Mental illness in jails and prisons

Current Opinion in Psychiatry

Volumn 12, Issue 6, 1999, Pages 677-682

  Arboleda Florez J ^a  

^a QUEEN S UNIVERSITY   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

HUMAN; MENTAL DISEASE; PREVALENCE; PRISON; PRISONER; SHORT SURVEY; VIOLENCE;

EID: 0032763619     PISSN: 09517367     EISSN: None     Source Type: Journal    
DOI: 10.1097/00001504-199911000-00016     Document Type: Short Survey

References (43)

1. 1 Fryers T, Brugha T, Grounds A, Melzor D. Severe mental illness in prisoners [Editorial]. Br Med J 1998; 317:1025-1026. This Editorial contains two important points. First, it has a reference to the study by the Department of Health: Singleton N, Meltzer H, Gatward R, Coid J, Deasy D. Psychiatric morbidity among prisoners. London: Stationery Office; 1998. Unfortunately, because of time pressures, this paper was unavailable for this review, but readers should be alerted to its existence. Second, the Editorial contains general comments on the implications of the policy survey, makes suggestions for the future and proposes more flexible policies.
2. 2 Watson G. Mental illness and suicides. HYPERLINK mail to:RCJNET-L@post.queensu.ca RCJNET-L@post.queensu.ca. June 8, 1999, 9:43 am. Commentary on news item in the Hartford (Connecticut) Courant of June 7, 1999: Prisons dealing with mentally ill.
3. 3 Peters RH, Greenbaum PE, Edens JF, Carter CR, Ortiz MM. Prevalence of DSM-IV substance abuse and dependence disorders among prison inmates. Am J Drug Alcohol Abuse 1996; 24:573-587. Although important in relation to the findings, the way in which participants were selected represents a major weakness in this study. The sampling frame was constituted from consecutive admissions into the inmate roster, but 'a significant number of inmates were excluded' for multiple reasons particular to the prison programmes. Although the authors indicate that the sample is similar to other state and federal prison populations for age, race and types of offences, it is not known how the actual sample of 400 inmates compared to the total sample that could have been accrued. Self-report information on prior criminal justice involvement and prior participation in substance abuse treatment is also a weakness given the inherent unreliability of self-reports, especially among inmates.
4. 4 Lamb HR, Weinberger LE. Persons with severe mental illness in jails and prisons: a review. Psychiatr Serv 1998; 49:483-492. This is an excellent review of the literature on all relevant references found in the three computerized systems mentioned in the text and starting in 1970.
5. 5 Hobson J, Shine J. Measurement of psychopathy in a UK prison population referred for long-term psychotherapy. Br J Criminol 1998; 38:504-515. Apart from being based on consecutive admissions, the sampling in this study was rather capricious and 27% of admissions were missed due to different reasons unrelated to the study protocol. The authors indicate that the sample was no different from those omitted in terms of demographic, criminological, and psychometric test score variables. It is not clear, however, what psychometric tests the authors referred to, given that those omitted did not, by definition, take the tests.
6. 6 Andersen HS, Sestoft D, Lillebaek T, Mortensen EL, Kramp P. Psychopathy and psychopathological profiles in prisoners on remand. Acta Psychiatr Scand 1999; 99:33-39. The authors do not specify the actual design of the study or how the sampling frame was obtained. They state that 228 prisoners on remand were randomly selected, and that 40 were selected after 2 months of solitary confinement. It seems that all those in solitary confinement were recruited into the study, and that all those excluded (90) were females or those who had not previously taken the PCL-R. Obviously, those so clearly selected and those so purposefully excluded could not have been randomly selected or excluded. The results of the study, however, are indicative of high levels of pathology among psychopathic offenders.
7. 7 Eastman N. Who should take responsibility for antisocial personality disorder? Br Med J 1999; 318:206-207. Although, technically, this is a minor contribution to the literature, the author has been able to express in a few words the difficulties that control and treatment of individuals with ASPD present to any system that houses them.
