Ex-prisoners
with common mental health problems, such as bipolar disorder, and who misuse
drugs and alcohol are more likely to commit violent offences after their
release than other former prisoners, according to research. The study from
Oxford University treads on highly sensitive ground, raising concerns among
some experts that it may lead to assumptions mentally ill people are more prone
to violence than others.But the authors
say that is the wrong interpretation. They call for better diagnosis and
treatment of mental illness for offenders in prison and after release, with the
aim of bringing down the reoffending rate.
“One in seven
prisoners has a psychotic illness or major depression and around one in five
enters prison with clinically significant substance abuse disorders,” said
Seena Fazel, lead author of the study and professor of forensic psychiatry at
the University of Oxford. “As these disorders are common and mostly treatable,
better screening and mental health services before and after release are
essential to prevent future violence and improve both public health and
safety,” he said.
The study, published
in the Lancet Psychiatry journal, suggests that diagnosed psychiatric
disorders are responsible for 20% of violent offences committed by male
ex-prisoners and 40% of those committed by female former inmates. Using the
records of nearly 48,000 ex-prisoners in Sweden, the researchers were able to
link common psychiatric disorders with convictions for violent offences such as
assault, robbery, arson and sexual offences over a 10-year period from 1
January 2000.
Fazel said the
study broke new ground by comparing the mental health and reoffending record of
siblings who had been jailed, which he said was a powerful way to ensure they
were calculating the impact only of mental health, unaffected by people’s
backgrounds.
They found that
42% of male prisoners were diagnosed with at least one psychiatric disorder
before release and 25% were convicted of violent crimes in the 3.2 years of
average follow-up in the released individuals. Around 60% of female prisoners
had a psychiatric disorder and 11% were convicted of violent crimes following
release.
“A lot of
people have been very cautious in this area not to place too much emphasis on
mental health problems linked with reoffending risk,” said Fazel. But small
studies have shown that other adverse outcomes, including deaths and suicides,
go up if ex-offenders are not treated. The study supported putting resources
into prison health, he said. Not only do prisoners have a right to health, “but
beyond that there are other consequences because we have to improve public
safety as well,” he said.
“The
implication of this study lies between the two: treatment of psychiatric
disorders in prisons and on release is crucial, but will not be enough to bring
about a major reduction in violent crime. Comprehensive packages of treatment
and social support are needed that hold a therapeutic mirror to the complexity
and adversity of offenders’ lives,” Louis Appleby, national director for health
and criminal justice and professor of psychiatry at the University of
Manchester, and colleagues.
Frances Crook,
chief executive of the Howard League for Penal Reform, said a prisoner may get
a few sessions of help but then the good was undone when they went back to
their cell and were offered illegal drugs, or became suicidal. “You can treat
people, but in the end a prison environment is so toxic and at the moment is so
awful that having a few sessions of treatment is a sticking plaster on a major
wound,” she said. “A prison is
not an environment to treat people. You don’t send people to prison for
treatment or education. You should offer them treatment they need, but people
who are ill should not be in prison.”
Article courtesy of http://www.theguardian.com/
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