Development and evaluation of a screening tool for identifying prisoners with severe mental illness

Abstract

Aims and method: To develop and evaluate a screening tool based on the observational skills of prison officers to identify adult male prisoners with severe mental illness. The tool was developed from open-ended interviews with officers and diagnostic interviews with prisoners. A case-comparison study was used to evaluate the tool. Fifty prisoners identified using the tool and 50 randomly selected prisoners underwent diagnostic interviews to determine the proportion in each group with severe mental illness. Results: Five behavioural indicators of severe mental illness were identified and incorporated into the tool. In the evaluation, 19 out of 50 (38%) of the cases identified were found to have severe mental illness compared with none in the comparison group. Clinical implications: The simple tool shows promise for the identification of prisoners with severe mental illness by prison officers. It does require further evaluation in other prison settings.