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The purpose of this paper is to illustrate how local drug services use their senior staff to respond to emerging ethnic groups presenting to treatment using flexible thinking and innovative processes.

The methodology was a case study design that used a semi-structured questionnaire that looked at two drug services and their staff’s influence on service delivery in different boroughs of east London.

The research found very innovative findings from the two boroughs. The boroughs had different racial mixes and therefore differing populations presenting to their local drug services. However, they used flexible approaches to structure their services to engage with emerging ethnic minority populations in drug treatment. From the findings, these different approaches and structures of providing drug treatment were very important. Approaches, for example, of clinical staff offering a “rapid assessment” are particularly important in engaging and retaining ethnic minority populations. Also, using flexible thinking within the staff team enables drug services to adapt treatments to be flexible in responding to emerging ethnic populations.

This paper shows that thinking in designing approaches to drug treatment shows that ethnic minority populations can be successfully engaged in drug treatment. This has implications for drug treatment nationally and across Europe where there are “emerging” ethnic populations presenting for drug treatment.

This paper shows that drug services can adapt and change to their different ethnic minority populations if they can able to be flexible in their clinical approach to service provision.

Hepatitis C virus (HCV) infection is a major public health concern in Canada, which now mostly affects marginalized populations, including correctional inmates. These populations ‐ until recently ‐ have largely been excluded from HCV pharmacotherapy. We report preliminary data on HCV treatment in a federal correctional population sample in British Columbia (BC), using Pegetron combination therapy. HCV RNA results are presented at week 12 of treatment, a strong predictor of treatment outcome. Just over four‐fifths (80.8%) of inmate patients had no detectable HCV RNA at week 12; inmates with genotype 2 and 3 fared better than those with genotype 1. These preliminary results suggest that HCV treatment is feasible and promises to be efficacious in correctional populations.

The UK Mental Health Act (MHA) Reform (2021) on race and ethnicity promotes new governmental strategies to tackle inequalities faced by ethnically racialised communities detained under the MHA. However, there is a scarcity in personality disorder and ethnicity research. This study aims to investigate what is available in the UK in relation to prevalence, aetiology and treatment provisions of personality disorder for ethnically diverse patients, and to understand their interconnectedness with mental health and criminal justice service provisions. Three key areas of investigations were reviewed, (1) UK prevalence of personality disorder amongst ethnically diverse individuals; (2) aetiology of personality disorder and ethnicity; (3) treatment provisions for ethnically diverse individuals diagnosed with personality disorder.

A scoping study review involved a comprehensive scanning of literature published between 2003 and 2022. Screening and data extraction tools were co-produced by an ethnically diverse research team, including people with lived experience of mental health and occupational expertise. Collaborative work was complete throughout the review, ensuring the research remained valid and reliable.

Ten papers were included. Results demonstrated an evident gap in the literature. Of these, nine papers discussed their prevalence, three papers informed on treatment provisions and only one made reference to aetiology. This review further supports the notion that personality disorder is under-represented within ethnic minority populations, particularly of African, Caribbean and British heritage, however, the reasons for this are multi-facetted and complex, hence, requiring further investigation. The evidence collected relating to treatment provisions of personality disorder was limited and of low quality to reach a clear conclusion on effective treatments for ethnically diverse patients.

The shortage of findings on prevalence, aetiology and treatment provisions, emphasises the need to prioritise further research in this area. Results provide valuable insights into this limited body of knowledge from a UK perspective.

The purpose of this paper is to systematically review quantitative research since 2000 on the effectiveness of residential therapeutic communities (TCs) for the treatment of substance-use disorders with reference to substance-use, crime, mental health and social engagement outcomes.

A systematic search with broad inclusion criteria resulted in the review of 11 studies. The studies investigated community-based TCs, as well as TCs modified for prisoners, prisoners transitioning to community living and TCs for individuals with co-occurring substance-use and mental health issues.

Results were analysed by comparing the findings of the studies under investigation, of which three studies investigated within-subjects outcomes, four compared TC treatment with a no-treatment control condition and four compared TC treatment with another treatment condition. Conclusion: consistent with previous systematic reviews of TCs, outcomes varied across studies but indicated TCs are generally effective as a treatment intervention, with reductions in substance-use and criminal activity, and increased improvement in mental health and social engagement evident in a number of studies reviewed.

