Evaluation of the Mobile Forensic Mental Health Service

Investigators:  Rachael Fullam, Lillian De BortoliJames Ogloff

Project type: Forensicare service evaluation. Funded by Justice Health, Department of Justice & Regulation ($229,525)

Rationale and aims:

  • The Mobile Forensic Mental Health Service (MobileFMHS) has been funded by the Department of Justice to provide assessment, intervention, and clinical management services to clients (both remanded and sentenced prisoners) with significantly impaired mental functioning, as they transition through the various custodial environments within Victoria.
  • The service will include psychological and psychiatric assessment of clients with impaired mental functioning who also engage in seriously challenging behaviours that involve subjective distress and suffering, for example through self-harming and aggressive behaviours. The focus will be on targeted clinical intervention, not just assessment. The service will also maintain a strong focus on identification of clients with psychotic illness, major mood disorders, and other high prevalence mental health disorders, with an emphasis on consolidation of recovery post the acute phase of illness.
  • The MobileFMHS is a novel service based on interventions for offenders with complex mental health/mental impairment issues. A formal, prospective evaluation of the service is required to assess whether the specified service outcomes are being achieved. In addition, very little is known about the effectiveness of custodial mental health interventions in reducing ongoing mental health crisis care and offending related to mental illness/mental impairment issues.
  • The aims of the evaluation are to examine:
    • The efficiency of the MobileFMHS over time
    • The impact of the service on the clearance (downgraded psychiatric rating and subsequent transfer) and acute service re-engagement (transfer back for assessment and treatment following deterioration in mental state) rates of offenders with mental impairment within Melbourne Assessment Prison (MAP)
    • The effectiveness of the service at reducing ongoing crisis based mental health care, incidents of suicide and self-harm, incidents of aggression while incarcerated, and recidivism post release
    • The characteristics of ongoing mental health service use by offenders following separation from the MobileFMHS

Methodology:

The rolling evaluation of the Mobile Forensic Mental Health Service (MobileFMHS) has a number of components and as such is being achieved through a series of related studies.

  • Study 1: efficiency, impact and effectiveness of the service – uses data linkage to link clinical and demographic information on patients receiving treatment from the MobileFMHS with Corrections Victoria data regarding behavioural outcomes in prison (e.g. aggression and self-harm), data from Victoria Police regarding post release offending and data from the Department of Health regarding ongoing mental health service use. It also uses KPI and Correction Victoria data to track the efficiency of the service and the impact on clearance rates at MAP
  • Study 2: Consumer and stakeholder views regarding the MobileFMHS – uses survey and interview methodology to collect information on offenders’ opinions regarding the treatment that they received from the MobileFMHS, and stakeholder awareness regarding the MobileFMHS and referral activity amongst staff working at MAP and the Melbourne Remand Centre (MRC).
  • Study 3: Effectiveness of the MobileFMHS group treatment programs – This study focuses on the impact of the brief, psycho-education based group treatment programs being offered by the MobileFMHS on mental health symptoms in offender participants. Group treatment related change on measures of mental illness symptom severity and on psychological measures related to the content of the group treatment program will be assessed on completion of the group treatment program and at 1 and 3 months post completion. Offenders who fail to complete the group programs will act as a control arm for the study