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National Guideline Alliance (UK). Mental health of adults in contact with the criminal justice system: Identification and management of mental health problems and integration of care for adults in contact with the criminal justice system. London: National Institute for Health and Care Excellence (NICE); 2017 Mar. (NICE Guideline, No. 66.)

Cover of Mental health of adults in contact with the criminal justice system

Mental health of adults in contact with the criminal justice system: Identification and management of mental health problems and integration of care for adults in contact with the criminal justice system.

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Appendix FAnalytical framework, review questions and protocols

1.1. Experience of care

Item No.Item [Prospero field No.]Details
Guideline details
1.Guideline*Mental health of adults in contact with the criminal justice system
2.Guideline chapter*Experience of care
3.Topic Group (if used)
4.Sub-section lead*
5.Review team lead*Odette Megnin-Viggars
6.Objective of review*To review experiences of care for adults with mental health problems in contact with the criminal justice system, from the perspective of practitioners, service users, and family or carers
Review title and timescale
7.Review title*Service user, family and carer, and practitioner experiences of care for adults with mental health problems in contact with the criminal justice system
8.Anticipated or actual start date
9.Anticipated completion date
10.Stage of review at time of registration
StartedCompleted
Preliminary searches☐☐
Piloting of the study selection process☐☐
Formal screening of search results against eligibility criteria☐☐
Data extraction☐☐
Risk of bias (quality) assessment☐☐
Data analysis☐☐
Prospective meta-analysis☐☐
Provide any other relevant information about the stage of the review here (e.g. Funded proposal, final protocol not yet finalised).
Review methods
11.Review question(s)*RQ 1.1: What factors support or hinder practitioners in their delivery of assessment, intervention or management for adults with mental health problems in contact with the criminal justice system?

RQ 1.2: What factors improve or diminish access to, or experience of, services for adults in contact with the criminal justice system and their family or carers?

Consider:-
  • stigma and barriers to disclosure
  • involvement in decisions and respect for preferences
  • individualised intervention and management
  • attention to physical and environmental needs
RQ 1.3: What factors improve or diminish uptake of and engagement with intervention and services for adults in contact with the criminal justice system?
12.Sub-question(s)Where possible, consideration should be given to the specific needs of:-
  • people with neurodevelopmental disorders (including learning disabilities)
  • women
  • older adults (aged 50 years and over)
  • young black men
  • young adults that have transitioned from juvenile services
13.Searches*Mainstream databases:
CENTRAL, Embase, MEDLINE, PsycINFO


Topic specific databases:
None

Other resources of evidence:
  • Reference lists of included studies
  • Citation tracking for included papers in Scopus and Web of Knowledge (WoK)
  • Calls for evidence from stakeholders
  • Contacting authors of relevant works for ‘sibling’ studies
  • “Related articles” searching in PubMed
  • Conference abstracts will be assessed for eligibility and potentially eligible studies will be checked to determine if they have been published in full
  • Dissertation titles/abstracts will be assessed for eligibility and potentially eligible studies will be checked to determine if they have been published in full
  • Non-English language papers (with English abstracts) will be assessed for eligibility and potentially eligible studies will be checked to determine if they have been published in an English language journal. [Note: inclusion criteria restricted to UK setting]


*The number of citations that might relate to relevant trials that haven’t been included will be recorded.

Note. Unpublished data will only be included where a full study report is available with sufficient detail to properly assess the risk of bias. Authors of unpublished evidence will be asked for permission to use such data, and will be informed that summary data from the study and the study’s characteristics will be published in the full guideline.
14.Condition or domain being studied*Mental health problems in adults in contact with the criminal justice system

‘Mental health problems’ includes: common mental health problems; severe mental illness; personality disorders; drug and alcohol problems; paraphilias; neurodevelopmental disorders; acquired cognitive impairment

Contact with the criminal justice system includes people: in police custody; in court custody; in contact with liaison, diversion and street triage services; remanded on bail; remanded in prison; who have been convicted and are serving a prison or community sentence; released from prison on licence; released from prison and in contact with a community rehabilitation company (CRC) or the probation service.
15.Perspective*Practitioners, service users, and family or carers

Excluded:
  • Children and young people (aged under 18 years)
  • People who are in contact with the criminal justice system solely as a result of being a witness or victim
16.Phenomenon of interest*
  • Factors or attributes (at the individual-, practitioner- or service-level) that can enhance or inhibit access to services
  • Factors or attributes (at the individual-, practitioner- or service-level) that can enhance or inhibit delivery of services
  • Factors or attributes (at the individual-, practitioner- or service-level) that can enhance or inhibit uptake of and engagement with intervention and services
  • Actions by services that could improve or diminish the experience of care for example:-
    • Form, frequency, and content of interactions with service users, families or carers
    • Sharing information with and receiving information from service users, families or carers
    • Planning of care with service users, families or carers
  • Experience of specific recognition or assessment tools, or specific interventions, from the perspective of practitioners, service users, family or carers
Excluded:
  • The provision of financial and practical support (for example direct payments) is outside the scope of this guideline and will not be included.
17.Comparison*None
18.Types of study to be included initially*Systematic reviews of qualitative studies and primary qualitative research

Excluded:

Surveys, case studies, autobiographical account, commentary, editorial, vignettes, books, policy and guidance, and non-empirical research
19.SettingCare and shared care provided or commissioned by health and social care services in the UK, for people in contact with the criminal justice system

Excluded:
  • Non-UK studies
  • Pre-2000 studies
  • People who are cared for in hospital, except for providing guidance on managing transitions between criminal justice system settings and hospital
  • People in immigration removal centres
20.Evaluation
  • Experience of assessment received
  • Experience of care received
  • Experience of access to care
  • Experience of engagement with care
  • Experience of and/or views on care planning, delivery and/or management
Excluded:
  • Experiences of disorder or criminal justice system with no explicit implications for management, planning and/or delivery of care
  • Qualitative measures of perceived intervention effectiveness where a quantitative approach would have been more appropriate
21.Data extraction (selection and coding)*Citations from each search will be downloaded into EndNote and duplicates removed. Records will then be screened independently by two reviewers against the eligibility criteria of the review (if there is disagreement, resolution will be by discussion or a third reviewer). Initially 10% of references will be double-screened. If inter-rater agreement is good (percentage agreement =>90%) then the remaining references will be screened by one reviewer. The unfiltered search results will be saved and retained for future potential re-analysis. All primary-level studies included after the first scan of citations will be acquired in full and re-evaluated for eligibility at the time they are being entered into a study database (standardised template created in Microsoft Excel). Eligibility will be confirmed by at least one member of the Guideline Development Group (GDG). Two researchers will extract data into the study database, comparing a sample of each other’s work (10%) for reliability. Discrepancies or difficulties with coding will be resolved through discussion between reviewers or with members of the GDG.

Data to be extracted:
Study characteristics: RQ, N, mental health problem, CJS setting, offence (if appropriate), length of sentence (if appropriate), demographics of service user and family/carer/practitioner (age, sex, ethnicity), treatment details, data collection method, data analysis method

Data extraction (for thematic meta-synthesis): RQ addressed, population, point on care pathway, overarching theme from the NICE Service User Experience in Adult Mental Health (NICE, 2011; NCCMH, 2012) matrix, intervention/service, practitioner, type of experience, emotional valence of experience, theme, sub-theme, author quote to support theme, participant quote to support theme
22.Risk of bias (quality) assessment*The Critical Appraisal Skills Programme CASP (2013) checklist (available from http://www​.casp-uk.net/) will be completed for each study
23.Strategy for data synthesis*If existing reviews are found, the review team with advice from the GDG will assess their quality, completeness, and applicability to the NHS and to the scope of the guideline. If the GDG agree that a systematic review appropriately addresses a review question we will assess if any additional studies, conducted or published since the review was conducted, could affect the conclusions of the previous review. If new studies could change the conclusions, we will conduct a new analysis to update the review. If new studies could not change the conclusions of an existing review, the GDG will use the existing review to inform their recommendations.

