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Haysom L. Forensic mental health issues for women in contact with the criminal justice system. Australas Psychiatry 2024; 32:210-213. [PMID: 38332690 DOI: 10.1177/10398562241232523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
OBJECTIVE This review demonstrates that women who encounter the Australian criminal justice system include some of the most disadvantaged and mentally unwell people in society, particularly Aboriginal women. Women in custody are a heterogeneous group and have different psychosocial needs when compared to male prisoners. CONCLUSION The approaches to female offending must address their significant psychosocial and mental health issues at every point of contact with the criminal justice system, be culturally informed and specifically address Indigenous overrepresentation.
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Affiliation(s)
- Leigh Haysom
- Adolescent Health and Medical Administration, Justice Health and Forensic Mental Health Network, Malabar, NSW, Australia
- School of Medicine, Western Sydney University, Penrith, NSW, Australia; and
- School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
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D'Orta I, Weber K, Herrmann FR, Giannakopoulos P. Women in acute forensic psychiatric care: comparison of clinical, sociodemographic, and detention-related characteristics in pretrial detention, sentence execution, and court-ordered treatment. BMC Psychiatry 2024; 24:94. [PMID: 38308259 PMCID: PMC10835924 DOI: 10.1186/s12888-024-05546-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/21/2024] [Indexed: 02/04/2024] Open
Abstract
Compared to men inmates, women display decreased prevalence of severe mental disorder but increased occurrence of substance use disorders (SUD) and higher rates of previous contacts with mental health services. The group of women in detention is highly heterogeneous according to the status of incarceration (pre-trial detention (PTD), sentence execution (SE) and court ordered treatments (COT)). Studies focusing on the comparison of sociodemographic patterns, detention-related and clinical variables between these groups are still lacking. We explored these parameters in 136 women admitted for acute psychiatric care in the sole Geneva forensic unit during a nine year period (2014-2023). Sociodemographic and detention-related data included age, nationality, marital status, presence of children, education attainment, most frequently speaking language, social support, employment before conviction and type of offenses. Clinical variables included the main ICD-10 diagnosis, presence of concomitant SUD, type of personality disorders, presence of suicidal thoughts and attempts at admission, as well as number and mean duration of stays. PTD and SE women had at least 9 years of formal education in 38.9% and 30.3% of cases. Most women in PTD (77.7%), SE (56.6%) and COT (56.2%) groups were Swiss or European citizens. The level of French knowledge was excellent in most of the cases. 43.8% of COT women had at least one child and this percentage is even higher for PTD and SE cases. The employment rate before conviction was also quite high, mainly for PTD and SE (61.1% and 60.6%) and, in a lesser degree, for COT (43.8%) women. Significant social support was present in the vast majority of women without any significant group difference. The distribution of type of offenses did not differ between the three types of detention with a predominance of physical violence, and drug trafficking. The number of stays during the period of reference was significantly higher in COT compared to both SE and PTD women. History of previous inpatient care was also significantly more frequent in COT that SE and PTD women. Adjustment and affective disorders were more often found in SE and PTD cases, these diagnoses were absent in the COT group. In contrast, a main diagnosis of psychotic disorders was found in 62.5% of COT cases compared to only 21.2% in SE and 24.1% in PTD cases. The number of stays, history of inpatient care and diagnosis of psychosis were independent predictors of COT status. In conclusion, the present data reveal the good social integration and emotional support of women needing acute psychiatric care in prison independently of the type of detention. Clinically, women in PTD and SE display more often emotional distress whereas those in COT suffer from acute psychotic symptoms with previous history of psychiatric care and multiple inpatient stays.
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Affiliation(s)
- Isabella D'Orta
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland.
