LATEST PUBLICATIONS by PORSCH Members:
Aboaja, A. M., et al. (2024). "Sleep interventions for adults admitted to psychiatric inpatient settings: a systematic scoping review." Sleep Medicine Reviews: 101950.
Summary: Sleep disturbances are common, affecting over half of adults with a mental disorder. For those admitted to a psychiatric ward, difficulties with sleep, particularly insomnia, are compounded by factors relating to the inpatient setting. We conducted a scoping review of sleep intervention studies involving adults admitted to psychiatric settings. We categorised the different types of sleep interventions and identified the effects on sleep and other mental and physical health outcomes. Instruments used to measure sleep were also examined. The search strategy yielded 4780 studies, of which 28 met the inclusion criteria. There was evidence of more non-pharmacological than pharmacological interventions having been tested in inpatient settings. Results indicated that non-pharmacological interventions based on cognitive behaviour therapy for insomnia improve sleep and may improve mental and physical health. Several distinct sleep measures were used in the studies. Gaps in the literature were identified, highlighting the importance of research into a wider range of sleep interventions tested against robust controls, using validated measures of sleep with evaluation of additional mental and physical health outcomes among a large sample size of adults in the psychiatric inpatient settings.
https://doi.org/10.1016/j.smrv.2024.101950
Aboaja, A., et al. (2023). "Six nations: a clinical scenario comparison of systems for prisoners with psychosis in Australia, Bolivia and four European nations." BJPsych International 20(1): 13-17.
Abstract: This paper compares across six nations the mental health systems available to prisoners with the highest acuity of psychosis and risk combined with the lowest level of insight into the need for treatment. Variations were observed within and between nations. Findings highlight the likely impact of factors such as mental health legislation and the prison mental health workforce on a nation's ability to deliver timely and effective treatment close to home for prisoners who lack capacity to consent to treatment for their severe mental illness. The potential benefits of addressing the resulting inequalities are noted. https://www.cambridge.org/core/journals/bjpsych-international/article/six-nations-a-clinical-scenario-comparison-of-systems-for-prisoners-with-psychosis-in-australia-bolivia-and-four-european-nations/3A4C594B7B65FE714E5879FAB2AA9CD
Aboaja, A., et al. (2021). "Sleep interventions for adults admitted to psychiatric inpatient settings: a scoping review protocol." JBI Evidence Synthesis.
This scoping review aims to identify how sleep is measured and what sleep interventions are used effectively in psychiatric inpatient settings. Potential barriers to measuring sleep in inpatient settings will be classified. Introduction: https://journals.lww.com/jbisrir/Fulltext/2021/09000/Sleep_interventions_for_adults_admitted_to.13.aspx
Aboaja, A., et al. (2020). "Involving service users to identify research priorities in a UK forensic mental health service." BJPsych Bulletin(45): 321-326.
Patient and public involvement (PPI) is a priority for health research. PPI improves the relevance and quality of research. The study aimed to involve service users in identifying research priorities for the service. A two-phase adapted Delphi technique was used to generate a list of research topics from service users in secure in-patient mental health settings and on specialist mental health prison wings. Topic content analysis was undertaken. Service users were further consulted, and research themes were ranked in order of priority.
Results: Of the eight research themes identified, the three given the highest priority by service users were, in descending order, physical health, future plans and moving on, and causes of illness and crime.
Clinical implications: Service users are willing to be involved in setting research priorities for mental health services. Through non-tokenistic PPI, service users can uniquely shape the research agenda of mental health services.
S205646942000131Xjra 321..326 (cambridge.org)
Alderson, H.; Spencer, L.; Scott, S.; Kaner, E.; Reeves, A.; Robson, S.; Ling, J. (2021) Using Behavioural Insights to Improve the Uptake of Services for Drug and Alcohol Misuse. Int. J. Environ. Res. Public Health 2021, 18, 6923.
