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Keen C, Foulds JA, Willoughby M, Newton-Howes G, Knight J, Fazel S, Borschmann R, Kinner SA, Young JT. Antidepressant use and interpersonal violence perpetration: a protocol for a systematic review and meta-analysis. BMJ Open 2021; 11:e043306. [PMID: 33441364 PMCID: PMC7812107 DOI: 10.1136/bmjopen-2020-043306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 12/08/2020] [Accepted: 12/19/2020] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION There are conflicting perspectives as to whether antidepressant medication increases, decreases or has no effect on violence perpetration, impulsivity and aggressive behaviour. This is an important question given the widespread use of antidepressant medication and the significant medical, social, legal and health consequences of violence. We aim to: (1) systematically identify observational studies and randomised controlled trials that quantify the relationship between antidepressant use and interpersonal violence; (2) assess the quality of studies that quantify the relationship between antidepressant use and interpersonal violence and (3) estimate the pooled prevalence and measure of effect for the relationship between antidepressant use and interpersonal violence. METHODS AND ANALYSIS We will search MEDLINE, EMBASE, CINAHL, PsycINFO, PubMed and the Cochrane Library for relevant peer-reviewed literature. Our primary outcome is the perpetration of violent acts directed at others. Our secondary outcome is physical, interpersonal aggression measured through validated surveys. We will include randomised controlled trials, cohort studies and case-control studies that examine the association between the use of antidepressants and violence perpetration and/or physical aggression. No restrictions will be placed on the population. We will use the Methodological Standard for Epidemiological Research scale to assess the quality of included studies. We will provide an overview of the included studies and assess heterogeneity and publication bias. If there are sufficient studies, we will conduct meta-analyses to examine the possible association between antidepressants and violence, and undertake meta-regression to examine the effect of antidepressant class, length of follow-up, age of participants and population subgroups on the association between antidepressants and violence. ETHICS AND DISSEMINATION No ethics approval is required. Our findings will be disseminated through a peer-reviewed journal article and conference presentations. PROSPERO REGISTRATION DETAILS CRD42020175474.
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Borschmann R, Keen C, Young JT, Love AD, Spittal M, Preen D, Larney S, Pirkis J, Rosen D, Kinner SA. Using Linked Data to Examine the Epidemiology of All-Cause and Cause-Specific Mortality Following Release from Incarceration in Eleven Countries. Int J Popul Data Sci 2020. [DOI: 10.23889/ijpds.v5i5.1478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
IntroductionMore than 30 million adults are released from incarceration globally each year. Many experience complex physical and mental health problems, and are at markedly increased risk of preventable mortality. Despite this, evidence regarding the global epidemiology of mortality following release from incarceration is insufficient to inform the development of targeted, evidence-based responses. Many previous studies have suffered from inadequate power and poor precision, and even large studies have limited capacity to disaggregate data by specific causes of death, sub-populations or time since release to answer questions of clinical and public health relevance.
Objectives and ApproachWe aimed to comprehensively document the incidence, timing, causes and risk factors for mortality in adults released from incarceration. We created the Mortality After Release from Incarceration Consortium (MARIC), a multi-disciplinary collaboration representing 29 cohorts of adults who have experienced incarceration from 11 countries. Findings across cohorts will be analysed using a two-step, individual participant data meta-analysis methodology.
ResultsUsing linked data from the 29 individual cohorts, the combined sample includes 1,337,993 individuals (89% male), with 75,795 deaths recorded over 9,191,393 person-years of follow-up. Preliminary analyses indicate a marked elevation in mortality risk following release from incarceration, with this risk beginning on the day of release. At the time of writing, more detailed analyses are underway regarding all-cause and cause-specific deaths – along with risk and protective factors – and findings will be presented at the IPDLN conference in October.
Conclusion / ImplicationsThe MARIC consortium represents an important advancement in the field, bringing international attention to this problem. It will provide internationally relevant evidence to guide policymakers and clinicians in reducing preventable deaths in this marginalised population.
