Behavioural activation for people in custody with depression: A protocol for a feasibility randomised controlled...

Area of Science:

• Mental Health Research
• Correctional Healthcare
• Psychological Interventions

Background:

• Incarcerated individuals face high depression rates and limited access to mental health services.
• Specialist mental health worker shortages pose challenges for prison-based psychological treatment.
• Behavioural Activation (BA) shows promise for improving depressive symptoms in this population.

Purpose of the Study:

• To assess the feasibility and acceptability of custodial health nurses delivering BA to people in custody with depressive symptoms.
• To inform the design of a larger randomized controlled trial (RCT) on BA efficacy in prison settings.
• To determine the suitability of BA within the prison healthcare system.

Main Methods:

• A pilot randomized controlled trial involving 60 participants with depressive symptoms.
• Randomization to BA plus treatment as usual (TAU) or TAU alone, delivered by trained custodial health nurses.
• Process observation, depression and quality of life assessments, and participant interviews.

Main Results:

• The study will assess changes in depression and quality of life at baseline, 6 weeks, and 3 months.
• Participant interviews will provide insights into the feasibility and acceptability of BA in a custodial setting.
• The findings will guide the development of a full-scale effectiveness trial.

Conclusions:

• Demonstrating feasibility and acceptability will support progression to an effectiveness study.
• Successful implementation could enhance mental healthcare delivery for incarcerated populations.
• The scalable trial model has potential for wider application across correctional facilities.