title: Disentangling Alcohol-Related Needs Among Pre-trial Prisoners: A Longitudinal Study.
abstract: OBJECTIVE
  To disentangle the alcohol-related needs of short stay, revolving door, male prisoners, and offer a theoretically driven but practical approach for allocation of scarce service resources.
  
  
  METHODS
  A prospective longitudinal interview, questionnaire and records study of pre-trial men newly imprisoned in Wales and SW England.
  
  
  RESULTS
  Two hundred and forty-one pre-trial men completed an interview and questionnaires within a week of a new reception into prison; 170 completed follow-up 3 weeks later. Questions about problems with alcohol or illicit drugs revealed that problem drinkers were less likely than problem drug users to recognize their difficulty or seek or get help for this during their first month of imprisonment. Co-morbidity was common, but a third of the men had alcohol problems alone. Use of the Alcohol Use Disorders Identification Test (AUDIT) questionnaire identified 80% (195/241) men likely to require some intervention, twice the number identified by direct questions relying on prisoners' judgment about problem use. Furthermore it allowed categorization according to likely risk (dependency), need (problem recognition) and responsivity (wish for help).
  
  
  CONCLUSIONS
  Alcohol misuse is recognized, worldwide, as fuelling crime and more common among prisoners than the general population. In England and Wales, it is a particular factor in brief but recurrent periods of imprisonment. There have been calls to pay more attention to its use in this context, albeit without any increase in resources. Adding two questions to standard screening enables application of the risk-need-responsivity model to problem drinkers and may identify those most likely to benefit from treatment.
authors.affiliation: Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK kissellae@cardiff.ac.uk.
authors.forename: Anna
authors.initials: A
authors.lastname: Kissell
authors.affiliation: Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK kissellae@cardiff.ac.uk.
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Taylor
authors.affiliation: West of England Forensic Mental Health Services, Bristol, UK Centre for Academic Mental Health, Bristol University, Bristol, UK.
authors.forename: Julian
authors.initials: J
authors.lastname: Walker
authors.affiliation: Research and Development Office, Cardiff and Vale University, Local Health Board, Cardiff, UK.
authors.forename: Emma
authors.initials: E
authors.lastname: Lewis
authors.affiliation: South London and South East Hub, Mental Health Research Network, London, UK.
authors.forename: Amy
authors.initials: A
authors.lastname: Hammond
authors.affiliation: West of England Forensic Mental Health Services, Bristol, UK Centre for Academic Mental Health, Bristol University, Bristol, UK.
authors.forename: Tim
authors.initials: T
authors.lastname: Amos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000453:epidemiology*; D004739:England / Q000453:epidemiology; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011329:Prisoners / Q000523:psychology / Q000706:statistics & numerical data*; D011446:Prospective Studies; D019966:Substance-Related Disorders / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014852:Wales / Q000453:epidemiology; D055815:Young Adult