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Young JT, Tibble H, Borschmann R, Kinner SA. Drug-Related Deaths Among Young People Involved in The Criminal Justice System: A Whole-Population Multi-Sectoral Data Linkage Study. Int J Popul Data Sci 2020. [DOI: 10.23889/ijpds.v5i5.1570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
IntroductionDrug-related death is substantially higher in formerly incarcerated adults compared to the general population. Despite this, remarkably little is known about the epidemiology of drug-related death among justice-involved adolescents. A richer understanding of drug-related mortality in justice-involved young people is essential for the development of effective, evidence-based interventions for this vulnerable group.
Objectives and ApproachIn a whole-population cohort of justice-involved young people in Queensland, Australia, we aimed to: 1) calculate the rate of drug-related death overall, and separately by intent and drug category; and 2) estimate the probability, and identify the predictors of, drug-related death. We probabilistically linked Youth Justice Queensland and National Death Index (NDI) records for every young person who came into contact with the youth justice system in Queensland between 1 January 1993 and 31 December 2014 (N=48,963). The NDI provided death data until 31 December 2017. Crude mortality rates (CMR) were calculatedoverall, separately by intent, and by prescribed versus illicit drug cause. Competing risk survival analysis will be conducted.
ResultsOf the 48,963 individuals, 1452 (3%) died by 31 December 2017. Of these, 204 (14%) deaths were due to drugs, yielding a CMR of 31 (95%CI:27-36) per 100,000 person-years. Most drug-related deaths were recorded as intentional (CMR=28; 95%CI:24-33 per 100,000 person-years) and deaths from prescribed medications were more common than illicit drugs (CMR=17; 95%CI:14-20 and CMR=11; 95%CI:9-14 per 100,000 person-years, respectively).
Conclusion / ImplicationsRates of drug-related deaths following contact with the youth justice system are disproportionately high and represent a major public health concern. Our findings highlight the importance of initiation of alcohol and other drug (AOD) treatment upon contact with the youth justice system and continuous engagement with community treatment after discharge from the youth justice system. Evidenced-base prevention strategies and efforts to improve the continuity of care are urgently needed.
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Kinner SA, Gan W, Slaunwhite A. High Rate of Fatal Overdose After Release from Prison In BC, Canada: A Data Linkage Study. Int J Popul Data Sci 2020. [DOI: 10.23889/ijpds.v5i5.1606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
IntroductionThe province of BC, Canada is in the grips of a sustained overdose epidemic. People released from prison are at increased risk of fatal drug overdose, but the impact of the overdose epidemic on mortality after release from prison in BC is poorly understood. Few studies have been able to examine risk factors for overdose death in this population.
Objectives and ApproachWe aimed to (a) measure risk of overdose-related and all-cause death in different time periods after release from prison; and (b) identify risk factors for overdose-related and all-cause death. In a random 20% sample of the population of BC, Canada, we identified those released from prison 2015-2017 and examined linked health and correctional records for this cohort.
ResultsOf 6106 persons released from prison 2015-2017, 77 (1.3%) died from any cause and 48 (0.8%) died from overdose 2015-2017. The incidence of all-cause death was 16.1 (95%CI 13.7-18.8) per 1000 person years, and the incidence of overdose death was 11.2 (95%CI 9.2-13.5) per 1000 person years. Risk factors for overdose death included a history of 3 or more incarcerations (HR=3.00, 95%CI 1.67-5.39), co-occurring substance use disorder and mental illness (HR=4.73, 95%CI 2.94-7.62), chronic physical morbidity (HR=3.10, 95%CI 1.97-4.88), and being dispensed benzodiazepines (HR=3.31, 95%CI 2.27-4.84) or opioids for pain (HR=6.77, 95%CI 3.86-11.89). The incidence of fatal overdose was significantly higher in the first two weeks post-release than at any other time during follow-up.
ConclusionPeople released from prison in BC are at markedly increased risk of preventable death, mainly due to overdose. As such, people transitioning from prison to the community should be a key target population for overdose prevention efforts. To be maximally effective, these efforts must go beyond provision of methadone and naloxone on release, to consider physical and mental health comorbidities, and psychosocial disadvantage.
