Title: The Physical And Mental Health of Older Prisoners (PAMHOP): An integrated systematic review and co-production of an intervention tool kit to improve common mental health disorders in prison.
Funder: Department of Health and Social Care

Abstract: Increasing numbers of older prisoners have physical and mental health problems. They represent an under-served community that is disproportionately affected by mental illness at higher rates than age-matched counterparts. Interventions targeted to support this group are scant and little is known about their unmet needs. Current UK policy and NICE guidelines recognize the need to promote and improve the physical and mental health of adults in contact with the criminal justice system. Guidelines recommend that all older prisoners have the right to benefit from the same quality of care that is granted to younger citizens. Prison healthcare is expensive and resources are limited, healthcare must be optimized to deliver high quality complex care. To address this problem we will conduct an integrated systematic review and co-produce a new intervention tool kit(s) to improve the mental health of older prisoners with physical and mental health needs. Using Cochrane procedures we will search 15 databases from 1990 onward and publish a protocol. A standardized template and two independent researchers will support the data extraction. The literature will be combined with data gathered from two prisons (one male and one female) in the North of England. The data collection will include a survey of the protected characteristics and unmet needs, a series of 20 qualitative interviews involving prison staff and prisoners and a resource questionnaire to identify use and engagement with NHS services. A logic model will inform the co-production of a new intervention toolkit(s) with prisoners via a series of six workshops. Prisoners will be involved in a full dissemination strategy including prison radio association broadcasts, writing a newspaper article and co-presentation at a virtual conference. This study will test the feasibility and acceptability and will estimate costs for a subsequent main trial.

Lay abstract: What is the problem? There has been an increase in the numbers of older male and female prisoners. Older prisoners are more likely to suffer from physical and mental health problems such as depression. We know very little about the needs of this group of people and what activities can be used to support them. How will we address this problem? We will review the literature to identify different types of activities that improve the mental health of people involved in the criminal justice system. We will use this information to develop an activity tool kit involving two prisons in the North of England. The findings will determine a bigger evaluation. How will we develop the new tool kit? We will develop a tool kit by combining data from published research, a survey and interviews with prison staff and prisoners. Who will conduct the work? Senior academics from the University of York will collaborate with prison staff, prisoners, an ex-service user, the prison radio association and one NHS trust. How will prisoners and the public be involved? The proposal was informed by a workshop with 10 men in prison. They helped us develop the idea, gather views about NHS prison services and identify potential problems. Prison staff and prisoners will be involved in the design and development of the tool kit. Prisoners will tell people about their involvement in the study. How will we tell people about our research? Prisoners will be involved in three radio broadcasts, an article for a national prison newspaper and will co-present the findings at a conference. Information will be shared on the prison service intranet and our toolkit will be freely available on our project website. We will publish the findings in an academic journal.

Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: MENTAL HEALTH