Informal coercion: current evidence

2016 ◽  
Author(s):  
Ksenija Yeeles
Keyword(s):  
Mental Health ◽  
Criminal Justice ◽  
Financial Incentives ◽  
Community Treatment ◽  
Current Evidence ◽  
Future Research ◽  
Perceived Coercion ◽  
International Evidence ◽  
Health Community ◽  
Informal Coercion

This chapter considers non-legislative pressures in mental health community treatment, reviews the current body of evidence, and offers recommendations for future research. It attempts to clarify terminology on treatment pressures including different forms of ‘leverage’ such as housing, financial, criminal justice, childcare leverages, and perceived coercion. Based on a scoping review the chapter portrays current international evidence on prevalence, predictors, and outcomes of informal coercion (for example persuasion, interpersonal leverage, inducement, threats, and force) in both quantitative and qualitative studies with patients, with attention to the issues of the perception of fairness and the effectiveness of treatment, financial incentives to improve adherence, and sources of informal coercion. It also discusses common limitations and recommendations for future research.

scholarly journals Coercion in mental health: a trial of the effectiveness of community treatment orders and an investigation of informal coercion in community mental health care

2016 ◽  
Vol 4 (21) ◽  
pp. 1-354 ◽  
Author(s):  
Tom Burns ◽  
Jorun Rugkåsa ◽  
Ksenija Yeeles ◽  
Jocelyn Catty
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Primary Outcome ◽  
Research Programme ◽  
Community Treatment ◽  
Community Treatment Orders ◽  
Informal Coercion ◽  
Treatment Order ◽  
Community Treatment Order

BackgroundCoercion comprisesformal coercionorcompulsion[treatment under a section of the Mental Health Act (MHA)] andinformal coercion(a range of treatment pressures, includingleverage). Community compulsion was introduced in England and Wales as community treatment orders (CTOs) in 2008, despite equivocal evidence of effectiveness. Little is known about the nature and operation of informal coercion.DesignThe programme comprised three studies, with associated substudies: Oxford Community Treatment Order Evaluation Trial (OCTET) – a study of CTOs comprising a randomised controlled trial comparing treatment on CTO to voluntary treatment via Section 17 Leave (leave of absence during treatment under section of the MHA), with 12-month follow-up, an economic evaluation, a qualitative study, an ethical analysis, the development of a new measure of capabilities and a detailed legal analysis of the trial design; OCTET Follow-up Study – a follow-up at 36 months; and Use of Leverage Tools to Improve Adherence in community Mental Health care (ULTIMA) – a study of informal coercion comprising a quantitative cross-sectional study of leverage, a qualitative study of patient and professional perceptions, and an ethical analysis.ParticipantsParticipants in the OCTET Study were 336 patients with psychosis diagnoses, currently admitted involuntarily and considered for ongoing community treatment under supervision. Participants in the ULTIMA Study were 417 patients from Assertive Outreach Teams, Community Mental Health Teams and substance misuse services.OutcomesThe OCTET Trial primary outcome was psychiatric readmission. Other outcomes included measures of hospitalisation, a range of clinical and social measures, and a newly developed measure of capabilities – the Oxford Capabilities Questionnaire – Mental Health. For the follow-up study, the primary outcome was the level of disengagement during the 36 months.ResultsCommunity treatment order use did not reduce the rate of readmission [(59 (36%) of 166 patients in the CTO group vs. 60 (36%) of 167 patients in the non-CTO group; adjusted relative risk 1.0 (95% CI 0.75 to 1.33)] or any other outcome. There were no differences for any subgroups. There was no evidence that it might be cost-effective. Qualitative work suggested that CTOs’ (perceived) focus on medication adherence may influence how they are experienced. No general ethical justification was found for the use of a CTO regime. At 36-month follow-up, only 19 patients (6% of 329 patients) were no longer in regular contact with services. Longer duration of compulsion was associated with longer time to disengagement (p = 0.023) and fewer periods of discontinuity (p < 0.001). There was no difference in readmission outcomes over 36 months. Patients with longer CTO duration spent fewer nights in hospital. One-third (35%) of the ULTIMA sample reported lifetime experiences of leverage, lower than in the USA (51%), but patterns of leverage experience were similar. Reporting leverage made little difference to patients’ perceived coercion. Patients’ experiences of pressure were wide-ranging and pervasive, and perceived to come from family, friends and themselves, as well as professionals. Professionals were committed to patient-centred approaches, but felt obliged to assert authority when patients relapsed. We propose a five-step framework for determining the ethical status of offers by mental health professionals and give detailed guidance for professionals about how to exercise leverage.ConclusionsCommunity Treatment Orders do not deliver clinical or social functioning benefits for patients. In the absence of further trials, moves should be made to restrict or stop their use. Informal coercion is widespread and takes different forms.Trial registrationCurrent Controlled Trials ISRCTN73110773.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

scholarly journals Epidemiology of sleep disorders during COVID-19 pandemic: A systematic scoping review protocol

