Prospective cohort study of mental health during imprisonment (original) (raw)
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Mental disorders and mental health symptoms during imprisonment: A three-year follow-up study
PLOS ONE, 2019
Background Data on the course of mental disorders during imprisonment are scarce. Longitudinal studies from high-income Western countries point to improvements of symptoms over time. The aim of the present study was to assess mental disorders and symptoms three years after baseline evaluation at imprisonment and to determine predictors of change in a South American prison context. Methods Consecutively admitted prisoners in Santiago de Chile were assessed at intake and reassessed after three years using the Mini International Neuropsychiatric Interview and the Symptom-CheckList 90 Revised (SCL-90-R). The global severity index (GSI) was calculated with standard deviations (SD) and compared using paired t-tests. The prevalence of mental disorders at baseline and at follow-up were compared using McNemar tests. Analyses of variance were conducted to evaluate whether prespecified socio-demographic variables and disorders at baseline predicted symptom change at follow-up. Results 73 (94%) out of 78 prisoners participated. The prevalence of major mental illnesses was lower at follow-up: 47 (64%) at intake vs. 23 (32%) at follow-up had major depression (p<0.001); 22 (30%) at intake vs. 10 (14%) at follow-up had psychosis (p = 0.008). The mean GSI improved from 1.97 (SD 0.65) at intake to 1.16 (SD 0.82) at follow-up (p<0.001). Depression at baseline (F = 9.39; Z 2 p = 0.137; β =-0.67; p = 0.003) and working or studying during imprisonment (F = 10.61; Z 2 p = 0.152; β =-0.71; p = 0.002) were associated with strong improvement of the GSI at follow-up, whereas psychosis at intake was associated with relatively small symptom improvement (F = 12.11; Z 2 p = 0.17; β = 0.81; p = 0.001).
Mental health of prisoners: prevalence, adverse outcomes, and interventions
The Lancet Psychiatry, 2016
More than 10 million people are imprisoned worldwide, and the prevalence of all investigated mental disorders is higher in prisoners than in the general population. Although the extent to which prison increases the incidence of mental disorders is uncertain, considerable evidence suggests low rates of identifi cation and treatment of psychiatric disorders. Prisoners are also at increased risk of all-cause mortality, suicide, self-harm, violence, and victimisation, and research has outlined some modifi able risk factors. Few high quality treatment trials have been done on psychiatric disorders in prisoners. Despite this lack of evidence, trial data have shown that opiate substitution treatments reduce substance misuse relapse and possibly reoff ending. The mental health needs of women and older adults in prison are distinct, and national policies should be developed to meet these. In this Review, we present clinical, research, and policy recommendations to improve mental health care in prisons. National attempts to meet these recommendations should be annually surveyed.
The impact of incarceration on mental health and its prevalence
The present paper aims to synthesize the available literature related to prison conditions and mental health as little is known about the impact of prison climate on the mental health of adult prisoners. Mental health issues are more common among the inmates than the general population. The prison environment, its strict regime and the “society of captives” are said to be detrimental to mental health. High rates of psychiatric co-morbidity have been documented and it is suggested that these also contribute to the general problem of poor mental health inside prison. A systematic review of literature has been done in order to identify the possible factors of the prison environment and their effects on mental health of prisoners and the prevalence of such issues. The study highlights the main problems that arise from the negative effect of the prison environment on the mental health of prisoners. However, some investigations regard the prison as a place of a respite. Yet, there is need for further research in this area as many of the mental disorders still remain undiagnosed or even unrecognised inside prison. Staff and institutions involved should recognise the possible risks caused by the mental health issues of inmates and take imaginative and innovative steps to improving the prison climate and the delivery of mental health services inside correction centres.
Assessing needs for psychiatric treatment in prisoners: 1. Prevalence of disorder
Social Psychiatry and Psychiatric Epidemiology
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.
