1
|
Matheson FI, Dastoori P, Whittingham L, Calzavara A, Keown LA, Durbin A, Kouyoumdjian FG, Lin E, Volpe T, Lunsky Y. Intellectual/developmental disabilities among people incarcerated in federal correctional facilities in Ontario, Canada: Examining prevalence, health and correctional characteristics. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:900-909. [PMID: 35338547 DOI: 10.1111/jar.12995] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 11/22/2021] [Accepted: 02/12/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND There is little research with people who experience intellectual/developmental disabilities and imprisonment. METHODS The study linked health and correctional data to examine prevalence of intellectual/developmental disabilities and health and correctional characteristics among adults experiencing their first federal incarceration between 1 January 2002 and 31 December 2011 (n = 9278) and two non-incarcerated groups (n = 10,086,802). RESULTS The prevalence of intellectual/developmental disabilities was 2.1% in the incarcerated group and 0.9% in the non-incarcerated group. Before incarceration, those with, versus without, intellectual/developmental disabilities were at greater risk of traumatic brain injury, mental illness, and substance use disorders. While incarcerated, those with intellectual/developmental disabilities were more likely to incur serious institutional disciplinary charges. Post-incarceration, persons with intellectual/developmental disabilities were at greater risk of emergency department visits, and psychiatric and acute hospitalizations, than the non-incarcerated groups. CONCLUSIONS People with intellectual/developmental disabilities are overrepresented in Canadian federal correctional institutions. The authors offer strategies to support people prior to, during, and post-incarceration.
Collapse
Affiliation(s)
- Flora I Matheson
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, Centre for Criminology & Sociolegal Studies, University of Toronto, Toronto, Ontario, Canada
| | - Parisa Dastoori
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Lisa Whittingham
- Department of Child and Youth Studies, Brock University, St. Catharines, Ontario, Canada
| | | | - Leslie A Keown
- Research Branch, Correctional Service of Canada, Ottawa, Ontario, Canada
| | - Anna Durbin
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Fiona G Kouyoumdjian
- ICES, Toronto, Ontario, Canada.,Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Elizabeth Lin
- ICES, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Office of Education, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Tiziana Volpe
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Yona Lunsky
- ICES, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| |
Collapse
|
2
|
van den Bemd M, Cuypers M, Bischoff EWMA, Heutmekers M, Schalk B, Leusink GL. Exploring chronic disease prevalence in people with intellectual disabilities in primary care settings: A scoping review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:382-398. [PMID: 34750946 PMCID: PMC9298833 DOI: 10.1111/jar.12957] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 06/02/2021] [Accepted: 10/06/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Primary care providers require accurate evidence on chronic disease prevalence in people with intellectual disabilities in order to apply this information into practice. This study aimed to map the broadness of literature on chronic disease prevalence in people with and without intellectual disabilities, and to explore main characteristics of these studies. METHOD A scoping review of peer-reviewed literature was conducted, covering 2000 to February 2020, including literature that discussed chronic disease prevalence in people with and without intellectual disabilities, with similar data collection method for both groups. RESULTS Nineteen studies were included. Chronic disease prevalence varied considerably between people with and without intellectual disabilities. Studies differed in their methodologies, country and age groups that were enrolled. CONCLUSIONS Primary care providers should interpret results on disease prevalence among people with intellectual disabilities in light of the study characteristics. Researchers should always interpret prevalence rates in the context of methodology.
