A recent study funded by the Confederation of European Probation (CEP) features research by Professor Charlie Brooker, University of London, and Professor Karen Tocque, University of Chester, examining the knowledge about and attitudes toward mental health disorders among probation staff in Europe. Here, we summarize the research purpose, design, and findings. The full, original article, entitled "The European survey of probation staff’s knowledge of, and attitudes to, mental illness," is available through CEP.
Background for the Study
Mental health disorders are much more prevalent among those within the probation system in comparison to the general population, affecting approximately 40% of those in the probation population. In conjunction with the presence of these mental health issues, suicide is also a higher risk and has a higher occurrence rate among the probation population.
Given the higher rates of prevalence and risk for this population, the ability for probation staff to properly identify the presence of mental health disorders and connect individuals in the probation system with appropriate treatment options can be identified as a clear need. Yet, among many European countries, mental health awareness training is not required for those who qualify as probation officers (e.g., "Denmark, Brandenburg (G), Hesse (G), Nordrhein-Westfalen (G), Schelswig-Holstein (G), Scotland and France").
Among those countries that do require training (e.g., "Austria, England, Malta, Northern Ireland, Romania, and Spain"), only England and France have identified suicide prevention as "an important area to cover."
Past studies have shown that probation staff are often trained to identify substance use disorders, with some countries (e.g., "Belgium and Northern Ireland") including education on the effects of "commonly prescribed psychotropic drugs and their side effects." Yet, despite this training, research in those countries has shown that staff still struggle to assess the mental health needs of those in their caseloads and to make "appropriate referrals" to other mental health professionals.
Purpose and Design
For these reasons, this CEP-funded study was conducted to improve the situation across European countries wherein "cases of mental health disorder are frequently missed and referral to the appropriate agency does not occur." By using assessments "of probation staff’s knowledge of mental illness and their attitudes to mental illness" to establish a baseline, the organization can then determine how best to increase probation staff's ability to identify and provide referrals for mental health disorders.
From September to November, 2022, probation staff in CEP-member countries were invited to complete an anonymous questionnaire measuring their knowledge and attitudes about mental health disorders. This included:
- Questions about their employment and training history and
- A "full set of questions" contained within the Mental Health Literacy Scale (MHLS) developed in 2015 by O’Connor and Casey.
Of the CEP-member countries contacted for the study, 60% participated, with 51% of responses coming from four countries: 1) Ireland; 2) Switzerland; 3) Netherlands; and 4) Croatia. Ukraine, England and Austria encountered circumstances that prevented them from participating, while France, Spain and Italy did not take part. "In total, 467 completed questionnaires were received."
"It seems clear that there is much work to be done, across Europe, to meaningfully increase probation staff’s knowledge of mental illness."
The authors identified the following results and findings from their analysis:
- "The overall mean score for the MHLS was 128" among all the probation staff in CEP-member countries that participated.
- Northern Ireland, Ireland, and the Netherlands "scored significantly higher than the overall average" among all the participants.
- Belgium, Estonia, Romania, Turkey and Albania "scored significantly lower than the average MHLS score."
- While neither hours of direct contact nor probation staff's age were seen to influence the MHLS score, it was noted that "females (128) scored significantly higher than males (123)."
- In addition, "confidence in knowledge and training was strongly correlated with the MHLS score."
"Probation staff display[ed] non-stigmatising positive attitudes to mental illness."Questions that were hardest to answer pertained to "technical and more in-depth knowledge of mental illness."
- The majority of respondents reported feeling positive about participating in the study. "Mental health was a key issue for them and many freely admitted their knowledge was lacking."
- Most participants agreed "that more needed to be done to improve probation staff’s knowledge of mental health issues" and many supported "a common core of mental health training for staff across Europe."
Ultimately, the authors concluded that "knowledge of, and attitudes, to mental health, are highly variable across Europe." The high correlation found between mental health knowledge scores and probation staff confidence also "makes the case for mental health training to be available to all probation staff across Europe."
Future research on how such training could most effectively be delivered may be addressed "when the Council of Europe paper on mental health and probation/prisons is published in 2023."
To read the full, original article, click here. The CEP European survey of knowledge of, and attitudes to, mental health disorders will be discussed at the forthcoming CEP Mental Health Expert Group meeting on April 18th. In anticipation that a training curriculum will be developed, Charlie Brooker would be very grateful if you would forward any examples of in-house mental health training. These might be on-line training courses, training based on PowerPoint presentations or paper-based training curricula. Please direct them to firstname.lastname@example.org.
* References available upon request.