Mental health screening tools in correctional institutions: a systematic review.

Michael S Martin,Alexander If Simpson,Kwame Mckenzie,Ian Colman

doi:10.1186/1471-244x-13-275

Michael S Martin, Alexander If Simpson + Show 2 more

Open Access

https://doi.org/10.1186/1471-244x-13-275

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Abstract

BackgroundPast studies have identified poor rates of detection of mental illness among inmates. Consequently, mental health screening is a common feature to various correctional mental health strategies and best practice guidelines. However, there is little guidance to support the selection of an appropriate tool. This systematic review compared the sensitivity and specificity of mental health screening tools among adult jail or prison populations.MethodsA systematic review of MEDLINE and PsycINFO up to 2011, with additional studies identified from a search of reference lists. Only studies involving adult jail or prison populations, with an independent measure of mental illness, were included. Studies in forensic settings to determine fitness to stand trial or criminal responsibility were excluded. Twenty-four studies met all inclusion and exclusion criteria for the review. All articles were coded by two independent authors. Study quality was coded by the lead author.ResultsTwenty-two screening tools were identified. Only six tools have replication studies: the Brief Jail Mental Health Screen (BJMHS), the Correctional Mental Health Screen for Men (CMHS-M), the Correctional Mental Health Screen for Women (CMHS-W), the England Mental Health Screen (EMHS), the Jail Screening Assessment Tool (JSAT), and the Referral Decision Scale (RDS). A descriptive summary is provided in lieu of use of meta-analytic techniques due to the lack of replication studies and methodological variations across studies.ConclusionsThe BJMHS, CMHS-M, CMHS-W, EMHS and JSAT appear to be the most promising tools. Future research should consider important contextual factors in the implementation of a screening tool that have received little attention. Randomized or quasi-randomized trials are recommended to evaluate the effectiveness of screening to improve the detection of mental illness compared to standard practices.

Highlights

Past studies have identified poor rates of detection of mental illness among inmates
Study characteristics Twenty-two screening tools were identified from the twenty-four studies included in the review
Whereas the Brief Jail Mental Health Screen (BJMHS), Correctional Mental Health Screen for Men (CMHS-M) and Correctional Mental Health Screen for Women (CMHS-W) and England Mental Health Screen (EMHS) are brief tools (i.e. 5 minutes or less) that can be administered by health or custodial staff, the Jail Screening Assessment Tool (JSAT) is completed by nursing or psychology staff, and requires 20-30 minutes to complete

Summary

Introduction

Past studies have identified poor rates of detection of mental illness among inmates. Teplin [10] found that only 32.5% of inmates with severe mental illness were detected at intake This same study noted mental health needs were more likely to be identified among those with a past psychiatric treatment (91.7% of whom were detected). 23% of those with a current mental illness were identified by prison staff They did not find a higher detection rate of psychotic disorders as observed by Teplin. Findings such as these have led to the inclusion of mental health screening as a key component of a correctional mental health strategy [12,13,14,15]

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