Anxiety, Depression, Psychological Distress, Suicidal Ideation
Conditions
Brief summary
In response to the significant mental health challenges faced by pretrial detainees, the Swiss Federal Justice Department has initiated a model trial in pretrial detention centres in Zurich and Bern. This model trial, named in German as a Modellversuch, is designed to enhance detainees' wellbeing and evaluates various interventions through a randomized controlled trial. The Prison Stress Management (PRISMA) programme, a key intervention derived from the WHO's cognitive-behavioral therapy strategies, seeks to address the lack of mental health support within jails. The goal of this pilot RCT is to evaluate the feasibility and acceptability of PRISMA for inmates inform a full-scale, definitive randomized controlled trial.
Detailed description
Given the high prevalence of mental health issues, such as anxiety and depression, in pretrial detainees, the Swiss Federal Justice Department (SFJD) approved a model trial (in German named Modellversuch Untersuchungshaft, MV). The MV will be carried out in pretrial detention facilities in the cantons of Zurich and Bern and aims to improve the wellbeing and social integration of individuals in pretrial detention. As part of the MV the investigators are evaluating the impact of two interventions using a randomized controlled trial (RCT). The first intervention, Prison Stress Management (PRISMA), addresses the issue of poor mental health of inmates during pretrial detention and after release. PRISMA is a scalable World Health Organization (WHO)-developed psychological intervention based on cognitive-behavioral therapy (CBT) program and goes beyond the status-quo mental health support offered in jails. Currently, only inmates with severe mental health problems are referred to the psychiatric ward of the health services provided in jails and no continuation of support is offered after the transition to the outside world. The second intervention (SOCIAL) uses extended social services to address potential disruptions incarceration might cause in detainees' social and economic lives. The isolation from the outside world implies that detainees might lose their jobs and housing, their relationships with their family and friends are strained, all factor hindering re-integration into society and taxing their mental wellbeing. The present pilot RCT aims to investigate the feasibility and acceptability of an PRISMA for inmates to inform a full-scale, definitive randomized controlled trial. Data will be collected regarding the feasibility and acceptability of all study components, including recruitment, drop-out rate, protocol adherence, study visit attendance and the time burden of parent questionnaires. These data will inform the design of a full scale randomized controlled trial to evaluate the efficacy of PRISMA in inmates. For this purpose only 20 people in each arm will be included.
Interventions
BEHAVIORALPRISMA
PRISMA has been developed adapting PM+, a brief, psychological intervention program based on CBT techniques that are empirically supported and formally recommended by the WHO. The adapted manual was developed to tailor the sessions to the structure of the Swiss prison system and the needs of inmates of jails in Switzerland. PRISMA involves the following elements: stress management, problem-solving, meaningful activities and relapse prevention PRISMA has four core features: * Evidence-based problem-solving strategies * Brief and easy to learn * Delivered by lay-helpers (trainers) * Transdiagnostic, addressing depression, anxiety, stress, and practical problems as defined by participants; PRISMA has four sessions.
Sponsors
ETH Zurich
The University of New South Wales
University of Zurich
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
All instruments and questions will be administered online.
Intervention model description
The pilot RCT will inform us about the feasibility of PRISMA under usual practice conditions.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Entering pretrial detention inmate in any of the 11 pretrial detention facilities in the Cantons of Zurich and Bern * aged ≥ 18 years
Exclusion criteria
* Not fluently speaking any of the nine languages in which PRISMA is offered: German, Albanian, Arabic, English, French, Italian, Romanian, Serbian/ Croatian, Spanish * Acute suicidality * Not interested in PRISMA and its randomized evaluation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Verification procedure to the measurement in psychological distress | Three weeks (primary outcome) after intake; 10 weeks, and 6 months | The primary outcome is mental health at three weeks as assessed by the scale for depression measured by Patient Health Questionnaire - 9 (PHQ9). A higher score on the PHQ9 (range = 1 - 27) means a greater severity of depressive symptoms. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Verification procedure to the measurement suicidal ideation | Screening, 3 weeks follow-up assessment, 10 weeks, 6 months and 1 year after the intervention | Suicidal Ideation is measured using an adapted version of the Suicidal Ideation Attribution Scale (SIDAS), a brief measure of severity of suicidal ideation assessing frequency, controllability, closeness to attempt, level of distress associated with the thoughts and impact on daily functioning. It consists of 3 items rated on an 11-point scale (0 = Never to 10 = Always). |
| Feasibility of PRISMA by the number of dropouts | Screening, 3 weeks follow-up assessment, 10 weeks, 6 months and 1 year after the intervention | Monitoring of the dropouts by number of participants |
Countries
Switzerland
Contacts
Primary ContactNaser Morina, PhD
Outcome results
None listed