Amanda Perry

The Costs and Benefits of Sentencing: A Systematic Review:

It is increasingly being recognized that it is essential to know not only what is effective in reducing criminal behavior but also the relative costs and benefits of criminal justice interventions. While a number of studies now include such costs and benefits, the evidence is difficult to compare because of differing research designs and cost-benefit methodologies. This article systematically reviews the current evidence on the costs and benefits of different sentencing options. A cost-benefit validity scale is proposed as a mechanism to evaluate systematically the quality of costs and benefits data. A systematic review of the literature revealed only nine published studies that fit the criteria of the review. Many were of poor methodological quality, and the authors recommend the development of standardized methodologies for assessing the costs and benefits of criminal justice programs.

The Effectiveness of Interventions for Drug-Using Offenders in the Courts, Secure Establishments and the Community: A Systematic Review

Interventions for drug-using offenders are employed internationally to reduce subsequent drug use and criminal behavior. This paper provides information from a systematic review of 24 randomized controlled trials (RCTs) conducted between 1980 and 2004. Thirteen of the 24 trials were included in a series of meta-analyses, and tentative conclusions are drawn on the basis of the evidence. Pretrial release with drugs testing and intensive supervision were shown to have limited success when compared to routine parole and probation, with effect sizes favoring routine parole and probation. Therapeutic community interventions showed promising results when compared to dispensation of treatment to individuals as usual, reducing risk of future offending behavior. A few studies evaluated the effectiveness of assertive case management and other community-based programs, but due to the paucity of information few inferences could be drawn from these studies. Little is known about the cost and cost effectiveness of such interventions, and the development of established protocols is required.

Screening Tools Assessing Risk of Suicide and Self-Harm in Adult Offenders: A Systematic Review

This systematic review assessed the validity of screening instruments to identify the risk of suicide and self-harm behaviour in offenders. A search of 11 electronic databases and grey literature resulted in the inclusion of five studies. The five studies revealed four screening instruments, including the Suicide Checklist, the Suicide Probability Scale, Suicide Concerns for Offenders in Prison Environment (SCOPE), and the Suicide Potential Scale. Two instruments, SCOPE and Suicide Potential Scale, shared promising levels of sensitivity and specificity. The reporting of information was generally varied across items on the Standards for the Reporting of Diagnostic accuracy (STARD). Research is needed to assess the predictive validity of tools for offender populations in the identification of those at risk, particularly those in probation and community settings.

Detecting and predicting self-harm behaviour in prisoners: a prospective psychometric analysis of three instruments

BackgroundResearch has revealed high levels of suicide and self-harm within young adult prisoners, but many studies have not considered the applicability and validity of its measurement for both male and female prisoners. Previous studies have focused on retrospective evaluations of instruments which are not useful evidence in informing clinical practice and decision making.ObjectivesTo evaluate the validation and prediction of suicide and self-harm risk in young adult prisoners.MethodThe study was divided into two stages. Stage one used a cross-sectional design of 1,166 prisoners across six HM Prisons to validate the use of three questionnaires: the Beck Depression Inventory, the Beck Hopelessness Scale and a newly devised instrument (SCOPE tool). The second stage assessed the predictive validity of the three instruments using a 4-year-follow-up study of female prisoners across two HM Prisons in UK. Self-report and official records were used to measure suicide and self-harm risk. Logistic regression methodology, receiver operator characteristic curves and Youden’s index were used to determine the range of thresholds for the three tools.ResultsSelf-report measurement of suicide and self-harm behaviour using the three instruments presented a range of sensitivity and specificity values (65.9–72.3% and 64.9–74.0%, respectively). Predictive measurement of suicide and self-harm behaviour in the follow-up study presented a range of sensitivity and specificity values (54.6–80% and 62.2–69.4%, respectively).ConclusionScreening for self-harm and suicidal behaviour in young prisoners has generated a range of cut off points for the identification of those at risk. These serve as a bench mark for service planners and practitioners.

A new psychometric instrument assessing vulnerability to risk of suicide and self-harm behaviour in offenders: Suicide Concerns for Offenders in Prison Environment (SCOPE).

