The prevalence of self-reported mental illness among those imprisoned in New South Wales across three health surveys, from 2001 to 2015

Abstract

Objective: The prevalence of mental illness among those in prison is much higher than in the community; however, very few studies have examined whether rates have changed over time, in line with increasing self-reported rates in the community. Methods: This study compares the prevalence of self-reported mental illness, self-harm and suicidal thoughts/behaviours, and drug and alcohol use across three waves (2001, 2009 and 2015) of health surveys involving men and women in New South Wales prisons and compared these rates with published community-level findings. Results: The prevalence of those reporting any mental health diagnosis increased significantly across the three surveys, even after adjustment for socio-demographic and criminal justice variables that also changed over time. Individuals surveyed in 2015 were more likely to report a mental health diagnosis than those surveyed in 2001 (adjusted odds ratio = 2.66, 95% confidence interval = [2.16, 3.27]). The prevalence of self-harm and suicidal thoughts and behaviours remained stable across the three surveys, while self-reported regular drug use decreased over the period. Women experienced a far greater burden of mental illness than men across all three surveys and experienced more growth in the prevalence of most psychiatric disorders. Conclusion: These findings have important implications for public and prison health systems given the poor social, health and criminal justice outcomes of those imprisoned with mental illness, both in custody and post-release.

Individual and environmental contributors to psychological distress during imprisonment

“…followed by a comprehensive list of diagnostic labels (including mood, anxiety, psychotic, personality, and substance use disorders). The wording of the question and choice of a self-report measure of lifetime psychiatric diagnoses is consistent with previous research in prisoners (Binswanger et al, 2010;Browne et al, 2023). Participants were further asked about whether they used any illicit drugs (including nonprescribed psychotropic medications such as benzodiazepines but excluding tobacco and alcohol) during their current incarceration (Favril, 2023).…”

“…Epidemiological evidence consistently indicates a substantially higher prevalence of mental disorders and psychological distress among people in prison compared with the general adult population (e.g., Baranyi et al, 2019; Bronson and Berzofsky, 2017; Butler et al, 2006; Fovet et al, 2020). One in seven prisoners worldwide has a severe mental illness (Fazel and Seewald, 2012), with data suggesting an increase in their mental health needs over the past decade (Browne et al, 2023; Butler et al, 2022). Although women only comprise a small proportion (7%) of the global prison population (Fair and Walmsley, 2022), research shows that female prisoners bear a higher burden of psychiatric morbidity compared with their male peers (Binswanger et al, 2010; Browne et al, 2023; Svendsen et al, 2023; Tyler et al, 2019).…”

“…One in seven prisoners worldwide has a severe mental illness (Fazel and Seewald, 2012), with data suggesting an increase in their mental health needs over the past decade (Browne et al, 2023; Butler et al, 2022). Although women only comprise a small proportion (7%) of the global prison population (Fair and Walmsley, 2022), research shows that female prisoners bear a higher burden of psychiatric morbidity compared with their male peers (Binswanger et al, 2010; Browne et al, 2023; Svendsen et al, 2023; Tyler et al, 2019). This high prevalence is a cause for concern since men and women who experience poor mental health in prison are at increased risk of a confluence of adverse outcomes – including violence, victimisation, and self-harm while in custody (Favril et al, 2020b; Fazel et al, 2016) as well as reoffending and premature mortality after release into the community (Chang et al, 2015; Forsyth et al, 2018).…”

Forensic mental health issues for women in contact with the criminal justice system

“…A greater proportion of women reported substance use disorders across all surveys, in contrast to the general population where men have more than twice the rate of substance use disorder than women. 5,6 In the 2015 study, more than three-quarters of women reported at least one lifetime mental health diagnosis with almost twice the rates of all mental illness when compared to the men. Depression was seen in 61% of women, anxiety 51% and suicidal ideation in more than twothirds in the previous 12 months.…”

Gender affirmation and mental health in prison: A critical review of current corrections policy for trans people in Australia and New Zealand

“…lack of clinician training and restrictive policies, as well as biases and limited cultural competence by healthcare providers (Clark et al., 2017). Trans people face these issues in addition to the stressors faced by all incarcerated people, with higher rates of substance use disorders, mental illness, self-harm, suicidal ideation and inadequate availability of mental healthcare in prisons (Browne et al., 2022; Fazel et al., 2016; Monasterio et al., 2020).…”