People with mental health problems leaving institutions such as hospitals and prisons often have difficulties in receiving continuity of care in the community. Care programmes are not integrated within mental health services and specifically across other sectors such as the criminal justice system. Could intensive case management established before release improve continuity of care. Further individuals have a range of health and social problems such as mental health, physical illness, substance misuse, housing issues, financial problems, isolation from family and informal support networks. These are particularly problematic for people serving short sentences and on remand (unsentenced).

Methods:

Critical literature review of forms and contents of intensive case management programmes and their relevance for people with mental health problems involved in the criminal justice system at various points such as 1)arrest, 2)remand into prison/awaiting trial and 3)release from prison.

The aims of the review were to:

• Examine transitional Intensive Case Management and Critical Time Intervention among criminal justice populations

Search Strategy

Databases searches from January 1990 to January 2013 using combinations of keywords relating to offenders, aftercare, interventions and diversion; including Ovid MEDLINE other non-indexed citations, EMBASE, IngentaConnect, PsycINFO, ScienceDirect, PubMed, CINAHL (Cumulative Index to nursing & Allied Health Literature), and AMED (Allied and Complimentary Medicine). Search terms were (i) Police custody* AND health* AND UK*, (ii) Courts* AND Health* AND UK*, (iii) Prison* AND Remand AND Health* AND UK*. These were broadened to include terms including Arrestee, Arrested*, Defendant, Prisoner, Offender, Ex-prisoner to optimise inclusion. Research articles were also sought from peer review journals and relevant reference lists. Internet searches were conducted using: Google, Department of Health (DH), Ministry of Justice (MoJ), Association of Chief Police Officers (ACPO), Her Majesty’s Court Service (HMCS), Home Office, NACRO, Centre for Mental Health (CMH), Rethink and Revolving Doors Agency websites.

Key questions for the purposes of the literature review were: a) what is the available literature describing forms of intensive case management including transitional or short term care provided to offenders with mental illness?, b) what point on the offender pathway where interventions provided? c) what gaps exist in the literature?

Search terms and literature selection inclusion criteria included: i) people with mental illness ii) who also exhibit offending behaviour iii) relevance to mental health and criminal justice systems; iv) restricted to countries with similar health care services to the UK, e.g. Canada, Australia and the US v) English language papers only; and vi) any study design.

This was then synthesised using narrative analysis, including a description of all included studies (Dixon-Woods et al, 2004), applying the ?�levels of evidence’ typology (Ontario Ministry of Health, 2003; Novo Scotia Department of Health, 2003) Mental Health Accountability Framework.

Information examination of study design, inclusion and exclusion criteria, geographical location, sample size, characteristics of the participants including gender, age, diagnoses, type of aftercare or diversion programme, Intervention content, development, fidelity and sustainability were recorded. Limitations at the study and outcome level (e.g. risk of bias) and review level (e.g. reporting bias) to be recorded.

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