If primary qualitative studies are included, qualitative data synthesis will be guided by a “best fit” framework synthesis approach (Carroll et al., 2011). The distinguishing characteristic of this type of approach, and the aspect in which it differs from other methods of qualitative synthesis such as meta-ethnography (Campbell et al., 2003) is that it is primarily deductive involving a priori theme identification and framework construction against which data from included studies can be mapped. This review will use the thematic framework identified and developed by the Service User Experience in Adult Mental Health guidance (NICE, 2011; NCCMH, 2012) as a starting point to systematically index and organise all relevant themes and sub-themes within an Excel-based matrix. A secondary thematic analysis will then be used to inductively identify additional themes in cyclical stages (Carroll et al., 2011).
24.Analysis of subgroups or subsetsN/A
Further information
Existing reviews utilised in this review:*
25.
  • Updated
26.
  • Not updated

1.2. Recognition and assessment

Item No.Item [Prospero field No.]Details
PROSPERO: Reg. No.CRD#########
Guideline details
1.Guideline*Mental health of adults in contact with the criminal justice system
2.Guideline chapter*Recognition and assessment
3.Topic Group (if used)
4.Sub-section lead*
5.Review team lead*
6.Objective of review*
  • To estimate the diagnostic recognition tools that asses assessment of adults in contactwi justice system with a suspe problem
  • To estimate the diagnostic assessment tools
  • To identify the key components of a comprehensive assessmen
Review title and timescale
7.Review title [1]*The recognition and assessment of mental health problems in adults in contact with the criminal justice system
8.Anticipated or actual start date [3]
9.Anticipated completion date [4]
10.Stage of review at time of registration [5]
StartedCompleted
Preliminary searches☐☐
Piloting of the study selection process☐☐
Formal screening of search results against eligibility criteria☐☐
Data extraction☐☐
Risk of bias (quality) assessment☐☐
Data analysis☐☐
Prospective meta-analysis☐☐
Provide any other relevant information about the stage of the review here (e.g. Funded proposal, final protocol not yet finalised).
Review team details
11.Named contact [6]Odette Megnin-Viggars
12.Named contact email ku.ca.hcyspcr@ningemo
13.Named contact address [8]NCCMH
Royal College of Psychiatrists,
3rd Floor, 21 Prescot Street
London E1 8BB
14.Named contact phone number [9]020 3701 2645
15.Review team members and their organisational affiliations [10]Dr. Odette Megnin-Viggars NCCMH
16.Organisational affiliation of the review [11]National Collaborating Centre for Mental Health
17.Funding sources/sponsors [12]National Institute for Health and Care Excellence
18.Conflicts of interest [13]◉ None known
◯ Yes
19.Collaborators [14]Title/First name/Last name/Organisation details
Review methods
20.Review question(s) [15]*RQ 2.1: 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:
  • in contact with the police?
  • in police custody?
  • for the court process?
  • at reception into prison?
  • at subsequent time points in prison?
  • in the community (serving a community sentence, released from prison on licence or released from prison and in contact with a community rehabilitation company [CRC] or the probation service)?
RQ 2.2: 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:
  • in contact with the police?
  • in police custody?
  • for the court process?
  • at reception into prison?
  • at subsequent time points in prison?
  • in the community (serving a community sentence, released from prison on licence or released from prison and in contact with a community rehabilitation company [CRC] or the probation service)?
RQ 2.3: What are the most appropriate tools to support or assist in risk assessment, for adults with mental health problems:
  • in contact with the police?
  • in police custody?
  • for the court process?
  • at reception into prison?
  • at subsequent time points in prison?
  • in the community (serving a community sentence, released from prison on licence or released from prison and in contact with a community rehabilitation company [CRC] or the probation service)?
RQ 2.4: What are the key components of, and the most appropriate structure for a comprehensive assessment of mental health problems for adults:
  • in police custody?
  • for the court process?
  • at reception into prison?
  • at subsequent time points in prison?
  • in the community (serving a community sentence, released from prison on licence or released from prison and in contact with a community rehabilitation company [CRC] or the probation service)?
21.Sub-question(s)Where possible, consideration should be given to the specific needs of:-
  • people with neurodevelopmental disorders (including learning disabilities)
  • women
  • older adults (aged 50 years and over)
  • young black men
  • young adults that have transitioned from juvenile services
22.Searches [16]*Mainstream databases:
CENTRAL, Embase, MEDLINE, PsycINFO

Topic specific databases:
None

Other resources of evidence:
  • Reference lists of included studies
  • Citation tracking for included papers in Scopus and Web of Knowledge (WoK)
  • Calls for evidence from stakeholders
  • Contacting authors of relevant works for ‘sibling’ studies
  • “Related articles’ searching in PubMed
  • Conference abstracts will be assessed for eligibility and potentially eligible studies will be checked to determine if they have been published in full
  • Dissertation titles/abstracts will be assessed for eligibility and potentially eligible studies will be checked to determine if they have been published in full
  • Non-English language papers (with English abstracts) will be assessed for eligibility and potentially eligible studies will be checked to determine if they have been published in an English language journal.


*The number of citations that might relate to relevant trials that haven’t been included will be recorded.

Note. Unpublished data will only be included where a full study report is available with sufficient detail to properly assess the risk of bias. Authors of unpublished evidence will be asked for permission to use such data, and will be informed that summary data from the study and the study’s characteristics will be published in the full guideline.
23.Condition or domain being studied [18]*Mental health problems in adults in contact with the criminal justice system

‘Mental health problems’ includes: common mental health problems; severe mental illness; personality disorders; drug and alcohol problems; paraphilias; neurodevelopmental disorders; acquired cognitive impairment

Contact with the criminal justice system includes people: in police custody; in court custody; in contact with liaison, diversion and street triage services; remanded on bail; remanded in prison; who have been convicted and are serving a prison or community sentence; released from prison on licence; released from prison and in contact with a community rehabilitation company (CRC) or the probation service.
24.Participants/population [19]*Included: Adults (aged 18 and over) with, or at risk of developing, a mental health problem who are in contact with the criminal justice system

Excluded:
  • people who are cared for in hospital, except for providing guidance on managing transitions between criminal justice system settings and hospital
  • people in immigration removal centres
  • children and young people (aged under 18 years)
  • people who are in contact with the criminal justice system solely as a result of being a witness or victim.
25.Intervention(s), exposure(s) [20]*RQ 2.1–2.3: Included: Any formal recognition and assessment tools considered appropriate and suitable for use