Collapse
Affiliation(s)
- Milou van den Bemd
- Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Maarten Cuypers
- Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Erik W M A Bischoff
- Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Marloes Heutmekers
- Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Bianca Schalk
- Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Geraline L Leusink
- Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands
| |
Collapse
|
3
|
Wu H, Wu J, Zhang Z, Zheng Y, Niu W, Zheng L, Li J. Prevalence and Associated Risk Factors of Hypertension in Adults with Disabilities: A Cross-Sectional Study in Shanghai, China. Clin Epidemiol 2021; 13:769-777. [PMID: 34475784 PMCID: PMC8408044 DOI: 10.2147/clep.s322791] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/14/2021] [Indexed: 12/03/2022] Open
Abstract
Background Although hypertension is highly prevalent in China, epidemiologic data of hypertension among people with disabilities remain largely unknown. This study aims to examine the prevalence and associated risk factors of hypertension in patients with disabilities. Methods A cross-sectional study was carried out among 7348 adults with disabilities from February to December 2018 in Shanghai, and patient data from physical, imageological and routine blood examinations were collected and analyzed. Logistic regression models were performed to determine the associated risk factors of hypertension in adults with disabilities. Results Among the 7348 disabled patients, the prevalence of hypertension, rate of receiving treatment, and blood pressure control were 42.5%, 85.0% and 46.0%, respectively. Increases in the levels of age, physical disability, body mass index (BMI), fasting plasma glucose (FBG), total triglyceride (TG), hyperuricemia (hyper-UA), serum urea (SU), and estimated creatinine clearance (eCrCl <80 μmol/L) were independently correlated with hypertension. Conclusion Patients with physical disabilities have a significantly higher prevalence of hypertension compared to the normal population. Patients with intellectual or mental disabilities have lower rates of blood pressure control compared to other types of disabilities. Assessment of associated risk factors highlights an increased likelihood of potential renal dysfunction among hypertensive disabled patients.
Collapse
Affiliation(s)
- Hengjing Wu
- Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, People's Republic of China
| | - Jing Wu
- Department of Fundamental Nursing, School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Ziyan Zhang
- Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, People's Republic of China
| | - Yongtao Zheng
- Department of Infectious Disease, Xiaoshan Center for Disease Control and Prevention, Hangzhou, People's Republic of China
| | - Wenxin Niu
- Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, People's Republic of China
| | - Liang Zheng
- Research Center for Translational Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, People's Republic of China
| | - Jue Li
- Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, People's Republic of China
| |
Collapse
|
4
|
Trofimovs J, Dowse L, Srasuebkul P, Trollor JN. Using linked administrative data to determine the prevalence of intellectual disability in adult prison in New South Wales, Australia. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:589-600. [PMID: 33821542 DOI: 10.1111/jir.12836] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 03/10/2021] [Accepted: 03/11/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Studies of the representation of people with intellectual disability (ID) in custody report widely inconsistent findings that reflect variation in how ID is defined and the methods employed for identification. Using linked administrative data may be of utility in studies of the representation of people with ID in custody. However, this approach requires an understanding of the purpose of and factors influencing identification in disparate administrative datasets. METHODS This study uses linked administrative data encompassing disability, health and corrections data for the year 2014 to estimate the prevalence of ID in adult custody and explore how ID representation within administrative data impacts prevalence estimates and what patterns of identification reveal about support service access for this group. RESULTS This study finds that 4.3% of the New South Wales adult custody population had an identified ID. Prisoners with ID were younger, more likely to have had a previous custodial episode and more likely to be Indigenous than the general prison population. Identification of ID across linked administrative datasets is uneven, which, if used in isolation, would result in variation in prevalence estimates according to source data. CONCLUSIONS The utilisation of linkage data from a broad range of health and support services including custody offers a comprehensive identification methodology. Inconsistency in the identification of ID across datasets indicates a potential disjuncture between prisoners with ID and support services, which may have relevance for efforts to reduce reincarceration of those in this population.
Collapse
Affiliation(s)
- J Trofimovs
- Department of Developmental Disability Neuropsychiatry (3DN), School of Psychiatry, UNSW Sydney, Sydney, New South Wales, Australia
| | - L Dowse
- School of Social Sciences, UNSW Sydney, Sydney, New South Wales, Australia
| | - P Srasuebkul
- Department of Developmental Disability Neuropsychiatry (3DN), School of Psychiatry, UNSW Sydney, Sydney, New South Wales, Australia
| | - J N Trollor
- Department of Developmental Disability Neuropsychiatry (3DN), School of Psychiatry, UNSW Sydney, Sydney, New South Wales, Australia
- Centre for Healthy Brain Ageing, School of Psychiatry (CHeBA), UNSW Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
5
|
Whittingham L, Durbin A, Lin E, Matheson FI, Volpe T, Dastoori P, Calzavara A, Lunsky Y, Kouyoumdjian F. The prevalence and health status of people with developmental disabilities in provincial prisons in Ontario, Canada: A retrospective cohort study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 33:1368-1379. [PMID: 32529696 DOI: 10.1111/jar.12757] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 04/15/2020] [Accepted: 05/06/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Data on the prevalence of developmental disabilities in people who experience imprisonment and on their characteristics are lacking. METHODS The present authors identified adults with developmental disabilities who were released from Ontario provincial prisons in 2010 and a general population comparator group using administrative data. The present authors examined demographic characteristics, morbidity and healthcare use. RESULTS The prevalence of developmental disabilities was 2.2% in the prison group (N = 52,302) and 0.7% in the general population (N = 10,466,847). The prevalence of psychotic illness, substance-related disorder and self-harm was higher among people in the prison group with developmental disabilities. People with developmental disabilities were more likely to have emergency department visits and hospitalizations in prison and in the year after release. CONCLUSIONS People with developmental disabilities are overrepresented in provincial prisons and have a high burden of disease. Strategies are indicated to prevent incarceration and to improve health.
