Psychiatric morbidity in a cross-sectional sample of male remanded prisoners?

Abstract

Objectives: To estimate the psychiatric service requirements for the remand population.Method: We interviewed 232 (42.6%) men, a representative sample of men on remand, using the SADS-L, SODQ and a structured demographic interview.Results: We found high rates of psychiatric morbidity in our sample. The six month prevalence of psychosis was 7.6%, almost twice the rate in a recent international meta-analysis. Major depressive disorder was present in 10.1% (six month prevalence). Substance misuse problems were also common but there was no significant difference between rates of substance misuse in psychotic and nonpsychotic prisoners. A total of 31.2% had a lifetime history of any mental illness (excluding substance misuse, adjustment disorder and personality disorder).Conclusions: The high levels of psychiatric morbidity detected in our sample indicate a substantial unmet need for mental health services and addiction treatment services for the mentally ill in Irish prisons.

Dignity, human rights and the limits of mental health legislation

“…This reform was a result of changes in mental health policy (Department of Health 1984) and attitudes of Irish society in general (Viney 1968), rather than changes in mental health legislation. While this level of change raises unresolved issues about the right to treatment, and there are undoubtedly substantial problems with levels of mental disorder in prisons (Linehan et al 2005;Flynn et al 2012;Kennedy 2012), it remains the case that while the psychiatric inpatient population declined by 16 143 between 1963 and 2003, the prison population rose by just 16.4% of this number (2642) (Kelly 2007).…”

Psychiatric deinstitutionalisation in Ireland 1960–2013

“…A major survey in 2003 covering interviews with 1582 prisoners used standardised diagnostic methods (Linehan et al 2005). Addictions were, by far, the commonest diagnoses, most of whom would not require inpatient care.…”

Liaison between criminal justice and psychiatric systems: Diversion services

“…In Irish prisons, 91 % of those with major depressive disorder and 6 6 % of those with a psychosis were already known to community psychiatric services. 3 Such patients are generally young, male and often socially disconnected. They are frequently homeless or have regular changes of address.…”