Variability in outcomes suggests further TC research and research syntheses focusing on a second key research question in the evaluation of complex interventions – how the intervention works – could play an important role in understanding TC effectiveness, and for whom it is effective and in what contexts.

Although there is some variability in treatment populations included in this review, evidence reported in other studies suggests individuals with severe substance-use disorders, mental health issues, forensic involvement and trauma histories, will benefit from TC treatment. This is supported by the literature which has found a general relationship between severity of substance use and treatment intensity (Darke et al., 2012; De Leon et al., 2008) with outcomes further enhanced by self-selection into treatment and appropriate client-treatment matching (see De Leon, 2010; De Leon et al., 2000, 2008). The weight of evidence gleaned from multiple sources of research, including randomised control trials and field outcome studies (De Leon, 2010) suggests TCs are an important and effective treatment for clients in improving at least some aspects of their quality of life, specifically mental health and social engagement, and in reducing harmful behaviours, including substance-use and crime. Variability in treatment setting and populations reflect the real-world setting in which TC treatment is delivered, providing a multifaceted treatment modality to a complex population in variable circumstances.

The strength of the current study is that it provided a broad evaluation of TC effectiveness across a range of outcomes (substance-use, criminal activity, mental health and social engagement), and is therefore valuable in updating the current literature and providing context for future research in this area. It aimed to address a key question in evaluating complex interventions: whether they are effective as they are delivered. Findings suggest that TC treatment is generally effective for the populations of concern in reducing substance use and criminal activity and contributing to some improvement in mental health and social engagement outcomes.

This paper aims to describe: the need for substance misuse treatment with high risk, personality disordered prisoners, and the implementation of two evidence-based psychological interventions aimed at addressing substance misuse within a high secure, personality disorder treatment unit and potential future evaluation options.

In addition to the literature base evidencing the need for substance misuse treatment with this population, the Iceberg and ‘InsideOut’ interventions are presented. These interventions adopt a risk reduction and health intervention approach respectively. This includes explanations of how they came to be implemented within a prison based personality disorder treatment service and potential ways to evaluate these services.

Evidence-based psychological interventions can be implemented for this population whilst being responsive to changing government priorities for substance misuse treatment. The organisation’s research strategy includes an intention to evaluate these interventions in order to inform future delivery.

The high levels of co-morbidity between personality disorder and substance misuse disorders in the high security prison estate highlights the need for substance related treatment for this population. Given the responsivity issues relevant to personality disordered offenders, the format of delivery of evidence-based psychological interventions has to be considered.

This paper discusses the application of evidence-based psychological interventions for substance use within a high secure, personality disordered population which has developed as a result of ministerial changes within the treatment of both substance misuse and personality disorder.

The purpose of this paper is to summarize the development of a treatment program for students found responsible of sexual misconduct.

This project, supported by the SMART (Office of Sex Offender Sentencing, Monitoring, Apprehending, Registering and Tracking) of the Department of Justice, was requested by The White House toward the end of President Obama’s last term and was intended to identify the confluence of factors related to sexual misconduct on college campuses, and to design a treatment program to address those factors.

This paper will discuss the unique factors of this population that ought to be considered to successfully develop an effective program, and the complexities of implementing treatment programs to this population, within a higher education system. This will include a discussion of barriers to implementation and challenges of employing treatment. This paper will present steps for implementing a treatment program and outline the core components of a treatment intervention for this population.

Implementing a treatment option for students found responsible of sexual misconduct that specifically targets the associated risk factors as part of a comprehensive approach to help improve campus safety.

Empirical evidence suggests that a complex relationship exists between substance misuse, mental illness and violence in forensic populations. Therefore, effective treatment and intervention is essential in order for this population to live a life free from substance use and offending behaviour. This paper discusses the literature related to interventions for dual diagnosis and how this may be related to mentally disordered offenders. The paper also highlights paucities in the literature where further research is needed to inform practice, and concludes with current recommendations for best practice.

