title: Did female prisoners with mental disorders receive psychiatric treatment before imprisonment?
abstract: BACKGROUND
  Throughout the world, high prevalence rates of mental disorders have been found in prison populations, especially in females. It has been suggested that these populations do not access psychiatric treatment. The aim of this study was to establish rates of psychiatric in- and outpatient treatments prior to imprisonment in female prisoners and to explore reasons for discontinuation of such treatments.
  
  
  METHODS
  150 consecutively admitted female prisoners were interviewed in Berlin, Germany. Socio-demographic characteristics, mental disorders, and previous psychiatric in- and outpatient treatments were assessed by trained researchers. Open questions were used to explore reasons for ending previous psychiatric treatment.
  
  
  RESULTS
  A vast majority of 99 prisoners (66%; 95% CI: 58-73) of the total sample reported that they had previously been in psychiatric treatment, 80 (53%; 95 CI: 45-61) in inpatient treatment, 62 (41%; 95 CI: 34-49) in outpatient treatment and 42 (29%; 21-39) in both in- and outpatient treatments. All prisoners with psychosis and 72% of the ones with any lifetime mental health disorder had been in previous treatment. The number of inpatient treatments and imprisonments were positively correlated (rho = 0.27; p < 0.01). Inpatient treatment was described as successfully completed by 56% (N = 41) of those having given reasons for ending such treatment, whilst various reasons were reported for prematurely ending outpatient treatments.
  
  
  CONCLUSIONS
  The data do not support the notion of a general 'mental health treatment gap' in female prisoners. Although inpatient care is often successfully completed, repeated inpatient treatments are not linked with fewer imprisonments. Improved transition from inpatient to outpatient treatment and services that engage female prisoners to sustained outpatient treatments are needed.
authors.affiliation: Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, Newham Centre for Mental Health, London, E13 8SP, UK. a.mundt@qmul.ac.uk.|Escuela de Medicina sede Puerto Montt, Universidad San Sebastián, Puerto Montt, Chile. a.mundt@qmul.ac.uk.
authors.forename: Adrian P
authors.initials: AP
authors.lastname: Mundt
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Charité Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany. sinja.kastner@web.de.
authors.forename: Sinja
authors.initials: S
authors.lastname: Kastner
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Charité Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany. mail.mir.an@gmail.com.
authors.forename: Jan
authors.initials: J
authors.lastname: Mir
authors.affiliation: Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, Newham Centre for Mental Health, London, E13 8SP, UK. s.priebe@qmul.ac.uk.
authors.forename: Stefan
authors.initials: S
authors.lastname: Priebe
mesh_terms: D000328:Adult; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007297:Inpatients / Q000523:psychology / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D010045:Outpatients / Q000523:psychology / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D015995:Prevalence; D011329:Prisoners / Q000523:psychology* / Q000706:statistics & numerical data*; D011613:Psychotherapy / Q000706:statistics & numerical data*