Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
New York State Psychiatric Institute, New York, New York, USA.
Early Interv Psychiatry. 2023 Aug;17(8):798-806. doi: 10.1111/eip.13370. Epub 2023 Jan 15.
Given a lack of interventions to identify and engage individuals with early psychosis in jail and connect them to specialty care in the community upon release, we designed a Targeted Educational Campaign (TEC) for correction officers working in jails. We report on impacts of the TEC on officers' cognitive and attitudinal outcomes.
Three different cohorts of officers-totaling n = 451-took part in a survey: 200 at baseline before the TEC began, 123 at 6-months into the TEC, and 128 at 12-months into the TEC. Among each cohort of officers, four constructs were measured: (1) knowledge about early psychosis; (2) self-efficacy around detecting early psychosis and referring to mental health services within the jail; (3) expectations about the benefits of detection and referral to specialty care; and (4) social distance stigma toward detainees with early psychosis.
While exposure to TEC elements was as-planned in the first 6-months, exposure diminished substantially at 12-months, coinciding with increasing fatigue among correction officers due to the COVID-19 pandemic as well as serious staffing shortages. Knowledge, behavioural expectations, and self-efficacy scores improved from baseline to 6-months, with greater exposure to roll-call messages driving scores. Knowledge and behavioural expectations at 12-months were associated with having received an information post card. Social distance stigma worsened across timepoints.
An educational campaign for jail staff can enhance knowledge, self-efficacy, and behavioural expectations regarding early psychosis, though only while the campaign elements are active. Further research should investigate whether or not social distance stigma or other types of stigma increase alongside improvements.
鉴于缺乏干预措施来识别和接触监禁中早期精神病患者,并在释放后将他们与社区专业护理联系起来,我们为在监狱工作的狱警设计了一项针对性教育运动(TEC)。我们报告了 TEC 对狱警认知和态度结果的影响。
共有三批不同的狱警——共计 451 人——参与了一项调查:200 人在 TEC 开始前的基线时,123 人在 TEC 进行 6 个月时,128 人在 TEC 进行 12 个月时。在每批狱警中,都测量了四个结构:(1)对早期精神病的认识;(2)在监狱内发现早期精神病和转介到心理健康服务机构方面的自我效能感;(3)对检测和转介到专业护理的益处的期望;(4)对早期精神病被拘留者的社会距离污名。
虽然 TEC 元素的暴露在最初的 6 个月内按计划进行,但在 12 个月时大幅减少,这与 COVID-19 大流行期间狱警的疲劳以及严重的人员短缺同时发生。知识、行为期望和自我效能感得分从基线到 6 个月时有所提高,而更多地接触点名信息推动了得分的提高。12 个月时的知识和行为期望与收到信息明信片有关。社会距离污名在整个时间点上都有所恶化。
针对监狱工作人员的教育运动可以提高他们对早期精神病的认识、自我效能感和行为期望,尽管只有在运动元素活跃时才会如此。进一步的研究应调查随着改善是否会增加社会距离污名或其他类型的污名。