A systematic review of outcome measures used in forensic mental health research with consensus panel opinion

Abstract

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What do the experts by experience tell us about ‘what works’ in high secure forensic inpatient hospital services?

“…On a pragmatic level, the high secure inpatient perspective on the impact of treatment may be particularly valued where rigorous clinical evidence is absent, as is commonly reported in the forensic mental health arena (Blackburn, 2004;Quinsey, 1988;Rice & Harris, 1997), and where the focus on outcomes is weighed on public interest, for example recidivism (Fitzpatrick et al, 2010). Such information might also contribute to both academic and public debates that re-emerge on the need for high secure inpatient facilities (Thomas, Dolan, & Thornicroft, 2004).…”

A Systematic Review and Synthesis of Outcome Domains for use Within Forensic Services for People with Intellectual Disabilities

“…They were able to successfully review a variety of specific outcome measures that would enable measurement across these domains, whereas in our study there are relatively fewer instruments that have been standardised for use with people with intellectual disabilities across the sub-domains we have included within our framework. At the same time, there were some noted differences between our framework and that reported by Fitzpatrick et al 8 For example, substance misuse did not feature explicitly in our framework, but nevertheless is an issue for many with intellectual disabilities, and would fall easily within our Incidents sub-domain. Conversely, there were specific sub-domains that we included which did not appear within the framework reported by Fitzpatrick et al, 8 such as adaptive functioning, access to meaningful activity, as well as the use of restrictive practices, which no doubt are all issues for those with forensic mental health problems and are likely to be more salient with services for people with intellectual disabilities.…”

“…Contrasting our framework with that developed by Fitzpatrick et al, 8 there are both similarities and differences. Fitzpatrick et al 8 grouped outcome measures across a variety of similar domains, such as recidivism, service outcomes, mental state, compliance, satisfaction and substance misuse, among others.…”

“…This is of concern in a health climate focused on outcomes 6 and 'payment by results', but is even more relevant because of the recent government initiative to fundamentally transform care for people with intellectual disabilities. 7 Although Fitzpatrick et al 8 have conducted a systematic review of outcome measures used in generic forensic mental health services, and Gilbody et al 9 completed a similar review of outcome studies in mental health, there has been no such work for forensic services providing care to people with intellectual disabilities. Further, although there has been a marked focus on recovery from mental health services, there has been comparatively little focus on this construct and its measurement within psychiatric hospital settings for people with intellectual disabilities, including forensic services.…”

Treatment perspectives on interned mentally ill offenders in a forensic psychiatric center (FPC): a Delphi study on experts' opinions

“…These underlying controversies are acknowledged by international authors (e.g. Adams & Ferrandino, 2008;Adshead & Sarkar, 2005;Fitzpatrick et al, 2010;Steadman, Morrissey, & Robbins, 1985;Weinberger & Sreenivasan, 1994) and will be discussed in relation to the Delphi results.…”