Zielinski Melissa J, Allison M Kathryn, Brinkley-Rubinstein Lauren, Curran Geoffrey, Zaller Nickolas D, Kirchner Jo Ann E
Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR, 72205, USA.
University of Arkansas, Fayetteville, AR, USA.
Health Justice. 2020 Sep 6;8(1):21. doi: 10.1186/s40352-020-00122-6.
It is a constitutional right to receive health care, including mental health care, while incarcerated. Yet, even basic evidence-based mental health care practices have not been routinely integrated into criminal justice (CJ) settings. Strategies from implementation science, or the study of methods for integrating evidence-based practices into routine care, can accelerate uptake of established interventions within low-resource, high-need settings such as prisons and jails. However, most studies of mental health practices in CJ settings do not use implementation frameworks to guide efforts to integrate treatments, systematically select or report implementation strategies, or evaluate the effectiveness of strategies used.
After introducing implementation science and articulating the rationale for its application within CJ settings, we provide two illustrative case examples of efforts to integrate mental health interventions within CJ settings. Each case example demonstrates how an implementation framework either was applied or could have been applied to promote intervention adoption. The first focuses on poor implementation of a mental health screener in a county jail, retrospectively highlighting how use of a determinants framework (e.g., the Consolidated Framework for Implementation Research [CFIR]) could help staff identify factors that led to the implementation failure. The second describes an investigator-initiated research study that used a process framework (the Exploration, Preparation, Implementation, Sustainment [EPIS] framework) to systematically investigate and document the factors that led to successful implementation of a psychotherapy group for survivors of sexual violence in a women's community corrections center. Both are presented in accessible language, as our goal is that this article can be used as a primer for justice health researchers, community partners, and correctional leadership who are unfamiliar with implementation science.
Scientific research on the application of implementation science to justice settings is growing, but lags behind the work done in health systems. Given the tremendous need for mental and behavioral health intervention across the full spectrum of justice settings, information on how to successfully implement evidence-based intervention and prevention efforts is sorely needed but possible to obtain with greater integration of knowledge from implementation science.
在被监禁期间接受包括精神卫生保健在内的医疗保健是一项宪法权利。然而，即使是基本的循证精神卫生保健实践也尚未常规纳入刑事司法环境。实施科学（即将循证实践整合到常规护理中的方法研究）中的策略可以加速在监狱等资源匮乏、需求高的环境中采用既定干预措施。然而，大多数关于刑事司法环境中精神卫生实践的研究并未使用实施框架来指导整合治疗的努力、系统地选择或报告实施策略，也未评估所使用策略的有效性。
在介绍实施科学并阐明其在刑事司法环境中应用的基本原理后，我们提供了两个在刑事司法环境中整合精神卫生干预措施的说明性案例。每个案例都展示了一个实施框架是如何被应用或本可被应用以促进干预措施的采用。第一个案例聚焦于一个县监狱中精神卫生筛查工具的实施不力，回顾性地强调了使用一个决定因素框架（如实施研究综合框架[CFIR]）如何能帮助工作人员识别导致实施失败的因素。第二个案例描述了一项由研究者发起的研究，该研究使用了一个过程框架（探索、准备、实施、维持[EPIS]框架）来系统地调查和记录在一个女性社区矫正中心成功实施针对性暴力幸存者的心理治疗小组的因素。两个案例均以通俗易懂的语言呈现，因为我们的目标是，本文可作为不熟悉实施科学的司法卫生研究人员、社区伙伴和惩教管理人员的入门读物。
关于将实施科学应用于司法环境的科学研究正在增加，但落后于卫生系统所做的工作。鉴于在整个司法环境中对精神和行为健康干预的巨大需求，关于如何成功实施循证干预和预防措施的信息极为匮乏，但通过更多地整合实施科学知识是有可能获取的。
