Mental Health Research

The attached presentation attempts to summarise a series of research studies undertaken largely at the University of Lincoln and at Royal Holloway, University of London. The slides outline a series of studies that are mostly focused on mental health issues for probation.

The research questions addressed are various and, in the first instance, this text aligns the slides with the questions posed.

Slides 1-12  :  We ask ‘what is the likely prevalence of mental health disorders in the probation population’? We also estimate the extent of comorbidity.

Slides 13-17 :  In this series of slides we examine the extent to which offender managers recognise mental health disorders on their caseload

Slides 18-25  :  In these slides we examine both the barriers and the facilitators to people on probation accessing health services

Slide 26  :  This slide gives details of other papers, written at the time, that examine personality disorder and suicidality.

Slides 27-30 :  These slides outline recent research on suicide and probation. The paper by Philips and colleagues examines prevalence in England in detail. The other paper by Sirdifield et al is a recently published systematic review of suicide and probation.

Slides 31  :  Notes that two other recent systematic reviews have been undertaken Brooker and Sirdifield. One on mental health and the other on substance misuse.

Slide 32  :  This slide gives more detail about the findings from the systematic review of substance misuse.

Slides 33-35 :     Examine health care funding by Clinical Commissioning groups in England and show that there is very little spend.

Slide 36 :  We give the link for the commissioning guidance we produced as a result of a recent study.

Slides 37-38  :  We reference a recent national healthcare strategy for probation produced in England by the National Probation Service

Slides 40-43 :  We detail findings from a recent study by Fowler et al undertaken in London which shows the results of screening for a mental health problem in probation and then offering a CBT type intervention. The study had good results although the sample suffered from attrition.

Slide 44 :                References a small survey undertaken across the EU in 2012 which obtained a poor response

Slide 45-46 :         Summarise the research and are reproduced below

The Issues Worth Considering

• Recognition and assessment of mental health problems and suicidality by probation staff – Who does this? How?
• Healthcare funding for probation where needs are highly complex (dual diagnosis and personality disorder) – How much is such healthcare funded?
• The lack of rigorous research on effective mental health interventions for probationers – much more research is needed
• If mental health problems were detectable, but they are complex, how do you develop pathways between probation and mental health services? – a key questions when most mainstream MH services are averse to taking ‘offenders’
• High levels of suicide a significant issue in their own right – this is a serious issue in England and other EU countries such as Sweden

Conclusions

• The evidence base has been systematically reviewed in three main areas: mental health, suicide and substance misuse. We know there is little information, world-wide, on effective mental health/substance misuse interventions
• We have useful descriptive data on the epidemiology of mental health disorders and suicide data from England, Sweden and Ireland (although, as yet, the data from Ireland is unpublished)
• We also know that healthcare/substance misuse services in probation in England are under-funded and indeed, almost unrecognised by CCGs in England as a ‘need’
• There has been one recent study of a CBT type intervention in London where of 569 people that met screening criteria only 75 completed treatment.

 References

For copies of any of the papers referenced here please contact Charlie Brooker at charlie.brooker@rhul.ac.uk

An executive summary

Final report