Index test: Recognition or assessment tool

RQ2.1:
Included:
  • 6-Item Cognitive Impairment Test (6-CIT)
  • Abbreviated Mental test (AMT)
  • Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)
  • Alcohol Use Disorders Inventory Test (AUDIT)
  • Amritsar Depression Inventory (ADI)
  • Anxiety and Depression Detector
  • Autism-Spectrum Quotient (AQ-10 or AQ-20 or AQ-50)
  • Autism Behavior Checklist (ABC)
  • Autism Screening Questionnaire (ASQ) now known as the Social Communication Questionnaire (SCQ)
  • Autonomic Nervous System Questionnaire (ANS)
  • Beck Anxiety Inventory (BAI)
  • Beck Depression Inventory (BDI) and BDI - short form
  • Binge Eating Scale (BES)
  • Brief DSMPTSD-III-R and DSMPTSD-IV
  • Brief Jail Mental Health Screen (BJMHS) or Brief Jail Mental Health Screen - Revised (BJMHS-R)
  • Bulimic Investigatory Test, Edinburgh (BITE)
  • CAGE questionnaire and CAGE questionnaire adapted to include drugs (CAGE-AID)
  • Caribbean Culture-Specific Screen for emotional distress (CCSS)
  • Center for Epidemiological Studies Depression Scale (CES-D)
  • Chemical Use Abuse and Dependency (CUAD)
  • Clock-drawing test
  • Co-occurring Disorders Screening Instruments (CODSI) - any mental disorder and severe mental disorder
  • Confusion Assessment Method, short or long version (CAM)
  • Correctional Mental Health Screen for Men (CMHS-M) or Correctional Mental Health Screen for Women (CMHS-W)
  • Dartmouth Assessment of Lifestyle Instrument (DALI)
  • Davidson Trauma Scale (DTS)
  • Delirium Rating Scale (DRS) or Delirium Rating Scale-Revised-98 (DRS-R-98)
  • Disaster-Related Psychological Screening Test (DRPST)
  • Distress Thermometer
  • Don Grubin prison reception health screening tool
  • Drug Abuse Screening Test (DAST-10)
  • Drug Use Disorders Identification Test (DUDIT)
  • Eating Attitudes Test (EAT-12 or EAT-26)
  • Eating Disorder Diagnostic Scale (EDDS)
  • Eating Disorder Examination Questionnaire (EDE-Q)
  • Eating Disorders Screen for Primary Care (ESP)
  • Eating Disturbance Scale (EDS-5)
  • Edinburgh Postnatal Depression Scale (EPDS)
  • England Mental Health Screen (EMHS)
  • General Health Questionnaire (GHQ-12 or GHQ-28 or GHQ-30)
  • General Practitioner Assessment of Cognition (GPCOG)
  • Generalized Anxiety Disorder scale (the GAD)
  • Geriatric Depression Scale (GDS) and short form (GDS-15)
  • Global appraisal of individual needs Short Screener version 1 (GSS)
  • Hamilton Anxiety Rating Scale (HAM-A)
  • Hamilton Rating Scale for Depression (HRSD), also called the Hamilton Depression Rating Scale (HDRS/HAM-D)
  • Health Screening of People in Police Custody (HELP-PC)
  • Hospital Anxiety and Depression Scale (HADS)
  • Impact of Event Scale (IES)
  • Jail Screening Assessment Tool (JSAT)
  • Kessler-6orKessler-10(K6orK10)
  • Mental Disability/Suicide Intake Screen (MDSIS)
  • Mental Health Screen for Adults (MHS-A)
  • Mental Health Screening Form (MHSF)
  • Michigan Alcoholism Screening Test (MAST)
  • Millon Clinical Multiaxial Inventory-III (MCMI-III)
  • Mini Mental State Examination (MMSE)
  • Mini Social Phobia Inventory (Mini-SPIN)
  • Mood Disorder Questionnaire (MDQ)
  • National Strategy for Police Information Systems (NSPIS) custody risk assessment
  • New York State brief screening tool (NYS BST)
  • Newcastle Mental Test Score
  • Paddington Alcohol Test
  • Panic and Agoraphobia Scale (PAS)
  • Panic Disorder Severity Scale, self-report (PDSS-SR)
  • Patient Health Questionnaire (PHQ-2 or PHQ-8 or PHQ-9)
  • Penn Inventory
  • Personality Assessment Screener (PAS)
  • Pervasive Developmental Disorder in Mental Retardation Scale (PDD-MRS)
  • Post-traumatic Stress Disorder Questionnaire (PTSD-Q)
  • Posttraumatic Stress Symptom Scale - Self-Report version (PSS-SR) and Post-traumatic Diagnostic Scale (PDS)
  • Prisoner Intake Screening Procedure (PISP)
  • PTSD Checklist - Civilian version (PCL-C)
  • Referral Decision Scale (RDS)
  • Richmond Agitation Sedation Scale (RASS)
  • Risk Behaviors Related to Eating Disorders (RiBED-8)
  • SCOFF questionnaire
  • Screen for Post-traumatic Stress Symptoms (SPTSS)
  • Screening Instrument for Psychosis (PS)
  • Self-Rating Inventory for Post-traumatic Stress Disorder (SRIP)
  • Self-Rating Scale for Post-traumatic Stress Disorder (SRS-PTSD)
  • Seven-minute screen
  • Sheehan Disability Scale (SDS)
  • Sheehan Patient-Related Anxiety Scale (SPRAS)
  • Single Alcohol Screening Question (SASQ)
  • Social Communication Questionnaire (SCQ)
  • Social Phobia Questionnaire (SPQ)
  • Social Phobia module of the Structured Clinical Interview for DSM-IV (SCID-SP) - screening questions
  • SPAN test
  • Symptom Checklist 90 (SCL-90) or Symptom Checklist 90-Revised (SCL-90-R)
  • T-ACE Screening Tool
  • Trauma Screening Questionnaire (TSQ)
  • TWEAK alcohol screening test
  • ‘Whooley questions’
  • Zung Self Rated Depression Scale
RQ 2.2:
Included:
  • Aberrant behaviour checklist (ABC)
  • Addenbrooke’s Cognitive Examination (ACE)
  • Adult Asperger Assessment (AAA)
  • Alcohol Problems Questionnaire (APQ)
  • Alcohol Use Disorders Inventory Test (AUDIT)
  • Alzheimer’s Disease Assessment Scale cognitive subscale (ADAS-cog)
  • Anxiety Disorders Interview Schedule for DSM-IV (ADIS-IV)
  • Asperger Syndrome (and high-functioning autism) Diagnostic Interview (ASDI)
  • Autism-Diagnostic Interview-Revised (ADI-R)
  • Autism Diagnostic Observation Schedule (ADOS)
  • Autism Spectrum Disorders Diagnosis Scale for Intellectually Disabled Adults (ASD-DA)
  • Behavior Summarized Evaluation - Revised (BSE-R)
  • Behaviour Problem Inventory (BPI-01) or Behaviour Problem Inventory - Short Form (BPI-S)
  • Cambridge Cognitive Examination - Revised (CAMCOG-R)
  • Challenging Behaviour Interview (CBI)
  • Childhood Autism Rating Scale (CARS)
  • Clinical Institute Withdrawal Assessment for Alcohol scale, revised (CIWA-Ar)
  • Developmental Behaviour Checklist for adults (DBC-A)
  • Developmental, Dimensional and Diagnostic Interview (3di)
  • Diagnostic Interview for Social and Communication Disorders (DISCO)
  • Eating Disorder Inventory (EDI)
  • Functional Analysis Screening Tool (FAST)
  • Leeds Dependence Questionnaire (LDQ)
  • Middlesex Elderly Assessment of Mental State (MEAMS)
  • Modified Overt Aggression Scale (MOAS)
  • Movie for the Assessment of Social Cognition (MASC)
  • Pervasive Developmental Disorders Rating Scale (PDDRS)
  • Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)
  • Ritvo Autism and Asperger’s Diagnostic Scale (RAADS) or Ritvo Autism and Asperger’s Diagnostic Scale - Revised (RAADS-R)
  • Severity of Alcohol Dependence Questionnaire (SADQ)
  • Social Responsiveness Scale (SRS)
RQ 2.3:
Included:
  • Adult Suicide Ideation Questionnaire (ASIQ)
  • Beck Depression Inventory (BDI)
  • Beck Hopelessness Scale (BHS)
  • Brøset-Violence Checklist (BVC)
  • Dynamic Appraisal of Situational Aggression - In patient Version (DASA-IV)
  • Edinburgh Risk of Repetition Scale (ERRS)
  • Global Clinical Assessment (GCA)
  • Hamilton Depression Rating Scale (HDRS)
  • Health Screening of People in Police Custody (HELP-PC)
  • Historical, Clinical, Risk Management-20 (HCR-20)
  • Level of Supervision Inventory (LSI)
  • Manchester Self-harm Rule (MSHR)
  • National Strategy for Police Information Systems (NSPIS) custody risk assessment
  • Offender Group Reconviction Scale (OGRS)
  • Psychopathy Checklist (PCL), Psychopathy Checklist-Revised (PCL-R) or Psychopathy Checklist-Screening Version (PCL-SV)
  • Reasons for Living Inventory (RFL)
  • Risk Assessment Management and Audit Systems (RAMAS)
  • Scale for Suicide Ideation (SSI)
  • Suicide Assessment Scale (SUAS)
  • Suicide Behaviours Questionnaire – Revised (SBQ-R)
  • Suicide Checklist (SCL)
  • Suicide Concerns for Offenders in Prison Environment (SCOPE)
  • Suicide Intent Scale (SIS)
  • Suicide Potential Scale
  • Suicide Probability Scale (SPS)
  • Violence Risk Assessment Guide (VRAG)
RQ 2.1–2.2: Exclud

RQ 2.3: Excluded: Risk assessment tools measuring risk of offending or reoffending where the offending behaviour is not linked to the mental health problem

RQ 2.4: Key components of, and the most appropriate structure for a comprehensive assessment of mental health problems for adults in contact with the criminal justice system
26.Comparator(s)/control [21]*RQ 2.1–2.3: Included: Gold standard

RQ 2.1–2.2: Reference test: Diagnosis Statistical Manual (DSM) or International Classification of Diseases (ICD) diagnosis

Excluded: N/A

RQ 2.4: N/A
27.Types of study to be included initially [22]*RQ 2.1–2.3: Included: Systematic reviews of diagnostic test accuracy studies, diagnostic cross-sectional studies (including cohort studies, case-control studies and nested case-control studies)

Excluded: N/A

RQ 2.4: N/A; GDG consensus-based
28.Context [23]*Included: Care and shared care provided or commissioned by health and social care services, for people in contact with the criminal justice system in any Organisation for Economic Co-operation and Development (OECD) country

