The Unhappy Mental Health Triad: Comorbid Severe Mental Illnesses, Personality Disorders, and Substance Use Disorders in Prison Populations

Mundt, Adrian P.; Baranyi, Gergő

doi:10.3389/fpsyt.2020.00804

Cited by 42 publications

(22 citation statements)

References 35 publications

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“…Many individuals experience recurrent psychiatric hospitalizations and incarcerations over time—the so called revolving door phenomenom [19] , [20] , [21] . Repeated episodes of inpatient treatment and imprisonment have been reported for people with severe mental illness, comorbid substance use and personality disorders [22] . In 1939, Penrose described for the first time a possible inverse relationship between the number of psychiatric beds and the size of prison populations, based on a cross-sectional analysis of data from 18 European countries [23] .…”

Section: Introductionmentioning

confidence: 99%

Changes in national rates of psychiatric beds and incarceration in Central Eastern Europe and Central Asia from 1990-2019: A retrospective database analysis

Mundt

Serri

Siebenförcher

et al. 2021

The Lancet Regional Health - Europe

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Background Numbers of psychiatric beds (general, forensic, and residential) and prison populations have been considered to be indicators of institutionalisation of people with mental illnesses. The present study aimed to assess changes of those indicators across Central Eastern Europe and Central Asia (CEECA) over the last three decades to capture how care has developed during that historical period. Methods We retrospectively obtained data on numbers of psychiatric beds and prison populations from 30 countries in CEECA between 1990 and 2019. We calculated the median of the percent changes between the first and last available data points for all CEECA and for groups of countries based on former political alliances and income levels. Findings Primary national data were retrieved from 25 out of 30 countries. Data from international registries were used for the remaining five countries. For all of CEECA, the median decrease of the general psychiatric bed rates was 33•8% between 1990 and 2019. Median increases were observed for forensic psychiatric beds (24•7%), residential facility beds (12•0%), and for prison populations (36•0%). Greater reductions of rates of psychiatric beds were observed in countries with lower per capita income as well as in countries that were formerly part of the Soviet Union. Seventeen out of 30 countries showed inverse trends for general psychiatric beds and prison populations over time, indicating a possible shift of institutionalisation towards correctional settings. Interpretation Most countries had decreased rates of general psychiatric beds, while there was an increase of forensic capacities. There was an increase in incarceration rates in a majority of countries. The large variation of changes underlines the need for policies that are informed by data and by comparisons across countries. Funding Agencia Nacional de Investigación y Desarrollo in Chile, grant scheme FONDECYT Regular, grant number 1190613.

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Section: Introductionmentioning

confidence: 99%

Changes in national rates of psychiatric beds and incarceration in Central Eastern Europe and Central Asia from 1990-2019: A retrospective database analysis

Mundt

Serri

Siebenförcher

et al. 2021

The Lancet Regional Health - Europe

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“…The young people in this study reported that, from their experiences, the interventions they participated in focused primarily on drug problems, and other problems or needs were neglected. Co-morbidity is a rather common problem among drug consumers, in particular in prisons (Mundt & Baranyi, 2020). Some of our interviewees experienced a lack of help in relation to mental health problems.…”

Section: Low Motivation To Participate In Interventionsmentioning

confidence: 99%

Unintended consequences of drug policies experienced by young drug users in contact with the criminal justice systems

Moskalewicz

Dąbrowska

Herold

et al. 2021

Drugs: Education, Prevention and Policy

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The aim of this paper is to assess to what extent prohibitive drug policies hamper the management of drug problems from the perspective of young people who have experience with the criminal justice systems (CJS). Qualitative, in-depth interviews were carried out in six European countries (Austria, Denmark, Germany, Italy, Poland, and the UK) following a common interview guide to obtain comparative data on the life trajectories of drug experienced youth. Altogether 198 interviews with people aged 14-25 years were collected and analysed by national teams following a common coding book. Unintended consequences of drug policies for the individual and society were identified. Individual consequences included health consequences and traumatic experiences with law enforcement. Social consequences included those affecting social relations such as stigmatisation and those impacting on institutions, for example, focusing on drug use and neglecting other problems. This paper confirmed earlier research indicating unintended consequences of prohibitive drug policies but also added to the literature its cross-national perspective and use of young people narratives as a source of analyses. There are, however, policy measures available that may reduce the volume and range of unintended effects. Their implementation is crucial to reduce the array of unintended consequences of prohibitive drug policies.

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“…1 Violent offenders constitute a heterogeneous group, with some demonstrating very complex psychiatric comorbidities (e.g., forensic psychiatric patients) and others predominantly criminogenic needs. However, common denominators for violent offenders housed in forensic settings are difficulties with emotion regulation, impulsivity, and empathy in combination with different mental disorders (e.g., antisocial and other personality syndromes) (Bogaerts et al, 2012;Lobbestael et al, 2015;Filov, 2019;Mundt and Baranyi, 2020). Given this, maintaining an environment that reduces the risk of aggression represents a distinct challenge.…”

Section: Introductionmentioning

confidence: 99%

New Developments in Virtual Reality-Assisted Treatment of Aggression in Forensic Settings: The Case of VRAPT

Moraga

Tuente

Perrin

et al. 2022

Front. Virtual Real.

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Aggression is a known problem in individuals being cared for in forensic settings, yet the evidence base for its treatment is scarce. Virtual Reality (VR) has been proposed as a promising addition to interventions in forensic settings, as it may increase the motivation among participants, bridge the gap between real life, therapeutic and laboratory experiences, and increase the ecological validity of psychological research. Recently, a new treatment for aggression using VR as the treatment environment, Virtual Reality Aggression Prevention Training (VRAPT), was developed to provide realistic and safe environments for participants to practice aggression management. In its current revised version, VRAPT is conceptualized as a form of cognitive behavioral therapy with its theoretical background in the General Aggression Model. Its purpose is to increase awareness of, and improve control over, one’s own aggression and that of others through social interactions in individually tailored virtual environments. This manuscript describes how the lessons learned from the first randomized controlled trial of VRAPT have been applied to further develop the method and discusses challenges and future directions for VR-assisted treatment of aggression in forensic settings. VRAPT is a new psychological treatment for aggression and the coming years will provide expanded scientific evidence for further developments and adaptations.

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The Unhappy Mental Health Triad: Comorbid Severe Mental Illnesses, Personality Disorders, and Substance Use Disorders in Prison Populations

Cited by 42 publications

References 35 publications

Changes in national rates of psychiatric beds and incarceration in Central Eastern Europe and Central Asia from 1990-2019: A retrospective database analysis

Changes in national rates of psychiatric beds and incarceration in Central Eastern Europe and Central Asia from 1990-2019: A retrospective database analysis

Unintended consequences of drug policies experienced by young drug users in contact with the criminal justice systems

New Developments in Virtual Reality-Assisted Treatment of Aggression in Forensic Settings: The Case of VRAPT

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