Collapse
Affiliation(s)
- Lisa Whittingham
- Department of Child and Youth Studies, Brock University, Saint Catharines, ON, Canada
| | - Anna Durbin
- ICES, Toronto, ON, Canada.,MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Elizabeth Lin
- ICES, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Office of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Flora I Matheson
- ICES, Toronto, ON, Canada.,MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
| | - Tiziana Volpe
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Parisa Dastoori
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
| | | | - Yona Lunsky
- ICES, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Fiona Kouyoumdjian
- ICES, Toronto, ON, Canada.,Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| |
Collapse
|
6
|
Rowe S, Dowse L, Newton D, McGillivray J, Baldry E. Addressing Education, Training, and Employment Supports for Prisoners With Cognitive Disability: Insights from an Australian Programme. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2019. [DOI: 10.1111/jppi.12321] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Simone Rowe
- School of Social SciencesUniversity of New South Wales Sydney NSW Australia
| | - Leanne Dowse
- School of Social SciencesUniversity of New South Wales Sydney NSW Australia
| | | | | | - Eileen Baldry
- School of Social SciencesUniversity of New South Wales Sydney NSW Australia
| |
Collapse
|
7
|
Young JT, Cumming C, van Dooren K, Lennox NG, Alati R, Spittal MJ, Brophy L, Preen DB, Kinner SA. Intellectual disability and patient activation after release from prison: a prospective cohort study. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2017; 61:939-956. [PMID: 28090702 DOI: 10.1111/jir.12349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 10/05/2016] [Accepted: 10/12/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Intellectual disability and patient activation may be important drivers of inequities in health service access and health outcomes for people with intellectual disability transitioning from prison to the community. We assessed the association between intellectual disability and patient activation after prison release and examined whether this association varied, depending on whether intellectual disability was identified prior to prison release. METHODS Overall, 936 prisoners were screened for intellectual disability by using the Hayes Ability Screening Index and completed the Patient Activation Measure (PAM) within 6 weeks of prison release and again at 1, 3 and 6 months post-release. We estimated the association between intellectual disability status and PAM scores by using a multilevel linear model, adjusting for sociodemographic, behavioural, health and criminogenic factors. We used propensity score matching to estimate the impact of being identified with intellectual disability prior to release from prison on the change in mean PAM score after prison release. RESULTS Compared with those who screened negative for intellectual disability, ex-prisoners who screened positive, both with and without prior identification of intellectual disability, had significantly decreased mean PAM scores [(B = -4.3; 95% CI: -6.3, -2.4) and (B = -4.5; 95% CI: -6.8, -2.3), respectively] over 6 months of follow-up. Among those who reported being identified with intellectual disability prior to release from prison, a significant increase in PAM score at the 6-month follow-up interview (B = 5.89; 95% CI: 2.35, 9.42; P = 0.001) was attributable to being identified with intellectual disability prior to release. CONCLUSIONS Ex-prisoners screening positive for possible intellectual disability have decreased patient activation for at least 6 months after release from prison. However, individuals whose possible intellectual disability is unidentified appear to be particularly vulnerable. Incarceration is a pivotal opportunity for the identification of intellectual disability and for initiating transitional linkages to health and intellectual disability-specific community services for this marginalised population.