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Fletcher J, Reece J, Kinner SA, Brophy L, Hamilton B. Safewards Training in Victoria, Australia: A Descriptive Analysis of Two Training Methods and Subsequent Implementation. J Psychosoc Nurs Ment Health Serv 2020; 58:32-42. [DOI: 10.3928/02793695-20201013-08] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 06/29/2020] [Indexed: 11/20/2022]
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Borschmann R, Dos Santos MM, Young JT, Andreoli SB, Love AD, Kinner SA. Health, social and criminal justice factors associated with dual diagnosis among incarcerated adults in Brazil and Australia: a cross-national comparison. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1355-1362. [PMID: 32047971 DOI: 10.1007/s00127-020-01832-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 02/03/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE To estimate the prevalence of dual diagnosis and identify health, social and criminal justice factors associated with dual diagnosis among incarcerated adults in Australia and Brazil. METHODS We compared data from cross-sectional surveys of incarcerated adults (aged ≥ 18 years) in Australia and Brazil. Using data from linked emergency department, hospital, and in-prison medical records in the Australian sample, and from the Composite International Diagnostic Interview (CIDI) in the Brazilian sample, participants were categorised as having: (1) no mental disorder; (2) substance use disorder only; (3) mental illness only; or (4) dual diagnosis. A multivariate multinomial logistic regression model was fitted to identify factors associated with dual diagnosis in each country. RESULTS Approximately one quarter of participants in both Australia (22%) and Brazil (25%) met the diagnostic criteria for dual diagnosis. In both countries, dual diagnosis was associated with being female [relative risk (RR) = 2.25 (95% CI 1.47-3.43) Australia; RR = 2.59 (95% CI 1.79-3.74) Brazil], having a history of prior incarceration [RR = 2.99 (95% CI 1.99-4.48) Australia; RR = 2.27 (95% CI 1.57-3.29) Brazil], and having comorbid physical health problems [RR = 1.54 (95% CI 1.08-2.19) Australia; RR = 2.53 (95% CI 1.75-3.65) Brazil]. CONCLUSIONS Despite differences in health, social, and criminal justice systems between Australia and Brazil, the prevalence of and factors associated with dual diagnosis in incarcerated adults appear to be similar in the two countries. A number of generalisable principles can be inferred and should be considered in health and criminal justice policy making.
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Young JT, Borschmann R, Heffernan E, Spittal MJ, Brophy L, Ogloff JRP, Moran P, Armstrong G, Preen DB, Kinner SA. Contact with Mental Health Services After Acute Care for Self-Harm Among Adults Released from Prison: A Prospective Data Linkage Study. Suicide Life Threat Behav 2020; 50:990-1006. [PMID: 32359122 DOI: 10.1111/sltb.12639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 01/28/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine the care pathway and rate and predictors of mental health care contact within seven days of discharge from acute care following self-harm. METHOD In a representative cohort of adults released from prisons in Queensland, Australia, we probabilistically linked person-level, statewide ambulance, emergency department, and hospital records, both prospectively and retrospectively, and community mental health service and Medicare records prospectively, to baseline survey data. We fit multivariate modified log-linked Poisson regression models to examine the association between sociodemographic, health, and criminal justice factors and mental health care contact after self-harm. RESULTS Of 217 discharges from acute care following self-harm, 55% (n = 119) received mental health care within seven days of discharge. Mental health care contact was associated with substance use disorder (adjusted relative risk (ARR) = 0.48; 95% CI: 0.27-0.85), dual diagnosis (ARR = 0.58; 95% CI: 0.41-0.82), physical health-related functioning (ARR = 0.98; 95% CI: 0.97-0.99), being female (ARR = 1.39; 95% CI: 1.02-1.90), being identified as at risk of self-harm by correctional authorities (ARR = 1.50; 95% CI: 1.07-2.09), and prior engagement with state-funded mental health care (ARR = 1.55; 95% CI: 1.08-2.22). CONCLUSION Our findings highlight the need to improve the integration of community mental health care for people who present to acute care following self-harm with a recent history of incarceration, particularly for men and those with substance use disorder or dual diagnosis.
