Early detection and early intervention in prison: improving outcomes and reducing prison returns

Abstract

This is a repository copy of Early detection and early intervention in prison : improving outcomes and reducing prison returns.

Decision curve analysis as a framework to estimate the potential value of screening or other decision‐making aids

“…The net benefit of screening with multiple cut‐offs which has sensitivity (75%) and specificity (71%) comparable to the best studied tools ranged from 7 to 13% over the range of thresholds for which it was the optimal strategy. However, as discussed in the introduction, observational studies have reported approximately 3 to 5% increases in uptake of treatment following screening (Evans et al, ; Pillai et al, ), and some of these increases may be through greater provision of services to those who do not require treatment (Martin et al, ). Given these gaps from potential to actual impacts of screening, results of our subgroup analyses warrant attention to better understand the limitations of screening as currently practiced.…”

“…This is because the intensity of follow‐up to a positive screen may vary depending on the priorities of the screening process. For example, screening may aim to identify sub‐threshold or prodromal symptoms to prevent onset of illness (Evans et al, ; van Zoonen et al, ). In this case, the follow‐up to screening will be lower intensity and entail less potential harm; thus, a larger number of false positives would be tolerable and the treatment threshold would be lower.…”

“…Although there are no RCTs of mental health screening in prisons, two observational studies have reported 3–5% increases in the proportion of inmates accessing treatment (Evans et al, ; Pillai et al, ). Neither study looked at duration of care or accuracy of treatment decisions.…”

Mental health in the criminal justice system: A pathways approach to service and research design

“…A high prevalence of mental disorder among prisoners has been reported across the world and is well established in the international literature (Fazel & Baillargeon, ). Specific concerns have also been investigated, including alcohol and substance misuse (Kissell et al, ; Singleton, Farrell, & Meltzer, ), self‐harm and self‐inflicted death among prisoners (Hawton, Linsell, Adeniji, Sariaslan, & Fazel, ), traumatic brain injury (Williams, Cordan, Mewse, Tonks, & Burgess, ), attention deficit hyperactivity disorder (Young et al, ), and ultra‐high psychosis risk (Evans et al, ). Meanwhile, the idea that health care screening must take place at prison reception has gained international approval (United Nations General Assembly, ).…”

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

“…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 ).…”