The mental ill-health of prisoners.

Abstract

This review of research on the mental ill-health of prisoners includes an analysis of the risk factors which influence it, and its associated disability and wider consequences. In general, psychiatric disorders are more prevalent among prisoners than the general population, with variations according to the type of prisoner: sentenced, remand, male or female. Personality disorder rates range from 50 to 78%, with antisocial personality disorders being most prevalent of all categories. Psychotic disorders are far more highly represented than in the general population, with schizophrenia and delusional states being more common than affective disorders. Neurotic disorders in prisoners, as in the general population, are more common among women. Suicidal behaviour and completed suicides are both serious issues. Around a quarter of all remand prisoners have attempted suicide at some time in their lives. These suicidal thoughts and behaviours are significantly associated with the higher rates of psychosis, neurosis and personality disorders in the prison population. Rates of alcohol and drug abuse or dependence vary considerably, though the majority of all prisoners report using illicit drugs at some time in their lives. Mental disorders tend to co-occur among prisoners: one in five have four of the five major mental health problems. At least one-third of all prisoners report long-standing physical health problems, especially musculo-skeletal and respiratory conditions. Analysis of risk factors for psychiatric morbidity shows local authority care, early school leaving, stressful life events, domestic violence or abuse, low economic status and poorly functioning families as most influential. The mental health of prisoners is also shaped by the prison environment itself: relations with staff, isolation, and lack of stimulus. (PsycINFO Database Record (c) 2012 APA, all rights reserved). (chapter)