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Kinner SA, Snow KJ, van Dooren K, Gill CE, Burford BJ, Janca E. Service brokerage for improving health outcomes in ex-prisoners. Hippokratia 2020. [DOI: 10.1002/14651858.cd010343.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Davidson F, Clugston B, Perrin M, Williams M, Heffernan E, Kinner SA. Mapping the prison mental health service workforce in Australia. Australas Psychiatry 2020; 28:442-447. [PMID: 31868515 DOI: 10.1177/1039856219891525] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The rapidly growing number of people in prison in Australia, combined with the high prevalence of mental disorder in this population, results in high demand for mental health services in prison settings. Despite their critical role as part of a national mental health response, prison mental health services (PMHS) in Australia have been poorly characterised. In this paper, we describe findings of the first national survey of PMHS in Australia. METHODS We distributed a survey to key representatives of PMHS in all Australian states and territories in 2016. RESULTS Our method constitutes a replicable process for quantifying and comparing PMHS in Australia. We describe the structure, governance and staffing models in seven jurisdictions. When compared against international recommendations, only one Australian jurisdiction (the ACT) is funded to provide services at a level equivalent to mental health services provided in the community. CONCLUSION Prison mental health services in Australia are delivered by a complex mix of government, private sector and non-government services. Services appear to be severely under-resourced when compared with the available benchmarks.
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Bukten A, Lund IO, Kinner SA, Rognli EB, Havnes IA, Muller AE, Stavseth MR. Factors associated with drug use in prison - results from the Norwegian offender mental health and addiction (NorMA) study. HEALTH & JUSTICE 2020; 8:10. [PMID: 32399643 PMCID: PMC7218530 DOI: 10.1186/s40352-020-00112-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 04/01/2020] [Indexed: 05/27/2023]
Abstract
BACKGROUND Remarkably little is known about drug use during imprisonment, including whether it represents a continuation of pre-incarceration drug use, or whether prison is also a setting for drug use initiation. This paper aims to describe drug use among people in prison in Norway and investigate risk factors associated with in-prison drug use. METHODS We used data from the Norwegian Offender Mental Health and Addiction (NorMA) Study, a cross-sectional survey of 1499 individuals in Norwegian prisons. Respondents reported on drug use (narcotics and non-prescribed medications) both before and during imprisonment. We used multivariate logistic regression to investigate the associations between drug use in prison and demographics, previous drug use, mental health, and criminal activity. RESULTS Sixty-five percent of respondents reported lifetime drug use, and about 50% reported daily use of drugs during the 6 months before incarceration. Thirty-five percent reported ever using drugs in prison, but initiation of drug used during incarceration was uncommon. In a multivariate model, factors independently associated with drug use in prison included lifetime number of drugs used (adjusted odds ratio [aOR] = 1.17; 95% confidence interval [CI] 1.12-1.23; p < 0.001), daily drug use in the 6 months before imprisonment (aOR = 7.12; 95%CI 3.99-12.70; p < 0.001), and being intoxicated while committing the crime related to current imprisonment (aOR = 2.13; 95%CI 1.13-4.03; p = 0.020). CONCLUSIONS In-prison drug use is independently associated with high-risk drug use before imprisonment. To reduce drug use in prison, correctional services must systematically screen for pre-prison drug use and offer effective drug treatment for those in need.