2020 ◽  
Author(s):  
Samia Tasnim ◽  
Mariya Rahman ◽  
Priyanka Pawar ◽  
Liye Zou ◽  
Abida Sultana ◽  
...  
Keyword(s):  
Mental Health ◽  
Sleep Disorders ◽  
Scoping Review ◽  
Mental Health Problems ◽  
Empirical Studies ◽  
Professional Community ◽  
Health Problems ◽  
Current Evidence ◽  
Future Research ◽  
Scoping Reviews

Background: The coronavirus disease (COVID-19) is impacting human health globally. In addition to physical health problems, a growing burden of mental health problems has become a global concern amid this pandemic. Sleep disorders are major mental health problems associated with increased psychosocial stressors; however, no research synthesis is available on the epidemiology of sleep disorders. In this systematic scoping review, we aim to assess the current evidence on the epidemiological burden, associated factors, and interventions from the existing literature on sleep disorders. Methods: We will search seven major health databases and additional sources to identify, evaluate, and synthesize empirical studies on the prevalence and correlates of sleep disorders and available interventions addressing the same. We will use the Joanna Briggs Institute Methodology for Scoping Review and report the findings using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. Conclusion: This review will identify the epidemiological burden of and interventions for sleep disorders. The findings of this review will be widely communicated with the research and professional community to facilitate future research and practice.

scholarly journals Economic Burden of Mental Disorders in Bangladesh: A Systematic Review and Recommendations for Future Research

2020 ◽  
Author(s):  
Tahmina Tasnim Rodela ◽  
Samia Tasnim ◽  
Hoimonty Mazumder ◽  
Dilruba Fatima Sharmin ◽  
Farah Faizah ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Health Economic ◽  
Mental Disorders ◽  
Economic Burden ◽  
Mental Health Problems ◽  
Economic Research ◽  
Current Evidence ◽  
Future Research ◽  
Health Economic Research

Mental disorders are highly prevalent in different population groups in Bangladesh. Effective policymaking and evaluation may need economic evidence on complex mental health problems. In this systematic review, we aimed to evaluate the current evidence on the economic burden of mental disorders in Bangladesh. We searched six major databases and additional sources using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We included studies that were published in English, as peer-reviewed articles, reported any economic burden of any mental disorders, and focused on the Bangladeshi population. Among a total of 1241 citations, no study met our criteria. This scarcity of evidence on the economic burden of mental disorders can be attributable to many factors, including a suboptimal state of research in mental health, lack of institutional and national priorities on mental health economic research, and lack of capacities or resources to improve knowledge. Future efforts should aim at strengthening research capacities, providing resources, prioritizing mental health research, improving collaboration, and effective policymaking and strategic planning to promote mental health economic research in the context of Bangladesh.

Interventions in Forensic Settings: Juveniles in Residential Placement, Defendants in Drug Courts or Mental Health Courts, and Defendants in Forensic Hospitals as Incompetent to Stand Trial

2010 ◽  
pp. 649-680 ◽  
Author(s):  
Kirk Heilbrun ◽  
Naomi Goldstein ◽  
David DeMatteo ◽  
Allison Hart ◽  
Christina Riggs Romaine ◽  
...  
Keyword(s):  
Mental Health ◽  
Criminal Justice ◽  
Future Research ◽  
Mental Health Courts ◽  
Residential Placement ◽  
Research Attention ◽  
Criminal Justice Systems ◽  
Specialized Courts ◽  
Incompetent To Stand Trial ◽  
Effectiveness Data

Interventions for criminal justice–involved populations have been an increasing focus of theoretical and research attention, and have also been recognized as among the “next frontier” of priorities for the forensic mental health professions. In this chapter, we present a description of three different kinds of interventions with criminal justice populations. These interventions—for adjudicated delinquents, defendants diverted into specialized courts, and defendants hospitalized as incompetent to stand trial—represent a range of population ages, traditional versus relatively new modalities, and stages of the juvenile/criminal justice systems. Perhaps surprisingly, the more established of these interventions (juvenile placement and forensic hospitalization) have relatively less empirical data regarding their effectiveness than do the newer drug and mental health court modalities. In this chapter, we summarize the evidence that does exist, describe existing and recommended practices where indicated (unfortunately, often without the assistance of effectiveness data), and draw conclusions regarding our future research needs in light of this discussion.