The aim of this study was to explore the factors that affect drug and alcohol treatment uptake within a drug and alcohol service in North East England. https://doi.org/10.3390/ijerph18136923
Bowden J, Logan C, Robinson L, Carey J, McDonald J, McDonald R, et al. (2024) Clinicians’ use of the structured professional judgement approach for adult secure psychiatric service admission assessments: A systematic review. PLoS ONE 19(9): e0308598. Clinicians’ use of the structured professional judgement approach for adult secure psychiatric service admission assessments: A systematic review | PLOS ONE
The structured professional judgement (SPJ) approach was initially developed to support risk assessment and management decisions. The approach is now being adapted and applied to admission assessments for adult secure services. This systematic review aims to summarise the evidence for the effectiveness and acceptability of the SPJ approach in admission assessments of this kind. A comprehensive electronic search strategy was used to identify studies indexed in PubMed, PsycInfo, Medline and Cochrane Library (January 2007 –January 2024). Two search strategies included terms (and synonyms) for psychiatric patients (quantitative) or clinicians and clinicians’ experiences (qualitative), structured professional judgement, admission, and secure services. Twelve quantitative articles (published 2007–2020) were identified. SPJ-informed guidance included were the DUNDRUM-1, DUNDRUM-2, DUNDRUM-3, DUNDRUM-4, and the HCR-20. While findings were variable, the overall pattern indicated that ratings suggestive of more problems were associated with increased likelihood of admission or movement to higher security levels. There is emerging evidence for the use of SPJ guidance to support admission decision-making. Specifically, it should be used as an adjunct to existing decision-making processes rather than as a replacement for those processes. Further research, both quantitative and qualitative, across a wider range of settings and populations is recommended.
Bowden, J., Robinson, L., Logan, C., Carey, J., McDonald, R., Shaw, J., Senior, J., & Leonard, S. (2022). "A systematic review of clinicians’ use of structured professional judgement approaches for adult secure psychiatric service admission assessments. " NIHR PROSPERO 2022 CRD42022351425. crd.york.ac.uk/prospero/display_record.php?ID=CRD42022351425
Carey, J. F. (2021). "Projected reality, critical realism and boundary objects: a new model for assessment in forensic psychiatry." Academia Letters AL1388.
Initial assessment in forensic psychiatry should strive to be a process that allows service users, referrers and assessing professionals to develop an understanding of the person being assessed as an individual and to appreciate their strengths, needs and risks in a collaborative, holistic and inclusive manner. Assessment should then lead to the formulation of an inter-disciplinary plan to meet those needs and enhance strengths with the aim of improving mental health and reducing levels of risk. https://doi.org/10.20935/AL1388
Cassidy, K., Dyer, W., Biddle, P., Ridley, L., Brandon, T. and McClelland, N., (2022) Prisoners with severe mental illnesses and everyday prison interior (re)design. Palgrave Handbook of Prison Design. Springer Nature. https://link.springer.com/book/9783031119712
McClelland, N. A., et al. (2023). "The introduction and development of a mental health integrated support unit within an English prison: clinical, care staff and operational officer perspectives." The Journal of Forensic Practice 25(1): 1-11.
Abstract: Purpose There is clear evidence that prison can be detrimental to mental health and that wider society has tended to assume “out of sight, out of mind” for prisoners in mental distress. The lack of access to effective mental health care in prisons along with increasingly lower numbers of prison officers, or Operational Officers (OOs), has created a negative culture that requires the development of specialist services. With this comes a need to conduct evaluations, and investigations, into the roles of OOs and mental health-care staff. This study aims to report on a commissioned evaluation around the introduction and development of an HMP Mental Health Unit, named the integrated support unit (ISU), in the North of England. https://www.emerald.com/insight/content/doi/10.1108/JFP-05-2022-0021/full/html
Perry, A. E. (2020). "Self-harm in prisons: what do we know and how can we move forwards?" The Lancet Psychiatry 7(8): 649-650.
Abstract: Research has consistently shown that the prevalence of poor mental health among prisoners is considerably higher than that in the community. Mental health services in prisons cite several other vulnerabilities, such as substance misuse problems and poor physical health, and report high rates of self-harm behaviour. In prisons, little is known about the underlying mechanisms for self-harm behaviour and research on this topic is crucial to understand more about how the problem can be addressed. Louis Favril and colleagues reported on the results of a systematic review and meta-analysis of four databases with the aim of identifying risk factors for self-harm in prison. https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30298-4/fulltext
Perry, A. E., et al. (2024). "Co-production and adaptation of a prison-based problem-solving workbook to support the mental health of patients housed within a medium- and low-secure forensic service." Health Expectations 27(2): e13997.
