Developing evidence for a national strategy for older adults in the criminal justice system: overview of the nominal group approach for this series of brief reports.

The number of people aged 50 and over entering the criminal justice system (CJS) in England and Wales is growing. This raises questions as to the suitability of the CJS to equitably accommodate individuals with complex illness or impairment, who might experience difficulties in cognitive function, frailty, and/or impaired mobility. Findings from the government, the third sector, and academic literature have highlighted the difficulties experienced by older adults in the CJS and those tasked with supporting them.

Older women in the criminal justice system: a brief report from a nominal group.

There are increasing numbers of older women in prison in England and Wales. The needs of older women in prison have been under researched and are often unmet. This paper explores staff and expert perspectives on the needs of older women in prison through a nominal group attended by six participants, including a consultant at the UK Health Security Agency; a General Practitioner; a postgraduate student completing a project on older women in prison; an academic researcher with expertise on older women in prison; a National Women's Health, Social Care, and Environment Review Group lead; and a HMMPS Diversity and Inclusion Lead.

The mental health of older adults in the criminal justice system: a brief report from a nominal group.

The number of older people in prison is increasing, and this group has significant mental health needs. Despite this, little research has evaluated mental healthcare for older prisoners, and examples of best practice are unknown. This paper explored staff experiences of supporting the mental health needs of older prisoners to identify existing forms of care provision, challenges to implementation, and areas for improvement.

The COVID-19 pandemic and older adults in prison: a brief report from a nominal group.

Throughout the COVID-19 pandemic, concerns were raised regarding the vulnerability of prisoners to infection from the virus, leading to numerous changes to prison regimes and healthcare delivery. A nominal group was conducted exploring the experiences and views of prison staff involved in supporting older adult prisoners in England and Wales during times of COVID-19, including considering improvements in prison healthcare that can be applied beyond the pandemic. The group included seven participants with relevant knowledge and experience, comprising two consultants in public health, four heads of prison healthcare, and a prison governor.

Providing appropriate health and social care for people with dementia or mild cognitive impairment in the criminal justice system of England and Wales: a thematic analysis of prisoner and staff interview data.

Background: The number of older adults entering the criminal justice system is growing. Approximately 8% of older prisoners in England and Wales have suspected dementia or mild cognitive impairment (MCI) and experience difficulties in everyday functioning, and disruption to their daily life. At present, no specific dementia/MCI care pathway has been implemented that is applicable and appropriate for use across different prisons in England and Wales.

Understanding the scale and nature of avoidable healthcare-associated harm for prisoners in England: protocol for a retrospective cross-sectional study.

Introduction: Around 1 in 20 patients experience avoidable healthcare-associated harm worldwide. Despite longstanding concerns, there is insufficient information available about the safety of healthcare for prisoners. To address this, this study will investigate the scale and nature of avoidable healthcare-associated harm for prisoners in England.

Clinicians' use of the structured professional judgement approach for adult secure psychiatric service admission assessments: A systematic review.

The structured professional judgement (SPJ) approach was initially developed to support risk assessment and management decisions. The approach is now being adapted and applied to admission assessments for adult secure services. This systematic review aims to summarise the evidence for the effectiveness and acceptability of the SPJ approach in admission assessments of this kind.

Interventions for the detection, monitoring, and management of chronic non-communicable diseases in the prison population: an international systematic review.

Background: High rates of health inequalities and chronic non-communicable diseases exist amongst the prison population. This places people in and/or released from prison at heightened risk of multimorbidity, premature mortality, and reduced quality of life. Ensuring appropriate healthcare for people in prison to improve their health outcomes is an important aspect of social justice.

Conducting Randomized Controlled Trials of Complex Interventions in Prisons: A Sisyphean Task?

Randomized Controlled Trials (RCT) are the "gold standard" for measuring the effectiveness of an intervention. However, they have their limitations and are especially complex in prison settings. Several systematic reviews have highlighted some of the issues, including, institutional constraints e.

The older prisoner health and social care assessment and plan (OHSCAP) versus treatment as usual: a randomised controlled trial.

Background: Older people are the fastest-growing demographic group among prisoners in England and Wales and they have complex health and social care needs. Their care is frequently ad hoc and uncoordinated. No previous research has explored how to identify and appropriately address the needs of older adults in prison.

Health trainer-led motivational intervention plus usual care for people under community supervision compared with usual care alone: a study protocol for a parallel-group pilot randomised controlled trial (STRENGTHEN).

Introduction: People with experience of the criminal justice system typically have worse physical and mental health, lower levels of mental well-being and have less healthy lifestyles than the general population. Health trainers have worked with offenders in the community to provide support for lifestyle change, enhance mental well-being and signpost to appropriate services. There has been no rigorous evaluation of the effectiveness and cost-effectiveness of providing such community support.

The mental health and substance misuse needs of male ex-armed forces personnel in prison.

Ex-armed forces personnel constitute the largest known occupational group in prison but there is little evidence regarding their mental health, or substance misuse, needs. A total of 105 participants were interviewed and measures assessing symptoms of common mental health (CMH) problems and substance misuse were completed along with a review of their health care records. Forty (38%) participants screened for current CMH problems (CCMH) and high levels of dual symptomology and alcohol misuse were assessed.

Trouble sleeping inside: a cross-sectional study of the prevalence and associated risk factors of insomnia in adult prison populations in England.

Objective: To investigate the prevalence of insomnia and identify associated demographic, clinical and forensic risk factors in adult prisoners in England.

Methods: A cross-sectional study of 237 prisoners aged 18-72 years, across two male prisons and one female prison in North England. We used the Sleep Condition Indicator to measure probable DSM-V insomnia disorder (ID) and the Pittsburgh Sleep Quality Index to examine sleep quality.

Insomnia management in prisons in England and Wales: a mixed-methods study.

Insomnia in prison is common; however, research is limited regarding the management strategies that prison establishments employ. To address this knowledge gap, we conducted a survey to identify how insomnia is detected, diagnosed and treated in adult prisons in England and Wales. Telephone interviews with a purposive sample of health-care managers were then conducted.

Prevalence and appropriateness of psychotropic medication prescribing in a nationally representative cross-sectional survey of male and female prisoners in England.

Background: Mental illness is highly prevalent among prisoners. Although psychotropic medicines can ameliorate symptoms of mental illness, prescribers in prisons must balance clinical needs against risks to safety and security. Concerns have been raised at the large number of prisoners reportedly receiving psychotropic medicines in England.

Police custody health care: a review of health morbidity, models of care and innovations within police custody in the UK, with international comparisons.

This paper is a scoping review of the available evidence regarding health care issues in police custody. It describes the types and prevalence of health disorders encountered in custody and provides an overview of current practice and recent innovations in police custody health care. In contrast to the health of prisoners, the health of police custody detainees has, until recently, received little academic or clinical attention.

Soldier, civilian, criminal: identifying pathways to offending of ex-armed forces personnel in prison.

Little is known about why some ex-armed forces personnel become involved in the criminal justice system, however, they represent the largest known occupational group in prison. In-depth interviews were employed to explore possible pathways to offending. Twenty ex-armed forces personnel in prison were recruited from five prisons in England.

Treatment Barriers and Support for Male Ex-Armed Forces Personnel in Prison: Professional and Service User Perspectives.

Ex-armed forces personnel represent a potentially vulnerable group within the prison population. To provide support to this group, we need to understand their needs and help-seeking behavior. A focus group with professionals and semi-structured interviews with service users explored perspectives of the treatment barriers faced by this group and their support needs.