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The prison population is seldom studied and often overlooked in many countries despite their vulnerability to long-term illness. This study aims to explore the factors associated with the non-treatment for long-term illnesses among incarcerated individuals.

This study is a cross-sectional analysis. The authors conducted a secondary data analysis using information collected in the Peruvian census of incarcerated individuals. The study population consisted of incarcerated individuals diagnosed with a long-term illness. To evaluate the factors associated with non-treatment, the authors used a Poisson regression model.

The authors included 12,512 incarcerated individuals (age: 40.9 ± 13.1 years), and 39% of them did not receive treatment for their long-term illness. The authors observed that non-treatment was statistically associated with gender, age, having children, use of the Spanish language, sexual identity, judicial situation, penitentiary location, discrimination inside the penitentiary and health insurance before incarceration. However, only having children (prevalence ratio [PR]: 1.11, confidence interval [CI]95% 1.03–1.19), using the Spanish language (PR: 1.15, CI95%: 1.01–1.31), being in a penitentiary not in Lima (PR: 1.11, CI95%: 1.06–1.17) and perceiving discrimination inside the penitentiary (PR: 1.12, CI95% 1.06–1.18) increased the prevalence of non-treatment.

Identifying the factors associated with non-treatment will allow us to implement measures for prioritizing groups and developing strategies for the evaluation, close follow-up of their health and management of comorbidities.

Inpatient violence can have a major impact in terms of traumatic experiences for victims and witnesses, an unsafe treatment climate, and high-financial costs. Therefore, the purpose of this paper is to gain more insight into patterns of violent behavior, so that adequate preventive measures can be taken.

Data on inpatient violence in a Dutch forensic psychiatric hospital between 2008 and 2014 were extracted from hospital files on 503 patients.

More than half of all the patients (n=276, 54.9 percent) displayed verbal aggression on at least one occasion, whereas 27.2 percent of all patients (n=137) exhibited one or more incidents of physical violence. Female patients were responsible for more physically violent episodes than male patients. Patients admitted with a civil court order exhibited more violent behavior than patients with a criminal court order. Violent patients with a civil commitment had a significantly longer length of stay than non-violent patients with a civil commitment. More violence was found to take place on the earlier days of the week.

This study points at important differences between groups of forensic inpatients in frequency and type of inpatient violent behavior and in temporal factors. Interventions aimed at reducing the number of violent incidents should take these differences into account. Further research is necessary to gain more insight into the background of inpatient violence.

Technology in various forms is being developed and applied to provide new solutions to the increasing prevalence of long‐term health conditions. This article describes the potential of telehealth and telecare applications in response to increased demands for health and social care. The impact of technology on provision of person‐centred treatment and self‐management is described using the emergent results from the SMART2 project. SMART2 is a multi‐disciplinary collaboration which spans academia, health providers and people with long‐term conditions.

Cognitive-behavioural interventions, such as the substance related offending behaviour programme (SROBP), are being implemented across forensic contexts in an attempt to address the detrimental economic, social and personal impacts of substance use and offending. Whilst support exists for the effectiveness of such treatment, there remains to be limited knowledge of offenders’ experiences of treatment and factors that promote treatment efficacy and support desistance. This study aims to develop an idiographical understanding of those processes.

Six prisoners who had completed the SROBP were interviewed via a semi-structured schedule to collate their individual experiences of engaging in treatment. Interviews transcripts were analysed by the lead researcher using interpretative phenomenological analysis, and external auditing analysis was conducted by the research supervisors.

Three superordinate themes resulted: “Therapeutic processes and relationships,” “Therapeutic outcomes” and “Threats to post treatment recovery.” Participants identified factors which facilitated the effectiveness of treatment and were effective in meeting their needs, although there were other factors that required improvement.

The important role of motivation at various stages of treatment as this engenders commitment to treatment aims and longer-term recovery. Treatment efficacy is linked with perceived relevance and value of treatment outcomes in supporting desistence from substance use. Pro-social peer relationships are important for effective application of learning and recovery. Attentiveness to participants specific needs is required. The lack of post-programme support has the potential to threaten therapeutic alliances and reinforce experiences of rejection and abandonment. The management of the exit phase from programmes is critical.

Results are discussed in light of their implications for future working practices in supporting therapeutic processes and rehabilitative culture.

The purpose of this paper is to summarize research conducted in long-term residential rehabilitation centers, including therapeutic communities (TCs), in order to further clarify the effectiveness of this treatment approach and to evaluate the quality of TC research conducted in the period 2000-2013.

The composite search engine UQ database Summon were used to find articles with “Therapeutic Community” as title words, and the search was limited to adult participants, peer-reviewed articles, published between January 2000 and June 2013 in the English language. The review was conducted using Cochrane Collaboration methods and reported under the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines.

In total, 25 studies met inclusion criteria for the review and represented data from n=5,923 participants in the USA, Australia, Spain, England, and Belgium. Evidence supports the TC approach for a diverse range of individuals who misuse a range of substances. Several studies reported a relationship between retention and outcomes however dropout from treatment is a widespread issue. A paucity of research using multiple time points precludes any firm conclusions regarding the optimal length of treatment in a TC. There is a lack of research on the interplay between individual and community-level factors on client well-being, retention, and longer term outcomes.