This study aimed to develop a new psychometric instrument to assess vulnerability to risk of suicide and nonfatal self-harm behaviour in young adult male and female offenders. In total three studies were conducted to assess the psychometric properties of the new instrument using both exploratory and confirmatory factor analysis in different samples. Participants in all three studies included a total of 1,166 young adult offenders across six Her Majestys Prisons. The new instrument, Suicide Concerns for Offenders in Prison Environment (SCOPE), contained 28 items scoring on two subscales. The factorial structure of the new instrument initially obtained with exploratory factor analysis was subsequently confirmed in a new sample. The internal consistency of the two subscales were acceptable but the test—retest reliability coefficients were moderate. Concurrent validation with the Beck Hopelessness Scale was acceptable and SCOPE showed the ability to discriminate between those at risk and those with no known history of attempted suicide and nonfatal self-harm behaviour ( p < 0.01).

A Systematic Review of Interventions for Anxiety, Depression, and PTSD in Adult Offenders

There is a high prevalence of anxiety and depression in offender populations but with no recent systematic review of interventions to identify what is effective. This systematic review was undertaken to identify randomised controlled trials of pharmacological and non-pharmacological interventions in adult offenders in prison or community settings. A search of five databases identified 14 studies meeting inclusion criteria, which considered the impact of psychological interventions, pharmacological agents, or exercise on levels of depression and anxiety. A narrative synthesis was undertaken and Hedges g effect sizes calculated to allow comparison between studies. Effect sizes for depression interventions ranged from 0.17 to 1.41, for anxiety 0.61 to 0.71 and for posttraumatic stress disorder 0 to 1.41. Cognitive behavioural therapy interventions for the reduction of depression and anxiety in adult offenders appear effective in the short term, though a large-scale trial of sufficient duration is needed to confirm this finding.

Descriptive Validity and Transparent Reporting in Randomised Controlled Trials

While the concept of validity has been around for a number of decades, descriptive validity has been considered to a lesser extent in criminal justice research. In this chapter, we illustrate and evaluate several examples of descriptive validity in randomized controlled trials conducted in criminal justice. In particular, we introduce the idea of the CONSORT Statement, which was originally developed in healthcare to assess the descriptive validity of trials. This Statement was developed originally over concerns about the appropriateness of synthesising trials together in meta-analyses with differing levels of descriptive validity. We then go on to demonstrate the use of descriptive validity, using two recent studies. We examine examples of descriptive validity which report poorly in criminal justice trials and provide examples of good practice.Throughout this chapter, we emphasize the importance of descriptive validity to criminal justice researchers in upholding the quality of research within the field. A comparison and discussion about the applicability of the CONSORT Statement with criminal justice and healthcare trials suggests that some amendments may need to be made to make relevance to trials conducted in criminal justice. Generally adoption of a CONSORT-like Statement in criminal justice is thought to improve the reporting of descriptive validity in future research.

Screening for psychological and mental health difficulties in young people who offend: a systematic review and decision model

