Background: Head injury (HI) has been linked with offending behaviour. Self-report studies indicate a high prevalence of HI amongst offenders. Routine screening for HI for offenders has been recommended, to inform triage towards needs-led assessment and intervention (NPHN, 2016). However, there is a need to validate a screening tool for HI that can be used with offenders in the Scottish Prison Service (SPS). Aims: To examine the sensitivity, specificity and construct validity of the BISI and the OSU TBI ID against the reference standards of evidence of neuropsychological or psychiatric impairment or disability. The practical usefulness of the tools will also be considered. A parallel study by a second trainee examined the prevalence of disability associated with HI using the same data. Methods: A retrospective, cross-sectional design was utilised to gather data from 82 male participants (aged >21) from a Scottish prison. The two screening measures were used alongside measures of disability, mental health, cognitive function, and effort. Results: Construct validity was better for the OSU TBI-ID than the BISI. The OSU TBI-ID was significantly associated with neuropsychological, mental health and disability outcomes (p<0.05). Both tools had measures with good sensitivity (BISI injury severity rating: 86-100%; OSU TBI-ID clinical rating: 100%), but specificity was low (BISI injury severity rating: 17-24%; OSU TBI-ID clinical rating: 11-17%). The tools were equally practical to use in the SPS, and any differences were not clinically meaningful. Conclusion: This study indicates that the OSU TBI-ID may be more useful than the BISI as a screening tool for HI-related impairment or disability in Scottish prisons. Limitations and implications for future research are discussed.

By 1966 it had become clear that the doctrine of individual ministerial responsibility, which lay at the heart of the British constitution, had failed to evolve in order to meet the requirements of modern government. This thesis puts forward a review of the doctrine's operation and theoretical basis over a seventeen year period, starting with the advent of new organs of parliamentary scrutiny under the second Wilson Government. It is argued that individual ministerial responsibility can best be understood with reference to four distinct, yet interlocking elements. One of these, accountability, was the focus of significant change between 1966 and 1983. During these years, it was possible to discern the emergence of a new regime of parliamentary accountability. Within this, the traditional methods of scrutiny continued to operate, but they were joined by new Select Committees and the Parliamentary Commissioner for Administration. These new organs had the effect of increasing the quantity and enhancing the quality of scrutiny which could be brought to bear on ministers and civil servants. In a real sense, ministers became more accountable to Parliament for their role responsibilities, while the civil servants' accountability to their superiors in the administrative hierarchy, to their ministerial masters, and most importantly, to Parliament, was enhanced. In particular, the operation of the new Select Committees created a situation where the de lure statement of civil service non-accountability to Parliament came into obvious conflict with the emerging de facto accountability to this source. Individual ministerial responsibility remains a useful description of how British government is organised and operates. The doctrine should not be viewed as a constitutional myth, although one of its elements, sanctions, is nearer to myth than reality. The period 1966-83 witnessed no "revival" of this element, only a few false starts.

No description available.

Offender learning policy in England and Wales is vocationally focused and thus primarily aims to educate prisoners to increase their employability. Through an analysis of letters written by prisoners and interviews with serving prisoners, ex prisoners and prison staff, this qualitative study investigates prisoners’ experiences of education to explore the broad range of ways that such experiences are interpreted. A recurring interpretation involves personal development and this study shows that a range of personal changes and transformations can be attributed to prison education experiences. This suggests that prisoners’ interpretations of their educational experiences often go beyond employability. This study also provides a greater understanding of prisoners’ identities by drawing on elements of the research participants’ life histories and locating experiences of education within their narratives. This places the study in an in depth human context and as such, it has emerged that prisoners’ experiences of education can be better understood in the context of aspects of their life stories. This study reveals that prisoners who have not previously had positive educational experiences are often lacking in personal development and emotional maturity and therefore offender learning should be concerned with developing the ‘whole person’ in addition to giving prisoners skills for employment. As such, value can be ascribed to personal developments that are not directly related to employability such as the ability to cope with the experience of imprisonment and improved family relationships. By including such findings, this research also shows how understanding prisoners’ experiences of education contributes to understanding key themes in prison sociology: coping, masculinity, identity and the pains of imprisonment. This study concerns issues spanning a range of academic disciplines including criminology, sociology and education. As such, it is hoped that this thesis will be of interest to academics in the aforementioned subject areas as well as prison researchers, future prison researchers, prison teachers, prison staff, professionals in criminal justice, and any person with an interest in contemporary imprisonment.