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Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, O'Moore É. Prisons and custodial settings are part of a comprehensive response to COVID-19. THE LANCET PUBLIC HEALTH 2020. [DOI: 10.1016/s2468-2667%2820%2930058-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Cumming C, Kinner SA, McKetin R, Li I, Preen D. Methamphetamine use, health and criminal justice system outcomes: A systematic review. Drug Alcohol Rev 2020; 39:505-518. [DOI: 10.1111/dar.13062] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 03/03/2020] [Accepted: 03/04/2020] [Indexed: 12/27/2022]
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Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, O'Moore É. Prisons and custodial settings are part of a comprehensive response to COVID-19. LANCET PUBLIC HEALTH 2020; 5:e188-e189. [PMID: 32197116 PMCID: PMC7103922 DOI: 10.1016/s2468-2667(20)30058-x] [Citation(s) in RCA: 162] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 03/12/2020] [Indexed: 01/08/2023]
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Borschmann R, Tibble H, Spittal MJ, Preen D, Pirkis J, Larney S, Rosen DL, Young JT, Love AD, Altice FL, Binswanger IA, Bukten A, Butler T, Chang Z, Chen CY, Clausen T, Christensen PB, Culbert GJ, Degenhardt L, Dirkzwager AJE, Dolan K, Fazel S, Fischbacher C, Giles M, Graham L, Harding D, Huang YF, Huber F, Karaminia A, Keen C, Kouyoumdjian FG, Lim S, Møller L, Moniruzzaman A, Morenoff J, O’Moore E, Pizzicato LN, Pratt D, Proescholdbell SK, Ranapurwala SI, Shanahan ME, Shaw J, Slaunwhite A, Somers JM, Spaulding AC, Stern MF, Viner KM, Wang N, Willoughby M, Zhao B, Kinner SA. The Mortality After Release from Incarceration Consortium (MARIC): Protocol for a multi-national, individual participant data meta-analysis. Int J Popul Data Sci 2020; 5:1145. [PMID: 32935053 PMCID: PMC7473255 DOI: 10.23889/ijpds.v5i1.1145] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION More than 30 million adults are released from incarceration globally each year. Many experience complex physical and mental health problems, and are at markedly increased risk of preventable mortality. Despite this, evidence regarding the global epidemiology of mortality following release from incarceration is insufficient to inform the development of targeted, evidence-based responses. Many previous studies have suffered from inadequate power and poor precision, and even large studies have limited capacity to disaggregate data by specific causes of death, sub-populations or time since release to answer questions of clinical and public health relevance. OBJECTIVES To comprehensively document the incidence, timing, causes and risk factors for mortality in adults released from prison. METHODS We created the Mortality After Release from Incarceration Consortium (MARIC), a multi-disciplinary collaboration representing 29 cohorts of adults who have experienced incarceration from 11 countries. Findings across cohorts will be analysed using a two-step, individual participant data meta-analysis methodology. RESULTS The combined sample includes 1,337,993 individuals (89% male), with 75,795 deaths recorded over 9,191,393 person-years of follow-up. CONCLUSIONS The consortium represents an important advancement in the field, bringing international attention to this problem. It will provide internationally relevant evidence to guide policymakers and clinicians in reducing preventable deaths in this marginalized population. KEY WORDS Mortality; incarceration; prison; release; individual participant data meta-analysis; consortium; cohort.
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McLeod KE, Butler A, Young JT, Southalan L, Borschmann R, Sturup-Toft S, Dirkzwager A, Dolan K, Acheampong LK, Topp SM, Martin RE, Kinner SA. Global Prison Health Care Governance and Health Equity: A Critical Lack of Evidence. Am J Public Health 2020; 110:303-308. [PMID: 31944844 DOI: 10.2105/ajph.2019.305465] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The large and growing population of people who experience incarceration makes prison health an essential component of public health and a critical setting for reducing health inequities. People who experience incarceration have a high burden of physical and mental health care needs and have poor health outcomes. Addressing these health disparities requires effective governance and accountability for prison health care services, including delivery of quality care in custody and effective integration with community health services.Despite the importance of prison health care governance, little is known about how prison health services are structured and funded or the methods and processes by which they are held accountable. A number of national and subnational jurisdictions have moved prison health care services under their ministry of health, in alignment with recommendations by the World Health Organization and the United Nations Office on Drugs and Crime. However, there is a critical lack of evidence on current governance models and an urgent need for evaluation and research, particularly in low- and middle-income countries.Here we discuss why understanding and implementing effective prison health governance models is a critical component of addressing health inequities at the global level.
