title: Improving mental state in early imprisonment.
abstract: BACKGROUND
  Pre-trial prisoners have high rates of mental disorder, but to date, little is known about mental state change or stability among them.
  
  
  OBJECTIVE
  The aim of this study was to describe mental state change over the first 4 weeks of imprisonment.
  
  
  METHODS
  Two hundred and fifty-seven new pre-trial male prisoners consented to participate in a prospective interview study. Recruited men tended to be younger than non-recruited men, but otherwise similar. Mental state was assessed 1 and 4 weeks after reception, using the Comprehensive Psychopathological Rating Scale and two self-rating instruments [the 90-item symptom checklist (SCL-90); the Beck Depression Inventory].
  
  
  RESULTS
  After 4 weeks, 170 of the men were still in prison. In their demographics, previous offending, imprisonment, mental health histories or mental health ratings at initial interview, they did not differ from the 87 who were bailed, transferred, sentenced or had their case discontinued. The most sensitive of the rating schedules - the SCL-90 - identified only one new case among the 170 men, but the more illness-specific ratings suggested up to a 10% emergence of new cases by then. By contrast, while two-thirds of the men remained cases according to the SCL-90, about half of the men who had initial interview illness ratings were no longer 'cases'.
  
  
  CONCLUSIONS
  Measured in terms of 'caseness', distress is likely to be apparent on reception into prison and relatively resistant to change compared with symptoms of mental disorder per se. One-off screening at reception could be misleading. A limitation of our study is that we could measure mental state only twice. A third measure would have clarified whether, in such circumstances, the trend towards improvement is sustained, but brevity of residence in any one prison at this stage tends to preclude this.
authors.affiliation: Department of Psychological Medicine, School of Medicine, Cardiff University, Cardiff, Wales, UK. taylorpj2@cardiff.ac.uk
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Taylor
authors.forename: Julian
authors.initials: J
authors.lastname: Walker
authors.forename: Emma
authors.initials: E
authors.lastname: Dunn
authors.forename: Anna
authors.initials: A
authors.lastname: Kissell
authors.forename: Amy
authors.initials: A
authors.lastname: Williams
authors.forename: Tim
authors.initials: T
authors.lastname: Amos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis*; D008603:Mental Health; D008875:Middle Aged; D011329:Prisoners / Q000523:psychology*; D011330:Prisons; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires