Mental wellbeing among people in prison in Scotland: an analysis of repeat cross-sectional surveys

Abstract

Background Mental wellbeing among people in prison is poorly studied, despite featuring in many health and justice policies. We aimed to describe for the first time mental wellbeing among an unselected national prison sample. Methods Since 2013, the Scottish Prisoner Survey—a biennial survey of people in custody in Scotland—has included the Warwick-Edinburgh mental wellbeing scale (WEMWBS), a 14-item scale with higher scores indicating greater wellbeing. We analysed data from sweeps in 2013 (n = 3158), 2015 (n = 2892) and 2017 (n = 2405) using Student’s t-test, ANOVA and multiple linear regression. We also used WEMWBS data from the Scottish Health Survey stratified by age, gender and deprivation to compare with the population at liberty. Results Mean WEMWBS scores overall were 43.4 in 2013 (SD = 12.2), 41.8 (SD = 11.9) in 2015 and 41.2 (SD = 12.3) in 2017. Mean scores were lower among people on remand and with multiple prison episodes. Age-standardized mean scores were lower among people in prison than their peers at liberty. Conclusions Poor mental wellbeing is an important, under-studied facet of the extreme health inequalities associated with imprisonment. These results identify that people on remand or with multiple episodes are particularly disadvantaged and provide a baseline for monitoring impacts of service or policy interventions.

Adverse childhood experiences: a retrospective study to understand their associations with lifetime mental health diagnosis, self-harm or suicide attempt, and current low mental wellbeing in a male Welsh prison population

“…Though widely explored at the population level, few studies have measured MWB in prisoners (Tweed et al 2018(Tweed et al , 2019 and there is a limited evidence base on the factors associated with current low MWB in this group. We found multiple ACEs to be predictive of current low MWB in incarcerated males, even after controlling for lifetime mental illness diagnosis, self-harm or suicide attempt.…”

“…However, low MWB is associated with vulnerability to mental illness alongside poorer health outcomes and behaviours (Howell et al 2007;Stranges et al 2014). Studies evidence a higher prevalence of current low MWB, mental illness and self-harm amongst those incarcerated than the general population (Fazel et al 2016;Kariminia et al 2007;Tweed et al 2018Tweed et al , 2019, whilst suicide is the leading cause of death in custody globally (Butler et al 2018). In England and Wales, rates of selfharm in the male adult prison population have been increasing, with over 43,000 incidents reported in the year ending September 2018; a rate of 540 incidents per 1000 prisoners (Ministry of Justice 2019).…”

Me-thinking: report on a pilot intervention with women in custody

“…This 14-item questionnaire is sensitive to changes in mental well-being at the individual level and has been extensively used nationally and internationally to evaluate projects, programmes and interventions that aim to improve well-being (see, e.g. Farrier et al , 2019; Tweed et al , 2019).…”

Innate Health: A Novel Examination of What Explains Well-being, Prosocial Behavior, and Aggression among Men Living in a UK Prison

“…The total economic and social cost of reoffending by adults within one year was estimated at 16.7 billion in 2016 (Ministry of Justice [MoJ], 2019a). While the evidence demonstrates that: (a) patients with severe mental health disorders can experience higher outcomes in measures of well-being (Valiente et al, 2021); (b) well-being for mental health in prison is an important component of prison rehabilitation efforts (Woodall & Freeman, 2020); and (c) support for well-being initiatives in UK prisons has grown (Tweed et al, 2021)-investments into well-being interventions have lagged considerably (Turner et al, 2021).…”