title: Links between depressive symptoms and unmet health and social care needs among older prisoners.
abstract: BACKGROUND
  absolute numbers of older prisoners and their proportion of the total prison population are increasing. They have multiple health and social care needs that are prominent on entry into prison. No previous studies have identified older prisoners' health and social care needs at this crucial point.
  
  
  OBJECTIVE
  to examine unmet health and social care needs among older men entering prison and their links with depressive symptoms.
  
  
  METHODS
  a cross-sectional survey across nine prisons in the North of England was completed. One hundred male prisoners aged between 60 and 81 were interviewed, using the Camberwell Assessment of Need-Forensic short version (CANFOR-S) and Geriatric Depression Scale-Short Form (GDS-15). Descriptive statistics were generated and χ(2) tests performed.
  
  
  RESULTS
  participants reported high levels of unmet needs as measured with the CANFOR-S, notably in the domains of knowledge about their condition and treatment (38%); psychological distress (34%); daytime activities (29%); benefits (28%); food (22%) and physical health (21%). The mean total number of unmet needs was 2.74, with a median of 2.0. More than half the sample (56%, 95% CI 45-66%) exhibited clinical signs of depression. A significant association between depressive symptomology and an unmet physical health need, as measured by the CANFOR-S, was detected (χ(2) = 6.76, df = 1, P < 0.01).
  
  
  CONCLUSIONS
  high levels of depressive symptoms were experienced by older prisoners on entry into prison. Personalised health and social care needs assessment and discrete depression screening are required on prison entry to facilitate effective management of unmet needs.
authors.affiliation: School of Languages, Law and Social Sciences, Dublin Institute of Technology, Dublin, Ireland.
authors.forename: Kate
authors.initials: K
authors.lastname: O'Hara
authors.affiliation: Offender Health Research Network, University of Manchester, Manchester, UK.
authors.forename: Katrina
authors.initials: K
authors.lastname: Forsyth
authors.affiliation: Institute of Brain Behaviour and Mental Health, University of Manchester, Manchester, UK.
authors.forename: Roger
authors.initials: R
authors.lastname: Webb
authors.affiliation: Offender Health Research Network, University of Manchester, Manchester, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Senior
authors.affiliation: University of Warwick-Medicine, Medical Teaching Centre, Coventry CV4 7AL, UK.
authors.forename: Adrian Jonathan
authors.initials: AJ
authors.lastname: Hayes
authors.affiliation: School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK.
authors.forename: David
authors.initials: D
authors.lastname: Challis
authors.affiliation: Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.
authors.forename: Seena
authors.initials: S
authors.lastname: Fazel
authors.affiliation: Offender Health Research Network, University of Manchester, Manchester, UK.
authors.forename: Jenny
authors.initials: J
authors.lastname: Shaw
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000097:blood / Q000523:psychology; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D004739:England / Q000453:epidemiology; D015577:Geriatric Assessment; D006301:Health Services Needs and Demand; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D015995:Prevalence; D011329:Prisoners / Q000523:psychology*; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: ageing prisoners; depression; older people; prison entry; unmet needs