8. 8 Kaye S, Darke S, Finlay-Jones R. The onset of heroin use and criminal behaviour: does order make a difference? Drug Alcohol Depend 1998; 53:79-86. The sample in this study could not be considered representative of the methadone maintenance population in the community or in the prisons. It is of interest, however, to note that a logistic regression model showing a very good fit indicated that sex (male) and ASPD were significant predictors of criminality among primary antisocial persons.
9. 9 Barnfield TV, Leathem JM. Incidence and outcomes of traumatic brain injury and substance abuse in a New Zealand prison population. Brain Injury 1998; 12:455-466. Methodological deficiencies take away from the importance of this study. The paper does not explain how 360 inmates came to be participants of the study, but only half of these were approached, of whom 118 agreed to participate, indicating a modest response rate of 32%. The methodology to determine TBI was a self-report questionnaire, and the subjects' medical files were not reviewed. It is not clear whether the authors are reporting prevalence or incidence.
10. 10 Barnfield TV, Leathem JM. Neuropsychological outcomes of traumatic brain injury abuse in a New Zealand prison population. Brain Injury 1998; 12:951-962. This study is affected by the methodological problems of the basic sample used for the first study and has the added difficulty of volunteer bias. The results of the study, however, are important to keep in mind because it is one of only a handful of studies describing the impact of TBI on antisocial behaviour and its effects on outcomes for community adjustment after release.
11. 11 Thorburn KM. Conditions in prisons. Lancet 1998; 351:1003-1004.
12. 12 Freer R. Human rights in the USA: land of the free? Lancet 1998; 352:1853-1854. This small commentary sets the tone of what is shaping up as one of the major debates at the beginning of the next millennium: the rightfulness or inherent evil of the death penalty, and the ethical responsibilities of physicians involved in determinations of competency to be executed.
13. 13 Brownlee I. Taking DNA samples without consent from mentally disordered offenders: the impact of Home Office Circular 27/1997. J Forens Psychiatry 1998; 9:413-423. The brave new world of forensic evidence is upon us. Given the close relationship between mental health systems and prison systems, it would not be far-fetched to consider the possibilities of attempts by authorities to extend their powers for data collection to other areas of psychiatry where patients may be hospitalized because of dangerous tendencies.
14. 14 Exworthy T. Institutions and services in forensic psychiatry. J Forens Psychiatry 1998; 9:395-412. This paper presents an excellent review of the extent and types of forensic psychiatric services in the UK. The article focuses on service provision and developments, and includes descriptions of innovative schemes in settings ranging from maximum security to community treatment alternatives.
15. 15 Watson W. Designed to cure: the clinician-led development of England's regional secure units. J Forens Psychiatry 1998; 9:519-531.
16. 16 Gordon H, Hammond S, Veeramani R. Special care units in special hospitals. J Forens Psychiatry 1998; 9:571-587. Although this paper lacks a good description of the population of the hospital as a whole, it contains a good comparison between groups of patients requiring special care and patients in the hospital as a whole.
17. 17 Jones J, Thomas-Peter B, Warren S, Leadbeater C. An investigation of the personality characteristics of mentally disordered offenders detained under the Mental Health Act. J Forens Psychiatry 1998; 9:58-73.
18. •].
19. •] report on 20 males admitted to a regional secure unit over a 12-year period with an index sexual offence. Although the numbers are small, the results are of major interest because they lend support to a relationship between sexual offending and psychosis.
20. 20 Sahota K, Chesterman P. Sexual offending in the context of mental illness. Journal of Forens Psychiatry 1998; 9:267-280.
21. 21 De Taranto N, Bester P, Pierczhniak P, McCallum A, Kennedy H. Medium secure provision in NHS and private units. J Forens Psychiatry 1998; 9:369-378. All patients funded in medium secure accommodation in three different health authorities (n = 42) were examined on a specific single day and compared with those hospitalized as medium secure patients (not open or rehabilitation wards) in five different private sector units (n = 54). The two groups were compared on a series of measures including demographic parameters, type of offence, duration of stay, previous number of admissions and psychiatric assessment with standardized instruments. The present paper reports only on demographic and historical data collected from the case notes. For obvious reasons, comparison of the data was not blind, and given that all patients were included, no sampling issues arise.