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Borschmann R, Janca E, Carter A, Willoughby M, Hughes N, Snow K, Stockings E, Hill NTM, Hocking J, Love A, Patton GC, Sawyer SM, Fazel S, Puljević C, Robinson J, Kinner SA. The health of adolescents in detention: a global scoping review. LANCET PUBLIC HEALTH 2020; 5:e114-e126. [PMID: 31954434 PMCID: PMC7025881 DOI: 10.1016/s2468-2667(19)30217-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/18/2019] [Accepted: 10/18/2019] [Indexed: 12/12/2022]
Abstract
Adolescents detained within the criminal justice system are affected by complex health problems, health-risk behaviours, and high rates of premature death. We did a global synthesis of the evidence regarding the health of this population. We searched Embase, PsycINFO, Education Resources Information Center, PubMed, Web of Science, CINCH, Global Health, the Cochrane Database of Systematic Reviews, the Campbell Library, the National Criminal Justice Reference System Abstract Database, and Google Scholar for peer-reviewed journal articles, including reviews, that reported the prevalence of at least one health outcome (physical, mental, sexual, infectious, and neurocognitive) in adolescents (aged <20 years) in detention, and were published between Jan 1, 1980, and June 30, 2018. The reference lists of published review articles were scrutinised for additional relevant publications. Two reviewers independently screened titles and abstracts, and three reviewed full texts of relevant articles. The protocol for this Review was registered with PROSPERO (CRD42016041392). 245 articles (204 primary research articles and 41 reviews) were included, with most primary research (183 [90%]) done in high-income countries. A high lifetime prevalence of health problems, risks, and conditions was reported in detained adolescents, including mental disorders (0–95%), substance use disorders (22–96%), self-harm (12–65%), neurodevelopmental disabilities (2–47%), infectious diseases (0–34%), and sexual and reproductive conditions (pregnant by age 19 years 20–37%; abnormal cervical screening test result 16%). Various physical and mental health problems and health-risk behaviours are more common among adolescents in detention than among their peers who have not been detained. As the social and structural drivers of poor health overlap somewhat with factors associated with exposure to the criminal justice system, strategies to address these factors could help to reduce both rates of adolescent detention and adolescent health inequalities. Improving the detection of mental and physical disorders, providing appropriate interventions during detention, and optimising transitional health care after release from detention could improve the health outcomes of these vulnerable young people.
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Keen C, Kinner SA, Borschmann R, Young JT. Comparing the predictive capability of self-report and medically-verified non-fatal overdose in adults released from prison: A prospective data linkage study. Drug Alcohol Depend 2020; 206:107742. [PMID: 31778949 DOI: 10.1016/j.drugalcdep.2019.107742] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 11/08/2019] [Accepted: 11/13/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Self-reported non-fatal overdose (NFOD) is a predictor of future overdose and is often used to target overdose prevention for people released from prison. However, the level of agreement between self-reported and medically-verified NFOD history remains unknown. This study aimed to determine the agreement between, and predictive value of, self-reported and medically-verified history of NFOD in people recently released from prison. METHODS Pre-release baseline survey data from 1307 adults in prison surveyed from 2008 to 2010 in Queensland, Australia were linked to ambulance, emergency department, and hospital records. We compared the agreement of self-reported NFOD history in the baseline survey and medically-verified NFOD ascertained through linked medical data. Unadjusted and adjusted regression models were used to determine the association between self-reported and medically verified NFOD history and medically-verified NFOD after release from prison. RESULTS 224 (19 %) participants self-reported NFOD history only, 75 (5 %) had medically-verified NFOD history only, and 56 (4 %) both self-reported and had medically-verified NFOD history. Compared to those with no NFOD history, those who self-reported and had a medical history of NFOD (adjusted hazard ratio (AHR) 6.1, 95 %CI 3.1-11.9), those with a medical history only (AHR 3.4, 95 %CI 1.7-7.0), and those who self-reported only (AHR 1.8, 95 %CI 1.0-3.5) were at increased risk of medically-verified NFOD after release from prison. CONCLUSIONS Relying on self-report of NFOD is likely to miss people at increased risk of future NFOD, many of whom could be identified through medical records. Wherever possible, data related to NFOD should be triangulated from multiple sources.
