Help-seeking for substance use and mental health among justice-involved people in Scottish community contexts: An analysis of social network influence

背景：涉及司法的人（因犯罪而被判刑的人）比一般人更有可能有物质使用（毒品和酒精）和精神健康问题。然而，他们不太可能获得支持。这导致生活质量差、急诊使用率高，并最终导致与药物有关的死亡和自杀率上升。减少与药物有关的死亡和自杀是苏格兰政府的优先事项。苏格兰是西欧监禁率和社区监督率最高的地区之一。注重确保与司法有关的人获得有效支助，将对实现政策目标作出宝贵贡献。为了设计有效的解决办法，至关重要的是要了解为什么与司法有关的人会/不会获得药物使用和/或精神卫生服务。目前的理解并没有充分考虑关系和社区的影响。因此，干预措施可能没有得到充分优化。解决这一知识差距将为政策和实践带来新的视角，有助于将重点从个性化解决方案转向创新的关系和社区一级的方法。社会网络分析（SNA）是一种新兴的方法，用于研究形成个人社会网络和影响行为的关系和社区背景。它还有待于在社区环境中充分利用与司法有关的人员。该项目采用混合方法SNA，首次从欧洲司法相关人员那里收集网络数据。目的：确定社会网络如何影响在苏格兰的两个社区背景下司法参与的人寻求帮助的SU/MH。这些知识将被用于：1)制定针对具体情况的关系和社区层面的政策和实践对策建议；2)记录在该人群中使用混合方法SNA的程序。运用社会资本理论研究苏格兰司法涉事者的态度、行为和网络特征对SU/MH求助的影响。2 .解决在当地情况下嵌入的社会网络对司法相关人员寻求支助/保健帮助的影响方面存在的巨大知识差距。3 .在整个研究过程中，让利益攸关方（最终用户）、有实际司法参与经验的人以及支持他们的人参与进来，为政策和实践提出有影响力的、有证据依据的建议，以解决因情况而定以及关系和社区层面的影响。展示混合方法SNA在研究社区环境中与司法有关的人的行为影响方面的效用，并提供有关程序的方法学文件。这将为今后对服务不足和研究不足的群体进行SNA研究提供信息和实际指导。应用/效益：该项目将对两个ESRC优先领域的知识、政策和实践作出重要贡献：心理健康以及卫生和社会保健方面的创新。可以在政策和实践中应用建议，以增加司法相关人员获得社会服务/保健服务的机会。这通过改善福祉、减少对紧急护理的需求、减少与SU/MH有关的犯罪和死亡，使个人受益。它通过减少SU/MH相关的社会和经济成本，使那些关心司法相关人员、社区和社会的人受益。所产生的知识将为那些与司法有关的人一起工作的人提供信息，而方法学习将增加与研究不足的群体就敏感主题进行成功的SNA研究。该项目是一系列工作的第一步，重点是改善参与司法的人的健康和社会成果。

Context: Justice-involved people (people sentenced for a crime) are much more likely to have substance use (drugs and alcohol) and mental health problems than the general population. Yet, they are less likely to access support. This contributes to poor quality of life, high emergency care use, and, ultimately, elevated rates of substance related deaths and suicide.Reducing substance related deaths and suicides are Scottish Government priorities. Scotland has among the highest imprisonment and community supervision rates in Western Europe. Focusing on ensuring justice-involved people access effective support will make a valuable contribution to achieving policy objectives.To design effective solutions, it is vital to understand why justice-involved people do/do not access substance use and/or mental health (SU/MH) services. Current understandings do not fully consider the relational and community influences in context. Consequently, interventions may be under-optimised. Addressing this knowledge gap will bring a new perspective to policy and practice, contributing to shifting focus away from individualised solutions and towards innovative relational and community level approaches.Social Network Analysis (SNA) is an emerging methodology for studying the relational and community contexts that form individuals' social networks and influence behaviour. It is yet to be fully leveraged with justice-involved people in community contexts. This project applies mixed methods SNA, collecting network data from justice-involved people in Europe for the first known time.Aim: To identify how social networks influence help-seeking for SU/MH among justice-involved people in two community contexts in Scotland. This knowledge will be used to 1) develop recommendations for contextually-tailored relational and community level policy and practice responses; and 2) to document procedures in using mixed methods SNA with this population.Objectives:1. To apply theories of social capital to examine how help-seeking for SU/MH is influenced by attitudes, behaviours and network features among justice-involved people in Scotland.2. To address substantial gaps in knowledge concerning the influence of social networks, embedded in local contexts, on help-seeking for SU/MH among justice-involved people.3. To involve stakeholders (end users), people with lived/living experience of justice involvement and those who support them, throughout the research to produce impactful, evidence-informed recommendations for policy and practice that address contextual-tailoring and relational and community level influences.4. To demonstrate the utility, and provide methodological documentation on procedures, of mixed methods SNA for studying influences on behaviour among justice-involved people in community contexts. This will inform and provide practical guidance for future SNA studies with under-served and under-researched groups.Applications/benefits: The project will make an important contribution to knowledge, policy and practice in two ESRC priority areas: mental health, and innovation in health and social care. Recommendations can be applied in policy and practice to increase access to SU/MH services among justice-involved people. This benefits the individual by improving wellbeing, and reducing need for emergency care, SU/MH related crime and deaths. It benefits those who care about a justice-involved person, their community, and society, by reducing SU/MH related social and economic costs. The knowledge generated will inform those working with justice-involved people, whilst methodological learning will increase successful SNA research on sensitive topics with under-researched groups. The project is a first step in a body of work focused on improving health and social outcomes for justice-involved people.