What is the Evidence for Offense-Specific Group Treatment Programs for Forensic Patients?

Mallion, Jaimee S.; Tyler, Nichola; Miles, Helen

doi:10.1080/14999013.2019.1648344

Cited by 8 publications

(10 citation statements)

References 57 publications

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“…This is despite figures from NHS Digital (2021) showing black people are more than four times as likely as white people to be detained under the Mental Health Act (321.7 detentions per 100,000 people, compared with 73.4, respectively), so there may be differences in outcomes of psychological interventions depending on factors of social difference, which the current body of evidence cannot speak to. Additionally, the evidence lacks findings regarding the efficacy of third‐wave CBT interventions, highlighting the dissonance between the therapies being practised and current research being conducted (Mallion et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

A systematic review of the efficacy of psychological treatments for people detained under the Mental Health Act

Baldwin

Beazley

2023

Psychiatric Ment Health Nurs

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Accessible Summary What is known on the subject? International reviews have looked at therapy outcomes for patients on mental health wards, showing it is associated with reduced emotional distress and readmission. Reviews have not looked at which specific treatments are most effective. No review has been done in England and Wales for patients detained specifically under the Mental Health Act. What the paper adds to existing knowledge The paper gives an overview of the limited evidence in England and Wales. The paper shows which therapies have been measured. What are the implications for practice? Larger studies are needed across all types of patient wards in England and Wales with random allocation to types of therapy and longer‐term follow‐up. More studies are needed where researchers are not aware of the therapy being delivered. More studies need to use a mixture of patient and clinician outcome measures. Outcomes should also measure incident, readmission and reoffending rates. More evidence is needed from patients who are female, non‐white and who are diagnosed with depression and anxiety. Abstract Introduction The efficacy of psychological interventions delivered under the Mental Health Act (1983) (MHA) in England and Wales is unclear. While meta‐analyses have reviewed acute and forensic psychological interventions in wider geographical areas, there has been no review specifically in the unique MHA context. Aim A systematic review was conducted of psychological outcomes for inpatients detained under the MHA in England and Wales. Method Diagnoses and type of psychological intervention were not restricted, provided a psychological outcome measure was used. Studies were identified through APA PsychInfo, MEDLINE, CINAHL and Academic Search using a combination of key terms. Data extraction included effect direction, statistical significance, intervention type, format and duration, study size, inpatient setting, control group and study quality. Results High‐quality evidence was sparse. Some improvements were found in overall well‐being, self‐esteem, social functioning, problem‐solving, substance use, anger, offending attitudes, fire‐setting, violence, anxiety, depression, personality disorder and psychosis. However, the overall evidence base is lacking. Discussion Larger‐scale randomized controlled trials are needed across secure, acute and learning disability inpatient settings in England and Wales with longer term follow‐up, blind assessors and both self‐report and clinician‐rated measures, as well as incident, readmission and reoffending rates. Greater representation is needed of females, non‐white groups and affective disorders. Clinical Implications The efficacy of psychological interventions for inpatients detained under the MHA in England and Wales remains unclear. Clinicians are encouraged to use relevant outcome measures in relation to treatment goals, to monitor the efficacy of interventions being offered to this client group. Relevance to Mental Health Nursing This paper highlights the curren...

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Section: Discussionmentioning

confidence: 99%

A systematic review of the efficacy of psychological treatments for people detained under the Mental Health Act

Baldwin

Beazley

2023

Psychiatric Ment Health Nurs

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“…The need for a specialist approach to deliberate firesetting This lack of knowledge regarding VR and different types of offending represents a significant issue because offence-specific treatments are essential when working with forensic clients (Mallion et al, 2020). This is particularly concerning when considering the offence of deliberate firesetting [1] since there is a wealth of empirical evidence supporting the need for a specialist approach to tackling this behaviour.…”

Section: The Potential Of Virtual Realitymentioning

confidence: 99%

Clinicians’ perceptions of virtual reality for firesetting

Sambrooks

Lockerbie²,

Majid³

et al. 2022

JFP

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Purpose Virtual reality (VR) is a novel technology that could be used in the assessment and/or treatment of deliberate firesetting. This study aims to develop an understanding of clinicians’ views of VR for deliberate firesetting, to identify areas where VR could potentially add value to current practice and any particular barriers to using VR in this context. Design/methodology/approach Through an online survey, 73 clinicians rated their agreement with nine potential benefits of using VR for firesetting and 11 potential barriers to using it. They also provided free text responses detailing the greatest perceived potential benefit and the greatest perceived barrier. Factors related to intent to use VR for firesetting in the future were explored. Findings Clinicians perceived the ability to safely expose clients to fire-related stimuli to be highly beneficial. However, clinicians were concerned about the possibility of re-traumatisation and logistic barriers. Previous experience of using VR with individuals who have set fires was significantly related to using it in the future. Practical implications Further research establishing the feasibility and effectiveness of using VR with individuals who have set fires may help alleviate clinicians’ concerns. Increasing opportunities for clinicians to experience a firesetting VR programme may widen the implementation of firesetting VR. Originality/value Previous research has only focused on clinicians’ perceptions of VR in the general field of forensic mental health and has failed to consider offence-specific applications.

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“…Between 60 and 75% of forensic inpatients meet the DSM‐IV and DSM‐5 diagnostic criteria for substance use disorder [1–4]. Although the link between substance use and offending is acknowledged [5,6], it has not always been accompanied by adequate changes to forensic mental health service delivery [7].…”

Section: What Is the Scale And Impact Of This Issue?mentioning

confidence: 99%

“…There is a range of challenges faced by forensic patients with substance use histories in the UK and Australia; both during their treatment in forensic services and upon their release into the community. Forensic services tend to lack treatments that fully support patients in their rehabilitation, with treatments varying in design and levels of sophistication [7–9]. The presence of severe, complex mental illness can also prevent patients from engaging fully in rehabilitation programs.…”

Section: What Is the Scale And Impact Of This Issue?mentioning

confidence: 99%

Genesis of change: Substance use treatment for forensic patients with mental health concerns

McFadden

Prior

Miles

et al. 2021

Drug and Alcohol Review

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Substance use disorders are highly prevalent among forensic patients. They are associated with many challenges for patients with these problems, including their ability to rehabilitate and successfully move through secure forensic mental health services, as well as increasing risk for recidivism. Traditionally, forensic services have been more adept at focusing on and treating the primary mental health diagnosis alone and have been less likely to prioritise this co‐occurring patient need. Opportunities exist to foster effective treatment strategies for substance use disorders, and past research has produced positive outcomes among forensic patients in studies in both Australia and the UK to navigate a new course for patients with these problems. By providing empirically validated, co‐produced and culturally competent treatment responses, forensic patients living with substance use disorders will have the opportunity to significantly improve their wellbeing and progress through the system. They will also be more prepared and equipped to face challenges upon discharge into the community, including increased availability of alcohol and other drugs, social stigma and barriers to employment. Moreover, by prioritising effective substance use treatment programs during inpatient rehabilitation, services can reduce the levels of post‐discharge recidivism.

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What is the Evidence for Offense-Specific Group Treatment Programs for Forensic Patients?

Cited by 8 publications

References 57 publications

A systematic review of the efficacy of psychological treatments for people detained under the Mental Health Act

A systematic review of the efficacy of psychological treatments for people detained under the Mental Health Act

Clinicians’ perceptions of virtual reality for firesetting

Genesis of change: Substance use treatment for forensic patients with mental health concerns

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