title: Assessing needs for psychiatric treatment in prisoners: 1. Prevalence of disorder.
abstract: High levels of psychiatric morbidity in prisoners have important implications for services. Assessing Needs for Psychiatric Treatment in Prisoners is an evaluation of representative samples of prisoners in a male and a female prison in London. This paper reports on the prevalence of mental disorders. In a companion paper, we describe how this translates into mental health treatment needs and the extent to which they have been met.
  
  
  
  Prisoners were randomly sampled in a sequential procedure based on the Local Inmate Data System. We interviewed roughly equal numbers from the following groups: male remand; male sentenced prisoners (Pentonville prison); and female remand; female sentenced prisoners (Holloway prison). Structured assessments were made of psychosis, common mental disorders, PTSD, personality disorder and substance abuse.
  
  
  
  We interviewed 197 male and 171 female prisoners. Psychiatric morbidity in male and female, sentenced and remand prisoners far exceeded in prevalence and severity than in equivalent general population surveys. In particular, 12% met criteria for psychosis; 53.8% for depressive disorders; 26.8% for anxiety disorders; 33.1% were dependent on alcohol and 57.1% on illegal drugs; 34.2% had some form of personality disorder; and 69.1% had two disorders or more. Moreover, in the year before imprisonment, 25.3% had used mental health services.
  
  
  
  These rates of mental ill-health and their similarity in remand and sentenced prisoners indicate that diversion of people with mental health problems from the prison arm of the criminal justice system remains inadequate, with serious consequences for well-being and recidivism.
authors.affiliation: UCL Division of Psychiatry, Faculty of Brain Sciences, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK. p.bebbington@ucl.ac.uk.
authors.forename: Paul
authors.identifier: 0000-0002-6030-7456
authors.initials: P
authors.lastname: Bebbington
authors.affiliation: UCL Division of Psychiatry, Faculty of Brain Sciences, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
authors.forename: Sharon
authors.initials: S
authors.lastname: Jakobowitz
authors.affiliation: UCL Division of Psychiatry, Faculty of Brain Sciences, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.|Camden and Islington Foundation Trust, St Pancras Hospital, 4 St Pancras Way, London, NW1 OPE, UK.
authors.forename: Nigel
authors.initials: N
authors.lastname: McKenzie
authors.affiliation: UCL Division of Psychiatry, Faculty of Brain Sciences, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Killaspy
authors.affiliation: North London Forensic Service, Chase Farm Hospital, The Ridgeway, Enfield, Middlesex, EN2 8JL, UK.
authors.forename: Rachel
authors.initials: R
authors.lastname: Iveson
authors.affiliation: North London Forensic Service, Chase Farm Hospital, The Ridgeway, Enfield, Middlesex, EN2 8JL, UK.
authors.forename: Gary
authors.initials: G
authors.lastname: Duffield
authors.affiliation: Faculty of Social Sciences, School of Social Policy, Sociology and Social Research, Cornwallis North East, University of Kent, Canterbury, Kent, CT2 7NF, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Kerr
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007604:Juvenile Delinquency / Q000706:statistics & numerical data*; D008131:London / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D020380:Needs Assessment; D015995:Prevalence; D011329:Prisoners / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Epidemiology; Needs for care; Prevalence; Prisoners; Psychiatric disorders; Psychosis; Substance abuse