Evidence-Based Ethics and Mental Health Research with Prisoners

囚犯的循证伦理与心理健康研究

• 批准号: 7872931
• 负责人: GLORIA D ELDRIDGE
• 金额: $ 55.68万
• 依托单位: UNIVERSITY OF ALASKA ANCHORAGE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-01 至 2014-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7872931
• 关键词: Address; Administrator; Advocacy; Affect; Alabama; Alaska; Americas; Area; Awareness; Back; Beneficence; Benefits and Risks; Child; Coercion; Communities; Consensus; Data; Decision Making; Development; Disease; Drug abuse; Ensure; Environment; Environmental Protection; Epidemiologic Studies; Epidemiology; Equilibrium; Ethical Issues; Ethical Theory; Ethicists; Ethics; Fetus; Foundations; Funding; Gap Junctions; Goals; Grant; Growth; Guidelines; Health; Housing; Human; Human Resources; Impairment; Imprisonment; Individual; Informed Consent; Inpatients; Intervention; Intervention Studies; Interview; Jail; Justice; Knowledge; Laws; Lead; Literature; Medical; Medical Staff; Mental Health; Mental disorders; Mentally Ill Persons; Methodology; Participant; Patients; Perception; Persons; Phase; Policies; Population; Pregnant Women; Prisoner; Prisons; Procedures; Process; Protocols documentation; Psychiatric Hospitals; Psychiatric therapeutic procedure; Public Health; Published Comment; Publishing; Recommendation; Recording of previous events; Recruitment Activity; Relative (related person); Research; Research Ethics; Research Ethics Committees; Research Infrastructure; Research Personnel; Resource Development; Review Literature; Rights; Role; Safety; Sampling; Schizophrenia; Security; Solutions; Substance abuse problem; Surveys; Testing; Training; Universities; Vulnerable Populations; Wisconsin; Work; base; correctional system; design; dissemination research; evidence base; experience; human subject protection; informant; information gathering; interest; journal article; medical schools; member; neonate; public health relevance; research and development; research based treatment; sound; symposium

DESCRIPTION (provided by applicant): Ethics and federal laws about human subject protections have evolved to protect research participants in general and vulnerable groups in particular. Under federal law, vulnerable groups include pregnant women; fetuses, neonates, and children; and prisoners. According to ethicists, vulnerable groups also include individuals who suffer from impairment due to mental illness, stigmatized medical illness, and other debilitating disorders. Given these definitions, prisoners with mental illnesses are multiply vulnerable. With the number of prisoners with serious psychiatric disorders exceeding the number of patients in psychiatric hospitals, jails and prisons have become "America's new mental hospitals" (Torrey, 1995) and for many individuals with mental illness, inpatient psychiatric care is now provided in jails and prisons (Lamb & Weinberger, 2005). Research with prisoners, especially those with the added vulnerability of mental illness, poses ethical challenges and responsibilities, yet there have been no empirical studies of the interpretation and application of ethical principles and regulatory safeguards by researchers and IRBs involved in mental health research with prisoners. This application focuses on 1) how researchers and IRB members interpret and apply ethical principles of autonomy, justice, and beneficence in mental health research with prisoners; 2) how researchers and IRB members interpret and apply regulatory safeguards for mental health research with prisoners; 3) ways in which policies and structural environments of correctional systems (including prisons and jails) create ethical challenges that must be addressed by mental health researchers and IRBs; and 4) ways in which ethical safeguards and oversight affect mental health research with prisoners. This project will use sequential qualitative and quantitative phases to examine ethical challenges, responsibilities, and solutions regarding the conduct and oversight of mental health research with prisoners. Phase 1 involves key informant interviews with individuals who have conducted mental health research with prisoners; IRB Chairs and members; IRB prisoner representatives; prison administrators; and research ethicists. Using these data, Phase 2 focuses on construction of a quantitative survey about ethical challenges and solutions. In Phase 3, this survey is administered to a national sample of mental health researchers, IRB chairs and members, and IRB prisoner representatives. In Phase 4, findings from prior phases are taken to prison administrators, security officials, and medical officials, and prison advocacy group members, to gather their perspectives on the meaning and implications of these findings. Phase 5 focuses on initiating a data-driven dialogue through dissemination of research findings to important stakeholder groups, including researchers; IRB chairs, members, and prison representatives; and prison administrators, medical staff, and security personnel to result in enhanced application of ethics and regulatory safeguards to mental health research with prisoners, with the goal of reducing barriers to epidemiologic and intervention research focused on mental illness among prisoners. PUBLIC HEALTH RELEVANCE: Prisons have become "America's new mental hospitals", housing, but rarely treating, as many individuals with mental disorders as all psychiatric hospitals in the US combined. By providing an empirical basis with which to strengthen ethical safeguards for mental health research in correctional systems, this project will contribute to the enhancement of research-based treatment for prisoners with mental illness. Of great relevance to public health, our work will provide ethical guidance to researchers, IRBs, and prison officials; enhance the quality, conduct, and range of mental health research in prison populations; and, ultimately, enhance the health and safety of prisoners and the communities to which they return upon release.