Excluded: Studies from non-OECD countries
29.Primary/Critical outcomes [24]*RQ 2.1–2.3:
  • Sensitivity: the proportion of true positives of all cases diagnosed with autism in the population
  • Specificity: the proportion of true negatives of all cases not-diagnosed with autism in the population
  • Reliability (for instance, inter-rater or test-retest reliability or internal consistency)
  • Validity (for instance, criterion or construct validity)
RQ 2.4: Key components of, and the most appropriate structure for a comprehensive assessment of mental health problems for adults in contact with the criminal justice system. Consider:-
  • the nature and content of the interview and observation
  • formal diagnostic methods/psychological tools for the assessment of mental health problems
  • the assessment of risk to self and others
  • the assessment of need of self and others
  • the setting(s) in which the assessment takes place
  • the role of any informants
  • gathering of independent and accurate information from informants
30.Secondary/Important, but not critical outcomes [25]*RQ2.1&2.2:
  • Positive Predictive Value (PPV): the proportion of patients with positive test results who are correctly diagnosed.
  • Negative Predictive Value (NPV): the proportion of patients with negative test results who are correctly diagnosed.
  • Area under the Curve (AUC): are constructed by plotting the true positive rate as a function of the false positive rate for each threshold.
RQ 2.4: N/A
31.Data extraction (selection and coding) [26]*Citations from each search will be downloaded into EndNote and duplicates removed. Records will then be screened independently by two reviewers against the eligibility criteria of the review (if there is disagreement, resolution will be by discussion or a third reviewer). Initially 10% of references will be double-screened. If inter-rater agreement is good (percentage agreement =>90%) then the remaining references will be screened by one reviewer. The unfiltered search results will be saved and retained for future potential re-analysis. All primary-level studies included after the first scan of citations will be acquired in full and re-evaluated for eligibility at the time they are being entered into a study database (standardised template created in Microsoft Excel). Eligibility will be confirmed by at least one member of the Guideline Development Group (GDG). Two researchers will extract data into the study database, comparing a sample of each other’s work (10%) for reliability. Discrepancies or difficulties with coding will be resolved through discussion between reviewers or with members of the GDG.

Data to be extracted:

Study characteristics: RQ addressed, study design, country, N, age, recruitment location, target condition, index test, no. of items, cut-off, reference standard, CJS setting

Outcomes: Sensitivity, specificity, number of ‘cases’, N, PPV, NPV, TP, FP, FN, TN, PLR, NLR, prevalence, AUR (mean), AUR (sd)
32.Risk of bias (quality) assessment [27]*The quality of individual studies will be assessed using the QUADAS-2 quality checklist (available from: http://www​.bris.ac.uk​/media-library/sites​/quadas/migrated/documents/quadas2.pdf)
33.Strategy for data synthesis [28]*RQ 2.1–2.3:

If existing reviews are found, the review team with advice from the GDG will assess their quality, completeness, and applicability to the NHS and to the scope of the guideline. If the GDG agree that a systematic review appropriately addresses a review question we will assess if any additional studies, conducted or published since the review was conducted, could affect the conclusions of the previous review. If new studies could change the conclusions, we will conduct a new analysis to update the review. If new studies could not change the conclusions of an existing review, the GDG will use the existing review to inform their recommendations.

Review Manager 5 will be used to summarise diagnostic accuracy data from each study using forest plots and summary ROC plots. Where appropriate (where more than two studies report comparable data), a bivariate diagnostic accuracy meta-analysis will be conducted using Metadisc (Zamora et al., 2006, publically available at http://www​.hrc.es/investigacion​/metadisc_en.htm), in order to obtain pooled estimates of sensitivity and specificity using a random effects model. Alternatively, a narrative synthesis will be used.

RQ 2.4: The GDG will use a consensus-based approach to identify the key components of an effective assessment
34.Analysis of subgroups or subsets [29] (including sensitivity analyses)Heterogeneity is usually much greater in meta-analyses of diagnostic accuracy studies compared with RCTs. Therefore, a higher threshold for acceptable heterogeneity in such meta-analyses is required.

Where substantial heterogeneity exists, sensitivity analyses will be considered, including:
  • Excluding case-control (from cohort) studies
  • Excluding non-UK studies
General information
35.Type of review [30]Diagnostic
36.Dissemination plans [35]This review is being conducted for the NICE guideline on Mental health of adults in contact with the criminal justice system. Further information about the guideline and plans for implementation can be found on the NICE website: http://guidance​.nice.org.uk

The review findings will be included in the full guideline developed by the National Collaborating Centre for Mental Health: http://www​.nccmh.org.uk/
37.Details of any existing review of the same topic by the same authors [37]*
38.Review status [38]Ongoing
Further information (not needed for Prospero registration)
Existing reviews utilised in this review:*
39.
  • Updated
40.
  • Not updated

1.3. Interventions and their adaptations to the criminal justice system

Item No.Item [Prospero field No.]Details
PROSPERO: Reg. No.CRD#########
Guideline details
41.Guideline*Mental health of adults in contact with the criminal justice system
42.Guideline chapter*Interventions and their adaptation to the criminal justice system
43.Topic Group (if used)
44.Sub-section lead*
45.Review team lead*
46.Objective of review*To review the evidence for interventions to promote mental health and wellbeing, and for the care and treatment of mental health problems, in adults in contact with the criminal justice system
Review title and timescale
47.Review title [1]*Interventions to promote mental health and wellbeing, and for the care and treatment of mental health problems, in adults in contact with the criminal justice system
48.Anticipated or actual start date [3]
49.Anticipated completion date [4]
50.Stage of review at time of registration [5]
StartedCompleted
Preliminary searches☐☐
Piloting of the study selection process☐☐
Formal screening of search results against eligibility criteria☐☐
Data extraction☐☐
Risk of bias (quality) assessment☐☐
Data analysis☐☐
Prospective meta-analysis☐☐
Provide any other relevant information about the stage of the review here (e.g. Funded proposal, final protocol not yet finalised).
Review team details
51.Named contact [6]Odette Megnin-Viggars
52.Named contact email ku.ca.hcyspcr@ningemo
53.Named contact address [8]NCCMH
Royal College of Psychiatrists,
3rd Floor, 21 Prescot Street
London E1 8BB
54.Named contact phone number [9]020 3701 2645
55.Review team members and their organisational affiliations [10]Dr. Odette Megnin-Viggars NCCMH
56.Organisational affiliation of the review [11]National Collaborating Centre for Mental Health
57.Funding sources/sponsors [12]National Institute for Health and Care Excellence
58.Conflicts of interest [13]◉ None known
◯ Yes
59.Collaborators [14]Title/First name/Last name/Organisation details
Review methods
60.Review question(s) [15]*RQ 3.1: 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:
  • alcohol-use disorders?
  • antenatal or postnatal mental health problems [for women]?
  • antisocial personality disorder?
  • attention deficit hyperactivity disorder?
  • autism?
  • bipolar disorder?
  • borderline personality disorder?
  • challenging behaviour or mental health problems [for adults with learning disabilities]?
  • delirium?
  • dementia?
  • depression (with or without a coexisting chronic physical health problem)?
  • eating disorders?
  • generalised anxiety disorder and panic disorder (with or without agoraphobia)?
  • obsessive-compulsive disorder and body dysmorphic disorder?
  • post-traumatic stress disorder?
  • psychosis (with or without coexisting substance misuse) or schizophrenia?
  • self-harmed (self-harming)?
  • social anxiety disorder?
  • substance misuse disorders?
  • violent and aggressive behaviour [for adults with mental disorders]?
RQ 3.2: 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?

RQ 3.3: 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?

RQ 3.4: 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?

RQ 3.5: 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)?
61.Sub-question(s)Where possible, consideration should be given to the specific needs of:-
  • people with neurodevelopmental disorders (including learning disabilities)
  • women
  • older adults (aged 50 years and over)
  • young black men
  • young adults that have transitioned from juvenile services
62.Searches [16]*Mainstream databases:
CENTRAL, Embase, MEDLINE, PsycINFO

Topic specific databases:
None

Other resources of evidence:
  • Reference lists of included studies
  • Citation tracking for included papers in Scopus and Web of Knowledge (WoK)
  • Calls for evidence from stakeholders
  • Contacting authors of relevant works for ‘sibling’ studies
  • “Related articles” searching in PubMed
  • Conference abstracts will be assessed for eligibility and potentially eligible studies will be checked to determine if they have been published in full
  • Dissertation titles/abstracts will be assessed for eligibility and potentially eligible studies will be checked to determine if they have been published in full
  • Non-English language papers (with English abstracts) will be assessed for eligibility and potentially eligible studies will be checked to determine if they have been published in an English language journal.


*The number of citations that might relate to relevant trials that haven’t been included will be recorded.

