Assessing needs for psychiatric treatment in prisoners: 2. Met and unmet need

BACKGROUND: In a companion paper, we established high levels of psychiatric morbidity in prisoners (Bebbington et al. Soc Psychiatry Psychiatr Epidemiol, 2016). In the current report, we evaluate how this morbidity translates into specific needs for treatment and the consequent implications for services. Mental health treatment needs and the extent to which they had been met were assessed in a representative sample of prisoners in a male and a female prison in London (Pentonville and Holloway). METHODS: Prisoners were sampled at random in a sequential procedure based on the Local Inmate Data System. We targeted equal numbers of male remand, male sentenced, female remand, and female sentenced prisoners. Following structured assessment of psychosis, common mental disorders, PTSD, personality disorders and disorders of abuse, we used the MRC Needs for Care Assessment (NFCAS) to establish whether potential needs for care in ten areas of mental health functioning were met, unmet, or incapable of being met by services. RESULTS: Data on treatment experience were provided by 360 inmates. Eighty percent of females and 70% of males had at least one need for treatment. Over half (53.7%) of the needs of female prisoners were met, but only one third (36.5%) in males. Needs for medication were unmet in 32% of cases, while those for psychological treatment were unmet in 51%. CONCLUSIONS: Unmet needs for mental health treatment and care were common in the two prisons. This has adverse consequences both for individual prisoners and for the effective functioning of the criminal justice system

Assessing needs for psychiatric treatment in prisoners: 1. Prevalence of disorder

BACKGROUND: High levels of psychiatric morbidity in prisoners have important implications for services. Assessing Needs for Psychiatric Treatment in Prisoners is an evaluation of representative samples of prisoners in a male and a female prison in London. This paper reports on the prevalence of mental disorders. In a companion paper, we describe how this translates into mental health treatment needs and the extent to which they have been met. METHODS: Prisoners were randomly sampled in a sequential procedure based on the Local Inmate Data System. We interviewed roughly equal numbers from the following groups: male remand; male sentenced prisoners (Pentonville prison); and female remand; female sentenced prisoners (Holloway prison). Structured assessments were made of psychosis, common mental disorders, PTSD, personality disorder and substance abuse. RESULTS: We interviewed 197 male and 171 female prisoners. Psychiatric morbidity in male and female, sentenced and remand prisoners far exceeded in prevalence and severity than in equivalent general population surveys. In particular, 12% met criteria for psychosis; 53.8% for depressive disorders; 26.8% for anxiety disorders; 33.1% were dependent on alcohol and 57.1% on illegal drugs; 34.2% had some form of personality disorder; and 69.1% had two disorders or more. Moreover, in the year before imprisonment, 25.3% had used mental health services. CONCLUSIONS: These rates of mental ill-health and their similarity in remand and sentenced prisoners indicate that diversion of people with mental health problems from the prison arm of the criminal justice system remains inadequate, with serious consequences for well-being and recidivism

Walking Behaviour of Individuals with Intermittent Claudication Compared to Matched Controls in Different Locations: An Exploratory Study

Individuals with intermittent claudication (IC) are less physically active than their peers, but how this varies with location is unclear. Individuals with IC and matched controls [sex, age ±5 years, home < 5 miles] wore an activity monitor (activPAL) and carried a GPS device (AMOD-AGL3080) for 7 days. GPS data categorised walking events as occurring at home (<=50 m from home coordinates) or away from home, and indoors (signal to noise ratio <= 212 dB) or outdoors. Number of walking events, walking duration, steps and cadence were compared between groups and each location pair using mixed model ANOVAs. In addition, the locus of activity (distance from home) at which walking was conducted was compared between groups. Participants (n = 56) were mostly male (64%) and aged 54-89 years. Individuals with IC spent significantly less time walking and took fewer steps than their matched controls at all locations, including at home. Participants spent more time and took more steps away from home than at home, but were similar when walking indoors and outdoors. The locus of activity was significantly smaller for individuals with IC, suggesting that it is not just physical capacity that influences walking behaviour, and other factors (e.g., social isolation) may play a role

Experience of clinical services shapes attitudes to mental health data sharing: findings from a UK-wide survey

BACKGROUND: Routinely-collected mental health data could deliver novel insights for mental health research. However, patients’ willingness to share their mental health data remains largely unknown. We investigated factors influencing likelihood of sharing these data for research purposes amongst people with and without experience of mental illness. METHODS: We collected responses from a diverse sample of UK National Health Service (NHS) users (n = 2187) of which about half (n = 1087) had lifetime experience of mental illness. Ordinal logistic regression was used to examine the influence of demographic factors, clinical service experience, and primary mental illness on willingness to share mental health data, contrasted against physical health data. RESULTS: There was a high level of willingness to share mental (89.7%) and physical (92.8%) health data for research purposes. Higher levels of satisfaction with the NHS were associated with greater willingness to share mental health data. Furthermore, people with personal experience of mental illness were more willing than those without to share mental health data, once the variable of NHS satisfaction had been controlled for. Of the mental illnesses recorded, people with depression, obsessive-compulsive disorder (OCD), personality disorder or bipolar disorder were significantly more likely to share their mental health data than people without mental illness. CONCLUSIONS: These findings suggest that positive experiences of health services and personal experience of mental illness are associated with greater willingness to share mental health data. NHS satisfaction is a potentially modifiable factor that could foster public support for increased use of NHS mental health data in research. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-022-12694-z

