The psychometric properties of a psychosis screen in a correctional setting

Many people who go to gaol are mentally ill. Remandees, prisoner receptions or people in jails have a substantially higher rate of severe mental disorder than other prisoners and the general population. There are no completely satisfactory ways to screen for psychosis and few existing screening questionnaires are available for use in correctional establishments. The Screening Instrument for Psychosis (PS) was developed in the context of the Australian Mental Health Survey: Study of Low Prevalence Disorders. It can help indicate whether a person should be referred to mental health professional for a diagnostic evaluation and possible treatment and/or diversion. We trialled the PS in a high security remand and reception centre. Measures of validity and reliability are reported.     

Texas Christian University (TCU) Short Forms for Assessing Client Needs and Functioning in Addiction Treatment

The TCU Short Forms contain a revised and expanded set of assessments for planning and managing addiction treatment services. They are formatted as brief (1-page) forms to measure client needs and functioning, including drug use severity and history (TCUDS II), criminal thinking and cognitive orientation (CTSForm), motivation and readiness for treatment (MOTForm), psychological functioning (PSYForm), social relations and functioning (SOCForm), and therapeutic participation and engagement (ENGForm). These instruments facilitate optically-scanned data entry, computerized scoring, and rapid graphical feedback for clinical decisions. The present study (based on 5,022 inmates from eight residential prison treatment programs) examines evidence on scale reliabilities and measurement structures of these tools. Results confirmed their integrity and usefulness as indicators of individual and group-level therapeutic dynamics.     

The Self-Report Symptom Inventory (SRSI): a New Instrument for the Assessment of Distorted Symptom Endorsement

Self-report instruments to detect distorted symptom reporting play a crucial role in clinical and forensic psychology. Most of the instruments currently available for this purpose only list implausible symptoms, which makes them easily identifiable as symptom validity tests. We developed the Self-Report Symptom Inventory (SRSI), combining five self-report scales of genuine symptoms with five pseudosymptom scales to screen for distorted symptom reporting in various domains (e.g., depression, post-traumatic stress). With a preliminary questionnaire version, we collected data in a heterogeneous sample (N?=?239) and performed an item selection, resulting in the final 107-item version. This version was evaluated in civil forensic patients, inmates of a prison, and a population-based sample; N?=?387). Data show that (a) SRSI pseudosymptom scores correlate highly (≥.80) with other instruments tapping distorted symptom endorsement, notably the Structured Inventory of Malingered Symptomatology; (b) High SRSI pseudosymptom scores tend to correlate with underperformance; and (c) The psychometric features of the SRSI are satisfactory, with internal consistency for the total scales >.90 and retest reliability >.85. The instrument appears to be a promising tool for examining symptom exaggeration, but further work is required, in particular cross-validation with other samples and different methods.     

Methadone in maintenance treatment of narcotic addicts; joint revision of conditions for use; interim maintenance treatment; human immunodeficiency virus disease counseling--FDA and SAMHSA. Final rule

The Food and Drug Administration (FDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) formerly the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA) are revising the conditions for the use of methadone in the maintenance treatment of narcotic addicts. The final rule allows, contingent on FDA and State approval, public and nonprofit private narcotic treatment programs to provide interim maintenance treatment to patients awaiting placement in comprehensive maintenance treatment and to require all narcotic treatment programs to provide counseling on preventing exposure to, and the transmission of, human immunodeficiency virus (HIV) disease.     

Therapeutic communities and prison management: an examination of the effects of operating an in-prison therapeutic community on levels of institutional disorder

There is a growing emphasis in corrections on the treatment of inmates with drug problems. The typical method of evaluating drug treatment programs is to examine how the treatment affects the inmate in terms of relapse and recidivism. This study examines the institutional consequences of operating a therapeutic community located in a medium/high-security male institution. The effect on management is examined from a perspective of institutional disorder. Disorders, from less severe inmate rule violations to more serious assaults, and rates of grievance filing are examined within the treatment unit and compared with rates in the general population. The inmate's perception of the environment, whether in treatment or non-treatment, is also examined. Findings indicate that in-prison therapeutic communities have lower levels of disorder than nontreatment housing units and tend to produce more positive perceptions of the living environment among the inmates living there. The impact of these findings for prison management is discussed.     

Assessing the Behavior and Needs of Veterans with Traumatic Brain Injury in Washington State Prisons: Establishing a Foundation for Policy,Practice, and Education

Abstract

A growing awareness of justice-involved veterans is revealing how little is known about this population, to what extent they have experienced a traumatic brain injury (TBI), and how this may relate to institutional behavior, participation in programs, and use of institutional resources. The current study identifies the prevalence of incarcerated veterans in Washington State who have experienced a TBI and how a TBI history may affect their prison experience and use of prison resources. The results of our study show that incarcerated veterans in Washington State with a moderate-to-severe TBI are more likely to use medical services, commit violent infractions, be placed in maximum custody (solitary confinement), and less likely to complete vocational and job skills programs. The importance of these findings to policy and practice is discussed.     

