Using multiple case studies of health and justice services to inform the development of a new complex intervention for prison-leavers with common mental health problems (Engager)

Charlotte Lennox, Rachel Stevenson, Cristabel Owens, Richard Byng, Sarah L. Brand, Mike Maguire, Graham Duncan, Caroline Stevenson, Jenny Shaw, Cath Quinn

    Research output: Contribution to journalArticlepeer-review

    1 Downloads (Pure)

    Abstract

    Background
    People in the criminal justice system have complex needs but often do not make use of services outside of prison, in many cases due to poorly joined up working between health and criminal justice services. The ‘Engager’ programme aimed to develop a complex collaborative care intervention for people leaving prison with common mental health problems that could support their transition into the community and facilitate joined up working between health, justice and social services. To augment our core intervention theory, we wanted to learn from innovative and forward-thinking services providing interagency support and/or treatment for people experiencing common mental health problems within the criminal justice system. We wanted to identify key elements of interagency practice to understand what was and was not effective in engaging people, maintaining their contact and improving mental health and other aspects of their lives.

    Method
    We used a multiple case study design with a focused ethnographic approach in four study sites. Data came from three sources (documents, field notes and semi-structured interviews) underwent a framework analysis.

    Results
    We identified seven main themes, namely: collaboration, client engagement, client motivation, supervision, therapeutic approach, peers and preparations for ending. Engaging and motivating clients was dependent on the relationship built with the professional. This relationship was developed through building trust and rapport, which required time and respectful, open and honest communication. Professionals were often unable to build this relationship effectively if they did not work in effective interagency collaborations, particularly those which included shared practices and were supported by effective supervision.

    Conclusions
    The multiple case study design contributed insights as to how health and justice services work together. The main themes identified are well known factors in health and justice co-working. However, the novel insights were gleaned examining interdependence and interactions in complex, multifactorial phenomena and practice, in particular the importance of shared practice and supervision models. The approach of selecting a small number of cases representing identified knowledge gaps contributed a valuable addition to the program theory and delivery for an innovative complex intervention.
    Original languageEnglish
    Article number6
    Number of pages15
    JournalHealth and Justice
    Volume 9
    Issue number1
    DOIs
    Publication statusPublished - 17 Feb 2021

    Keywords

    • case study design
    • Health services
    • Justice services
    • Common mental health
    • Interagency working
    • Collaboration
    • Engagement

    Fingerprint

    Dive into the research topics of 'Using multiple case studies of health and justice services to inform the development of a new complex intervention for prison-leavers with common mental health problems (Engager)'. Together they form a unique fingerprint.

    Cite this