A Substance Use Treatment Programme for Mentally Ill Forensic Patients in an Australian Setting: A Pilot Study of Feasib
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A Substance Use Treatment Programme for Mentally Ill Forensic Patients in an Australian Setting: A Pilot Study of Feasibility, Acceptability and Preliminary Efficacy Daniel McFadden 1,2
1
& Katrina Prior & Emma L. Barrett
1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract
This study aims to evaluate the feasibility, acceptability and preliminary efficacy of an Australian-adapted Substance Use Treatment Programme (SUTP) among mentally ill offenders in an Australian secure forensic setting. A single-group non-controlled pilot trial was conducted. Four SUTP treatment groups were run simultaneously (n = 39) with sessions held weekly over 12 weeks. Feasibility was assessed by examining attrition, study retention and motivation for treatment, and measures of therapeutic alliance, client satisfaction and qualitative interviews were used to determine acceptability. Preliminary efficacy was assessed using self-report questionnaires implemented at baseline and postintervention measuring drug related locus of control, confidence to resist substances in the future and beliefs about substance use. Low attrition, high levels of satisfaction and moderately positive levels of therapeutic alliance were found. Participants also demonstrated a significant shift towards an internal drug related locus of control upon completion of SUTP. SUTP is a promising intervention for mentally ill offenders with a history of substance use in Australian forensic services. A randomised controlled trial is warranted to rigorously evaluate the efficacy of SUTP in this setting. Keywords Forensic . Mental illness . Offenders . Substance use . Treatment . Group interventions Mental disorders occur at high rates among prisoners worldwide (Fazel 2012). In Australia, rates of mental disorders among these individuals are disproportionately high when compared with the general population. The 12-month prevalence of any mental disorder in prisoners is 46%, far exceeding that of a matched sample of the Australian general population (16%), indicating that prisoners are nearly five times more likely to have a mental disorder when * Daniel McFadden [email protected]
1
Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Level 6, Jane Foss Russell building (G02), Sydney, NSW 2006, Australia
2
Justice Health and Forensic Mental Health Network, Sydney, Australia
International Journal of Mental Health and Addiction
compared with the community (OR = 4.7, 95% CI = 4.0–5.6; Butler et al. 2006). A common point at which Australian prisoners are identified as having a mental disorder is during the course of a special hearing or trial where an individual can be found ‘Not Guilty by Reason of Mental Illness’ by a judge or jury. This is determined when the person is found not to have the requisite responsibility to be found guilty of the crime because of their mental illness (BoydCaine and Chappell 2005). In New South Wales (NSW), the most populous state in Australia, 364 individuals were fo
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