An updated picture of the mental health needs of male and female prisoners in the UK: prevalence, comorbidity, and gender differences

Abstract

Purpose Epidemiological data on the mental health needs of prisoners are essential for the organisation, planning, and delivery of services for this population as well as for informing policy and practice. Recent reports by the National Audit Office and NICE call for new research to provide an updated picture of the mental health needs of men and women in prison in the UK. This study aimed to measure the prevalence and comorbidity of mental health needs across a representative sample of both men and women across 13 prisons in one UK region. Method Participants completed a standardised battery of psychometric assessments which screened for a range of mental health difficulties including: mental disorders, personality disorder, and substance misuse. Results 469 participants were included in the final sample (338 males, 131 females). A high number of participants reported having had previous contact with mental health services and/or a pre-existing diagnosis of a mental disorder. High rates of current mental disorder were detected across the range of disorders screened for. Levels of comorbidity were also high, with nearly half of participants screening positive for two or more types of mental disorder. Gender differences were noted in terms of previous contact with mental health services, having a pre-existing diagnosis, prevalence of current mental disorder, and levels of comorbidity; with women reporting higher rates than men. Conclusions Rates of pre-existing and current mental illness continue to be high amongst prisoners. Women report significantly higher levels of mental health need compared to men.

PTSD in prison settings: A systematic review and meta-analysis of comorbid mental disorders and problematic behaviours

“…However, PTSD often goes undetected by mental health services [69]. Screening for this disorder is not routinely embedded in clinical services, and the disorder typically remains un-diagnosed and untreated within prison settings [5, 7, 70]. The need for improved identification and treatment of PTSD in prison settings is further underscored by findings suggesting that spontaneous long-term remission rates of this disorder are modest [71], and that the evidence for the efficacy of short-term trauma-based therapies in this population is limited [72].…”

The Unhappy Mental Health Triad: Comorbid Severe Mental Illnesses, Personality Disorders, and Substance Use Disorders in Prison Populations

“…However, in order to better understand the treatment and care needs, it is necessary to assess the co-occurrence of several mental health and substance use problems in prison populations. Comorbidity has been reported in different ways for differential purposes: First, it has been reported as the number of disorders co-occurring and covered by the given instrument used in a study ( 9 – 11 ), which serves the purpose of identifying groups with multiple disorders, polymorph psychopathology, and unfavorable outcomes. However, assessing the quantity of diagnoses has the disadvantage that it does not distinguish between the types of comorbidity.…”

Post traumatic stress disorder in incarcerated populations: current clinical considerations and recommendations

“…868). Facer-Irwin and colleagues (2019) have recently emphasised that there is currently no routine screening for PTSD in clinical services and PTSD is also typically undiagnosed and untreated within prison settings (Fazel, Hayes, Bartellas, Clerici, & Trestman, 2016;Jakobowitz, Bebbington, McKenzie, Iveson, Duffield, Kerr, & Killaspy, 2017;Tyler, Miles, Karadag, & Rogers, 2019see Facer-Irwin, Blackwood, Bird, Dickson, McGlade, Alves-Costa, & Macmanus, 2019.…”