841493. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 5, No. 31. See the NIHR Journals Library website for further project information.

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Section: Physical Health Needsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effectiveness of the Older prisoner Health and Social Care Assessment and Plan (OHSCAP): a randomised controlled trial

Forsyth

Archer-Power

Senior

et al. 2017

Health Serv Deliv Res

Self Cite

View full text Add to dashboard Cite

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“…Furthermore, Prins [75, p., 338] described that persons charged with a serious offence such as homicide are frequently found to be suffering from severe depressive episode at the time of breaching violence. The South African experience vividly verified the fact as over 70% of all offenders are currently incarcerated because of violent crimes and possibly some of these offenders experience psychosocial problems [57]. In conclusion, the epidemiological evidence drained from various studies showed that prisoners have experienced and continue to experience worse health problems than the general population [20; 23; 65; 39; 48).…”

Section: Introductionmentioning

confidence: 84%

“…Diverse sources of diagnostic estimate on persons with mental illness in jails and prisons were indicated. For example, in America 10 to 15 % [71], in Great Britain over 90% [8]; and in South Africa 70% have been stated as inmates [57].…”

Section: Introductionmentioning

confidence: 99%

Psychopathological Symptoms and Predictors among Inmates

Gemeda¹

2013

PBS

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Abstract:The study was meant to examine the prevalence of psychopathological symptoms among inmates, which in line, to suggest systems to accentuate psychosocial rehabilitation program in correction centers. The total number of participants was 420 (i.e., 384 males and 36 females). Multi-stage probability sampling (i.e., stratified, systematic and simple random) sampling techniques were employed, and for the data analysis t-test and logistic regression were applied. It was found that 48% (CI 95 = -0.08, 0.05) of inmates have been experiencing psychopathological symptoms, but not significantly different at . Thus, the number of inmates who grieves from mental and behavioral aches remains not nominal. Rehabilitation requires availability, accessibility and integration of professionals (i.e., psychologists, social workers and psychiatrists). Besides, prison tradition essentially duty-bound beyond mundane provisions comparable to shelter, food and medical treatment.

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“…Yet, despite this, all of the participants who were not living in a structured environment post-release had lost contact with mental health services by the end of the study. Low levels of engagement with community mental health services was found in a recent UK study for people with severe mental illness leaving prison (Lennox et al, 2012). The study involved 137 participants and 30% of the cohort had received no discharge planning.…”

Section: Discussionmentioning

confidence: 99%

Hoping Against Hope: The Prison-to-Community Transition Experience of Men With Co-Occurring Severe Mental Illness and Substance Use Disorder

Denton¹

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This thesis explores the prison-to-community transition experience after short-term incarceration, from the perspective of men with co-occurring mental illness and substance use disorder in Queensland, Australia. A specific focus was to examine the impact of systems and structures on the individual experience of transition. Prior research has established that people with co-occurring mental illness and substance use are overrepresented in the Australian prisoner population. It is also known that transition from prison to community for the general custodial population is a time of vulnerability, with increased risk of substance use, homelessness, unemployment, reincarceration and post-release death. All of these risks are compounded for prisoners with co-occurring disorders who are also at risk of a range of poor criminal justice outcomes and losing contact with mental health services after release.Review of the literature indicates a tendency for research to focus on recidivism as an outcome and emphasise either individual risk behaviour or social and structural factors influencing prison-to-community transition. Interventions during transition for the current population have traditionally been based on the criminalisation hypothesis, with a focus on increased provision of mental health services in prison and an emphasis on continuity of care in the community. There is a growing recognition in the international literature that the issues are much broader than mental illness; however, there is a lack of clarity as to how to respond to the complex needs of this population. Research exploring the perspective of men with cooccurring severe mental illness and substance use disorder during their prison-to-community transition experience has rarely been undertaken.The conceptual framework developed for this study shifts the emphasis away from recidivism towards recovery and wellbeing through a lens of individual action, but only in the context of the potential for systems and structures to impact on the ability of individuals to exercise agency. A qualitative method was used comprising repeat in-depth interviews with 18 men: within 1 month prior to leaving prison, within 2 weeks post-release and at 3 months postrelease. Three themes characterised the transition experience of participants: "hoping against hope"; "adrift in freedom"; and "the slippery slope". Participants reported leaving the predictable and routine life in prison where they hoped for a better life after release, to an uncertain, unstable and isolated environment in the community, eventually sliding into drug use, chaos and despair. The risk environment framework (Rhodes, 2009) and structuration theory (Giddens, 1984) were employed to understand how participants were caught in a complex dynamic between their individual risk behaviour and broader structural risk iii environments. This thesis proposes that a web of interrelated factors contributed to participants in the study as "ambivalent agents" who were suspended between the two worlds of priso...

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The management of released prisoners with severe and enduring mental illness

Cited by 37 publications

References 10 publications

The effectiveness of the Older prisoner Health and Social Care Assessment and Plan (OHSCAP): a randomised controlled trial

The effectiveness of the Older prisoner Health and Social Care Assessment and Plan (OHSCAP): a randomised controlled trial

Psychopathological Symptoms and Predictors among Inmates

Hoping Against Hope: The Prison-to-Community Transition Experience of Men With Co-Occurring Severe Mental Illness and Substance Use Disorder

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