Randomized controlled trial proves effectiveness of methadone maintenance treatment in prison

A study on methadone maintenance treatment (MMT) undertaken by the Correctional Service of Canada in 2001 demonstrated that MMT has a positive impact on release outcome and on institutional behaviour. Now, a new study undertaken in an Australian prison system has demonstrated that MMT also reduces drug use and injection in prisons. The implications of this study are far reaching. They suggest that in all jurisdictions where community-based programs operate, prison-based methadone programs should be introduced or expanded.     

Physical victimization in prison: the role of mental illness

This study compares prison physical victimization rates (inmate-on-inmate and staff-on-inmate) for people with mental disorder to those without mental disorder in a state prison system. Inmate subjects were drawn from 14 adult prisons operated by a single mid-Atlantic State. A sample of 7,528 subjects aged 18 or older (7,221 men and 564 women) completed an audio-computer administered survey instrument. Mental disorder was based on self-reported mental health treatment ever for particular mental disorders. Approximately one-quarter of the sample reported some prior treatment for schizophrenia, bipolar disorder, depression, PTSD, or anxiety disorder. Rates of physical victimization for males with any mental disorder were 1.6 times (inmate-on-inmate) and 1.2 times (staff-on-inmate) higher than that of males with no mental disorder. Female inmates with mental disorder were 1.7 times more likely to report being physically victimized by another inmate than did their counterparts with no mental disorder. Overall, both males and females with mental disorder are disproportionately represented among victims of physical violence inside prison.     

Predicting Probationer Rates of Reincarceration Using Dynamic Factors from the Substance Abuse Questionnaire-Adult Probation III (SAQ-Adult Probation III)

Individuals incarcerated for violating the terms of their probation constitute a large portion of the prison population. Intervention programs designed to rehabilitate probationers have the potential to reduce prison populations and moderate the costs associated with incarceration. Unlike previous research, which has focused on demographic and static characteristics, the present study examined dynamic factors as predictors of probation revocation, as they may be more amenable to rehabilitation. The sample was comprised of 8,310 adult probationers and used scores from the SAQ-Adult Probation III. Poisson regression analyses showed that three dynamic factors, violence, antisocial behavior, and stress risk were positively related to the number of lifetime probation revocations. These results are discussed in light of potential rehabilitative benefits.     

Assault in prison and assault in prison psychiatric treatment

Studies have described measures associated with assault in the community, but few have identified measures associated with assault in prison or prison psychiatric treatment. In this study, prison assault histories and assaults while in prison psychiatric treatment for 222 randomly selected male inmates were evaluated. Using record reviews, interviews, neuropsychological, Rorschach, and psychopathy measures, risk factors for assault in prison and in prison psychiatric treatment were identified. Youth Authority placement, inhalant use, antisocial lifestyle, neurological injury, neuropsychological impairment, and higher PCL-R Factor II ratings were associated with assault in prison. Absence of major mental disorder, neurological impairment, or psychotic thinking, but presence of psychopathy was associated with assault in prison psychiatric treatment. In identifying risk for violence, the importance of (1) the context in which violence occurs; (2) the need for clear admission criteria for prison psychiatric treatment; and (3) the need to develop risk assessments that are specific to prison environments are emphasized.     

Partner Violence in Women's Prison: The Social Consequences of Girlfriend Fights

In this article, we use qualitative interviews with female inmates to examine how these women describe the consequences of girlfriend fights in prison. We find that they describe these fights as both social and pervasive. We also find that those who were counseled by staff members describe being empowered by the event. We argue that prison officials must use better methods of identifying and addressing partner violence in prison. We also recommend the use of widespread programs aimed at reducing partner violence.     

Early and periodic screening, diagnosis, and treatment (EPSDT) program--HCFA. Final rule

This final rule modifies present regulations to conform to legislative changes enacted by section 2181 of Pub. L. 97-35, the Omnibus Budget Reconciliation Act of 1981. That section eliminates the penalty which reduces by one percent Federal funds for a State's Title IV-A program, Aid to Families with Dependent Children (AFDC), for any quarter during which a State fails to: (1) Inform all AFDC families of the availability of Early and Periodic Screening, Diagnosis, and Treatment (EPSDT), services; (2) provide or arrange for requested screening services; and (3) arrange for corrective treatment of health problems found as a result of screening. In addition, even though the penalty has been eliminated, section 2181 mandates that States incorporate these three requirements into their Medicaid State plan with respect to all EPSDT eligibles. Further, this rule modifies current regulations to reflect Congressional intent that while States should continue to develop fully effective EPSDT programs, the Federal government should work to reduce current reporting requirements which entail a large volume of paperwork.     

The effect of institutional educational programming on prisoner misconduct

Relative to studies of recidivism, past research on prison educational programming has largely neglected to examine the relationship, if any, between participation in these programs and institutional misconduct. Using data from the National Survey of Inmates in State and Federal Correctional Facilities (N = 6957), we assess the relationship between participation in prison educational programming and instances of prisoner misconduct, considering the types and completion of such programs. Utilizing a recently developed propensity score weighting procedure to adjust for selection into programming, our findings indicate that, contrary to research on educational participation and recidivism, those involved in prison educational programming are more likely to commit misconduct infractions than those who are not involved in these programs. Practical implications and directions for future research are explored.     