- Institute of Global Health, University of Geneva, Geneva, Switzerland.
| | - Kerstin Weber
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
- Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - François R Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Panteleimon Giannakopoulos
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
- Department of Psychiatry, University of Geneva, Geneva, Switzerland
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Dalzell LG, Pang SC, Brömdal A. Gender affirmation and mental health in prison: A critical review of current corrections policy for trans people in Australia and New Zealand. Aust N Z J Psychiatry 2024; 58:21-36. [PMID: 37638610 PMCID: PMC10756016 DOI: 10.1177/00048674231195285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
BACKGROUND Trans people in prison experience disproportionate rates of harm, including negative mental health outcomes, and thus require special protections. Instead, corrections policies have historically further marginalised them. This critical policy review aimed to compare corrections policies for trans people in Australia and New Zealand with human rights standards and consider their mental health impact. METHODS Online searches were conducted on corrections websites for each state/territory in Australia and New Zealand. Drawing on the Nelson Mandela Rules and Yogyakarta Principles, 19 corrections policies relevant to placement, naming, appearance and gender-affirming healthcare for trans people were reviewed. The potential mental health impact of these policies on incarcerated trans people was discussed using the Gender Minority Stress and Resilience framework. RESULTS Australian and New Zealand corrections policies have become more concordant with human rights standards in the past 5 years. However, gender-related discrimination and human rights violations were present in corrections policies of all jurisdictions. New South Wales and Victorian policies had the highest concordance with human rights standards, while Queensland and South Australian policies had the lowest. CONCLUSION Policies that contribute to discrimination and minority stress may increase risk of mental health problems and suicide for incarcerated trans people. Mental health professionals working in prisons need to be aware of these risks to provide safe and accessible mental healthcare for trans people. Collaborative policy development with trans people is essential to protect the safety and rights of incarcerated trans people and consider models beyond the gender binary on which correctional systems have been founded.
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Affiliation(s)
- Laura G Dalzell
- Victorian Institute of Forensic Mental Health (Forensicare), Clifton Hill, VIC, Australia
| | - Sam C Pang
- Victorian Institute of Forensic Mental Health (Forensicare), Clifton Hill, VIC, Australia
| | - Annette Brömdal
- School of Education, Faculty of Business, Education and Law and Centre for Health Research, Institute of Resilient Regions, University of Southern Queensland, Toowoomba, QLD, Australia
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Svendsen VG, Stavseth MR, Skardhamar T, Bukten A. Psychiatric morbidity among women in Norwegian prisons, 2010-2019: a register-based study. BMC Psychiatry 2023; 23:390. [PMID: 37268924 DOI: 10.1186/s12888-023-04886-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 05/18/2023] [Indexed: 06/04/2023] Open
Abstract
PURPOSE Research suggests that women in prison have more mental health problems than men and are prone to suffer from more severe psychiatric disorders. This study utilizes national registry data to describe demographic and psychiatric gender differences in Norwegian prisons, and to investigate comorbid psychiatric disorders and time trends in psychiatric morbidity among women. METHODS Longitudinal data from the Norwegian Prison Release Study linked with the Norwegian Patient Registry and data from Statistics Norway provided information on health care utilization, socioeconomic status, and history of psychiatric disorders among all individuals (nwomen = 5,429; nmen = 45,432) who were incarcerated in a Norwegian prison between 2010 and 2019. RESULTS Women were more likely than men to have a history of any psychiatric disorder (75% vs. 59%). Substance use disorders and dual disorders were highly prevalent in both genders, yet highest among women (56 and 38% respectively, versus 43 and 24% among men). From 2010 to 2019, we found a considerable increase in the 12-month prevalence of most diagnostic categories among women entering prison. CONCLUSION Psychiatric and dual disorders are highly prevalent in Norwegian prisons, and especially among women. The proportion of women entering prison with a recent history of mental health problems has increased rapidly over the last decade. Women's prison institutions need to adjust health and social services, and awareness about substance use and other psychiatric disorders in order to meet the increasing proportion of women facing these challenges.