Collapse
Affiliation(s)
- J T Young
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
- Centre for Health Services Research, School of Population Health, The University of Western Australia, Perth, Australia
- National Drug Research Institute, Curtin University, Perth, Australia
| | - C Cumming
- Centre for Health Services Research, School of Population Health, The University of Western Australia, Perth, Australia
| | - K van Dooren
- Queensland Centre for Intellectual and Developmental Disability, Mater Research Institute-UQ, University of Queensland, South Brisbane, Australia
| | - N G Lennox
- Queensland Centre for Intellectual and Developmental Disability, Mater Research Institute-UQ, University of Queensland, South Brisbane, Australia
| | - R Alati
- School of Public Health and Centre for Youth Substance Abuse Research, University of Queensland, Herston, Australia
| | - M J Spittal
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
| | - L Brophy
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
- Mind Australia, Heidelberg, Australia
| | - D B Preen
- Centre for Health Services Research, School of Population Health, The University of Western Australia, Perth, Australia
| | - S A Kinner
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
- Queensland Centre for Intellectual and Developmental Disability, Mater Research Institute-UQ, University of Queensland, South Brisbane, Australia
- Griffith Criminology Institute and Menzies Health Institute Queensland, Griffith University, Mt Gravatt, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Australia
| |
Collapse
|
8
|
Carroll M, Spittal MJ, Kemp-Casey AR, Lennox NG, Preen DB, Sutherland G, Kinner SA. High rates of general practice attendance by former prisoners: a prospective cohort study. Med J Aust 2017; 207:75-80. [PMID: 28701128 DOI: 10.5694/mja16.00841] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 01/03/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To determine the rates at which people recently released from prison attend general practitioners, and to describe service users and their encounters. DESIGN, PARTICIPANTS AND SETTING Prospective cohort study of 1190 prisoners in Queensland, interviewed up to 6 weeks before expected release from custody (August 2008 - July 2010); their responses were linked prospectively with Medicare and Pharmaceutical Benefits Scheme data for the 2 years after their release. General practice attendance was compared with that of members of the general Queensland population of the same sex and in the same age groups. MAIN OUTCOME MEASURES Rates of general practice attendance by former prisoners during the 2 years following their release from prison. RESULTS In the 2 years following release from custody, former prisoners attended general practice services twice as frequently (standardised rate ratio, 2.04; 95% CI, 2.00-2.07) as other Queenslanders; 87% of participants visited a GP at least once during this time. 42% of encounters resulted in a filled prescription, and 12% in diagnostic testing. Factors associated with higher rates of general practice attendance included history of risky opiate use (incidence rate ratio [IRR], 2.09; 95% CI, 1.65-2.65), having ever been diagnosed with a mental disorder (IRR, 1.32; 95% CI, 1.14-1.53), and receiving medication while in prison (IRR, 1.82; 95% CI, 1.58-2.10). CONCLUSIONS Former prisoners visited general practice services with greater frequency than the general Queensland population. This is consistent with their complex health needs, and suggests that increasing access to primary care to improve the health of former prisoners may be insufficient, and should be accompanied by improving the quality, continuity, and cultural appropriateness of care.
Collapse
Affiliation(s)
- Megan Carroll
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC
| | - Matthew J Spittal
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC
| | - Anna R Kemp-Casey
- Centre for Health Services Research, University of Western Australia, Perth, WA
| | - Nicholas G Lennox
- Queensland Centre for Intellectual and Developmental Disability, Brisbane, QLD
| | | | - Georgina Sutherland
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC
| | - Stuart A Kinner
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC
| |
Collapse
|
9
|
Robertson J, Emerson E, Baines S, Hatton C. Obesity and health behaviours of British adults with self-reported intellectual impairments: cross sectional survey. BMC Public Health 2014; 14:219. [PMID: 24588837 PMCID: PMC4233626 DOI: 10.1186/1471-2458-14-219] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 02/05/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND People with intellectual disability have significantly higher age-adjusted rates of mortality and morbidity (including obesity) than their non-disabled peers. They are also significantly less likely to be physically active. METHODS Secondary analysis of de-identified cross-sectional data from the first two waves of Understanding Society, a new longitudinal study focusing on the life experiences of UK citizens. Interviews were undertaken with 50,994 individuals aged 16 and over in Wave 1 and 54,585 in Wave 2. Of these, 520 participants age 16-49 (1.8% of the unweighted age-restricted sample) were identified at either Wave 1 or Wave 2 as having self-reported intellectual impairments. RESULTS British adults with self-reported intellectual impairments have higher rates of obesity, inactivity, tobacco and alcohol use and poorer nutrition than their non-disabled peers. Adjusting risk estimates for between group differences in age, gender and exposure to material hardship indicated that a significant proportion of their increased risk of obesity, tobacco use and poorer nutrition may be attributable to their poorer living conditions (rather than their self-reported intellectual impairments per se). CONCLUSIONS People with intellectual disabilities should begin to be regarded as a 'vulnerable' group in the context of public health policy and practice.
