International Adaptation of a brief Problem-Solving Skills (the IAPPS trial) training for people in custody with severe mental illness in Poland: an open multicentred, parallel group, feasibility randomised controlled trial.

ObjectivesThe primary aim of this study was to assess the feasibility of delivering an adapted problem-solving skills (PSS) intervention by quantifying the recruitment, follow-up and completion rates using a brief problem-solving intervention for people with a mental health diagnosis in two Polish prisons. DesignIAPPS is an open, multi-centred, parallel group feasibility randomised controlled trial (RCT). SettingTwo prisons in Poland. ParticipantsMen in custody aged 18 years and older, having a mental illness and living within the prison therapeutic unit. InterventionsThe intervention consisted of an adapted PSS skills intervention plus care as usual (CAU) or care as usual only. Delivered in groups of up to five people in 1.5-hour sessions over the course of two weeks. Main outcome measuresPrimary outcomes - rate of recruitment, follow-up, and feasibility to deliver the intervention. Secondary outcomes included measures of depression, general mental health, and coping strategies. Results129 male prisoners were screened, 64 were randomly allocated, with a mean age of 53.5 years (SD 14, range 23-84). 59 (95%) prisoners were of Polish origin. Our recruitment rate was 48%. There was differential follow up with those in the intervention group less likely to complete the post-test battery versus those who received care as usual. Outcome measures were successfully collected at both time points. ConclusionsWe were able to recruit, retain and deliver the intervention within the prison setting; some logistical challenges limited our assessment of intervention engagement. Our data helps to demonstrate how use of the RCT study design can be implemented and delivered within the complex prison environment. Trial registration numberISRCTN 70138247, protocol registration date May 2021 (insert link). STRENGTHS AND LIMITATIONS OF THIS STUDYThis is the first feasibility RCT to examine the recruitment, follow-up, and completion of measures to a brief PSS training for adult males with mental health problems in two Polish prisons. Results showed promising recruitment rates and retention to the intervention delivery. Whilst the study was not designed to test effectiveness, we demonstrated importantly that delivering brief interventions for people in custody were feasible and acceptable.