Using a knowledge exchange event to assess study participants’ attitudes to research in a rapidly evolving research context

Grant information: DJP, IJD and AMM are supported by Wellcome Trust Grant 104036. IJD, DJP, JPB and AMM, IB, EJK and SFW are supported by MRC Mental Health Data Pathfinder Grant MC_PC_17209. AMM and SML are supported by MRC Grant MC_PC_MR/R01910X/1. AMM is supported by MRC Grant MR/S035818/1. Theirworld Edinburgh Birth Cohort is funded by the charity Theirworld (www.theirworld.org), and is undertaken in the MRC Centre for Reproductive Health, which is funded by MRC Centre Grant (G1002033). CB and DJP are supported by Health Data Research UK, an initiative funded by UK Research and Innovation, Department of Health and Social Care (England) and the devolved administrations, and leading medical research charities.Peer reviewedPublisher PD

MQ Data Science Report to MRC on building a National Infrastructure for Mental Health Data Science in the UK

At the MQ meeting on 9th September 2019 (Edinburgh), we hosted a discussion session, where we asked participants how they would envision a National Infrastructure for Mental Health Data Science (referred to as “platform” below). Participants were advised that their collected input would be fed back to the MRC to serve as a starting point for their full consultation on this topic. Key findings ● Researchers are particularly interested in using such a platform themselves and recognise its utility to a large number of other organisations. ● The minimum useful requirement for such a platform is a searchable directory of available data with a note about access procedures. Whereas an ideal platform might contain the actual data. Our participants demonstrated a wide interest in the inclusion of different data types and research areas within such a platform. ● Participants were enthusiastic about the possibilities such a platform might enable, mentioning expansion of research topics and conducting more rigorous research. They felt the platform might enable this by maximizing data quality/usage and facilitating data access. ● Participants recognised the positive impact such a platform could have on people affected by mental illness. Patterns of responses arose around patient engagement, policy shaping, open science, and improved research quality. All these elements could help fight the stigma of mental illness in society. ● With regard to the MRC consultation, our participants recognised the need to consult with a range of organisations, including data donors, ethical boards, privacy panels and relevant charities - with an observed less enthusiastic support for political involvement (which may reflect current political circumstances). ● Our participants raised a number of concerns, which the MRC may wish to address during their consultation phase. These included long-term sustainability, governance, and ethical considerations. On a practical note, questions were raised around prioritization, practicalities on data management, platform operation and relevant training and capacity building. Lastly, the participants illustrated the need to raise public awareness of and involvement in this platform in order to ensure the successful implementation

Highly efficient separation of actinides from lanthanides by a phenanthroline-derived bis-triazine ligand

The synthesis, lanthanide complexation, and solvent ex- traction of actinide(III) and lanthanide(III) radiotracers from nitric acid solutions by a phenanthroline-derived quadridentate bis-triazine ligand are described. The ligand separates Am(III) and Cm(III) from the lanthanides with remarkably high efficiency, high selectivity, and fast extraction kinetics compared to its 2,2'-bipyridine counterpart. Structures of the 1:2 bis-complexes of the ligand with Eu(III) and Yb(III) were elucidated by X-ray crystallography and force field calculations, respec-tively. The Eu(III) bis-complex is the first 1:2 bis-complex of a quadridentate bis-triazine ligand to be characterized by crystallography. The faster rates of extraction were verified by kinetics measurements using the rotating membrane cell technique in several diluents. The improved kinetics of metal ion extraction are related to the higher surface activity of the ligand at the phase interface. The improvement in the ligand's properties on replacing the bipyridine unit with a phenanthroline unit far exceeds what was anticipated based on ligand design alone

Digitizing localism: anticipating, assembling and animating a ‘space’ for UK hyperlocal media production

This paper presents an unconventional view of media production, not as the direct production of media content or forms, but the cultivation of spaces for media production taking place elsewhere. I draw on a close analysis of Destination Local, a program of UK charity Nesta, which focused on the implications of location-based technologies for the emergent field of ‘hyperlocal’ media. Although the first round of the program – the focus in this paper – funded 10 experimental projects alongside extensive research, my argument is that Destination Local was less a matter of enabling specific place-based hyperlocal media outlets. Rather, it was an attempt to anticipate, assemble and animate a broader UK hyperlocal media ‘space’, composed of both technical ecologies (e.g. data, devices, platforms, standards) and practical fields (e.g. journalism, software development, local government, community activism). This space, I argue, was anchored to a largely implicit political discourse of localism

More-than-human politics in the new arctic landscape of youth : Atmospheric shifts at the shopping mall

Peer reviewe