Note. Unpublished data will only be included where a full study report is available with sufficient detail to properly assess the risk of bias. Authors of unpublished evidence will be asked for permission to use such data, and will be informed that summary data from the study and the study’s characteristics will be published in the full guideline.
63.Condition or domain being studied [18]*Mental health problems in adults in contact with the criminal justice system

‘Mental health problems’ includes: common mental health problems; severe mental illness; personality disorders; drug and alcohol problems; paraphilias; neurodevelopmental disorders; acquired cognitive impairment

Contact with the criminal justice system includes people: in police custody; in court custody; in contact with liaison, diversion and street triage services; remanded on bail; remanded in prison; who have been convicted and are serving a prison or community sentence; released from prison on licence; released from prison and in contact with a community rehabilitation company (CRC) or the probation service.
64.Participants/population [19]*Included: Adults (aged 18 and over) with, or at risk of developing, a mental health problem who are in contact with the criminal justice system

Excluded:
  • people who are cared for in hospital, except for providing guidance on managing transitions between criminal justice system settings and hospital
  • people in immigration removal centres
  • children and young people (aged under 18 years)
  • people who are in contact with the criminal justice system solely as a result of being a witness or victim.
65.Intervention(s), exposure(s) [20]*Included:
  • Psychological and social interventions
  • Pharmacological interventions
  • Combined psychological or social and pharmacological interventions
  • Support and education interventions aimed at promoting mental health and wellbeing (including environmental adaptations and individual- and population-based psychoeducational interventions)
RQ3.1:
Included:
  • Psychological and social interventions:
    • adherence therapy
    • anger/aggression management (Controlling Anger and Learning to Manage it [CALM])
    • animal-assisted therapy
    • arts-based therapies (art, drama, music or dance therapy)
    • behavioural therapies (applied behaviour analysis, aversion therapy, behavioural activation, behavioural self-control training, cue exposure, contingency management, systematic desensitisation)
    • biofeedback
    • breathing training
    • cognitive analytic therapy (CAT)
    • cognitive behavioural therapies (CBT)
    • cognitive bias modification
    • cognitive rehabilitation
    • cognitive remediation therapy (CRT) or cognitive enhancement therapy (CET)
    • cognitive stimulation (reality orientation)
    • cognitive therapy
    • counselling (directive or non-directive)
    • couples therapy
    • debriefing
    • dialectical behaviour therapy (DBT)
    • dietary counselling
    • eye movement desensitisation and reprocessing (EMDR)
    • facilitated self-help
    • family therapy and family interventions
    • harm minimisation/reduction strategies (replacement therapy, positive emotion technique)
    • home visits
    • humanistic therapy
    • hypnotherapy
    • interpersonal psychotherapy (IPT)
    • interpersonal and social rhythm therapy (IPSRT)
    • life review
    • mindfulness-based cognitive therapy (MBCT)
    • meditation
    • memory training (procedural memory stimulation)
    • mother-infant relationship interventions
    • motivational techniques (motivational interviewing, motivational enhancement therapy)
    • multimodal treatment
    • narrative exposure therapy (NET)
    • neurolinguistic programming (NLP)
    • panic control therapy
    • peer-mediated support and support groups
    • problem-solving skills training
    • psychodynamic psychotherapy
    • psychoeducational interventions, including psychologically (CBT or IPT)-informed psychoeducation (Building Skills for Recovery [BSR]; FOCUS substance misuse programme; Low Intensity Alcohol Programme [LIAP]; Medium Alcohol Requirement Intervention [MARI]; Offender Substance Abuse Programme [OSAP]; Prison - Addressing Substance Related Offending [P-ASRO])
    • rational emotive behaviour therapy
    • relaxation training (applied relaxation, progressive muscle relaxation, Jacobsonian relaxation)
    • reminiscence
    • self-help
    • social network and environment-based therapies (social behaviour and network therapy [SBNT], community reinforcement approach, social systems interventions)
    • social skills training
    • solution focused (brief) therapy (SFBT)
    • supportive therapy
    • therapeutic communities (democratic therapeutic communities [DTC]; Prison Partnership Therapeutic Community Programme [PPTCP])
    • trauma incident reduction (TIR)
    • twelve-step facilitation (TSF) (Prison Partnership Twelve Step Programme [PPTSP])
    • validation therapy
    • vocational interventions (pre-vocational training [sheltered workshop], supported employment)
  • Pharmacological interventions:
    • acetylcholinesterase inhibitors (donepezil, galantamine, rivastigmine)
    • alcohol deterrent compounds (disulfiram)
    • alpha-adrenergic agonists (clonidine, lofexidine)
    • antialcoholic agents (acamprosate calcium)
    • anticonvulsants (carbamazepine, gabapentin, lamotrigine, levetiracetam, phenytoin, pregabalin, topiramate, valproate)
    • antidepressants (atypical antidepressants [bupropion], monoamine oxidase inhibitors [MAOIs], selective serotonin reuptake inhibitors [SSRIs], serotonin-norepinephrine reuptake inhibitors [SNRIs], tricyclic antidepressants [TCAs])
    • antiemetics (ondansteron)
    • antihistamines (cyproheptadine, hydroxyzine, trimeprazine)
    • anti-inflammatory drugs (indomethacin)
    • antipsychotics (amisulpride, aripiprazole, asenapine, benperidol, chlorpromazine, clozapine, flupentixol, fluphenazine, haloperidol, levomepromazine/methotrimeprazine, lurasidone, olanzapine, paliperidone, pericyazine, perphenazine, pimozide, pipotiazine, prochlorperazine, promazine, quetiapine, risperidone, sertindole, sulpiride, trifluoperazine, ziprasidone, zotepine, zuclopenthixol)
    • anxiolytics (benzodiazepines [alprazolam, bromazepam, chlordiazepoxide, clobazam, clonazepam, clorazepate, diazepam, lorazepam, oxazepam], beta-blockers [atenolol, pindolol, practolol, propranolol, oxprenolol], busiprone, meprobamate)
    • cognitive enhancers (D-cycloserine, ergoloid mesylates, memantine, nicergoline)
    • 5HT3 antagonists (odansetron)
    • GABA-B agonists (baclofen)
    • hypnotics (benzodiazepines [flurazepam, nitrazepam, loprazolam, lormetazepam, temazepam], non-benzodiazepines [zaleplon, zolpidem, zopiclone], chloral and derivatives, clomethiazole [chlormethiazole], antihistamines [diphenhydramine, promethazine])
    • mood stabilisers (lithium)
    • N-methyl-D-aspartate (NMDA)-receptor antagonists (memantine)
    • norepinephrine (noradrenaline) reuptake inhibitors (atomoxetine)
    • opioid antagonists (naltrexone)
    • opioid maintenance treatment (methadone, buprenorphine, nalmefene, naltrexone)
    • rapid tranquillisation (antipsychotics [aripiprazole, chlorpromazine, haloperidol, loxapine, olanzapine, quetiapine, risperidone], benzodiazepines, antihistamines)
    • stimulants (dexamfetamine, methyl phenidate)
    • other substances (antiandrogens, botulinum toxin, folate [folacin, folic acid], ginkgo biloba, hydrocortisone, inositol, kava (also known as kava kava), kudzu root, nimodipine, omega-3 fatty acids, oxytocin, ritanserin, St John’s wort, sage [salvia officinalis, salvia lavendulafolia], triptans, tryptophan, valerian, vitamin E, vitamin B12, zinc)
  • Physical interventions:
    • acupuncture
    • aromatherapy
    • bright light therapy
    • deep brain stimulation
    • electroconvulsive therapy (ECT)
    • exercise or physical activity
    • hydration intervention
    • massage
    • nasogastric feeding
    • neurosurgery (stereotactic anterior capsulotomy/cingulotomy)
    • reactive strategies (physical restraint, mechanical restraint, modifications to the environment, personal and institutional alarms, de-escalation methods, confinement, and containment and seclusion)
    • sensory interventions (multi-sensory stimulation, Snoezelen)
    • thoracic sympathectomy
    • total parenteral nutrition (TPN)
    • transcranial magnetic stimulation (TMS) or repetitive TMS (rTMS)
    • vagus nerve stimulation (VNS)
RQ 3.2:
Included:
  • Psychological and social interventions:
    • behavioural interventions (aversion therapy, imaginal desensitisation, covert sensitisation or olfactory conditioning)
    • cognitive analytic therapy (CAT)
    • CBT (group or individual)
    • milieu therapy
    • motivational interviewing
    • multisystemic therapy
    • psychodynamic or psychoanalytic psychotherapy
    • psychoeducational interventions, including psychologically (CBT or IPT)-informed psychoeducation (Sex Offender Treatment Programmes [SOTP])
    • reintegration programmes (circles of support and accountability)
    • schema therapy
    • therapeutic communities
  • Pharmacological interventions:
    • antiandrogen hormone therapy (cyproterone acetate, medroxyprogesterone acetate)
    • antidepressants (SSRIs)
    • antipsychotic medication (benperidol)
    • gonadotropin-releasing hormone agonists (triptorelin)
RQ 3.4:
Included:
  • Psychological and social interventions:
    • therapeutic communities (democratic therapeutic communities)
Excluded: N/A
66.Comparator(s)/control [21]*Included:
  • Treatment as usual
  • No treatment
  • Waitlist control
  • Placebo (including attention control)
  • Any alternative management strategy
Excluded: N/A
67.Types of study to be included initially [22]*Included: Systematic reviews of RCTs and RCTs (including crossover randomised trials if data from the first phase is available)

If no existing systematic reviews address the review question, then in the first instance only RCTs will be included.

