The Parma integrated model for intervention on pathological addictions in an Italian prison: process description and preliminary findings.
Keywords:
Pathological Addiction; Drug Abuse; Psychiatric Services; Rehabilitation; Prison; Italy.Abstract
Background - Interventions for inmates with Pathological Addiction (PA) still remain a problematic issue in Italian prisons, despite a 1999 major government reform transferring PA care in prison to the National Health Service. Aim of this research was to describe the integrated intervention model implemented for prisoners with PA in the Parma Penitentiary Institutes from January 2020 to June 2020. This specific approach is based on “person-tailored” therapeutic-rehabilitation programs in line with local community PA services. Methods - All the procedures were first carefully illustrated, especially the service for newly admitted inmates and the specialized rehabilitation treatments provided. A process analysis on the first six months of clinical activity was then performed. Results - Since January 2020, 178 subjects entered the service for newly admitted inmates: 55 (30.9%) were taken in charge for a PA. Conclusions - Our results support the feasibility of an integrated intervention model for PA in Italian prisons, based on specialized psychiatric treatments planned and provided in collaboration with inmates and their community health and social services.
References
2. La Cerra C, Sorrentino M, Franconi I, Notarnicola I, Petrucci C, Lancia L. Primary care program in prison: a review of the literature. J Correctional Health Care 2017; 23: 147-156.
3. Peloso PF, D’Alema M, Fioritti A. Mental health care in prisons and the issue of forensic hospitals in Italy. J Nerv Ment Dis 2017; 202: 473-478.
4. Regione Emilia Romagna (RER). Programma regionale per la salute negli istituti penitenziari: indicazioni alle aziende USL per la redazione dei programmi aziendali. Bologna: Centro Stampa della Regione Emilia-Romagna; 2019.
5. Leuci E, Quattrone E, Pellegrini P, Pelizza L. The Parma-Early Psychosis program: general description and process analysis after 5 years of clinical activity. Early Interv Psychiatry 2019; DOI: 10.1111/eip.12897.
6. Haynie DL, Whichard C, Kreager DA, Schaefer DR, Wakefield S. Social networks and health in a prison unit. J Health Soc Behav 2018; 59: 318-334.
7. Landi G, Leuci E, Quattrone E, Azzali S, Pellegrini C, Pellegrini P, Pelizza L. The “Parma-Early Psychosis” programme: characterization of help-seekers with first episode psychosis. Early Interv Psychiatry 2020; DOI: 10.1111/eip.12968.
8. American Psychiatric Association (APA). Joint principles on opioid crisis call for comprehensive, public health approach to addiction treatment. Washington DC,: APA Press; 2020.
9. National Institute for Health and Care Excellence (NICE). Alcohol withdrawal management for acute admissions to hospital. London: London North West University Press; 2019.
10. Sinha S. Adjustment and mental health problem in prisoners. Ind Psychiatry J 2019; 19: 101-104.
11. Grisso T. Jail Screening Assessment Tool (JSAT): guidelines for mental health screening in jails. Psychiatr Services 2006; 7: 1049-1050.
12. Pelizza L, Pellegrini C, Quattrone E, Azzali S, Landi G, Pellegrini P, Leuci E. Suicidal ideation in patients experiencing a first-episode psychosis: findings from the 2-year follow-up of the “Parma-Early Psychosis program”. Suicide Life Threat Behav 2020; DOI: 10.1111/sltb.12625.
13. Eck M, Scouflaire T, Debien C, Amad A, Sannier O, Chan Chee K, Thomas P, Vaiva G, Fovet T. Suicide in prison: epidemiology and prevention. Presse Med 2019; 48: 46-54.
14. Pelizza L, Azzali S, Paterlini F, Garlassi S, Scazza I, Chiri LR, Poletti M, Pupo S, Raballo A. The “Reggio Emilia At-Risk Mental States” program: a diffused, liquid model of early intervention in psychosis implemented in an Italian Department of Mental Health. Early Interv Psychiatry 2019; 13: 1513-1524.
15. Ministero della Salute. Regolamento concernente la determinazione delle procedure diagnostiche e medico-legali per accertare l’uso abituale di sostanze stuoefacenti o psicotrope, delle metodiche per quantificare l’assunzione abituale nelle 24 ore e dei limiti quantitativi massimi di principio attivo per le dosi medie giornaliere. Roma: Gazzetta Ufficiale della Repubblica Italiana; 1990.
16. Weiss RD, Rao V. The prescription opioid addiction treatment study: what have we learned. Drug Alcohol Dependence 2017; 173 (suppl. 1): s48-s54.
17. Presidenza della Repubblica. Decreto del Presidente della Repubblica n.309/1990: testo unico stupefacenti. Roma: Gazzetta Ufficiale della Repubblica Italiana; 1990.
18. Yoon IA, Slade K, Fazel S. Outcomes of psychological therapies for prisoners with mental health problems: a systematic review and meta-analysis. J Consult Clin Psychol 2017; 85: 783-802.
19. Riedel-Heller SG, Guhne U, Weinmann S, Arnold K, Ay ES, Becker T. Psychosocial interventions in severe mental illness: evidence and recommendations - psychoeducation, social skill training and exercise. Nervenartz 2012; 83: 847-854.
20. Ferrazzi P, Krupa T. Mental health rehabilitation in therapeutic jurisprudence: theoretical improvements. Int J Law Psychiatry 2016; 46: 42-49.
21. Franke I, Vogel T, Eher R, Dudeck M. Prison mental health-care: recent developments and future challenges. Curr Opin Psychiatry 2019; 32: 342-347.
22. Forchuk C, Solomon M, Viran T. Peer Support. Healthcare Quart 2016; 18: 32-36.
23. Brulin-Solignac D, Bouchard JP, Zanetti A, Bouguin S. Support groups, preventing violence and dangerousness. Soins Psychiatr 2018; 9: 34-37.
24. Strang J, Bird SM, Dietze P, Gerra G, McLellan AT. Take-home emergency naloxone to prevent deaths from heroin overdose. BMJ 2014; 349: 6580.
25. SPSS Inc. Statistical Package for Social Science – version 15.0 for Windows. Chicago, IL: SPSS Inc. Press; 2010.
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