A Comparison of Substance Abuse and Mental Illness in Male Offenders in Jamaica and England and Wales

Abstract

Background:The present study sought to determine the prevalence of substance abuse, mental illness, sociodemographics and clinical characteristics of mentally ill offenders. These data were compared to data from the prison population in the United Kingdom. Method: This is a cross-sectional study of male, mentally ill offenders in two prisons in Jamaica, and four prisons in England and Wales. For the Jamaican sample, a psychopathology and forensic survey instrument was developed by the research personnel to extract specific information from the diagnostic interview. Data extraction was done over a one-year period. For the England and Wales sample, the participants were interviewed and assessed using various structured instruments. Results:The results indicate that approximately 18% of persons within the Jamaican prison population under study had a mental illness. Of this number, 57% of these persons had been previously diagnosed with a Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM IV-TR) Axis 1 disorder. Substance abuse was the most frequently diagnosed DSM-IV Axis I disorder within both populations. The prevalence of mental illness found in the Jamaican prison population was approximately four times greater than the rate in the comparison population of England and Wales. Conclusions: There was an over-representation of mentally ill offenders in the Jamaican prison population. This is most likely linked to the lack of appropriate diversion programmes and a forensic mental hospital in Jamaica.

Substance Abuse and Mental Health

“…Offending behaviour by mentally ill substance abusers is also highlighted. A comparison of prisoners in Jamaica with those in England and Wales brings to light the stark differences in the mentally ill population but the similar high rates of substance use (9). The ensuing recommendation is for attempts at diversion of persons with mental illness from the criminal justice system to be made a priority, while instituting substance abuse treatment programmes in jails/prisons.…”