If the RCT evidence is limited either in terms of numbers of RCTs (≤5), or numbers of included participants (≤100), the range of included studies will be expanded to include non-randomised studies. Preference will be given to quasi-randomised controlled trials (for example, allocation by alternation or date of birth), controlled non-randomised studies and large cohort studies. If little evidence meets the above criteria, then before-and-after studies will be considered cautiously.

Excluded: Case series or case reports
68.Context [23]*Included: Care and shared care provided or commissioned by health and social care services, for people in contact with the criminal justice system in any Organisation for Economic Co-operation and Development (OECD) country

Excluded: Studies from non-OECD countries
69.Primary/Critical outcomes [24]*
  • Mental health outcomes
  • Offending and reoffending
  • Service utilisation
  • Adaptive functioning (for example, employment status, development of daily living and interpersonal skills, and quality of life)
  • Rates of self-injury
70.Secondary/Important, but not critical outcomes [25]*
71.Data extraction (selection and coding) [26]*Citations from each search will be downloaded into EndNote and duplicates removed. Records will then be screened independently by two reviewers against the eligibility criteria of the review (if there is disagreement, resolution will be by discussion or a third reviewer). Initially 10% of references will be double-screened. If inter-rater agreement is good (percentage agreement =>90%) then the remaining references will be screened by one reviewer. The unfiltered search results will be saved and retained for future potential re-analysis. All primary-level studies included after the first scan of citations will be acquired in full and re-evaluated for eligibility at the time they are being entered into a study database (standardised template created in Microsoft Excel). Eligibility will be confirmed by at least one member of the Guideline Development Group (GDG). Two researchers will extract data into the study database, comparing a sample of each other’s work (10%) for reliability. Discrepancies or difficulties with coding will be resolved through discussion between reviewers or with members of the GDG.

Data to be extracted:

Study characteristics: RQ addressed, study design, country, N, inclusion/exclusion criteria, mental health problem, CJS setting, offence (if appropriate), length of sentence (if appropriate), demographics (age, sex, ethnicity, IQ), risk of bias (selection bias, performance bias, detection bias, attrition bias, other bias)

Comparisons: For both experimental and control interventions: Intervention, format, group size (if applicable), intensity/dose, frequency, duration (of treatment and follow-up), intervention setting, intervention administrator

Outcomes: Outcome name, outcome measure, rater, direction of scale, time point (for instance, weeks post-randomisation), phase, outcome data (for instance, mean, SD, N, events)
72.Risk of bias (quality) assessment [27]*The quality of individual studies will be assessed using the appropriate NICE quality assessment checklist. Where possible, the quality of evidence for each outcome will be assessed using the GRADE approach.
73.Strategy for data synthesis [28]*If existing reviews are found, the review team with advice from the GDG will assess their quality, completeness, and applicability to the NHS and to the scope of the guideline. If the GDG agree that a systematic review appropriately addresses a review question we will assess if any additional studies, conducted or published since the review was conducted, could affect the conclusions of the previous review. If new studies could change the conclusions, we will conduct a new analysis to update the review. If new studies could not change the conclusions of an existing review, the GDG will use the existing review to inform their recommendations.

If RCTs are included, meta-analysis using a random-effects model will be used to combine results from similar studies. If this is not possible, a narrative synthesis will be used.

Repeated observations on participants:

If studies report results for several periods of follow-up (e.g. 4 weeks, 12 weeks and 26 weeks post treatment) the longest follow-up from each study will be utilised in analyses. If the GDG feel that periods of follow-up are sufficiently distanced by time, we will consider defining several different outcomes, based on different periods of follow-up, to perform separate analyses (for example, short-term, medium-term and long-term follow-up).

Method of dealing with missing data

Because imputation of missing data in order to perform a full ITT analysis is controversial, only the results for available participants will be analysed in meta-analysis. However, for dichotomous outcomes a sensitivity analyses will be carried out whereby missing data will be imputed according to worst case scenario. Outcomes from the sensitivity analysis will only be presented if the ITT analysis differs significantly from the available case analysis.
74.Analysis of subgroups or subsets [29] (including sensitivity analyses)Where substantial heterogeneity exists, sensitivity analyses will be considered, including:
  • Excluding RCTs with <10 participants per arm
General information
75.Type of review [30]Intervention
76.Dissemination plans [35]This review is being conducted for the NICE guideline on Mental health of adults in contact with the criminal justice system. Further information about the guideline and plans for implementation can be found on the NICE website: http://guidance​.nice.org.uk

The review findings will be included in the full guideline developed by the National Collaborating Centre for Mental Health: http://www​.nccmh.org.uk/
77.Details of any existing review of the same topic by the same authors [37]*
78.Review status [38]Ongoing
Further information (not needed for Prospero registration)
Existing reviews utilised in this review:*
79.
  • Updated
80.
  • Not updated

1.4. Organisation and provision of services

Item No.Item [Prospero field No.]Details
PROSPERO: Reg. No.CRD#########
Guideline details
81.Guideline*Mental health of adults in contact with the criminal justice system
82.Guideline chapter*Organisation and provision of services
83.Topic Group (if used)
84.Sub-section lead*
85.Review team lead*
86.Objective of review*To review the evidence for the structure and systems for the delivery of health and social care services for adults with mental health problems who are in contact with the criminal justice system
Review title and timescale
87.Review title [1]*Organisation and provision of services for the assessment, intervention and management of mental health problems in adults in contact with the criminal justice system
88.Anticipated or actual start date [3]
89.Anticipated completion date [4]
90.Stage of review at time of registration [5]
StartedCompleted
Preliminary searches☐☐
Piloting of the study selection process☐☐
Formal screening of search results against eligibility criteria☐☐
Data extraction☐☐
Risk of bias (quality) assessment☐☐
Data analysis☐☐
Prospective meta-analysis☐☐
Provide any other relevant information about the stage of the review here (e.g. Funded proposal, final protocol not yet finalised).
Review team details
91.Named contact [6]Odette Megnin-Viggars
92.Named contact email ku.ca.hcyspcr@ningemo
93.Named contact address [8]NCCMH
Royal College of Psychiatrists,
3rd Floor, 21 Prescot Street
London E1 8BB
94.Named contact phone number [9]020 3701 2645
95.Review team members and their organisational affiliations [10]Dr. Odette Megnin-Viggars NCCMH
96.Organisational affiliation of the review [11]National Collaborating Centre for Mental Health
97.Funding sources/sponsors [12]National Institute for Health and Care Excellence
98.Conflicts of interest [13]◉ None known
◯ Yes
99.Collaborators [14]Title/First name/Last name/Organisation details
Review methods
10Review question(s) [15]*RQ 4.1: 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:
  • appropriate access to services?
  • positive experience of services?
  • positive mental health outcomes?
  • integrated multi-agency care?
  • successful transition between services?
  • successful discharge from services?
10Sub-question(s)Where possible, consideration should be given to the specific needs of:-
  • people with neurodevelopmental disorders (including learning disabilities)
  • women
  • older adults (aged 50 years and over)
  • young black men
  • young adults that have transitioned from juvenile services
10Searches [16]*Mainstream databases:

CENTRAL (date range), Embase (date range), MEDLINE (date range), PsycINFO (date range)

Topic specific databases:
[add]None

Other resources of evidence: [amend as appropriate]:
  • Reference lists of included studies
  • Citation tracking for included papers in Scopus and Web of Knowledge (WoK)
  • Calls for evidence from stakeholders
  • Contacting authors of relevant works for ‘sibling’ studies
  • “Related articles” searching in PubMed
  • Conference abstracts will be assessed for eligibility and potentially eligible studies will be checked to determine if they have been published in full
  • Dissertation titles/abstracts will be assessed for eligibility and potentially eligible studies will be checked to determine if they have been published in full
  • Non-English language papers (with English abstracts) will be assessed for eligibility and potentially eligible studies will be checked to determine if they have been published in an English language journal.


*The number of citations that might relate to relevant trials that haven’t been included will be recorded.

Note. Unpublished data will only be included where a full study report is available with sufficient detail to properly assess the risk of bias. Authors of unpublished evidence will be asked for permission to use such data, and will be informed that summary data from the study and the study’s characteristics will be published in the full guideline.
10Condition or domain being studied [18]*Mental health problems in adults in contact with the criminal justice system

‘Mental health problems’ includes: common mental health problems; severe mental illness; personality disorders; drug and alcohol problems; paraphilias; neurodevelopmental disorders; acquired cognitive impairment

Contact with the criminal justice system includes people: in police custody; in court custody; in contact with liaison, diversion and street triage services; remanded on bail; remanded in prison; who have been convicted and are serving a prison or community sentence; released from prison on licence; released from prison and in contact with a community rehabilitation company (CRC) or the probation service.
10Participants/population [19]*Included: Adults (aged 18 and over) with, or at risk of developing, a mental health problem who are in contact with the criminal justice system

Excluded:
  • people who are cared for in hospital, except for providing guidance on managing transitions between criminal justice system settings and hospital
  • people in immigration removal centres
  • children and young people (aged under 18 years)
  • people who are in contact with the criminal justice system solely as a result of being a witness or victim.
10Intervention(s), exposure(s) [20]*Included: Any service delivery model, including:
  • Assertive Community Treatment (ACT)
  • case management (including intensive case management)
  • CARAT (Counselling, Assessment, Referral, Advice and Throughcare)
  • collaborative care
  • Dangerous and Severe Personality Disorder (DSPD) programme
  • Drug Arrest Referral Schemes (DARS)
  • Drug Interventions Programme (DIP)
  • Drug Rehabilitation Requirements (DRRs)
  • Drug Treatment and Testing Orders (DTTO)
  • Integrated Drug Treatment System (IDTS)
  • mental health courts
  • prison/court liaison and diversion programmes
  • Psychologically Informed Planned Environments (PIPEs)
  • re-entry programmes
  • street triage
Excluded: N/A
10Comparator(s)/control [21]*Included:
  • Treatment as usual
  • No treatment
  • Waitlist control
  • Placebo (including attention control)
  • Any alternative service delivery model
Excluded: N/A
10Types of study to be included initially [22]*Included: Systematic reviews of RCTs and RCTs (including crossover randomised trials if data from the first phase is available)

If no existing systematic reviews address the review question, then in the first instance only RCTs will be included.

If the RCT evidence is limited either in terms of numbers of RCTs (≤5), or numbers of included participants (≤100), the range of included studies will be expanded to include non-randomised studies. Preference will be given to quasi-randomised controlled trials (for example, allocation by alternation or date of birth), controlled non-randomised studies and large cohort studies. If little evidence meets the above criteria, then before-and-after studies will be considered cautiously.

Excluded: Case series or case reports
10Context [23]*Included: Care and shared care provided or commissioned by health and social care services, for people in contact with the criminal justice system in any Organisation for Economic Co-operation and Development (OECD) country

Excluded: Studies from non-OECD countries
10Primary/Critical outcomes [24]*
  • Mental health outcomes
  • Offending and reoffending
  • Service utilisation
  • Access to services
  • Adaptive functioning (for example, employment status, development of daily living and interpersonal skills, and quality of life)
  • Rates of self-injury
  • Satisfaction
11Secondary/Important, but not critical outcomes [25]*
11Data extraction (selection and coding) [26]*Citations from each search will be downloaded into EndNote and duplicates removed. Records will then be screened independently by two reviewers against the eligibility criteria of the review (if there is disagreement, resolution will be by discussion or a third reviewer). Initially 10% of references will be double-screened. If inter-rater agreement is good (percentage agreement =>90%) then the remaining references will be screened by one reviewer. The unfiltered search results will be saved and retained for future potential re-analysis. All primary-level studies included after the first scan of citations will be acquired in full and re-evaluated for eligibility at the time they are being entered into a study database (standardised template created in Microsoft Excel). Eligibility will be confirmed by at least one member of the Guideline Development Group (GDG). Two researchers will extract data into the study database, comparing a sample of each other’s work (10%) for reliability. Discrepancies or difficulties with coding will be resolved through discussion between reviewers or with members of the GDG.

Data to be extracted:

Study characteristics: RQ addressed, study design, country, N, inclusion/exclusion criteria, mental health problem, CJS setting, offence (if appropriate), length of sentence (if appropriate), demographics (age, sex, ethnicity, IQ), risk of bias (selection bias, performance bias, detection bias, attrition bias, other bias)

Comparisons: For both experimental and control conditions: Service delivery model or control condition, group size (if applicable), intensity/dose, frequency, duration, setting

Outcomes: Outcome name, outcome measure, rater, direction of scale, time point (for instance, weeks post-randomisation), phase, outcome data (for instance, mean, SD, N, events)
11Risk of bias (quality) assessment [27]*The quality of individual studies will be assessed using the appropriate NICE quality assessment checklist. Where possible, the quality of evidence for each outcome will be assessed using the GRADE approach.
11Strategy for data synthesis [28]*If existing reviews are found, the review team with advice from the GDG will assess their quality, completeness, and applicability to the NHS and to the scope of the guideline. If the GDG agree that a systematic review appropriately addresses a review question, we will search for studies conducted or published since the review was conducted, and the GDG will assess if any additional studies could affect the conclusions of the previous review. If new studies could change the conclusions, we will update the review and conduct a new analysis. If new studies could not change the conclusions of an existing review, the GDG will use the existing review to inform their recommendations.

If RCTs are included, meta-analysis using a random-effects model will be used to combine results from similar studies. If this is not possible, a narrative synthesis will be used.

Repeated observations on participants:
If studies reports results for several periods of follow-up (e.g. 4 weeks, 12 weeks and 26 weeks post treatment) the longest follow-up from each study shall be utilised in analyses. If the GDG feel that periods of follow-up are sufficiently distanced by time, we shall consider defining several different outcomes, based on different periods of follow-up, and to perform separate analyses (e.g. short-term, medium-term and long-term follow-up).

Method of dealing with missing data
Because imputation of missing data in order to perform a full ITT analysis is controversial, only the results for available participants will be analysed in meta-analysis. However, for dichotomous outcomes a sensitivity analyses will be carried out whereby missing data will be imputed according to worst case scenario. Outcomes from the sensitivity analysis will only be presented if the ITT analysis differs significantly from the available case analysis.
11Analysis of subgroups or subsets [29] (including sensitivity analyses)Where substantial heterogeneity exists, sensitivity analyses will be considered, including:
  • Excluding RCTs with <10 participants per arm
General information
11Type of review [30]Service delivery
11Dissemination plans [35]This review is being conducted for the NICE guideline on Mental health of adults in contact with the criminal justice system. Further information about the guideline and plans for implementation can be found on the NICE website: http://guidance​.nice.org.uk

The review findings will be included in the full guideline developed by the National Collaborating Centre for Mental Health: http://www​.nccmh.org.uk/
11Details of any existing review of the same topic by the same authors [37]*
11Review status [38]Ongoing
Further information (not needed for Prospero registration)
Existing reviews utilised in this review:*
11
  • Updated
12
  • Not updated