22. 22 James D, Cripps J, Gray N. What demands do those admitted from the criminal justice system make on psychiatric beds? Expanding local secure services as a development strategy. J Forens Psychiatry 1998; 9:74-102. This was an exhaustive review of costs on all cases admitted to three London Boroughs on any form of National Health Service or private hospital from courts or prisons in the UK for 1 year (April 1994 to March 1995). Triangulation of information adds reliability to the data collected and to the results.
23. 23 Warden J. England abandons care in the community for the mentally ill. Br Med J 1998; 317:1611.
24. 24 Laing JM. A change of direction in the disposal of mentally disordered offenders: the impact of the Crime (Sentences) Act 1997. Med Sci Law 1998; 38:301-310. This paper presents a historical note to the origins of the 'hospital direction' and an in-depth legal review of the Crime (Sentences) Act, with commentaries on fundamental issues to forensic psychiatry such as responsibility, effective management of through care and implications for civil liberties.
25. 25 Stueve A, Link BG. Gendor differences in the relationship between mental illness and violence: evidence from a community-based epidemiological study in Israel. Soc Psychiatry Psychiatr Epidemiol 1998; 33:S61-S67.
26. 26 Swartz MS, Swanson JW, Hiday VA, Borum R, Wagner R, Burns BJ. Taking the wrong drugs: the role of substance abuse and medication noncompliance in violence among severely mentally ill individuals. Soc Psychiatr Epidemiol 1998; 33:S75-S80.
27. 27 Estroff SE, Swanson JW, Lachicotte WS, Swartz M, Bolduc M. Risk reconsidered: targets of violence in the social networks of people with serious psychiatric disorders. Soc Psychiatry Psychiatr Epidemiol 1998; 33:S95-S101.
28. 28 Link BG, Stueve A, Phelan J. Psychotic symptoms and violent behaviours: probing the components of 'threat/control-override' symptoms. Soc Psychiatry Psychiatr Epidemiol 1998; 33:S55-S60. This is a seminal paper on the issue of what components there are that cause a mentally ill person to act violently, as opposed to postulating a general association between mental illness and violence. The authors examined the hypothesis that links elevated rates of violence to threat/control-override symptoms and determined that both types of symptoms are independently associated with violent behaviour.
29. 29 Eronen M, Angermeyer MC, Schulze B. The psychiatric epidemiology of violent behaviour. Soc Psychiatry Psychiatr Epidemiol 1998; 33:S13-S23. This review presents a balance assessment of the evidence so far available to establish a relationship between mental illness and violence. It states that there is a moderate, but reliable association, and that an elevated risk is only evident for specific psychiatric diagnoses and symptoms constellations.
30. 30 Modestin J. Criminal and violent behaviour in schizophrenic patients: an overview. Review article. Psychiatry Clin Neurosci 1998; 52:547-554.
31. 31 Mitchell EW. Does psychiatric disorder affect the likelihood of violent offending? A critique of the major findings. Med Sci Law 1999; 39:23-30.
32. ••].
33. •] apply strict epidemiological criteria of causation in an exhaustive review of the factors affecting the relationship between mental illness and violence. Among other things, the author concludes that mental patients who have a history of violence and are experiencing psychotic symptoms are at a greater risk of violence, and that family members, not the general public, are the most likely targets of violence by the mentally ill. Furthermore, the author concludes that the many covariations that naturally affect the equation between mental illness and violence introduce uncertainties in establishing causality.
34. 34 Reith M. Risk assessment and management: lessons from mental health inquiry reports. Med Sci Law 1998; 38:221-226. The importance of this paper resides on the themes that the author could elucidate from a review of 28 mental health inquiries. These themes - thoroughness, team working, clinical team, and listening to carers and relatives - are of importance to concerned practitioners and inquiry teams.
