Psychotropic medication adherence in correctional facilities: a review of the literature

Abstract

Despite the high percentage of incarcerated persons with mental illness, surprisingly little is known about effective ways to increase psychotropic medication adherence in prison and upon release. Currently, there are limited definitive data regarding psychotropic medication adherence patterns among incarcerated persons, and the data that exist often miss specific information on changes in behaviour, symptom management and adherence patterns over the length of a person's sentence, which has implications for post-release ability to live in the community. This paper presents the current literature regarding psychotropic medication adherence among mentally ill persons who are incarcerated. The factors identified in support of medication adherence, future clinical research and care strategies are provided.

Randomised controlled trial of a treatment adherence programme for prisoners with mental health problems in Spain

“…Given that the prison population has a high rate of psychiatric problems (Fazel et al, ; Fazel & Seewald, ) and shows low medication adherence (Mills et al, ; Shelton et al, ), and that these two variables are in turn associated with poorer patient health and increased health costs, our results are highly encouraging in terms of promoting prisoner mental health. Indeed, they suggest that in the prison context an easy‐to‐apply intervention for improving treatment adherence can, as various authors have suggested (Fazel & Seewald, ; Shelton et al, ), help to prevent treatment dropout and improve prisoners' health. Our follow‐up period was not, however, long enough to determine the extent to which improvement in treatment adherence was sustained and effective in reducing the number and duration of hospital admissions and preventing relapses.…”

“…Given that the prison population has a high rate of psychiatric problems (Fazel et al, 2016;Fazel & Seewald, 2012) and shows low medication adherence (Mills et al, 2011;Shelton et al, 2010), and that these two variables are in turn associated with poorer patient health and increased health costs, our results are highly encouraging in terms of promoting prisoner mental health. Indeed, they suggest that in the prison context an easy-to-apply intervention 2010), help to prevent treatment dropout and improve prisoners' health.…”

“…Although no data are currently available regarding the effectiveness of this programme, studies conducted in other countries suggest that prisoners who are enrolled in programmes of this kind show low adherence to drug and psychosocial treatments (Mills et al, ; Shelton, Ehret, Wakai, Kapetanovic, & Moran, ). This can undermine the overall success of these intervention programmes, since as various authors have pointed out (Fazel & Seewald, ; Shelton et al, ), a lack of therapeutic adherence among people with mental disorders is associated with an increased number and duration of hospital admissions, heightened severity and treatment resistance during relapses, higher rates of completed suicide, a higher rate of assault and homicide, overuse of health services and greater healthcare costs. Furthermore, prisoners with mental health problems and low treatment adherence at the time of their release have a higher risk of suicidal behaviours during the first few months after leaving prison (Zlodre & Fazel, ).…”

“…Furthermore, prisoners with mental health problems and low treatment adherence at the time of their release have a higher risk of suicidal behaviours during the first few months after leaving prison (Zlodre & Fazel, ). Despite, however, the large numbers of prisoners with mental health disorders and the recognised problem of treatment adherence, very few interventions have been developed to tackle this issue (Shelton et al, ).…”

The clinician–patient working alliance: is it a significant predictor of psychiatric medication adherence in a sample of recently released parolees?

“…Despite the substantial amount of research examining the issue of psychiatric medication nonadherence, our knowledge about why justice-involved individuals do not adhere to their psychiatric medications as prescribed is still very limited, especially among those under community supervision (Shelton, Ehret, Wakai, Kapetanovic, & Moran, 2010). The few studies that have examined psychiatric medication adherence among a justice-involved population have mainly focused on prisoners, with only one study focusing on parolees (Baillargeon, 2000; Gray, Bressington, Lathlean, & Mills, 2008; Shelton et al, 2010).…”