Abstract: Introduction Problem-solving skills (PSS) help to provide a systematic approach to dealing with and managing complex problems. The overall aim of this study was to assess the acceptability and feasibility of developing and adapting a prison-based PSS workbook for adults within a medium- and low-secure hospital. https://onlinelibrary.wiley.com/doi/10.1111/hex.13997
Redgate S., Dyer, W. and Smith, M. (2022) Using a Realist approach in understanding Youth Offending Service delivery requirements for young people who offend with speech, language, and communication needs. Discover Social Science and Health. https://doi.org/10.1007/s44155-022-00024-y
Poulter, H. L., Walker, T., Ahmed, D., Moore, H. J., Riley, F., Towl, G., & Harris, M. (2023). More than just ‘free heroin’: Caring whilst navigating constraint in the delivery of diamorphine assisted treatment. International Journal of Drug Policy, 116, 104025.
Riley, F., Harris, M., Poulter, H. L., Moore, H. J., Ahmed, D., Towl, G., & Walker, T. (2023). ‘This is hardcore’: a qualitative study exploring service users’ experiences of Heroin-Assisted Treatment (HAT) in Middlesbrough, England. Harm Reduction Journal, 20(1), 66.
Rippon, D., Smith, M. & Dyer, W. (2021) The sources of adversity in the delivery of mental healthcare in prisons. Wellbeing, Space and Society. https://doi.org/10.1016/j.wss.2021.100046
Walker, T., et al. (2019). "A qualitative study of contemporary secure mental health services: women service users’ views in England." The Journal of Forensic Psychiatry & Psychology 30(5): 836-853.
Abstract: Women’s Enhanced Medium Secure Services (WEMSS) was a concept borne out of findings that an inappropriate number of women were being held in high secure services, despite not fulfilling high secure criterion. A qualitative study of women service users’ views of living in WEMSS and comparator medium secure services (MSS) in the UK is presented.
https://www.tandfonline.com/doi/full/10.1080/14789949.2019.1646305
RECENT OFFENDER HEALTH RESEARCH ARTICLES
2024
Dewa, L. H., et al. (2024). "Treating insomnia in people who are incarcerated: a feasibility study of a multicomponent treatment pathway." SLEEP Advances 5(1).
Abstract: Around 60% of people who are incarcerated have insomnia; 6–10 times more prevalent than the general population. Yet, there is no standardized, evidence-based approach to insomnia treatment in prison. We assessed the feasibility of a treatment pathway for insomnia in a high-secure prison to inform a future randomized controlled trial (RCT) and initial efficacy data for sleep and mental health outcomes.
Haines-Delmont, A., et al. (2024). "Dynamic Relationship Between Protective Factors and Violent Outcomes Assessed Using the Structured Assessment of Protective Factors (SAPROF) in Secure Forensic Services." Journal of Forensic Psychology Research and Practice: 1-21.
Abstract: This UK study is one of the first cohort studies exploring dynamic changes in risk and protective factors and the value of multiple risk assessments over time using the Structured Assessment of Protective Factors (SAPROF) tool. Multilevel linear regression was used to assess the stability of risk assessment ratings within patients and logistic regression to examine the likelihood of a violent incident following assessment. The analyses included 1560 observations for 65 adult forensic inpatients. This paper points to the need for services to model a more flexible review and application of the timescales in which the structured assessment/reassessment cycle operates.
Rainbow, J. A. (2024). Researching Prisons. London, Routledge.
Researching Prisons provides an overview of the processes, practices, and challenges involved in undertaking prison research. The chapters look at the different practical, theoretical, and emotional considerations required at the various stages of the research process, drawing on the reflections and challenges experienced by over 40 other prison researchers both in England and Wales, and across the world.
Spaan, P., et al. (2024). "How are you coping? Stress, coping, burnout, and aggression in forensic mental healthcare workers." Frontiers in Psychology 14.
