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      Alternativas al encarcelamiento de las personas con problemas de salud mental: experiencias internacionales Translated title: Alternatives to incarceration for people with mental health problems: international experiences

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          Abstract

          Resumen: Partiendo de la realidad de la plétora de personas con trastorno mental que pueblan las cárceles de países occidentales, la precaria atención clínica que reciben y el consiguiente efecto negativo que la estancia en prisión tiene para su porvenir, abordamos en este artículo los datos más relevantes de la relación entre delito y trastorno mental, y revisamos las experiencias más actuales en lo que se refiere a medidas alternativas a la prisión para personas con trastorno mental. Entre todas ellas nos ocupamos de revisar la experiencia de los tribunales especializados en EE. UU. que, desde la perspectiva de la Justicia Terapéutica, ofrecen programas alternativos a la prisión, con el objetivo de buscar una oportunidad para la recuperación de los pacientes.

          Translated abstract

          Abstract: Starting from the reality of the plethora of people with mental disorders that populate the prisons of Western countries, the precarious clinical care they receive, and the consequent negative effects that the stay in prison have on their future, in this article we review the most relevant aspects of the relationship between crime and mental disorder, and the newest experiences regarding alternative measures to prison for people with mental disorders. Among all of them, we examine the experience of specialized courts in the US, which, from the perspective of Therapeutic Justice, offer alternative programs to prison, aiming at offering an opportunity for the recovery of patients.

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          Most cited references37

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          Violence by People Discharged From Acute Psychiatric Inpatient Facilities and by Others in the Same Neighborhoods

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            Serious mental disorder in 23000 prisoners: a systematic review of 62 surveys.

            About 9 million people are imprisoned worldwide, but the number with serious mental disorders (psychosis, major depression, and antisocial personality disorder) is unknown. We did a systematic review of surveys on such disorders in general prison populations in western countries. We searched for psychiatric surveys that were based on interviews of unselected prison populations and included diagnoses of psychotic illnesses or major depression within the previous 6 months, or a history of any personality disorder. We did computer-assisted searches, scanned reference lists, searched journals, and corresponded with authors. We determined prevalence rates of serious mental disorders, sex, type of prisoner (detainee or sentenced inmate), and other characteristics. 62 surveys from 12 countries included 22790 prisoners (mean age 29 years, 18530 [81%] men, 2568 [26%] of 9776 were violent offenders). 3.7% of men (95% CI 3.3--4.1) had psychotic illnesses, 10% (9--11) major depression, and 65% (61--68) a personality disorder, including 47% (46--48) with antisocial personality disorder. 4.0% of women (3.2--5.1) had psychotic illnesses, 12% (11--14) major depression, and 42% (38--45) a personality disorder, including 21% (19--23) with antisocial personality disorder. Although there was substantial heterogeneity among studies (especially for antisocial personality disorder), only a small proportion was explained by differences in prevalence rates between detainees and sentenced inmates. Prisoners were several times more likely to have psychosis and major depression, and about ten times more likely to have antisocial personality disorder, than the general population. Worldwide, several million prisoners probably have serious mental disorders, but how well prison services are addressing these problems is not known.
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              Mental Health First Aid is an effective public health intervention for improving knowledge, attitudes, and behaviour: a meta-analysis.

              Mental Health First Aid (MHFA) is a standardized, psychoeducational programme developed to empower the public to approach, support and refer individuals in distress by improving course participants' knowledge, attitudes and behaviours related to mental ill-health. The present paper aims to synthesize published evaluations of the MHFA programme in a meta-analysis to estimate its effects and potential as a public mental health awareness-increasing strategy. Fifteen relevant papers were identified through a systematic literature search. Standardized effect sizes were calculated for three different outcome measures: change in knowledge, attitudes, and helping behaviours. The results of the meta-analysis for these outcomes yielded a mean effect size of Glass's Δ = 0.56 (95% CI = 0.38 - 0.74; p < 0.001), 0.28 (95% CI = 0.22 - 0.35; p < 0.001) and 0.25 (95% CI = 0.12 - 0.38; p < 0.001), respectively. Results were homogenous, and moderator analyses suggested no systematic bias or differences in results related to study design (with or without control group) or 'publication quality' (journal impact factor). The results demonstrate that MHFA increases participants' knowledge regarding mental health, decreases their negative attitudes, and increases supportive behaviours toward individuals with mental health problems. The MHFA programme appears recommendable for public health action.
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                Author and article information

                Journal
                neuropsiq
                Revista de la Asociación Española de Neuropsiquiatría
                Rev. Asoc. Esp. Neuropsiq.
                Asociación Española de Neuropsiquiatría (Madrid, Madrid, Spain )
                0211-5735
                2340-2733
                June 2022
                : 42
                : 141
                : 251-267
                Affiliations
                [1] orgnameHospital General Universitario Dr. Balmis orgdiv1Sección de Psiquiatría España
                [2] orgnameCP Alicante I y II España
                [3] Madrid orgnamePsiquiatra España
                Article
                S0211-57352022000100251 S0211-5735(22)04214100251
                10.4321/s0211-57352022000100016
                d49cc49b-b942-4d67-996c-50469c348ad4

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 International License.

                History
                : 29 April 2022
                : 09 March 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 38, Pages: 17
                Product

                SciELO Spain

                Categories
                Dossier: Atención a la salud mental en prisión

                prisons,juzgados específicos,trastorno mental grave,enfermedad mental,políticas penitenciarias,centros penitenciarios,mental health courts,severe mental disorder,mental disorder,prison policies

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