This review highlights the need for TC research that includes multiple time points and follow-up assessments, and measures of change in theoretically meaningful constructs alongside standard measures of demographics, substance use, and psychiatric symptoms.

The reporting format of TC research should be better standardized in order to create a better basis for research comparison. More standardized reporting would also allow for effect size analysis, and create a more efficacious evidence base.

This updates the systematic review body of research.

Opioid substitution treatment is effective in reducing harm for the person and society. However, the introduction of the recovery agenda has changed treatment philosophy. Associated targets such as successful treatment completions have introduced new expectations from treatment providers and service users. The purpose of this paper is to provide a service user-centred evaluation of underlying reasons that might prevent them from considering completion of treatment.

Ten service users who were stable on opioid substitution treatment for more than five years were interviewed face-to-face using a semi-structured format. Detailed inductive coding and thematic analysis of all transcripts was conducted.

Most participants expressed fear of change to their treatment and in particular reduction of the prescribed medication, due to past traumatic withdrawal experience, fear of relapse, fear of negative impact on their mental and physical health. Nevertheless all were optimistic about their future lives and were hoping to be able to complete their treatment at some point. A three-month follow-up revealed little change, with most participants not considering changing their medication dose in the future.

It could be argued that treatment providers, instead of focussing their efforts on stable service users in promoting treatment exit, should focus on new service users, avoiding coercion to treatment aims and rushed detoxifications.

This small qualitative study confirms results of other recent studies on the same theme and argues for the importance of the quality of the treatment experience of new people accessing treatment.

Dual‐diagnosis strategies are developing in medium secure services in response to both government policies and clinical need and there has been a move towards integrated services for this patient group. Substance use that has been a feature of the index offence must be taken into account as much as psychosis or the offending behaviour. Treatment of dual diagnosis relies heavily on cognitive‐behavioural therapies. Relapse in either psychosis or substance use increases risk and re‐admission rates to medium security. This paper reviews the literature on family interventions in dual diagnosis and its applicability to forensic mental health inpatient services. As there appeared to be limited direct evidence, various domains were examined and extrapolated to a forensic setting as appropriate. The review indicates the potential for positive outcomes for families following family interventions in dual diagnosis, which may be beneficial in a forensic setting in lowering risk.

Therapeutic communities (TC’s) are consciously designed, living-learning environments designed to evoke social, psychological and behavioural change. The success of the residential TC model saw these community-led, self-help environments for addicts move into custodial settings and early evidence suggests this transition was effective. The purpose of this paper is to examine the evidence relevant to the effectiveness of prison based, drug-free TCs.

In order to establish their true efficiency, particular focus has been placed on studies conducted over the last ten years (2007-2017).

To date, the TC remains superior to other forms of drug treatment in reducing recidivism and drug relapse amongst addicts who offend.

Outcomes of this review highlighted the importance of aftercare in providing transitional support; a fundamental aspect of treatment necessary for success and for maintaining long-term recovery post release.

Dependent alcohol use is a severe addictive disorder with significant enduring consequences for health and social functioning. This study aims to inductively explore the process of identity change for alcohol dependent people progressing through a “pre-habilitation” intervention, alcohol detoxification and post-detoxification recovery support.

Qualitative study as a part of a process evaluation situated within a UK feasibility trial of a group-based intervention in preparation for structured alcohol detoxification. Semi-structured qualitative interviews (face-to-face or telephone) collected self-reported data on experiences of treatment provision as part of the feasibility trial. Thematic analysis of transcripts and iterative categorisation of identity-related themes and concepts was conducted with verification of analysis undertaken by a second coder.

Identity change was revealed in participant narratives around the meta themes of external (social-identity) and internal (self-identity) concepts. External influences impacting social identity were key, having influenced initiation into alcohol use, influencing acceptance of the stigmatised “alcoholic” label and then being central to the treatment journey. Internal influences on self-identity also impacted on the process of identity change. In recovery, there was hope in discovering a new “normal” identity or rediscovering normality.

Analysis demonstrates that moving from regular alcohol use to problematic use is a journey of identity change that is influenced at the macro (cultural), meso (group) and micro (relational) social levels. Throughout the treatment journey, social influences in gaining a new non-drinker identity are key. Findings suggest a need for long-term support through treatment and community-based groups specifically to foster positive identity change that may not have been addressed previously.

This study aims to investigate into the future of cancer and cancer research in preparation for a strategic plan for a cancer research centre.

The study used framework foresight, a method for creating scenarios and their implications developed by the MS program in Foresight at the University of Houston.

The study identified four scenarios: a continuation scenario in which progress in detecting and treating cancer progressed as it has over the past few decades, a collapse scenario in which attention was diverted from medical research due to a climate crisis, a new equilibrium scenario in which cost became the overriding concern for cancer treatment, and a transformation scenario in which individuals took control of their treatment through Do-It-Yourself remedies. Those scenarios suggested four strategic issues for the planning exercise: the growing volume of genomic and clinical data and the means to learn from it, the increased involvement and influence of patients in diagnosis and treatment, the ability to conduct research in a time of fiscal austerity and declining levels of trust in all professions, including medicine.

The paper not only provides guidance for cancer centers but also for medical practice in general.

The client used the scenarios and their implications as part of its considerations in strategic planning.

This paper represents the first time that Framework Foresight has been applied to a medical topic.