Collapse
Affiliation(s)
- Janet Robertson
- Centre for Disability Research, Lancaster University, Lancaster, UK
| | - Eric Emerson
- Centre for Disability Research, Lancaster University, Lancaster, UK
- Centre for Disability Research and Policy, University of Sydney, Sydney, Australia
| | - Susannah Baines
- Centre for Disability Research, Lancaster University, Lancaster, UK
| | - Chris Hatton
- Centre for Disability Research, Lancaster University, Lancaster, UK
| |
Collapse
|
10
|
Dias S, Ware RS, Kinner SA, Lennox NG. Co-occurring mental disorder and intellectual disability in a large sample of Australian prisoners. Aust N Z J Psychiatry 2013; 47:938-44. [PMID: 23723292 DOI: 10.1177/0004867413492220] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Prisoners with intellectual disability who have a coexisting mental health issue often have unmet health needs and are more likely to reoffend than those with intellectual disability alone. The aims of this study were to estimate the prevalence of co-occurring mental disorder among prisoners with intellectual disability and to explore the association between intellectual disability and mental disorder. METHODS Cross-sectional study of adult prisoners within 6 weeks of release from custody in seven prisons in Queensland, Australia between August 2008 and July 2010. Intellectual disability was assessed using a practical composite screening tool. Prisoners who scored <85 on the Hayes Ability Screening Index and reported either having attended a special school or having been diagnosed with intellectual disability were identified as having an intellectual disability. Mental health was assessed using self-reported psychiatric diagnoses, the Kessler Psychological Distress Scale (K-10), and the Mental Component Summary score of the Short-Form-36 health survey version 2. The association between intellectual disability and mental health was assessed using univariate and multivariate logistic regression. RESULTS Overall, 1279 prisoners completed the HASI: 316 (24%) scored below the recommended cut off for further diagnostic assessment of intellectual disability, 181 (14%) reported attending a special school, and 56 (4%) reported that they had been diagnosed with an intellectual disability. On our composite measure, 115 (9%) participants were identified as having an intellectual disability. Among prisoners with intellectual disability, the estimated lifetime and current prevalence of co-occurring mental disorders was 52.5% (95% CI 43.3-61.5) and 37.2% (95% CI 28.8-46.5), respectively. Of those with intellectual disability, 13.5% (95% CI 8.3-21.1) reported very high psychological distress, as measured by the K10. Prisoners with intellectual disability were significantly more likely than their non-disabled peers to report a current diagnosis of depression [adjusted odds ratio (AOR) 1.8, 95% CI 1.1-3.2] or substance dependence (AOR 3.7, 95% CI 1.6-8.4], after adjusting for potentially confounding variables. Prisoners with intellectual disability were also significantly more likely than their non-disabled peers to use antipsychotic medication (AOR 1.7, 95% CI 1.0-2.8). CONCLUSIONS Prisoners with an intellectual disability were more likely than their non-disabled peers to have elevated rates of psychiatric comorbidity and unmet treatment needs. There is a need for enhanced collaboration between specialist intellectual disability psychiatric services and mainstream prison mental health services, to ensure coordinated service delivery for this dually disadvantaged group.
Collapse
Affiliation(s)
- Shannon Dias
- 1School of Medicine, University of Queensland, Brisbane, Australia
| | | | | | | |
Collapse
|