Background There is considerable evidence that mindfulness-based interventions help in the treatment of psychological and emotional distress. Incarcerated young men are known to experience difficulties in these areas. However, the utility of mindfulness-based interventions among incarcerated young men remains largely unknown. This thesis set out to explore mindfulness for young men, aged 18-21 years, housed at Her Majesty’s Young Offender Institute in Polmont, Scotland. The specific research objectives were to: 1. Develop a bespoke mindfulness-based course; 2. Determine recruitment and retention to the mindfulness course and research study; 3. Investigate the feasibility of data collection and potential effectiveness of the mindfulness course, in terms of its impact on impulsivity, mental wellbeing, inner resilience, mindfulness, and emotional regulation; 4. Explore the young men’s experience of the course. Methods The research was guided by the United Kingdom Medical Research Council guidance for developing and evaluating complex interventions. A scoping review assessed existing evidence for the use of mindfulness-based interventions in offending populations. A bespoke mindfulness-based intervention was developed and the feasibility of its evaluation assessed using a mixed-methods approach to data collection. Qualitative interviews with course participants (n=20), prison staff (n=4) and the mindfulness teacher (n=1) were conducted. Interviews with course participants and the mindfulness teacher were first subject to rapid appraisal to inform course development. The full qualitative data set were subject to in-depth thematic analysis to understand barriers to recruitment and retention and experience of the course. Quantitative measurements were targeted at key outcomes of interest: impulsivity, mental wellbeing, inner resilience, mindfulness and emotional regulation. SPSS was used to analysis the data. Results The scoping review identified that there is currently no optimal mindfulness-based intervention for use with incarcerated young men. A standardised Mindfulness-Based Stress Reduction (MBSR) course was initially delivered and then required numerous adaptations to meet the young men’s needs. Recruitment and retention was challenging; remaining low throughout the duration of the study despite trying several recruitment strategies and successive modifications to the intervention. Data collection was found to be feasible at baseline and post-course but not at 3-month follow-up. Most measures used were age appropriate and demonstrated good internal consistency. A trend towards positive improvements by the end of the course was shown for: impulsivity (effect size: 0.72, p=0.001), mental wellbeing (ES: 0.50, p= 0.003), mindfulness (ES: 0.32, p=0.03), and inner resilience/meaningfulness (ES: 0.32, p=0.03). Most young men spoke of finding the course boring, strange, and unfamiliar at first, but this changed as they began to experience benefit. They reported finding the ‘body scan’ and ‘breathing techniques’ most helpful. A range of positive experiences were described including better sleep, reduced stress, greater relaxation, enhanced sense of control, and improved relationships. Most of the young men said they hoped to sustain their mindfulness practices when released back into the community. Conclusions Despite the challenges faced, preliminary findings suggested that mindfulness-based interventions have the potential to benefit incarcerated young men. More high quality research is required before definitive recommendations on the effectiveness of a mindfulness-based course for incarcerated young men can be made.

This thesis identifies ‘imprisoned grief’ as a new phenomenon. The Living with Loss project was a theological, spiritual and practical response to it co-constructed by the research participants and myself as the practitioner-researcher. The project ran from 2008-2011 at both HMP Kirkham and HMP Whitemoor. My initial findings highlighted the fact that ‘disenfranchised grief’ (Doka 1989) and ‘self-disenfranchised grief’ (Doka 2002) were inadequate descriptions of what I uncovered in my research. Doka himself (2002, p18) called for further research to be carried out in particular circumstances including prison, encouraging my own confidence in the importance of such research. ‘Disenfranchised grief’ is a condition which people feel when unable to access support from family, friends, religious and professional organisations in living with issues of grief and loss. It is exhibited by prisoners where the acute loss of family, relationships, home, employment, finance, education and ability to parent come together. Issues of loss and bereavement accumulate when a parent or other family members becomes terminally ill or dies during their imprisonment. ‘Self-disenfranchised grief’ is a self- initiated form of disenfranchised grief where the self will not allow grieving to take place. I consider that neither description fully explains the condition I encountered, which I have called ‘imprisoned grief.’ Imprisoned grief is distinctive because it manifests itself due to the loss of freedom brought about by imprisonment; during anticipatory grieving whilst in prison; following bereavement in prison and loss acts as a factor in criminal behaviour which include loss due to homicide. My research offers spiritual, theological and practically distinctive coping strategies and insights into how imprisoned grief can be ‘unlocked’ and prisoners can feel liberated from it. Enfranchisement was established between family members by sharing feelings and emotions in group work and through the composition of and facilitation of faith rituals. I argue that it was their beliefs and spirituality which sustained, combated and freed them from ‘imprisoned grief’.