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Affiliation(s)
- Vegard G Svendsen
- Norwegian Centre for Addiction Research, SERAF, University of Oslo, Building 45, Kirkeveien 166, Oslo, 0450, Norway.
| | - Marianne Riksheim Stavseth
- Norwegian Centre for Addiction Research, SERAF, University of Oslo, Building 45, Kirkeveien 166, Oslo, 0450, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Torbjørn Skardhamar
- Department of Sociology and Human Geography, University of Oslo, Oslo, Norway
| | - Anne Bukten
- Norwegian Centre for Addiction Research, SERAF, University of Oslo, Building 45, Kirkeveien 166, Oslo, 0450, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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Marr C, Gaskin C, Kasinathan J, Kaye S, Singh Y, Dean K. The prevalence of mental illness in young people in custody over time: a comparison of three surveys in New South Wales. PSYCHIATRY, PSYCHOLOGY, AND LAW : AN INTERDISCIPLINARY JOURNAL OF THE AUSTRALIAN AND NEW ZEALAND ASSOCIATION OF PSYCHIATRY, PSYCHOLOGY AND LAW 2023; 31:235-253. [PMID: 38628250 PMCID: PMC11018085 DOI: 10.1080/13218719.2023.2192257] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 02/09/2023] [Indexed: 04/19/2024]
Abstract
Few studies have examined the prevalence of mental illness in young people over time within the same jurisdiction. In the current study, we compared data from three large surveys of youth in custody in New South Wales, conducted in 2003, 2009 and 2015. We examined rates of mental illness, self-harm and suicidal behaviours, substance use and childhood trauma and found little consistent change over time, though some fluctuations were observed regarding certain mental illnesses and substance use. We also descriptively compared findings with observed rates for the general population and found that young people in custody showed higher levels of all examined variables. In sum, these data suggest little improvement in the well-being of young people in custody in New South Wales over time. Better identification and treatment of these issues are vital if young people are to be prevented from becoming enmeshed in the criminal justice system.
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Affiliation(s)
- Carey Marr
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, University of New South Wales, Randwick, NSW, Australia
| | - Claire Gaskin
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, University of New South Wales, Randwick, NSW, Australia
- Justice Health and Forensic Mental Health Network, University of New South Wales, Randwick, NSW, Australia
| | - John Kasinathan
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, University of New South Wales, Randwick, NSW, Australia
- Justice Health and Forensic Mental Health Network, University of New South Wales, Randwick, NSW, Australia
| | - Sharlene Kaye
- Justice Health and Forensic Mental Health Network, University of New South Wales, Randwick, NSW, Australia
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, NSW, Australia
| | - Yolisha Singh
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, University of New South Wales, Randwick, NSW, Australia
- Justice Health and Forensic Mental Health Network, University of New South Wales, Randwick, NSW, Australia
| | - Kimberlie Dean
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, University of New South Wales, Randwick, NSW, Australia
- Justice Health and Forensic Mental Health Network, University of New South Wales, Randwick, NSW, Australia
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Favril L. Drug use before and during imprisonment: Drivers of continuation. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 115:104027. [PMID: 37060886 DOI: 10.1016/j.drugpo.2023.104027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/27/2023] [Accepted: 04/03/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND Many people who enter prison have recently used drugs in the community, a substantial portion of whom will continue to do so while incarcerated. To date, little is known about what factors may contribute to the continuation of drug use during imprisonment. METHODS Self-reported data were collected from a random sample of 1326 adults (123 women) incarcerated across 15 prisons in Belgium. Multivariate regression was used to investigate associations between in-prison drug use and sociodemographic background, criminological profile, drug-related history, and mental health among participants who reported pre-prison drug use. RESULTS Of all 1326 participants, 719 (54%) used drugs in the 12 months prior to their incarceration and 462 (35%) did so while in prison. There was a strong association between drug use before and during imprisonment (OR = 6.77, 95% CI 5.16-8.89). Of those who recently used drugs in the community, half (52%) continued to do so while incarcerated. Factors independently associated with continuation (versus cessation) were young age, treatment history, polydrug use, and poor mental health. In a secondary analysis, initiation of drug use while in prison was further related to incarceration history and low education. CONCLUSION Persistence of drug use following prison entry is common. People who continue to use drugs inside prison can be differentiated from those who discontinue in terms of drug-related history and mental health. Routine screening for drug use and psychiatric morbidity on admission to prison would allow for identifying unmet needs and initiating appropriate treatment.
