Addressing the Mental Health Needs of Older People in Prison: Development of an Initial Programme Theory (IPT) Based on Realist Synthesis

ABSTRACT The mental health needs of older people in prison (OPiP) are considerable but remain overlooked. This review aimed to develop an Initial Programme Theory (IPT) to understand how the mental health needs of OPiP can be addressed and how mental health care for older people in the community cou...

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Main Authors: Lee D. Mulligan, Deborah Buck, Falaq Ghafur, Joshua Southworth, Matilda Minchin, Jenny Shaw, Jane Senior, Katrina Forsyth
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:Mental Health Science
Subjects:
Online Access:https://doi.org/10.1002/mhs2.105
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author Lee D. Mulligan
Deborah Buck
Falaq Ghafur
Joshua Southworth
Matilda Minchin
Jenny Shaw
Jane Senior
Katrina Forsyth
author_facet Lee D. Mulligan
Deborah Buck
Falaq Ghafur
Joshua Southworth
Matilda Minchin
Jenny Shaw
Jane Senior
Katrina Forsyth
author_sort Lee D. Mulligan
collection DOAJ
description ABSTRACT The mental health needs of older people in prison (OPiP) are considerable but remain overlooked. This review aimed to develop an Initial Programme Theory (IPT) to understand how the mental health needs of OPiP can be addressed and how mental health care for older people in the community could be adapted for the prison environment. A review and realist synthesis pertaining to the mental health needs of OPiP was conducted across three stages, including: (1) a systematic review of empirical work; (2) a scoping review of prison guidance documents; and (3) a scoping review of community mental health guidance documents. Synthesis of eligible literature and development of the IPT followed realist principles and was supplemented by a stakeholder workshop of experts by personal and occupational experience. Overall, 122 sources were included. The IPT suggested that prisons can address the mental health needs of OPiP via micro‐level mechanisms (i.e., screening, assessment, care planning, intervention, continuity of care/release), meso‐level mechanisms (i.e., accommodation, environment, activities, religion/spirituality, peer support, family support) and macro‐level mechanisms (i.e., staff training/education, governance). Each mechanism is underpinned by trauma‐informed, integrated and patient‐centered care principles and their implementation should be guided by a local assessment of prison‐specific needs. Our IPT provides a framework for how prisons can address the mental health needs of OPiP, informed by community care provision, via several mechanisms across different levels. Future research should build on this work to inform a full evaluation of its impact on meaningful outcomes to promote equivalency of care for OPiP and non‐discriminatory access to mental health support for those at risk of marginalization.
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spelling doaj-art-66dd4d91c8484d24bf04fb44e5a89d222025-08-20T02:04:49ZengWileyMental Health Science2642-35882025-03-0131n/an/a10.1002/mhs2.105Addressing the Mental Health Needs of Older People in Prison: Development of an Initial Programme Theory (IPT) Based on Realist SynthesisLee D. Mulligan0Deborah Buck1Falaq Ghafur2Joshua Southworth3Matilda Minchin4Jenny Shaw5Jane Senior6Katrina Forsyth7Division of Psychology & Mental Health, Faculty of Biology, Medicine & Health University of Manchester Manchester UKSocial Care and Society University of Manchester Manchester UKDivision of Psychology & Mental Health, Faculty of Biology, Medicine & Health University of Manchester Manchester UKDivision of Psychology & Mental Health, Faculty of Biology, Medicine & Health University of Manchester Manchester UKDivision of Psychology & Mental Health, Faculty of Biology, Medicine & Health University of Manchester Manchester UKDivision of Psychology & Mental Health, Faculty of Biology, Medicine & Health University of Manchester Manchester UKDivision of Psychology & Mental Health, Faculty of Biology, Medicine & Health University of Manchester Manchester UKDivision of Psychology & Mental Health, Faculty of Biology, Medicine & Health University of Manchester Manchester UKABSTRACT The mental health needs of older people in prison (OPiP) are considerable but remain overlooked. This review aimed to develop an Initial Programme Theory (IPT) to understand how the mental health needs of OPiP can be addressed and how mental health care for older people in the community could be adapted for the prison environment. A review and realist synthesis pertaining to the mental health needs of OPiP was conducted across three stages, including: (1) a systematic review of empirical work; (2) a scoping review of prison guidance documents; and (3) a scoping review of community mental health guidance documents. Synthesis of eligible literature and development of the IPT followed realist principles and was supplemented by a stakeholder workshop of experts by personal and occupational experience. Overall, 122 sources were included. The IPT suggested that prisons can address the mental health needs of OPiP via micro‐level mechanisms (i.e., screening, assessment, care planning, intervention, continuity of care/release), meso‐level mechanisms (i.e., accommodation, environment, activities, religion/spirituality, peer support, family support) and macro‐level mechanisms (i.e., staff training/education, governance). Each mechanism is underpinned by trauma‐informed, integrated and patient‐centered care principles and their implementation should be guided by a local assessment of prison‐specific needs. Our IPT provides a framework for how prisons can address the mental health needs of OPiP, informed by community care provision, via several mechanisms across different levels. Future research should build on this work to inform a full evaluation of its impact on meaningful outcomes to promote equivalency of care for OPiP and non‐discriminatory access to mental health support for those at risk of marginalization.https://doi.org/10.1002/mhs2.105mental healtholder peopleprisonrealist review
spellingShingle Lee D. Mulligan
Deborah Buck
Falaq Ghafur
Joshua Southworth
Matilda Minchin
Jenny Shaw
Jane Senior
Katrina Forsyth
Addressing the Mental Health Needs of Older People in Prison: Development of an Initial Programme Theory (IPT) Based on Realist Synthesis
Mental Health Science
mental health
older people
prison
realist review
title Addressing the Mental Health Needs of Older People in Prison: Development of an Initial Programme Theory (IPT) Based on Realist Synthesis
title_full Addressing the Mental Health Needs of Older People in Prison: Development of an Initial Programme Theory (IPT) Based on Realist Synthesis
title_fullStr Addressing the Mental Health Needs of Older People in Prison: Development of an Initial Programme Theory (IPT) Based on Realist Synthesis
title_full_unstemmed Addressing the Mental Health Needs of Older People in Prison: Development of an Initial Programme Theory (IPT) Based on Realist Synthesis
title_short Addressing the Mental Health Needs of Older People in Prison: Development of an Initial Programme Theory (IPT) Based on Realist Synthesis
title_sort addressing the mental health needs of older people in prison development of an initial programme theory ipt based on realist synthesis
topic mental health
older people
prison
realist review
url https://doi.org/10.1002/mhs2.105
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