Psychiatric morbidity in male remanded and sentenced committals to Irish prisons

Abstract

Objectives: To describe the prevalence of psychiatric morbidity and the treatment needs of new committals to Irish prisons.Methods: A population survey of 615 prisoners representing 7.9% of male committals to Irish prisons in the year of survey, 313 remands (9.6% of total remand committals) and 302 sentenced committals (6.4% of total sentenced committals). The main outcome measures were ICD-10 diagnoses of mental disorder based on interviews using SADS-L and prison medical records.Results: Current prevalence rates of any psychotic illness were 3.8% (remand) and 0.3% (sentenced), six month prevalence rate 5.1% (remand) and 2.6% (sentenced) and lifetime rate 9.3% (remand) and 6.6% (sentenced). Schizophrenia and drug/organic psychoses were the most common psychoses. Major depressive disorder had a current prevalence of 4.5% (remand) and 4.6% (sentenced), a six month prevalence of 4.8% (remand) and 6.0% (sentenced), and a lifetime prevalence of 8.6% (remand) and 15.9% (sentenced). Sixty-point-six per cent of the sample had a current substance misuse problem.Conclusions: There is significant psychiatric morbidity in committal prisoners.

Implementing a court diversion and liaison scheme in a remand prison by systematic screening of new receptions: a 6 year participatory action research study of 20,084 consecutive male remands

“…Table 5 shows that the proportion of committals found to have a psychosis was fairly constant year on year and fell within the confidence interval of the research-standard estimate given by Curtin et al for current prevalence rate of any psychotic illness of 3.8% (95% confidence interval 2.2% to 6.6%) based on a survey in 2004 [11]. …”

“…These resources enabled needs assessment surveys to be carried out in the Irish prison population examining both the cross-sectional and point prevalence of severe mental illness and substance misuse [10,20] and the dynamic rates of reception of cases of severe mental illness in remand and sentenced prisons [11]. …”

“…Service users in Irish prisons had been extensively surveyed for mental health needs prior to the implementation of the service [10,11,20,26]. Carers’ groups pointed out the need to enable access to services at the earliest possible juncture.…”

“…A committal survey of newly-remanded male prisoners in the same prison in Ireland involving a large sample found that 3.8% had active symptoms of psychotic illness [11]. In the ten years since these Irish studies, the mean daily prison population in Ireland increased by 39% from 3,165 in 2002 to 4,390 in 2011 [12,13].…”

“…Firstly there was a need to implement a standardized system for identification of persons with major mental illness remanded to Ireland’s main remand prison, with audit procedures for comparison with predicted rates based on epidemiological evidence [10,11]. Secondly there was a need to implement systems to enable diversion to appropriate health care settings of mentally ill persons identified.…”