ABSTRACT
Early identification of treatment needs in incarcerated individuals with serious mental illness has significant implications. Validated assessment instruments to guide treatment are lacking in correctional settings. Hierarchical linear modeling was used to examine the predictive validity of the Level of Care Index (LOCI) in 35 inmates admitted to a specialized treatment unit. The LOCI score was predictive of levels of depressogenic psychopathology and psychological well-being as well as changes in these constructs over time. These results validate the use of the LOCI in a correctional setting and demonstrate the utility of the LOCI to identify treatment trajectories.
Subject(s)
Mental Disorders/epidemiology , Mentally Ill Persons , Needs Assessment/organization & administration , Prisoners , Adult , Female , Humans , Personality AssessmentABSTRACT
Providing cost-effective means to treat the influx of individuals with serious mental illness entering the correctional system is a major challenge. Failure to provide appropriate mental health treatment may lead to poor outcomes, including recidivism and suicide. Group intervention is an effective and cost efficient way to provide mental health treatment. However, it has been understudied in jail settings. To meet the needs of jail-inmates with serious mental illness, an eight-week group-based module curriculum was developed and studied through analyses of perceived usefulness, retention of key material, and associations with cognitive ability, improvement in psychiatric symptoms, and level of motivation. One week after the completion of a group session, the participants remembered the group topic and at least one key point from the group the majority of the time. Better recall of group material was associated with better overall cognitive ability and motivation at discharge. Participants found the groups to be somewhat to extremely useful 88.4% of the time. Higher levels of usefulness were associated with reduced psychopathology and psychiatric improvement, as well as higher motivation at discharge. The findings provide support for the group intervention and implementation in a jail setting. Further implications are discussed.
Subject(s)
Mental Disorders/therapy , Prisoners/psychology , Psychotherapy, Group/methods , Adolescent , Adult , Aged , Analysis of Variance , Attitude to Health , Cognition , Curriculum , Humans , Male , Mental Disorders/diagnosis , Mental Disorders/psychology , Mentally Ill Persons , Middle Aged , Motivation , New York , Prisons , Program Development , Psychiatric Status Rating Scales , Psychotherapy, Group/education , Substance-Related Disorders/psychology , Substance-Related Disorders/therapy , Treatment Outcome , Young AdultABSTRACT
Cognitive impairment among seriously mentally ill offenders has implications for legal matters (e.g., competency to stand trial), as well as clinical treatment and care. Thus, being able to identify potential cognitive concerns early in the adjudication process can be important when deciding on further interventions. In this study, we examined the validity scales of the Personality Assessment Inventory (PAI), scores on the Wechsler Adult Intelligence Scale-IV (WAIS-IV), and competency findings in male inmates (n=61) diagnosed with a serious mental illness. Lower scores on the WAIS-IV significantly (p=0.001) predicted invalid, versus valid, PAI profiles, with working memory impairment being the most significant (p=0.004) predictor of an invalid profile. Ancillary analyses on a smaller sample (n=18) indicate that those with invalid PAI profiles were more likely to be deemed legally incompetent (p=0.03). These findings suggest that the PAI validity scales may be informative in detecting cognitive concerns and help clinicians make determinations about competency restoration and treatment.
Subject(s)
Cognition Disorders/diagnosis , Cognition Disorders/psychology , Mental Competency/legislation & jurisprudence , Mental Disorders/diagnosis , Mental Disorders/psychology , Personality Assessment/statistics & numerical data , Prisoners/legislation & jurisprudence , Prisoners/psychology , Psychometrics/legislation & jurisprudence , Psychometrics/statistics & numerical data , Wechsler Scales/statistics & numerical data , Adult , Cognition Disorders/therapy , Humans , Male , Memory, Short-Term , Mental Disorders/therapy , Middle Aged , Reproducibility of Results , Residential Treatment/legislation & jurisprudenceABSTRACT
While improving the psychological health and well-being of individuals with serious mental illness can help reduce emotional distress and increase resilience, not enough is known about the well-being of incarcerated individuals with mental illness. Using the Schwartz Outcome Scale-10, the authors examined changes in subjective well-being and its association with other clinical symptoms and personality features in 43 mentally ill inmates in a large jail. All participants demonstrated significant improvement in general psychopathology and negative emotions. For well-being, however, different trajectories were associated with high versus low baseline ratings. Furthermore, those in the high well-being group were more likely to show features of aggression, dominance, hostility, mania, and more positive affect. These findings suggest that the level of well-being among inmates with serious mental illness may be an early indicator of personality features, clinical changes, and resilience, which is essential knowledge required when completing effective treatment planning.
