Assessing needs for psychiatric treatment in prisoners: 1. Prevalence of disorder

• Published in: Social Psychiatry and Psychiatric Epidemiology Vol. 52; no. 2; pp. 221 - 229
• Main Authors: Bebbington, Paul, Jakobowitz, Sharon, McKenzie, Nigel, Killaspy, Helen, Iveson, Rachel, Duffield, Gary, Kerr, Mark
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2017; Springer; Springer Nature B.V
• Subjects: Adolescent; Adult; Alcoholism; Criminal justice, Administration of; Drug abuse; Epidemiology; Female; Health services; Humans; Imprisonment; Juvenile Delinquency - statistics & numerical data; London - epidemiology; Male; Medicine; Medicine & Public Health; Mental disorders; Mental Disorders - epidemiology; Mental health; Mental health care; Morbidity; Needs Assessment; Original Paper; Personality disorders; Post-traumatic stress disorder; Prevalence; Prisoners; Prisoners - statistics & numerical data; Prisons; Psychiatric services; Psychiatry; Psychosis; Recidivism; Young Adult; United Kingdom > UK; Psychosis; Prevalence; Needs for care; Substance abuse; Epidemiology; Psychiatric disorders; Prisoners
• ISSN: 0933-7954; 1433-9285
• DOI: 10.1007/s00127-016-1311-7

Background High levels of psychiatric morbidity in prisoners have important implications for services. Assessing Needs for Psychiatric Treatment in Prisoners is an evaluation of representative samples of prisoners in a male and a female prison in London. This paper reports on the prevalence of mental disorders. In a companion paper, we describe how this translates into mental health treatment needs and the extent to which they have been met. Methods Prisoners were randomly sampled in a sequential procedure based on the Local Inmate Data System. We interviewed roughly equal numbers from the following groups: male remand; male sentenced prisoners (Pentonville prison); and female remand; female sentenced prisoners (Holloway prison). Structured assessments were made of psychosis, common mental disorders, PTSD, personality disorder and substance abuse. Results We interviewed 197 male and 171 female prisoners. Psychiatric morbidity in male and female, sentenced and remand prisoners far exceeded in prevalence and severity than in equivalent general population surveys. In particular, 12% met criteria for psychosis; 53.8% for depressive disorders; 26.8% for anxiety disorders; 33.1% were dependent on alcohol and 57.1% on illegal drugs; 34.2% had some form of personality disorder; and 69.1% had two disorders or more. Moreover, in the year before imprisonment, 25.3% had used mental health services. Conclusions These rates of mental ill-health and their similarity in remand and sentenced prisoners indicate that diversion of people with mental health problems from the prison arm of the criminal justice system remains inadequate, with serious consequences for well-being and recidivism.