Point prevalence of mental disorder in unconvicted male prisoners in England and Wales.
OBJECTIVE
To determine prevalence of mental disorder among male unconvicted prisoners and to assess the treatment needs of this population.


METHODS
Semi-structured interview and case note review of randomly selected cross section of male remand population. Non-attenders were replaced by the next name on prison roll.


METHODS
Three young offenders' institutions and 13 adult men's prisons.


METHODS
750 prisoners, representing 9.4% cross sectional sample of male unconvicted population.


METHODS
Prevalence of ICD-10 diagnoses of mental disorder, and associated treatment needs.


RESULTS
Psychiatric disorder was diagnosed in 469 (63%) inmates. The main diagnoses were: substance misuse, 285 (38%); neurotic illness, 192 (26%); personality disorder, 84 (11%); psychosis, 36 (5%); other and uncertain, 36 (0.5%). Subjects could have more than one diagnosis. The average refusal rate was 18%. In total 414 inmates (55%) were judged to have an immediate treatment need: transfer to an NHS bed, 64 (9%); treatment by prison health care services, 131 (17%); motivational interviewing for substance misuse, 115 (15%); and therapeutic community placement, 104 (14%).


CONCLUSIONS
Mental disorder was common among male unconvicted prisoners. Psychosis was present at four or five times the level found in the general population. Extrapolation of our results suggests that remand population as a whole probably contains about 680 men who need transfer to hospital for psychiatric treatment, including about 380 prisoners with serious mental illness.
Brooke
D
D
Department of Forensic Psychiatry, Institute of Psychiatry, De Crespigny Park, London.
Taylor
C
C
Gunn
J
J
Maden
A
A
D000328:Adult; D003430:Cross-Sectional Studies; D003657:Decision Making; D004739:England / Q000453:epidemiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000628:therapy; D010360:Patient Transfer; D015995:Prevalence; D011329:Prisoners; D011330:Prisons; D014852:Wales / Q000453:epidemiology