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Affiliation(s)
- Louis Favril
- Faculty of Law and Criminology, Ghent University, Belgium.
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Browne CC, Korobanova D, Chemjong P, Harris AWF, Glozier N, Basson J, Spencer SJ, Dean K. Continuity of mental health care during the transition from prison to the community following brief periods of imprisonment. Front Psychiatry 2022; 13:934837. [PMID: 36203827 PMCID: PMC9530150 DOI: 10.3389/fpsyt.2022.934837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 08/18/2022] [Indexed: 11/13/2022] Open
Abstract
PURPOSE The prison-to-community transition period is one of high risk and need, particularly for those with mental illness. Some individuals cycle in and out of prison for short periods with little opportunity for mental health stabilization or service planning either in prison or the community. This study describes the socio-demographic, clinical and criminal justice characteristics of individuals with mental illness and frequent, brief periods of imprisonment, examines continuity of mental health care between prison and the community for this group, and reports on their post-release mental health and criminal justice outcomes. DESIGN/METHODOLOGY/APPROACH This study examined a sample of 275 men who had recently entered prison in New South Wales (NSW), Australia, who had been charged with relatively minor offenses and had been identified on reception screening as having significant mental health needs. Baseline demographic and mental health information was collected via interview and file review and contacts with the prison mental health service were recorded for the period of incarceration. Follow-up interviews were conducted 3 months post-release to determine level of health service contact and mental health symptoms. Information on criminal justice contact during the 3 month period was also collected. FINDINGS The majority (85.5%) of the sample had contact with a mental health professional during their period of incarceration. Mental health discharge planning was, however, lacking, with only one in 20 receiving a referral to a community mental health team (CMHT) and one in eight being referred for any kind of mental health follow-up on release. Of those followed up 3 months post-release (n = 113), 14.2% had had contact with a CMHT. Of those released for at least 3 months (n = 255), one in three had received new charges in this period and one in five had been reincarcerated. CONCLUSION Continuity of mental health care for those exiting prison is poor, particularly for those with mental health needs experiencing brief periods of imprisonment, and rates of CMHT contact are low in the immediate post-release period. These findings suggest a need for early identification of individuals in this group for timely commencement of intervention and release planning, and opportunities for diversion from prison should be utilized where possible.
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Affiliation(s)
- Christie C Browne
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.,Justice Health and Forensic Mental Health Network, Sydney, NSW, Australia
| | - Daria Korobanova
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.,Justice Health and Forensic Mental Health Network, Sydney, NSW, Australia.,Western Sydney Local Health District, Sydney, NSW, Australia
| | - Prabin Chemjong
- Justice Health and Forensic Mental Health Network, Sydney, NSW, Australia.,Western Sydney Local Health District, Sydney, NSW, Australia
| | - Anthony W F Harris
- Western Sydney Local Health District, Sydney, NSW, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Nick Glozier
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,Sydney Local Health District, Sydney, NSW, Australia.,Australian Research Council Centre of Excellence for Children and Families Over the Life Course, Indooroopilly, QLD, Australia
| | - John Basson
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.,Western Sydney Local Health District, Sydney, NSW, Australia
| | - Sarah-Jane Spencer
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.,Justice Health and Forensic Mental Health Network, Sydney, NSW, Australia
| | - Kimberlie Dean
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.,Justice Health and Forensic Mental Health Network, Sydney, NSW, Australia
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