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Ageing patients in forensic psychiatric settings: a review of the literature
- Authors:
- DI LORITO Claudio, VOLLM Birgit, DENING Tom
- Journal article citation:
- International Journal of Geriatric Psychiatry, 33(12), 2018, pp.1548-1555.
- Publisher:
- Wiley
Objectives: The prevalence of ageing patients in forensic psychiatric settings is increasing. However, limited research has reported around this population. The aim of this scoping review is to synthesise the current evidence around ageing forensic psychiatric patients. Methods: The literature was searched through four databases and Google searches. The identified outputs were screened for suitability and assessed for quality. Quantitative data were extracted and analysed on SPSS; qualitative data were extracted and analysed onto NVivo. Results: Seven studies were included in the review. Quantitative results reported around demographics, service contact, offending patterns, mental, and physical health of ageing patients. Qualitative findings focused on age‐friendliness of services, staff‐patient rapport, activities, security issues, and discharge planning. Conclusions: Ageing forensic psychiatric patients present with complex and unique needs in relation to treatment, activities, mental, physical, and support. Further research looking at individual patients' needs is paramount to inform policy development and good practice in this area. (Edited publisher abstract)
The individual experience of ageing prisoners: systematic review and meta-synthesis through a Good Lives Model framework
- Authors:
- DI LORITO Claudio, VOLLM Birgit, DENING Tom
- Journal article citation:
- International Journal of Geriatric Psychiatry, 33(2), 2018, pp.252-262.
- Publisher:
- Wiley
Objective: The existing literature on ageing prisoners tends to focus on such aspects as diagnosis and physical ill-health. In contrast, the experience of imprisonment from the perspective of ageing prisoners has received less attention. Grounded in a Good Lives Model theoretical framework, the authors reviewed and meta-synthesised literature around their experience of life in prison, its impact on their wellbeing and how prison services are currently addressing their complex needs. They further identify potential areas of improvement. Methods: 1. Systematic search on Assia, PsycInfo, MedLine, Embase, Web of Science, Google and Gov.uk. 2. Extraction and categorisation of data on NVivo. 3. Development of themes through thematic analysis and meta-synthesis. 4. Identification of potential areas of improvement. Results: The authors selected 25 studies for their review, of which 13 were from the USA, seven from the UK, two from Australia and one each from Ireland, Switzerland and Israel. Three themes were identified: the hardship of imprisonment, addressing health and social care needs, and the route out of prison. Conclusions: Ageing prisoners have unique and complex health and social care needs which, to varying degree across different countries, are mostly unmet. Promising initiatives to address their needs are emerging, but, at present time, the overall experience of incarceration for the ageing prisoner is quite poor, given the inconsistent physical, emotional and social care support offered from prison intake to release and beyond. (Edited publisher abstract)
Psychiatric disorders among older prisoners: a systematic review and comparison study against older people in the community
- Authors:
- DI LORITO Claudio, VOLLM Birgit, DENING Tom
- Journal article citation:
- Aging and Mental Health, 22(1), 2018, pp.1-10.
- Publisher:
- Taylor and Francis
Objectives: Despite emerging evidence that older prisoners experience poor mental health, literature in this area is still limited. In the present systematic review and meta-analysis, the authors report on the prevalence of psychiatric disorders among older prisoners and compare their findings against community studies on older people. Methods: The authors searched on Assia, PsycInfo, MedLine, Embase, Web of Science, Google and Gov.uk. They carried out bias assessments, rated studies for quality and ran a heterogeneity test. They meta-analysed prevalence rates of psychiatric disorders through an aggregate weighted mean and calculated relative risk (RR) and statistical significance against community studies. Sensitivity analyses were further performed. Results: They reviewed nine studies and obtained the following prevalence: ‘Any psychiatric disorder’ 38.4%, depression 28.3%, schizophrenia/psychoses 5.5%, bipolar disorder 4.5%, dementia 3.3%, cognitive impairment 11.8%, personality disorder 22.9%, alcohol abuse 15.9%, anxiety disorders 14.2%, PTSD 6.2%. Older prisoners were found to have higher RR for every single psychiatric disorder against older people in the community, with the sole exception of alcohol abuse and dementia. The prevalence rates were statistically significantly higher among the prisoners for ‘Any psychiatric disorder’, depression and personality disorder. Overall, the sensitivity analyses confirmed the authors' original results. Conclusion: The findings point at a high prevalence of every single psychiatric disorder among older prisoners, who also experience rates of dementia and alcohol abuse comparable to those reported in the community. The results have relevant implications for policy and practice in this area. Further research is crucial to confirm findings from this study. (Edited publisher abstract)