1.5. Staff training and education

Item No.Item [Prospero field No.]Details
PROSPERO: Reg. No.CRD#########
Guideline details
12Guideline*Mental health of adults in contact with the criminal justice system
12Guideline chapter*Staff training or education
12Topic Group (if used)
12Sub-section lead*
12Review team lead*
12Objective of review*To review the evidence for support, training and supervision programmes for health, social care or criminal justice practitioners to improve the assessment, intervention and management of adults with mental health problems in contact with the criminal justice system
Review title and timescale
12Review title [1]*Support, training and supervision programmes for health, social care or criminal justice practitioners to improve the assessment, intervention and management of adults with mental health problems in contact with the criminal justice system
12Anticipated or actual start date [3]
12Anticipated completion date [4]
13Stage of review at time of registration [5]
StartedCompleted
Preliminary searches☐☐
Piloting of the study selection process☐☐
Formal screening of search results against eligibility criteria☐☐
Data extraction☐☐
Risk of bias (quality) assessment☐☐
Data analysis☐☐
Prospective meta-analysis☐☐
Provide any other relevant information about the stage of the review here (e.g. Funded proposal, final protocol not yet finalised).
Review team details
13Named contact [6]Odette Megnin-Viggars
13Named contact email ku.ca.hcyspcr@ningemo
13Named contact address [8]NCCMH
Royal College of Psychiatrists,
3rd Floor, 21 Prescot Street
London E1 8BB
13Named contact phone number [9]020 3701 2645
13Review team members and their organisational affiliations [10]Dr. Odette Megnin-Viggars NCCMH
13Organisational affiliation of the review [11]National Collaborating Centre for Mental Health
13Funding sources/sponsors [12]National Institute for Health and Care Excellence
13Conflicts of interest [13]◉ None known
◯ Yes
13Collaborators [14]Title/First name/Last name/Organisation details
Review methods
14Review question(s) [15]*RQ 5.1: 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?
14Sub-question(s)Where possible, consideration should be given to the specific needs of:-
  • people with neurodevelopmental disorders (including learning disabilities)
  • women
  • older adults (aged 50 years and over)
  • young black men
  • young adults that have transitioned from juvenile services
14Searches [16]*Mainstream databases:
CENTRAL (date range), Embase (date range), MEDLINE (date range), PsycINFO (date range)

Topic specific databases:
[add]None

Other resources of evidence: [amend as appropriate]:
  • Reference lists of included studies
  • Citation tracking for included papers in Scopus and Web of Knowledge (WoK)
  • Calls for evidence from stakeholders
  • Contacting authors of relevant works for ‘sibling’ studies
  • “Related articles” searching in PubMed
  • Conference abstracts will be assessed for eligibility and potentially eligible studies will be checked to determine if they have been published in full
  • Dissertation titles/abstracts will be assessed for eligibility and potentially eligible studies will be checked to determine if they have been published in full
  • Non-English language papers (with English abstracts) will be assessed for eligibility and potentially eligible studies will be checked to determine if they have been published in an English language journal.


*The number of citations that might relate to relevant trials that haven’t been included will be recorded.

Note. Unpublished data will only be included where a full study report is available with sufficient detail to properly assess the risk of bias. Authors of unpublished evidence will be asked for permission to use such data, and will be informed that summary data from the study and the study’s characteristics will be published in the full guideline.
14Condition or domain being studied [18]*Mental health problems in adults in contact with the criminal justice system

‘Mental health problems’ includes: common mental health problems; severe mental illness; personality disorders; drug and alcohol problems; paraphilias; neurodevelopmental disorders; acquired cognitive impairment

Contact with the criminal justice system includes people: in police custody; in court custody; in contact with liaison, diversion and street triage services; remanded on bail; remanded in prison; who have been convicted and are serving a prison or community sentence; released from prison on licence; released from prison and in contact with a community rehabilitation company (CRC) or the probation service.
14Participants/population [19]*Included: Adults (aged 18 and over) with, or at risk of developing, a mental health problem who are in contact with the criminal justice system

Excluded:
  • people who are cared for in hospital, except for providing guidance on managing transitions between criminal justice system settings and hospital
  • people in immigration removal centres
  • children and young people (aged under 18 years)
  • people who are in contact with the criminal justice system solely as a result of being a witness or victim.
14Intervention(s), exposure(s) [20]*Included: Any staff support, training or supervision programme, including:
  • Applied Suicide Intervention Skills Training (ASIST)
Excluded: N/A
14Comparator(s)/control [21]*Included:
  • Treatment as usual
  • No treatment
  • Waitlist control
  • Placebo (including attention control)
  • Any alternative staff training or education programme
Excluded: N/A
14Types of study to be included initially [22]*Included: Systematic reviews of RCTs and RCTs (including crossover randomised trials if data from the first phase is available)

If no existing systematic reviews address the review question, then in the first instance only RCTs will be included.

If the RCT evidence is limited either in terms of numbers of RCTs (≤5), or numbers of included participants (≤100), the range of included studies will be expanded to include non-randomised studies. Preference will be given to quasi-randomised controlled trials (for example, allocation by alternation or date of birth), controlled non-randomised studies and large cohort studies. If little evidence meets the above criteria, then before-and-after studies will be considered cautiously.

Excluded: Case series or case reports
14Context [23]*Included: Care and shared care provided or commissioned by health and social care services, for people in contact with the criminal justice system in any Organisation for Economic Co-operation and Development (OECD) country

Excluded: Studies from non-OECD countries
14Primary/Critical outcomes [24]*
  • Mental health outcomes
  • Offending and reoffending
  • Service utilisation
  • Adaptive functioning (for example, employment status, development of daily living and interpersonal skills, and quality of life)
  • Rates of self-injury
  • Satisfaction
15Secondary/Important, but not critical outcomes [25]*
15Data extraction (selection and coding) [26]*Citations from each search will be downloaded into EndNote and duplicates removed. Records will then be screened independently by two reviewers against the eligibility criteria of the review (if there is disagreement, resolution will be by discussion or a third reviewer). Initially 10% of references will be double-screened. If inter-rater agreement is good (percentage agreement =>90%) then the remaining references will be screened by one reviewer. The unfiltered search results will be saved and retained for future potential re-analysis. All primary-level studies included after the first scan of citations will be acquired in full and re-evaluated for eligibility at the time they are being entered into a study database (standardised template created in Microsoft Excel). Eligibility will be confirmed by at least one member of the Guideline Development Group (GDG). Two researchers will extract data into the study database, comparing a sample of each other’s work (10%) for reliability. Discrepancies or difficulties with coding will be resolved through discussion between reviewers or with members of the GDG.

Data to be extracted:

Study characteristics: RQ addressed, study design, country, N, inclusion/exclusion criteria, mental health problem, CJS setting, offence (if appropriate), length of sentence (if appropriate), demographics (age, sex, ethnicity, IQ), risk of bias (selection bias, performance bias, detection bias, attrition bias, other bias)

Comparisons: For both experimental and control conditions: Staff training or education programme or control condition, group size (if applicable), intensity/dose, frequency, duration, setting

Outcomes: Outcome name, outcome measure, rater, direction of scale, time point (for instance, weeks post-randomisation), phase, outcome data (for instance, mean, SD, N, events)
15Risk of bias (quality) assessment [27]*The quality of individual studies will be assessed using the appropriate NICE quality assessment checklist. Where possible, the quality of evidence for each outcome will be assessed using the GRADE approach.
15Strategy for data synthesis [28]*If existing reviews are found, the review team with advice from the GDG will assess their quality, completeness, and applicability to the NHS and to the scope of the guideline. If the GDG agree that a systematic review appropriately addresses a review question, we will search for studies conducted or published since the review was conducted, and the GDG will assess if any additional studies could affect the conclusions of the previous review. If new studies could change the conclusions, we will update the review and conduct a new analysis. If new studies could not change the conclusions of an existing review, the GDG will use the existing review to inform their recommendations.

If RCTs are included, meta-analysis using a random-effects model will be used to combine results from similar studies. If this is not possible, a narrative synthesis will be used.

Repeated observations on participants:
If studies reports results for several periods of follow-up (e.g. 4 weeks, 12 weeks and 26 weeks post treatment) the longest follow-up from each study shall be utilised in analyses. If the GDG feel that periods of follow-up are sufficiently distanced by time, we shall consider defining several different outcomes, based on different periods of follow-up, and to perform separate analyses (e.g. short-term, medium-term and long-term follow-up).

Method of dealing with missing data
Because imputation of missing data in order to perform a full ITT analysis is controversial, only the results for available participants will be analysed in meta-analysis. However, for dichotomous outcomes a sensitivity analyses will be carried out whereby missing data will be imputed according to worst case scenario. Outcomes from the sensitivity analysis will only be presented if the ITT analysis differs significantly from the available case analysis
15Analysis of subgroups or subsets [29] (including sensitivity analyses)Where substantial heterogeneity exists, sensitivity analyses will be considered, including:
  • Excluding RCTs with <10 participants per arm
General information
15Type of review [30]Intervention
15Dissemination plans [35]This review is being conducted for the NICE guideline on Mental health of adults in contact with the criminal justice system. Further information about the guideline and plans for implementation can be found on the NICE website: http://guidance​.nice.org.uk

The review findings will be included in the full guideline developed by the National Collaborating Centre for Mental Health: http://www​.nccmh.org.uk/
15Details of any existing review of the same topic by the same authors [37]*
15Review status [38]Ongoing
Further information (not needed for Prospero registration)
Existing reviews utilised in this review:*
15
  • Updated
16
  • Not updated
Copyright © National Institute for Health and Care Excellence, 2017.
Bookshelf ID: NBK533115
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