Many people in prison suffer from mental illness and the Prison Service in the UK has under its care one of the most vulnerable and mentally unhealthy populations anywhere. Epidemiological studies agree that the prevalence of serious personality disorders, drug and alcohol dependence, suicidal and self-harming behaviour, and all forms of mental illness (both psychotic and neurotic) is alarmingly high – much higher than in the general population. As a necessity, most care has to be provided within the prison setting.
10 per cent of men and 30 per cent of women have had a previous psychiatric admission before they entered prison, according to the Prison Reform Trust.
A significant number of prisoners suffer from a psychotic disorder. A recent study found that 25 per cent of women and 15 per cent of men in prison reported symptoms indicative of psychosis. The rate among the general public is about four per cent.
Personality disorders are particularly prevalent and 52 per cent of males and 57 per cent of females in UK prisons who have already been sentenced are diagnosed with these conditions.
Figures, collected by the Prison Service in 2005 showed that 597 out of every 1,000 women and 50 out of every 1,000 men harm themselves while in prison. Nearly half – 46 per cent – of women say that they have attempted suicide at some point in their lives, which is more than twice the rate for male prisoners (21 per cent) and far higher than the general population – just six per cent.
Prisons are hardly ideal places for people with mental health needs. Prisoners spend long periods of time locked up inside their cells. A culture of bullying and intimidation is rife in many centres. Mental health issues amongst prisoners are often linked to previous experiences of violence at home and sexual abuse. About half of women and about a quarter of men in prison have suffered from violence at home while about one in three women report having suffered sexual abuse compared with just under one in 10 men.
Half of all those sentenced to custody are not registered with a GP prior to being sent to prison.