Background: Few mental health screening tools have been validated with prisoners and existing tools, do not assess severity of need in line with contemporary stepped care service models. Aims: The current research aims to assess the CORE-10’s psychometric reliability, validity and predictive accuracy as a screening tool for common (primary care) and severe (secondary care) mental health problems in prisoners. Method: Cross –sectional study of 150 prisoners. All participants completed the CORE-10, Mini International Neuropsychiatric Interview version 6.0 (MINI) and the GHQ-12. Eighty-one participants repeated the CORE-10 and GHQ-12 two weeks later to assess re-test reliability. Clinical judgment data concerning referral for primary or secondary mental health services in prison were retrieved for each participant. Correlational, ROC and confirmatory factor analysis were utilised to assess the psychometric properties of the CORE-10 in comparison to the MINI, GHQ-12 and clinical judgment. Results: Significant positive correlations were identified between the CORE-10 and all other measures of mental health. ROC analysis on the CORE-10 against the MINI 6.0 revealed significant areas under the curve for predicting both primary (AUC .85) and secondary care (AUC .76) level needs. At cut points of >6 for primary care and >10 for secondary care sensitivity was .88 and .83, with specificity of 64 and .61 respectively. Sensitivity and specificity of the CORE-10 was superior to current clinical judgment and the GHQ-12. Internal reliability (α .84-.89) was good and two-week re-test reliability (ICC=.83) moderate. Confirmatory factor analysis confirmed the CORE-10’s original six-factor model to be a good fit. Conclusions: The CORE-10 is an accurate screen for common and severe mental health problems in prisoners. The CORE-10 is a psychometrically robust tool for use with prisoners demonstrating convergent, discriminate and construct validity as well as good internal and retest reliability.

The major objective of this study was to analyse the impact of the 2003 war on drugs policy on imprisonment and the prison social world in Thailand. While most studies on the drugs war have focused mainly on the quantitative increase in the prison population in the penal systems as the policy’s main impact, this research further examined the social shifts in Thai prisons driven by the drugs war. The data were qualitatively collected and analysed through documentary analysis, observations and in-depth interviews with forty-six participants: the former Director Generals of The Corrections Department, prison inmates, prison officers, and prison directors from Bangkwang Central Prison, Klongprem Central Prison, The Central Correctional Institution for Drug-addicts and The Women’s Correctional Institution for Drug-addicts. Although the Thai government declared a victory in the drugs war by claiming that the drug business had almost been eradicated due to the decrease in the size of the prison population and in the number of drug case arrests, in reality some changes caused by the drugs war within the prison world have been overlooked. The findings of this thesis reveal that the war on drugs produced significant effects upon various spheres of imprisonment. By dividing the framework into several levels for analysis focusing on prison inmates, prison officers and the social relationships behind bars, the lives and experiences of prisoners and prison officers are shown to have been effected in a negative and tougher way. Besides, there have been changes in social relations among prisoners and between inmates and prison officers. Crucially, the key factor leading to the policy impact was the replacement by the more powerful drug dealers in Thai prisons for drug users, due to the Narcotic Addict Rehabilitation Act B.E. 2545 (2002), which was a significant feature of the 2003 drugs war.

