Stress-testing approach to assessing outcomes of prison inreach mental health services
In 2006, Ireland introduced the Prison Inreach and Court Liaison Service (PICLS) with the aim of identifying prisoners with serious mental illness and diverting them to appropriate mental health services as soon as possible.
The PICLS model was designed to enhance the detection of mental illness through a structured, 2-stage screening process and to facilitate the provision of appropriate treatment. Depending on the seriousness of the offence and the severity of the mental illness, prisoners could be diverted to, for example, a secure forensic hospital, a community mental health hospital or another community mental health service.
A study published in the International Journal of Mental Health Systems in 2013 described the implementation of the model over the first 6 years (2006–2011) for over 20 000 consecutive remands.
In autumn 2016, the Journal published a further study from the same setting for 2012–2014, involving 6077 consecutive male remands. The paper describes a stress-testing approach to the assessment of outcomes and clinical efficiency of remand prison inreach mental health and diversion services. Importantly, it outlines a model for longitudinal evaluation of service effectiveness and outcomes over a 3-year period.
In addition to aiding service evaluation, the stress-testing structure may also help to guide the development of outcome standards for similar services.