Inmate Mental Health and the Pains of Imprisonment
Society and Mental Health, 2018
We use national data on 5,552 inmates and the 214 state prisons in which they reside to examine how prison conditions are associated with mental health symptoms net of individual-level factors. Structural equation models indicate that prison overcrowding and punitiveness are positively related to both depression and hostility, while the availability of work assignments is negatively related to both mental health indicators. The proportion of inmates whose home is more than 50 miles from the prison was positively associated with depression. Inmates reported higher levels of hostility when the prison did not allow television and there was a recent prison suicide. These results suggest the importance of examining a wide range of prison deprivations in research on inmate well-being to lay the groundwork for understanding the mechanisms through which prison deprivations are linked to mental health.
BMC Psychiatry, 2016
Background: Despite the high prevalence rate of mental health problems among young prisoners, little is known about the longitudinal course and covariates of their mental health symptoms during incarceration, especially the influence of the correctional climate. The current study aimed: (1) to examine changes in young prisoners’ mental health symptoms during incarceration, (2) to identify personal factors associated with their mental health symptoms and perceptions of the correctional climate, and (3) to test the incremental effect of perceptions of the correctional climate on mental health symptoms. Methods: Data were obtained from a sample of 75 youths (aged 17 to 22 years) detained in a Portuguese young offender prison. Data were gathered 1, 3, and 6 months after their admission in this facility. Socio-demographic, clinical and criminological variables were collected. Mental health symptoms and perceptions of the correctional climate were assessed through self-report assessment tools. Linear and logistic (multi-level) regressions and tests for differences between means were performed to analyze the data. Results: Overall, mental health symptoms marginally declined by the sixth month in prison. Prisoners with a history of mental health treatment were more likely to have increased symptoms. Higher levels of mental health symptoms were associated with a history of mental health treatment, remand status, and a lower educational level. Better perceptions of the correctional climate were associated with Black race and participation in prison activities. A negative perception of the correctional climate was the strongest covariate of young prisoners’ mental health symptoms and had incremental validity over that of personal variables. Conclusions: The results highlight that both characteristics of the prisoners and of the prison environment influence young prisoners’ mental health. Prison management can try to reduce young prisoners’ mental health problems by developing scientific procedures for their mental health assessment and creating a more beneficial correctional climate.
Prevalence of Psychiatric Disorders and Related Factors in Male Prisoners
Iranian Red Crescent Medical Journal, 2014
Background: Prisoners are at risk of mental disorders. Therefore attention to mental health of prisoners is important. Objectives: This study aimed determine to the prevalence of mental disorders among Kashan prisoners. Patients and Methods: This cross sectional study was carried out in Kashan prison (Iran). 180 Subjects were selected by using stratified random sampling and evaluated with Symptoms Check List-90-Revised (SCL-90-R) questionnaire and clinical interview based on Diagnostic Statistical Manual of Disease-IV (DSM-IV) check list by two psychiatrists. Data were analyzed by SPSS-16 software and Chi square, Kolmogrov Smirnov, Mann-whiteny and Leven tests. Results: The mean age of prisoners was 31.9 ± 8.96. The prevalence of psychiatric disorders in prisoners was 43.4 %. The most frequent disorders were major depressive disorders (27.9 %), Post traumatic Stress Disorder (17.4%) and substance use disorder (17.4 %). 28.3% of prisoners had personality disorders, that the most prevalent were antisocial personality and borderline personality. The comorbidity of psychiatric disorders was (36 %) in axis I. Suicidal thoughts there were in 44.6 % of prisoners. History of head trauma in Prisoners with psychiatric disorders was (52.2 %). There was significant difference between head trauma and psychiatric disorders (P = 0.05). Significant difference was between marital status and duration of imprisonment with psychiatric disorders P < 0.05. There was not significant difference between type of crime and educational level with psychiatric disorders. Conclusions: About half of all prisoners suffered from psychiatric disorders; therefore treatment psychiatric disorder in this group is essential for prevention of crime. Prisoners are at risk of mental disorders. Therefore attention to mental health of prisoners is important.