Psychological and psychosocial interventions offered to forensic mental health inpatients: a systematic review

OBJECTIVE: To examine the evidence for the use of psychological and psychosocial interventions offered to forensic mental health inpatients. DESIGN: CINAHL, MEDLINE, PsycINFO, ScienceDirect and Web of Science databases were searched for research published in English between 1 January 1990 and 31 May...

Descripción completa

Detalles Bibliográficos
Autores principales: MacInnes, Douglas, Masino, Serena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6475151/
https://www.ncbi.nlm.nih.gov/pubmed/30898809
http://dx.doi.org/10.1136/bmjopen-2018-024351
_version_ 1783412723016531968
author MacInnes, Douglas
Masino, Serena
author_facet MacInnes, Douglas
Masino, Serena
author_sort MacInnes, Douglas
collection PubMed
description OBJECTIVE: To examine the evidence for the use of psychological and psychosocial interventions offered to forensic mental health inpatients. DESIGN: CINAHL, MEDLINE, PsycINFO, ScienceDirect and Web of Science databases were searched for research published in English between 1 January 1990 and 31 May 2018. OUTCOME MEASURES: Disturbance, mental well-being, quality of life, recovery, violence/risk, satisfaction, seclusion, symptoms, therapeutic relationship and ward environment. There were no limits on the length of follow-up. ELIGIBILITY CRITERIA: We included randomised controlled trial (RCT) studies of any psychological or psychosocial intervention in an inpatient forensic setting. Pilot or feasibility studies were included if an RCT design was used. We restricted our search criteria to inpatients in low, medium and high secure units aged over 18. We focused on interventions considered applicable to most patients residing in forensic mental health settings. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers extracted data and assessed risk of bias. RESULTS: 17 232 citations were identified with 195 full manuscripts examined in detail. Nine papers were included in the review. The heterogeneity of the identified studies meant that meta-analysis was inappropriate. The results were presented in table form together with a narrative synthesis. Only 7 out of 91 comparisons revealed statistically significant results with no consistent significant findings. The most frequently reported outcomes were violence/risk and symptoms. 61% of the violence/risk comparisons and 79% of the symptom comparisons reported improvements in the intervention groups compared with the control groups. CONCLUSIONS: Current practice is based on limited evidence with no consistent significant findings. This review suggests psychoeducational and psychosocial interventions did not reduce violence/risk, but there is tentative support they may improve symptoms. More RCTs are required with: larger sample sizes, representative populations, standardised outcomes and control group interventions similar in treatment intensity to the intervention. PROSPERO REGISTRATION NUMBER: CRD42017067099.
format Online
Article
Text
id pubmed-6475151
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-64751512019-05-07 Psychological and psychosocial interventions offered to forensic mental health inpatients: a systematic review MacInnes, Douglas Masino, Serena BMJ Open Mental Health OBJECTIVE: To examine the evidence for the use of psychological and psychosocial interventions offered to forensic mental health inpatients. DESIGN: CINAHL, MEDLINE, PsycINFO, ScienceDirect and Web of Science databases were searched for research published in English between 1 January 1990 and 31 May 2018. OUTCOME MEASURES: Disturbance, mental well-being, quality of life, recovery, violence/risk, satisfaction, seclusion, symptoms, therapeutic relationship and ward environment. There were no limits on the length of follow-up. ELIGIBILITY CRITERIA: We included randomised controlled trial (RCT) studies of any psychological or psychosocial intervention in an inpatient forensic setting. Pilot or feasibility studies were included if an RCT design was used. We restricted our search criteria to inpatients in low, medium and high secure units aged over 18. We focused on interventions considered applicable to most patients residing in forensic mental health settings. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers extracted data and assessed risk of bias. RESULTS: 17 232 citations were identified with 195 full manuscripts examined in detail. Nine papers were included in the review. The heterogeneity of the identified studies meant that meta-analysis was inappropriate. The results were presented in table form together with a narrative synthesis. Only 7 out of 91 comparisons revealed statistically significant results with no consistent significant findings. The most frequently reported outcomes were violence/risk and symptoms. 61% of the violence/risk comparisons and 79% of the symptom comparisons reported improvements in the intervention groups compared with the control groups. CONCLUSIONS: Current practice is based on limited evidence with no consistent significant findings. This review suggests psychoeducational and psychosocial interventions did not reduce violence/risk, but there is tentative support they may improve symptoms. More RCTs are required with: larger sample sizes, representative populations, standardised outcomes and control group interventions similar in treatment intensity to the intervention. PROSPERO REGISTRATION NUMBER: CRD42017067099. BMJ Publishing Group 2019-03-20 /pmc/articles/PMC6475151/ /pubmed/30898809 http://dx.doi.org/10.1136/bmjopen-2018-024351 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Mental Health
MacInnes, Douglas
Masino, Serena
Psychological and psychosocial interventions offered to forensic mental health inpatients: a systematic review
title Psychological and psychosocial interventions offered to forensic mental health inpatients: a systematic review
title_full Psychological and psychosocial interventions offered to forensic mental health inpatients: a systematic review
title_fullStr Psychological and psychosocial interventions offered to forensic mental health inpatients: a systematic review
title_full_unstemmed Psychological and psychosocial interventions offered to forensic mental health inpatients: a systematic review
title_short Psychological and psychosocial interventions offered to forensic mental health inpatients: a systematic review
title_sort psychological and psychosocial interventions offered to forensic mental health inpatients: a systematic review
topic Mental Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6475151/
https://www.ncbi.nlm.nih.gov/pubmed/30898809
http://dx.doi.org/10.1136/bmjopen-2018-024351
work_keys_str_mv AT macinnesdouglas psychologicalandpsychosocialinterventionsofferedtoforensicmentalhealthinpatientsasystematicreview
AT masinoserena psychologicalandpsychosocialinterventionsofferedtoforensicmentalhealthinpatientsasystematicreview