New York State of Mind: Parental Incarceration and Children's Visitation in New York State

The incarceration of a parent has a variety of negative effects on a child's psychological, academic, and developmental success. Children can end up in foster care as a result of the state terminating parental rights due to the parent's incarceration. Despite imprisonment of their parent(s), maintenance of visitation with the parent(s) is still important for their children. However, not all prisons have visitation programs that are suitable to visiting children. This Note proposes a model state statute that will recognize the importance of visitation, implement “child friendly” visitation programs, facilitate training for prison staff, and provide transportation for children in major cities to the prison facilities.     

Developing relevant data for a prison organizational development program

A project to develop a set of techniques for bringing about change in an existing prison is described. The effort concentrated primarily on the managers of the statewide system, and the staff and inmates of one prison were the focus of a set of intervention experiments. Methods for modifying the network of human and organizational relationships in that system were objects of this project. The research instruments used, their use, and some of the things learned about them is given in detail.     

Patterns of Practice in Mental Health Courts: A National Survey

Mental health courts (MHCs) represent an important new development at the interface of the criminal justice and mental health systems. MHCs are criminal courts for persons with mental illness that were in part created to divert this population from jail/prison into community treatment. MHCs are proliferating rapidly despite limited knowledge regarding their characteristics or their efficacy. We surveyed the entire population of adult MHCs in the United States, n = 90. In the past 8 years, MHCs have been created in 34 states, with an aggregate current caseload of 7,560 clients in MHCs nationally. Most courts (92%) reported using jail as a sanction for noncompliance, if only rarely. Further, jail sanction use was significantly predicted by increased judicial supervision and number of felons in the court. Implications for MHCs and social monitoring are discussed.     

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

Our aim was to investigate whether early detection was feasible in prison and whether it could improve mental health outcomes in young prisoners. A secondary aim was to explore whether it can reduce returns to prison. Between 2011 and 2014, a total of 2115 young prisoners were screened, 94 (4.4%) met criteria for ultra-high risk for psychosis and were offered an intervention, 52 actually received it. Return to prison data were sought on the 52 participants, receiving a formal intervention. Of the 52 prisoners who received an intervention, 30.8% returned to custody compared to national average reconviction rates of between 45.4 and 66.5%. Our results suggest that early detection is a feasible option in a prison setting, improving mental health outcomes and reducing returns to prison. Mental health outcomes were recorded for a sub-sample of those receiving the intervention. The results indicated statistically significant improvements on measures of depression, anxiety and psychological distress.     

Prevalence of mental disorders and deliberate self-harm in Greek male prisoners

The aim of this survey was to determine the prevalence of current and lifetime mental disorder and deliberate self-harm among male prisoners in Greece. The subjects were 80 randomly selected remanded and sentenced prisoners in a Greek prison. They were assessed for mental disorder including suicidality and substance misuse using the Mini International Neuropsychiatric Interview (MINI). We also collected information regarding contact with psychiatric services, previous deliberate self-harm as well as physical health and conducted a brief assessment of their intellectual functioning. Mental disorder was diagnosed in 63 (78.7%) prisoners. The main diagnoses were: anxiety disorder, 30 (37.5%); major depression, 22 (27.5%); antisocial personality disorder, 30 (37.5%); alcohol dependence, 21 (26.3%) and opiate dependence 22 (27.5%) and schizophrenic or bipolar disorder 9 (11.2%). Deliberate self-harm prior to and during imprisonment was reported by 15% and 2.5% of prisoners, respectively, and 12 prisoners (15%) had IQ below 75. This survey identified a significant level of need for specialist mental health services in prison. Further studies are required to assess the specific needs of those patients who are too unwell to remain in prison, the need for specific treatments for substance misuse and improved assessment/treatment of common psychiatric disorders.     

The Personal Concerns Inventory (Offender Adaptation): measuring and enhancing motivation to change

Measuring offenders' motivation for treatment is important for selection and monitoring treatment engagement, yet few psychometrically robust measures of motivation exist. The Personal Concerns Inventory (PCI) was developed to assess motivation to change in people with addictive behaviours. It focuses on identifying goals in a wide variety of life areas, and two profiles have consistently been identified--adaptive and maladaptive. This study aimed to adapt the PCI for use with offenders and assess its suitability. Following amendment, 11 men serving prison sentences were interviewed using the PCI (Offender Adaptation, OA). Personal concerns related to self-change, and partner, family, and relationships were most commonly identified. Scores suggested that offenders show adaptive and maladaptive profiles, similar to those previously identified. The PCI (OA) has promise for use with offenders, although the issue of whether the PCI (OA) is better viewed as a measure of motivation or a motivational enhancer remains for further research.