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Title:

Issues encountered in research involving prisoners

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Ethical issues. Consent and recruitment. Confidentiality. Provision of health care. Ethical approval. Expertise. Specialist knowledge and skills required ... – PowerPoint PPT presentation

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Provided by: lukebir
Learn more at: http://www.liv.ac.uk
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Title: Issues encountered in research involving prisoners


1
Issues encountered in research involving prisoners
  • Dr Luke Birmingham
  • University of Southampton

2
Overview
  • Practical issues
  • Expertise
  • Research funding
  • The prison system
  • Study design and methods
  • Ethical issues
  • Consent and recruitment
  • Confidentiality
  • Provision of health care
  • Ethical approval

3
Expertise
  • Specialist knowledge and skills required
  • Emerging MH research network
  • Academic and research base for prison healthcare

4
Research funding
  • Positive developments
  • Integration with NHS
  • FMH RD
  • Responsive funding
  • Fellowships
  • Other sources e.g. Wellcome?

5
Research funding
  • Negative aspects
  • Cinderella speciality
  • Limited funds
  • Commissioned research?

6
The prison system
  • Positive aspects
  • Research opportunities
  • Captive population
  • Willing participants
  • Some very helpful staff
  • Routine returns providing data

7
The prison system
  • Potential obstacles
  • Highly bureaucratic
  • Institutional culture
  • Some very obstructive staff
  • Security
  • No research culture
  • Poor record keeping
  • Stigma associated with MH problems

8
The prison system
  • Potential obstacles
  • Prisons
  • Considerable variation between institutions
  • Remote
  • Overcrowded
  • Understaffed
  • Considerable throughput
  • Lack available interview rooms

9
Design and methods
  • Design considerations
  • Feasibility of RCT design
  • Following up cohorts
  • Control / Comparison groups
  • User involvement

10
Design and methods
  • Methodological considerations
  • Selecting appropriate outcome measures
  • Obtaining representative samples
  • Data collection
  • Reliability of records / routine returns
  • Access to interview participants
  • Validation of instruments
  • Refusal and drop-out rates

11
Consent and recruitment
  • Vulnerable population
  • Potential for coercion
  • Low IQ / literacy problems
  • 48 hours to decide
  • Inclusion of non-English speakers

12
Confidentiality
  • High rates of
  • Undetected mental illness
  • Drug use
  • Undisclosed criminal activity
  • Need to consider
  • Risk to self
  • Risk to others
  • Breach of establishment security

13
Confidentiality
  • Need to consider
  • Threshold for breach of confidentiality
  • How much information to provide?
  • Who do you inform?

14
Provision of healthcare
  • Many prisoners spend long periods locked up
  • Standard of health care in most prisons remains
    low
  • Access to services outside prison still limited

15
Obtaining ethical approval
  • Recent wider developments (COREC)
  • Stringent vetting of research involving prisoners
  • Limited knowledge and expertise relating to
    prisons

16
In conclusion
  • Research involving prisoners
  • Can be very rewarding and informative
  • Can fail catastrophically
  • Wont succeed without
  • Specialist knowledge and skills
  • Careful attention to design and methods
  • Adequate level of resources
  • Allowing a realistic amount of time
  • Co-operation of prison staff
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