描述（由申请人提供）：有关人类主题保护的道德和联邦法律已进化，尤其是保护研究参与者，尤其是弱势群体。根据联邦法律，弱势群体包括孕妇；胎儿，新生儿和儿童；和囚犯。根据伦理学家的说法，弱势群体还包括因精神疾病，污名化的医学疾病和其他使人衰弱的疾病而遭受损害的人。鉴于这些定义，患有精神疾病的囚犯是脆弱的。随着严重精神疾病的囚犯人数超过了精神病医院的患者人数，监狱和监狱已成为“美国的新精神病院”（Torrey，1995年），对于许多精神疾病的人，现在在监狱和监狱中提供了患病的精神病医院（Lamb＆Weinberger，2005年）。囚犯的研究，尤其是那些具有精神疾病的脆弱性的囚犯的研究，提出了道德挑战和责任，但是没有经验研究对与囚犯进行心理健康研究有关的研究人员和IRB的道德原则和法规保障的解释和应用。该申请的重点是1）研究人员和IRB成员如何在与囚犯的心理健康研究中解释和运用自治，正义和福利的道德原则； 2）研究人员和IRB成员如何与囚犯解释和应用监管保障措施； 3）惩教系统（包括监狱和监狱）的政策和结构环境提出道德挑战的方式，精神健康研究人员和IRB必须解决这些挑战； 4）道德保障和监督影响囚犯心理健康研究的方式。该项目将使用顺序定性和定量阶段来研究有关与囚犯对心理健康研究的行为和监督的道德挑战，责任和解决方案。第1阶段涉及对与囚犯进行心理健康研究的个人的重要线人访谈； IRB椅子和成员； IRB囚犯代表；监狱管理员；和研究伦理学家。使用这些数据，第2阶段的重点是构建有关道德挑战和解决方案的定量调查。在第3阶段，该调查是针对全国性的心理健康研究人员，IRB椅子和成员以及IRB囚犯代表的全国样本进行管理的。在第4阶段中，从前阶段的调查结果被带给监狱管理员，安全官员，医务官员和监狱倡导小组成员，以收集他们对这些发现的含义和含义的看法。第5阶段的重点是通过向包括研究人员在内的重要利益相关者群体传播研究发现来启动数据驱动的对话； IRB椅子，成员和监狱代表；以及监狱管理人员，医务人员和安全人员，从而加强了与囚犯一起在心理健康研究中的道德和监管保障措施的应用，目的是减少对囚犯中精神疾病的流行病学和干预研究的障碍。 公共卫生相关性：监狱已成为“美国的新精神病院”，但很少对待精神障碍的人，就像美国所有精神病医院一样。通过提供一个经验基础，以加强惩教系统中心理健康研究的道德保障，该项目将有助于加强针对精神疾病囚犯的基于研究的治疗。我们的工作与公共卫生非常相关，我们的工作将为研究人员，IRB和监狱官员提供道德指导；提高监狱人口中心理健康研究的质量，行为和范围；最终，可以增强囚犯的健康和安全，以及他们释放后返回的社区。