Suicide prevention across the UK criminal justice system: an overview of current provision and future directions

2021 ◽  
Vol 23 (1) ◽  
pp. 53-62
Author(s):  
Stefanie Oliveira Antunes ◽  
Verity Wainwright ◽  
Neil Gredecki
Keyword(s):  
Criminal Justice ◽  
Criminal Justice System ◽  
Suicide Prevention ◽  
Justice System ◽  
Current Evidence ◽  
Future Research ◽  
Content Type ◽  
Current Evidence Base ◽  
The Uk ◽  
Current Provision

Purpose This paper aims to provide an overview of current suicide prevention across the UK criminal justice system (CJS). It considers shortcomings in current provision and how improvements could be made by drawing on international practice. Recommendations for practice going forward and suggestions for future research are made based on the literature. Design/methodology/approach This paper provides an overview of suicide prevention research to date. Relevant literature was identified through a basic journal article search, including terms such as “probation”, “criminal justice system”, “suicide”, “suicide prevention”, “UK” and “suicide theory”. Findings This paper highlights opportunities to improve practice based on the current evidence base, making several recommendations and suggestions for practice, including improving multi-agency cooperation through clearer distribution of responsibilities, simplifying data sharing and investing in trauma-focussed suicide training for staff. Practical implications This paper considers how research and psychological theory has informed suicide prevention practice in the UK. Limitations and challenges in applying theory to practice are explored, in the context of research with frontline staff who use such policies. This review proposes potential improvements to suicide prevention implementation to reduce suicide across the wider CJS. Originality/value This article represents an overview of the existing literature as well as possible future ideas for policy. It is therefore a piece that represents the viewpoint of all involved authors.

The Victimization of Transgender Individuals

2021 ◽  
pp. 327-352
Author(s):  
Dean Fox ◽  
Barbara Sims
Keyword(s):  
Mental Health ◽  
Criminal Justice ◽  
Social Services ◽  
Intimate Relationships ◽  
Crime Statistics ◽  
Transgender People ◽  
Health Community ◽  
Race Ethnicity ◽  
Reported Crime ◽  
The Impact

The victimization of transgender individuals is not always present in reported crime statistics. The victimizations experienced by this population are often invisible and suffered in isolation. There are many reasons why transgender people do not report their victimization, either to family members and friends or to the various institutions of society such as the police, the physical and/or mental health community, or to other social services providers. The authors explore what is currently known about the extent and nature of the victimization of transgender individuals. They explore the research associated with the role race/ethnicity plays in transgender victimizations, the nuances of victimizations that occur within intimate relationships, the response of the criminal justice system, and the impact of victimization on the transgender community. Possible solutions to the problems identified in the chapter are addressed, not the least of which is to dispel many of the myths associated with transgender individuals.

scholarly journals Engagement in Digital Mental Health Interventions: Can Monetary Incentives Help?

2021 ◽  
Vol 12 ◽  
Author(s):  
Eliane M. Boucher ◽  
Haley E. Ward ◽  
Amelia C. Mounts ◽  
Acacia C. Parks
Keyword(s):  
Mental Health ◽  
Financial Incentives ◽  
Well Being ◽  
Health Interventions ◽  
Future Research ◽  
User Engagement ◽  
Monetary Incentives ◽  
Subjective Well Being ◽  
Digital Interventions ◽  
Mental Health Interventions

Digital mental health interventions (DMHI) are scalable and cost-effective strategies for increasing access to mental health care; however, dropout rates associated with digital interventions are high, particularly for open-access digital interventions. While some studies have focused on predictors of dropout from digital mental health programs, few studies have focused on engagement features that might improve engagement. In this perspective article, we discuss whether monetary incentives (MI) are one avenue to increasing user engagement in DMHI. We begin by reviewing the literature on the effects of MI for behavior change in health domains (e.g., dietary behaviors, substance use, and medication adherence). Then, drawing on a pilot study we conducted to test the effects of different levels of MI on usage and improvement in subjective well-being among users of a DMHI (Happify), we discuss the potential applications of MI for DMHI, the potential drawbacks of financial incentives in this context, and open questions for future research.

scholarly journals The Importance of Mental Health Courts for Psychiatry & the Criminal Justice System

2019 ◽  
Vol 9 (2) ◽  
pp. 20-23
Author(s):  
Alexander Simmons
Keyword(s):  
Mental Health ◽  
Criminal Justice ◽  
Criminal Justice System ◽  
Justice System ◽  
Treatment Programs ◽  
Mentally Ill Offenders ◽  
Future Research ◽  
Mental Health Courts ◽  
Promising Area ◽  
Legal Outcomes

Mental health courts are designed to divert mentally ill offenders away from the criminal justice system and into appropriate treatment programs. This commentary highlights the systemic issues that led to the development of mental health courts as a solution. Research has already demonstrated that these courts are associated with numerous positive psychiatric and legal outcomes. However, further research is required to determine what specifically makes them successful, and who is most likely to benefit from them. Mental health courts have earned their place as an essential part of the criminal justice system and are a promising area of future research.

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