This thesis is concerned with the transfer of prison healthcare to National Health Service (NHS) responsibility, and investigates whether equitable provision has been achieved for prison-based patients. The chronic ill health of prisoners in England has been recognised for centuries. For example, Howard debates the issue in 1784. When released from prison, English prisoners’ abilities to carry ill health and infection into the community is more recently acknowledged as an additional significant concern (Ramsbotham, 1996). Three themes are evident when analysing the policy and legislative background demanding fair and equitable provision for all. These are: Philanthropy and Concern for Prison Healthcare, Prison Specific Policy and Recommendations, and the Wider NHS Policy, National Service Frameworks and Strategies. Three distinct phases of the Public Health Agenda are considered in this thesis: 1784 - 1890, 1945 - 1996, and 1997 - 2010. Investigation of the Public Health Agenda is divided into sub-categories: Health Promotion, Health Education, Disease Prevention, Healthy Settings, and Prisoner Health providing a valuable structure within which the wider literature can be evaluated empirically via this thesis’ fieldwork. Interpretivist in its methodology, this qualitative study adopts Case Study as an appropriate methodology. Research methods include focus groups, interviews, and participant correspondence. Presentation of research phenomena through graphic representation was designed to overcome reported literacy and language issues present within the research population. Combined, these methods offer an opportunity to build a “polyhedron of intelligibility” (Foucault, 1981, p. 6) demanded of this methodological approach. Between 2005 and 2010, this study explored prisoners’ experiences of healthcare post-transfer to NHS responsibility via five distinct phases of fieldwork: the identification of key patient themes of interest within a self-selecting sample, the validation of Phase One material and the generation of 5 | P a g e additional themes, focus group discussions, followed by interviews with participants and wider stakeholders, and finally a discussion group. Data are analysed and structured according to prison category and gender, age, and ethnicity. Resultant analytical themes linked to a central coding category, the overarching topic of Patient Equivalence. Furthermore, there are three analytical Key Themes: Beliefs, Attitudes and Behaviour; Service Commissioning, Delivery and Constraints; and Patients’ Health and Patient Outcomes. Here, the identification of Imprisoned Carers provides a unique and novel finding of this work. From these three analytical categories, a Core Theory emerged. Research data indicates that, despite considerable policy focus and activity, the lack of integrated service commissioning means that equitable provision for this prisoner population has not been consistently experienced by imprisoned patients. In its absence, prisoners have themselves adopted the role of carer for the sick and frail amongst their prison communities. These individuals report that they undertake these caring roles unsupported by the NHS and/or the Prison Service, whilst at considerable risk to both themselves and the person for whom they care. To achieve equitable provision for English prisoners, this thesis suggests the development of a prison multi-agency health and social care integrated service commissioning plan which recognises the needs of imprisoned carers as highlighted in this study.

This thesis examines longitudinally how young offenders cope with prison life, in particular the relationship between early coping styles and later levels of psychological health' and homesickness. The research was conducted in two parts. The first was a preliminary study to modify a homesickness questionnaire (Archer et al, 1998) for use within a prison population. The modified questionnaire (HQ-P) demonstrated good reliability. The second part consisted of the longitudinal study. This comprised three phases where individuals were assessed within two weeks of arriving into the prison system (phase one, N = 261), six weeks later (phase two, N = 133) and four to six months after phase one (phase three, N = 55). At each phase, individuals were asked to complete a coping styles questionnaire, psychological health and homesickness measures. A small number of the sample at phase one also took part in a semi-structured interview. This was to explore qualitatively their methods of coping, management of relationships and levels of support experienced within the first two weeks of arrival into the prison system. The results demonstrated that the use of emotional and avoidance coping within two weeks of arrival into prison was related to better levels of psychological health and lower levels of homesickness some six weeks and four to six months later. Individuals also demonstrated preferences for particular coping strategies that remained consistent across each phase. There are many implications of these findings. The first of these is the demonstration that levels of homesickness remain consistently high as time continues in prison. The study also reflects the importance of not labelling coping strategies as universally effective or ineffective, and allowing a more realistic exploration of their significance as a result. The effective early use of avoidance and emotional coping upon later levels of psychological health and homesickness would contrast against coping theory, that has previously regarded emotional and avoidance coping as hindering effective management of the stressor (Zeinder and Endler, 1996 and Menaghan, 1982). ___________________ 'Psychological health refers to symptoms expressed in the Middlesex Hospital Questionnaire (Crown and Crisp, 1966). These include depression, free-floating anxiety, obsessional and hysteric symptoms, also somatic symptoms which has a physical base. When discussing the findings throughout this thesis, references to psychological health are a combination of the above symptoms.