Perceived stress at work has been linked to several adverse outcomes in workers, including increased risk of burnout and aggression (e.g., anger and irritability). However, much remains unknown about factors that might mitigate the negative influences of perceived stress on workers’ well-being. This study focusses on coping as a possible protective factor against perceived stress and its consequences in forensic mental healthcare workers. We aimed to identify which higher-order coping factors were present in this worker sample and to investigate whether these coping factors modify the associations between perceived stress and burnout or aggression.
2023
Iflaifel, M., et al. (2023). "Widening participation – recruitment methods in mental health randomised controlled trials: a qualitative study." BMC Medical Research Methodology 23(1): 211.
Abstract: Barriers to mental health research participation are well documented including distrust of services and research; and stigma surrounding mental health. They can contribute to a lack of diversity amongst participants in mental health research, which threatens the generalisability of knowledge. Given the recent widespread use of the internet in medical research, this study aimed to explore the perspectives of key partners on the use of online (e.g. social media) and offline (e.g. in-person) recruitment as an approach to improving diversity in mental health randomised controlled trials (RCTs).
Sales, C., et al. (2023). "Delays in transferring patients from prisons to secure psychiatric hospitals: An international systematic review." Criminal behaviour and mental health : CBMH.
Background: Transfer to a psychiatric hospital of prisoners who need inpatient treatment for a mental disorder is an important part of prison healthcare in the UK. It is an essential factor in ensuring the principle of equivalence in the treatment of prisoners. In England and Wales, delays in transferring unwell prisoners to hospital were identified by the 2009 Bradley Report. There has been no subsequent systematic review of progress in so doing nor a corresponding appraisal of transfer arrangements in other parts of the world. Aim: To conduct a systematic review of international literature about transfers of mentally unwell individuals from prison to hospital for the treatment of mental disorder since 2009. Delays in transferring patients from prisons to secure psychiatric hospitals: An international systematic review - Sales - 2023 - Criminal Behaviour and Mental Health - Wiley Online Library
2022
Bredenoort, M., et al. (2022). "A shifting paradigm? A scoping review of the factors influencing recovery and rehabilitation in recent forensic research." International Journal of Law and Psychiatry 83: 101812.
Abstract:
Forensic research and practice have historically focused on risk assessment and prevention. This risk-oriented paradigm is shifting towards a more recovery-oriented perspective. The aim of this scoping review is to provide an overview of research on the factors influencing rehabilitation and recovery and discuss the recovery paradigm in a forensic setting.
Butterworth, H., et al. (2022). "Patients’ and staff members’ experiences of restrictive practices in acute mental health in-patient settings: systematic review and thematic synthesis’." BJPsych Open 8(6): e178.
Background
Recent guidance has called for the reduction of restrictive practice use owing to growing concerns over the harmful physical and psychological effects for both patients and staff. Despite concerns and efforts, these measures continue to be used regularly to manage challenging behaviour in psychiatric in-patient settings.
Redgate, S., et al. (2022). "Using a realist approach in understanding youth offending service delivery requirements for young people who offend with speech, language and communication needs in England." Discover Social Science and Health 2(1): 21.
Research consistently demonstrates the over-representation of young people with speech, language and communication needs within the youth criminal justice system, with estimates suggesting this population accounts for up to 90% of young people who offend. Acknowledgement and understanding of these individual-based needs, along with identified service delivery adaptation(s) (where necessary) are required to ensure all young people, regardless of needs experienced, can effectively engage with, and have their voices heard, within the context of Youth Offending Services.
2020
Straub, C. and H. Annison (2020). "The mental health impact of parole on families of indeterminate-sentenced prisoners in England and Wales." Crim Behav Ment Health 30(6): 341-349.
BACKGROUND: The indeterminate sentence of Imprisonment for Public Protection (IPP), was created in England and Wales in 2003. After its abolition in 2012, many IPP-prisoners have become stuck in the prison system, facing considerable problems of sentence progression. The extant literature makes clear that the uncertainty and hopelessness caused by the indeterminacy of the IPP sentence are compounded by the negative impacts experienced by families and others providing support to people serving these sentences.