Abstract
It has long been known that psychiatric disorders are highly prevalent among prisoners (Coid, 1984; Gunn et al., 1991; Maden et al., 1995; Joukamaa, 1995; Bland et al., 1998; Lamb and Weinberger, 1998). However, the Survey of Psychiatric Morbidity Among Prisoners in England and Wales (Singleton et al., 1998) represents a considerable advance on earlier surveys. By using the same standardized psychiatric assessment procedures, and similar questions on medication, service use and social functioning, its findings can be compared with previous national surveys of adults living in private households (Meltzer et al., 1995), residents in institutions (Meltzer et al., 1996), homeless persons (Gill et al., 1996), and with the forthcoming household survey in England, Wales and Scotland. It should also inform the future organisation of healthcare for prisoners, following recent recommendations from a joint Home Office/Department of Health Working Party that Health Authorities must work with prisons in their catchment areas to carry out joint health needs assessments, agree prison healthcare improvement strategies and jointly plan and commission services (HM Prison Service and NHS Executive 1999). The ultimate test of the survey will be whether it provides a benchmark to evaluate the future effectiveness of the new policy changes.
"78% of male remand, 64% of sentenced men, and 50% of women prisoners received one or more diagnoses of personality disorder. As expected, anti-social personality disorder was estimated as the most prevalent condition in 63% of male remand, 49% male sentenced, and 31% of female prisoners. This was followed by paranoid personality disorder, although borderline personality disorder was more common in women. Personality disorder characterised prisoners who were more likely to cause management problems and indicated risk factors for subsequent social problems and recidivism on release. They were more likely to be UK born, less likely to have been employed, and more likely to have lived off crime. They had experienced a wider range of stressful life events, revealed poorer intellectual functioning, and had misused alcohol and drugs. Those with anti-social personality disorder were more likely to report periods of cellular (solitary) confinement and to have been given added days for disciplinary offences."
Coid, J; Bebbington, P; Jenkins, R; Brugha, T; Lewis, G; Farrell, M; Singleton, N; (2002) The national survey of psychiatric morbidity among prisoners and the future of prison Healthcare. MED SCI LAW , 42 (3) 245 - 250.
[Note: prison populations do not represent demographics that are the most likely to commit crimes, or commit the worst crimes, or commit more crimes than others. Prison demographics represent the people that are most likely to be arrested, charged with a crime, and then sentenced to prison time.]
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