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Keen C, Young JT, Borschmann R, Kinner SA. Non-fatal drug overdose after release from prison: A prospective data linkage study. Drug Alcohol Depend 2020; 206:107707. [PMID: 31757517 DOI: 10.1016/j.drugalcdep.2019.107707] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 10/10/2019] [Accepted: 10/21/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Adults released from prison are at increased risk of poor health outcomes and preventable mortality, including from overdose. Non-fatal overdose (NFOD) is a strong predictor of future overdose and associated with considerable morbidity. This study aims to the determine the incidence, predictors and clinical characteristics of NFOD following release from prison. METHODS We used pre-release interview data collected for a randomised controlled trial in 2008-2010, and linked person-level, state-wide ambulance, emergency department, and hospital records, from a representative sample of 1307 adults incarcerated in Queensland, Australia. The incidence of NFOD following release from prison was calculated. A multivariate Andersen-Gill model was used to identify demographic, health, social, and criminal justice predictors of NFOD. RESULTS The crude incidence rate (IR) of NFOD was 47.6 (95%CI 41.1-55.0) per 1000 person-years and was highest in the first 14 days after release from prison (IR = 296 per 1000 person-years, 95%CI 206-426). In multivariate analyses, NFOD after release from prison was positively associated with a recent history of substance use disorder (SUD), dual diagnosis of mental illness and SUD, lifetime history of injecting drug use, lifetime history of NFOD, being dispensed benzodiazepines after release, a shorter index incarceration, and low perceived social support. The risk of NFOD was lower for people with high-risk alcohol use and while incarcerated. CONCLUSIONS Adults released from prison are at high risk of non-fatal overdose, particularly in the first 14 days after release. Providing coordinated transitional care between prison and the community is likely critical to reduce the risk of overdose.
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Butler A, Love AD, Young JT, Kinner SA. Frequent Attendance to the Emergency Department after Release from Prison: a Prospective Data Linkage Study. J Behav Health Serv Res 2019; 47:544-559. [PMID: 31820327 PMCID: PMC7578130 DOI: 10.1007/s11414-019-09685-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of this paper was to identify characteristics and predictors of frequent emergency department (ED) use among people released from prisons in Queensland, Australia. Baseline interview data from a sample of sentenced adults were linked to ED and hospital records. The association between baseline characteristics and frequent ED attendance was modelled by fitting multivariate logistic regression models. Participants who had ≥ 4 visits to the ED in any 365-day period of community follow-up were defined as frequent attenders (FA). The analyses included 1307 people and mean follow-up time in the community was 1063 days. After adjusting for covariates, those with a dual diagnoses of mental illness and substance use (RR = 2.42, 95% CI 1.47–3.99) and those with mental illness alone (RR = 2.47, 95% CI 1.29–4.73) were at higher risk of frequent ED attendance, compared with those with no disorder. Future research should assess whether individually tailored transition supports from prison to community reduce the frequency of ED use among this population.
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Kinner SA, Hughes N, Borschmann R, Southalan L, Clasby B, Janca E, Willoughby M, Williams H. The health of children deprived of liberty: a human rights issue. THE LANCET CHILD & ADOLESCENT HEALTH 2019; 4:6-7. [PMID: 31784242 DOI: 10.1016/s2352-4642(19)30386-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 11/12/2019] [Indexed: 12/01/2022]
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Binswanger IA, Maruschak LM, Mueller SR, Stern MF, Kinner SA. Principles to Guide National Data Collection on the Health of Persons in the Criminal Justice System. Public Health Rep 2019; 134:34S-45S. [PMID: 31059411 PMCID: PMC6505315 DOI: 10.1177/0033354919841593] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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Marynowski-Traczyk D, Broadbent M, Kinner SA, FitzGerald G, Heffernan E, Johnston A, Young JT, Keijzers G, Scuffham P, Bosley E, Martin-Khan M, Zhang P, Crilly J. Mental health presentations to the emergency department: A perspective on the involvement of social support networks. Australas Emerg Care 2019; 22:162-167. [PMID: 31300299 DOI: 10.1016/j.auec.2019.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/19/2019] [Accepted: 06/24/2019] [Indexed: 12/30/2022]
Abstract
The involvement of families, carers and significant others (i.e. social support networks) has a positive corollary for a person experiencing mental health problems. Accordingly, in Australia involvement of social support networks within mental health services is endorsed in national health policy and service guidelines. Despite the endorsement, this is yet to be fully realised in all areas that provide mental health services, including emergency departments. Social support networks are integral in the provision of mental health consumers' care. Supporting the involvement of social support networks in the emergency department can provide healthcare services with opportunities for enhanced and cost-effective care, contributing to improved outcomes for consumers. An overview of some of the barriers and facilitators of social support network involvement is provided. The intention of this paper is to encourage reflection and dialogue on this important area of mental health service provision and support the evolution of a new paradigm of research into social support network involvement in the emergency department.