BACKGROUND There is policy interest in the screening and treatment of mental health problems in young people who offend, but the value of such screening is not yet known. OBJECTIVES To assess the diagnostic test accuracy of screening measures for mental health problems in young people who offend; to evaluate the clinical effectiveness and cost-effectiveness of screening and treatment; to model estimates of cost; to assess the evidence base for screening against UK National Screening Committee criteria; and to identify future research priorities. DATA SOURCES In total, 25 electronic databases including MEDLINE, PsycINFO, EMBASE and The Cochrane Library were searched from inception until April 2011. Reverse citation searches of included studies were undertaken and reference list of included studies were examined. REVIEW METHODS Two reviewers independently examined titles and abstracts and extracted data from included studies using a standardised form. The inclusion criteria for the review were (1) population - young offenders (aged 10-21 years); (2) intervention/instrument - screening instruments for mental health problems, implementation of a screening programme or a psychological or pharmacological intervention as part of a clinical trial; (3) comparator - for diagnostic test accuracy studies, any standardised diagnostic interview; for trials, any comparator; (4) outcomes - details of diagnostic test accuracy, mental health outcomes over the short or longer term or measurement of cost data; and (5) study design - for diagnostic test accuracy studies, any design; for screening programmes, randomised controlled trials or controlled trials; for clinical effectiveness studies, randomised controlled trials; for economic studies, economic evaluations of screening strategies or interventions. RESULTS Of 13,580 studies identified, nine, including eight independent samples, met the inclusion criteria for the diagnostic test accuracy and validity of screening measures review. Screening accuracy was typically modest. No studies examined the clinical effectiveness of screening, although 10 studies were identified that examined the clinical effectiveness of interventions for mental health problems. There were too few studies to make firm conclusions about the clinical effectiveness of treatments in this population. No studies met the inclusion criteria for the assessment of the cost-effectiveness of screening or treatment. An exemplar decision model was developed for depression, which identified a number of the likely key drivers of uncertainty, including the prevalence of unidentified mental health problems, the severity of mental health problems and their relationship to generic measures of outcome and the impact of treatment on recidivism. The information evaluated as part of the review was relevant to five of the UK National Screening Committee criteria. On the basis of the above results, none of the five criteria was met. LIMITATIONS The conclusions of the review are based on limited evidence. Conclusions are tentative and the decision model should be treated as an exemplar. CONCLUSIONS Evidence on the clinical effectiveness and cost-effectiveness of screening for mental health problems in young people who offend is currently lacking. Future research should consider feasibility trials of clinical interventions to establish important parameters ahead of conducting definitive trials. Future diagnostic studies should compare the diagnostic test accuracy of a range of screening instruments, including those recommended for use in the UK in this population. These studies should be designed to reduce the decision uncertainty identified by the exemplar decision model. REGISTRATION This study is registered as PROSPERO CRD42011001466. FUNDING The National Institute for Health Research Health Technology Assessment programme.

Benefit-cost analyses of sentencing

Introduction Sentencing policies are most frequently designed by policy-makers and implemented by the courts with the aim of punishing, deterring and rehabilitating offenders in order to reduce future re-offending. However many sentencing decisions are made without knowledge of the effectiveness of sentences in achieving their objectives, or the costs and benefits of the different sentencing alternatives. The following systematic review was conducted in order to address these questions and to review the existing evidence on the costs and benefits of different sentencing options. Results from costeffectiveness studies were retained to provide supporting information. Objective The objective of the review was to identify and assess the quality of studies of the costs and benefits of different sentencing options. Search Strategy Pre-screening and hand-searching of published and available unpublished literature was completed by two independent reviewers. The structured searches were carried out on studies published between 1980-2001, using nine electronic databases and by consulting experts in the field. Selection Criteria Studies were included in the review if they contained information on the costs and benefits of sentencing options. Due to the small number of benefit-cost studies found, cost-effectiveness study outcomes were also retained. Data collection and analysis Results from nine benefit-cost studies and eleven cost-effectiveness studies are reported in narrative and tabular form. Benefit-cost ratios are presented alongside benefit-cost outcome measures. The quality of studies is reported using the Maryland Benefit-cost of sentencing 4 Scientific Scale (Sherman, Farrington, Welsh & Mackenzie, 2002) and a BenefitCost Validity Scale Revised (Cohen & McDougall, 2008, Appendix 1).

Costs and Benefits of Sentencing

Since the early 1990’s there has been a move towards an evidence-based criminal justice policy internationally and in the United Kingdom. The development of ‘what works’ programs has provided a model for the evaluation of the effectiveness of current criminal justice interventions on the basis of research evidence. More recently, it has also become necessary to evaluate programs based on their relative costs and benefits, providing information not only on ‘what works’ with ‘which offenders’, but also ‘at what cost’ and with ‘what benefits.’ Evaluating the cost of criminal justice programs is not new to the criminal justice field, since virtually all programs require the support of a funding agency that is likely to request budget information. Government agencies routinely report on annual expenditures on police, courts, prisons, and various program interventions. Until recently, however, there have been few attempts to ask the related question of what these programs are actually buying in terms of crime control or public safety. Such analyses are termed ‘cost-effectiveness’ studies since they ask how much crime reduction (or other social benefit) is obtained per dollar spent. Even fewer studies have gone beyond this question to ask whether the benefits of the program exceed its costs, that is, by conducting a ‘cost-benefit’ study. The differences between cost-effectiveness and cost-benefit analyses are not well understood. One such definition provided by Barnett and Escobar (1990) suggests that cost-effectiveness is an ‘incomplete’ form of cost-benefit analysis because it fails to assign monetary values to the outcomes involved (i.e., benefits