Evidence suggests that the percentage of men seeking treatment for substance use disorders and other addictive behaviours is significantly higher than that of women. This fact raises several crucial questions concerning the field of addictions. This paper aims to emphasize to the study of addiction in the light of gender studies and especially in the light of theories of dominant/hegemonic masculinity.

The perspective of dominant/hegemonic masculinity in the field of addictions raises a number of questions: Can the dominant/hegemonic masculinity perspective contribute to the understanding of the phenomenon of addiction? What are the implications of male-dominated and male-centred treatment services on meeting the needs of other populations? Are androcentric approaches ultimately helpful for heteronormative men? This paper investigates the emerging questions through a critical review of the literature including the disciplines of psychology, sociology and anthropology.

The perspective of hegemonic masculinity can make an important contribution to the understanding of addiction as it sheds light on a dimension that is not well researched and used in the field of addictions. The influences of the androcentric approach to addiction treatment are significant and pose problems both in accessing and serving the needs of other populations. The androcentric approach to treatment is not helpful for heteronormative men either as there is a risk of not addressing the toxic dimensions of dominant/hegemonic masculinity that are directly linked to the problem of addiction.

This paper poses interesting research questions for further research in the field.

This paper raises important issues for practitioners in the field and at the same time suggests alternative perspectives on the interpretation and treatment of addiction.

The gender perspective that should further enrich psychosocial interventions is crucial for the equal access of all people with an addiction problem to appropriate support structures.

Gender studies can make an important contribution to further understanding of addiction problems and to the development of effective practices for dealing with it. The fact that in substance abuse treatment programmes the vast majority of participants are heteronormative men raises a number of concerns. These concerns relate to the extent to which structures are directed at meeting the needs of these men and whether because of this orientation the needs of other populations such as heteronormative women and those who do not meet the norms of heteronormativity are left uncovered. These concerns are linked to broader considerations of the role that dominant/hegemonic masculinity plays in the aetiology of addiction and in creating barriers to help-seeking for heteronormative men themselves.

The purpose of this paper is to examine recent trends in presentation to treatment where cannabis is identified as the primary drug.

Data is drawn from the recently published Public Health England report and supplemented with Home Office and European data.

The data shows a marked increase in presentations for cannabis treatment over recent years. The authors offer some potential explanations for this trend.

The authors need to improve our understanding of the type of cannabis that is available and how specifically it is used. In parallel there is a pressing need for an evaluation of evidence in relation to treatment for problematic cannabis users.

This paper highlights this recent trend in treatment presentations, offers some potential explanations and makes associated recommendations.

Hepatitis C (HCV) infections are prevalent in custodial settings worldwide, yet provision of antiviral therapies is uncommon. Approximately 30,000 prisoners are held in Australian prisons at any one time, with more than 30 per cent testing positive for HCV antibodies. Prisoners have been identified in the National Hepatitis C Strategy as a priority population for assessment and treatment. The purpose of this paper is to examine the rates of HCV testing and treatment, as well as barriers and opportunities for development of infrastructure for enhanced services.

Interviews were conducted with 55 stakeholders from the correctional sector in each state and territory in Australia in two stages: service directors to gather quantitative data regarding rates of testing and treatment; and other stakeholders for qualitative information regarding barriers and opportunities.

Of more than 50,000 individuals put in in custody in Australian prisons in 2013, approximately 8,000 individuals were HCV antibody positive, yet only 313 prisoners received antiviral treatment. The barriers identified to assessment and treatment at the prisoner-level included: fear of side effects and the stigma of being identified to custodial authorities as HCV infected and a likely injecting drug user. Prisoners who came forward may be considered unsuitable for treatment because of prevalent mental health problems and ongoing injecting drug use. Provision of specialist hepatitis nurses and consultants were the most frequently recommended approaches to how prison hepatitis services could be improved.

Many personal and systems-level barriers relevant to the delivery of HCV treatment services in the custodial setting were identified. Ready access to skilled nursing and medical staff as well as direct acting antiviral therapies will allow the prison-sector to make a major contribution to control of the growing burden of HCV disease.