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Fletcher J, Hamilton B, Kinner SA, Brophy L. Safewards Impact in Inpatient Mental Health Units in Victoria, Australia: Staff Perspectives. Front Psychiatry 2019; 10:462. [PMID: 31354541 PMCID: PMC6635577 DOI: 10.3389/fpsyt.2019.00462] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 06/12/2019] [Indexed: 12/02/2022] Open
Abstract
Introduction: Mental health professionals working in acute inpatient mental health wards are involved in a complex interplay between an espoused commitment by government and organizational policy to be recovery-oriented and a persistent culture of risk management and tolerance of restrictive practices. This tension is overlain on their own professional drive to deliver person-centered care and the challenging environment of inpatient wards. Safewards is designed to reduce conflict and containment through the implementation of 10 interventions that serve to improve the relationship between staff and consumers. The aim of the current study was to understand the impact of Safewards from the perspectives of the staff. Methods: One hundred and three staff from 14 inpatient mental health wards completed a survey 12 months after the implementation of Safewards. Staff represented four service settings: adolescent, adult, and aged acute and secure extended care units. Results: Quantitative results from the survey indicate that staff believed there to be a reduction in physical and verbal aggression since the introduction of Safewards. Staff were more positive about being part of the ward and felt safer and more connected with consumers. Qualitative data highlight four key themes regarding the model and interventions: structured and relevant; conflict prevention and reducing restrictive practices; ward culture change; and promotes recovery principles. Discussion: This study found that from the perspective of staff, Safewards contributes to a reduction in conflict events and is an acceptable practice change intervention. Staff perspectives concur with those of consumers regarding an equalizing of staff consumer relationships and the promotion of more recovery-oriented care in acute inpatient mental health services.
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Fletcher J, Buchanan-Hagen S, Brophy L, Kinner SA, Hamilton B. Consumer Perspectives of Safewards Impact in Acute Inpatient Mental Health Wards in Victoria, Australia. Front Psychiatry 2019; 10:461. [PMID: 31354540 PMCID: PMC6629935 DOI: 10.3389/fpsyt.2019.00461] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 06/12/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Inpatient mental health wards are reported by many consumers to be custodial, unsafe, and lacking in therapeutic relationships. These consumer experiences are concerning, given international policy directives requiring recovery-oriented practice. Safewards is both a model and a suite of interventions designed to improve safety for consumers and staff. Positive results in reducing seclusion have been reported. However, the voice of consumers has been absent from the literature regarding Safewards in practice. Aim: To describe the impact of Safewards on consumer experiences of inpatient mental health services. Method: A postintervention survey was conducted with 72 consumers in 10 inpatient mental health wards 9-12 months after Safewards was implemented. Results: Quantitative data showed that participants felt more positive about their experience of an inpatient unit, safer, and more connected with nursing staff. Participants reported that the impact of verbal and physical aggression had reduced because of Safewards. Qualitatively, participants reported increased respect, hope, sense of community, and safety and reduced feelings of isolation. Some participants raised concerns about the language and intention of some interventions being condescending. Discussion: Consumers' responses to Safewards were positive, highlighting numerous improvements of importance to consumers since its implementation across a range of ward types. The findings suggest that Safewards offers a pathway to reducing restrictive interventions and enables a move toward recovery-oriented practice.
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