Excerpt

This guideline has been developed to advise on identification and management of mental health problems and integration of care for adults in contact with the criminal justice system. The guideline recommendations have been developed after careful consideration of the best available evidence by a multidisciplinary team of healthcare professionals, criminal justice system professionals, people with mental health problems who have been in contact with the criminal justice system, their carers and guideline methodologists. It is intended that the guideline will be useful to clinicians and service commissioners in the identification and management of mental health problems and integration of care for adults in contact with the criminal justice system (see Appendix A for more details on the scope of the guideline).

Although the evidence base is rapidly expanding, there are a number of significant gaps. The guideline makes a number of research recommendations specifically to address gaps in the existing evidence base. In the meantime, this guideline aims to assist clinicians and people with mental health problems in contact with the criminal justice system and their carers, by identifying the merits of particular identification treatment and management approaches where the evidence from research and clinical experience exists.

Contents

• Guideline Committee Group members and National Guideline Alliance (NGA) review team
• Acknowledgements
• 1. Preface
  • 1.1. National clinical guidelines
  • 1.2. The national mental health of adults in contact with the criminal justice system guideline
• 2. Introduction
  • 2.1. Mental Health and the Criminal Justice System
  • 2.2. Current practice
  • 2.3. The Relationship between Offending and Mental Health Problems
  • 2.4. The Relationship between the Criminal Justice System and Mental Health Services
  • 2.5. Transitions between the Criminal Justice System and Mental Health Services
  • 2.6. Economic Costs
• 3. Methods used to develop this guideline
  • 3.1. Overview
  • 3.2. The scope
  • 3.3. The Guideline committee
  • 3.4. Review protocols
  • 3.5. Clinical review methods
  • 3.6. The search process
  • 3.7. Data extraction
  • 3.8. Presenting evidence to the Guideline Committee
  • 3.9. Health economics methods
  • 3.10. Using NICE evidence reviews and recommendations from existing NICE clinical guidelines
  • 3.11. From evidence to recommendations
  • 3.12. Stakeholder contributions
  • 3.13. Validation of the guideline
• 4. Staff training
  • 4.1. Introduction
  • 4.2. Review question: What are the most effective support, training and education and supervision programmes for health, social care or criminal justice practitioners to improve awareness, recognition, assessment, intervention and management of mental health problems in adults in contact with the criminal justice system?
  • 4.3. Recommendations and link to evidence
• 5. Recognition and assessment
  • 5.1. Introduction
  • 5.2. Review question: What are the most appropriate tools for the recognition of mental health problems, or what modifications are needed to recognition tools recommended in existing NICE guidance, for adults
  • 5.3. Review question: What are the most appropriate tools to support or assist in the assessment of mental health problems, or what modifications are needed to assessment tools recommended in existing NICE guidance, for adults
  • 5.4. Recommendations and link to evidence
  • 5.5. Review question: What are the most appropriate tools to support or assist in risk assessment, for adults with mental health problems
  • 5.6. Recommendations and link to evidence
  • 5.7. Review question: What are the key components of and the most appropriate structure for a comprehensive assessment of mental health problems for adults
  • 5.8. Recommendations and link to evidence
• 6. Interventions
  • 6.1. Introduction
  • 6.2. Review question: What are the most effective interventions to promote mental health and wellbeing in adults in contact with the criminal justice system (including environmental adaptations and individual- and population-based psychoeducational interventions)?
  • 6.3. Recommendations and link to evidence
  • 6.4. Review question: What interventions are effective, or what modifications are needed to psychological, social, pharmacological or physical interventions recommended in existing NICE guidance, for adults in contact with the criminal justice system who have
  • 6.5. Recommendations and link to evidence
  • 6.6. Review question: For adults with a paraphilic disorder who are in contact with the criminal justice system, what are the benefits and harms of psychological, social or pharmacological interventions aimed at reducing or preventing the expression of paraphilic behaviour, or preventing or reducing sexual offending or reoffending?
  • 6.7. Recommendations and link to evidence
  • 6.8. Review question: For adults with acquired cognitive impairment who are in contact with the criminal justice system, what are the benefits and harms of psychological, social or pharmacological interventions aimed at rehabilitation?
  • 6.9. Recommendations and link to evidence
  • 6.10. Review question: For adults with a personality disorder (other than antisocial or borderline personality disorder) who are in contact with the criminal justice system, what are the benefits and harms of psychological, social or pharmacological interventions aimed at reducing personality disorder symptomatology, or preventing or reducing offending or reoffending?
  • 6.11. Recommendations and link to evidence
• 7. Service Delivery
  • 7.1. Introduction
  • 7.2. Review question: What are the most effective care plans and pathways and organisation and structure of services, for the assessment, intervention and management of mental health problems in people in contact with the criminal justice system to promote
  • 7.3. Recommendations and link to evidence
• 8. Abbreviations
• 9. References
• Appendices
  • Appendix A. Scope for the development of the clinical guideline
  • Appendix B. Declarations of interests by Guideline Committee members
  • Appendix C. Special advisors to the Guideline Committee
  • Appendix D. Stakeholders who submitted comments in response to the consultation draft of the guideline
  • Appendix E. Researchers contacted to request information about unpublished or soon-to-be published studies
  • Appendix F. Analytical framework, review questions and protocols
  • Appendix G. Research recommendations
  • Appendix H. Search strategies for the identification of clinical studies
  • Appendix I. Search strategies for the identification of health economic and quality of life evidence
  • Appendix J. Clinical Evidence_Study characteristics, outcomes, methodology checklist for experience of care
  • Appendix K. Clinical Evidence_Study characteristics, outcomes, methodology checklist for recognition and assessment
  • Appendix L. Clinical evidence_Study characteristics, outcomes, methodology checklists for intervention, service delivery and staff training studies
  • Appendix M. Clinical evidence – flow diagrams
  • Appendix N. Clinical Evidence_GRADE evidence profiles
  • Appendix O. Clinical evidence – forest plots and summary ROC curves for all studies
  • Appendix P. Flow diagrams
  • Appendix R. Health economic evidence – completed health economics checklists
  • Appendix S. HE Evidence_Evidence tables
  • Appendix T. Health economic evidence – economic profiles
  • Appendix U. Clinical Evidence_NGT blank questionnaires
  • Appendix V. Clinical Evidence_NGT to recommendations
  • Appendix W. Clinical evidence expert testimony

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Disclaimer: Healthcare professionals are expected to take NICE clinical guidelines fully into account when exercising their clinical judgement. However, the guidance does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of each patient, in consultation with the patient and/or their guardian or carer.