35. 35 Belfrage H. Implementing the HCR-20 scheme for risk assessment in a forensic psychiatric hospital: integrating research and clinical practice. J Forens Psychiatry 1998; 9:328-338. Along with the Hare PCL-R, the Historical Clinical Risk Management (HCR)-20 [43] has received much attention from clinicians and researchers as a tool that could help in the prediction and the management of risk. This paper presents a validation study of the HCR-20 in Sweden and finds that it has high internal consistency and high inter-rater reliability. The paper does not submit information on reasons for the selection of subjects (43 violent offenders) or methods used to chose them.
36. 36 Draine J, Solomon P. Describing and evaluating jail diversion services for persons with serious mental illness. Psychiatr Serv 1999; 50:56-61. This theoretical paper is of importance because it describes the overall concept of jail diversion and outlines research issues in the evaluation of the effectiveness of jail diversion strategies.
37. 37 Deane MW, Steadman HJ, Borum R, Veysey BM, Morrissey JP. Emerging partnerships between mental health and law enforcement. Psychiatr Serv 1999; 50:99-101. Of city police departments, out of 194 cities over 100 000 in population, 90% responded to a questionnaire regarding whether they had any strategy in their dealings with the mentally ill offender. Only 40% had any strategy. The accuracy of the data received from this type of survey remains an enigma, because surveys are often filled out by less than senior staff who tend to do it just pro forma.
38. 38 Chung MC, Cumella S, Wensley J, Easthope Y. A follow-up study of mentally disordered offenders after a court diversion scheme: six-month and one-year comparison. Med Sci Law 1999; 39:31-37. Sixty-five offenders that were diverted from a court system were followed up for 6 months, and 22 for over a year on different measures including quality of life, type of aftercare and psychological well-being. Transient life styles, poor health and poor quality of life were the norms. Unfortunately, the paper does not comment or provide further information on data relevant to forensic psychiatry, such as police contacts or rates of reincarceration, but it was noted that 11 had been rearrested and two were sent to prison at 6 months. At 1 year, one had been rearrested and 11 were in prison. It is not clear whether these were the same as at 6 months. The study sampled only a very small group of patients, but is important in relation to debates on the effectiveness of community alternatives.
39. 39 Wolff N. Interactions between mental health and the law enforcement systems: problems and prospects for cooperation. J Health Politics Policy Law 1998; 23:133-174. This is a long, but well researched, paper on the origins of the difficulties found at the interface between mental health and law enforcement systems. The author suggests that inadequacies in the interaction between the two systems may increase the incidence of disorderly and violent behaviour among the mentally ill.
40. 40 Ventura LA, Cassel CA, Jacoby JE, Huang B. Case management and recidivism of mentally ill persons released from jail. Psychiatr Serv 1998; 49:1330-1337. The authors of this paper tested the hypothesis that case management provided to mentally ill offenders both in jail and after release from jail would reduce their recidivism. Two hundred and sixty-one inmates from the Lucas County (Toledo, Ohio) jail were followed up for a period of 3 years. The authors concluded that expanded case management, both inside and outside the prison, will help mentally ill offenders to stay out of prison, but the data present a different picture. In fact, 72% were rearrested, of which 23% were for violent misdemeanours and 11% were for violent felonies. Certainly, the arrest rate of those who received community case management was 60% and 36% for violent offences, which compares somewhat favourably to those who did not receive community case management (79 and 45%, respectively). The authors, however, do not comment on possible selection and misclassification biases affecting those who benefited from case management in prison but who did not receive it upon discharge to the community.
41. ••].
42. ••] are massive and in-depth reviews of the literature on the subject, conducted with the thoroughness and careful critical analysis that characterizes the Cochrane Library.
43. 43 Webster CD, Douglas KS, Eaves D, Hart SD. HCR-20 Assessing risk for violence, Version 2. Mental Health Law and Policy Institute, Simon Fraser University, 1997.