Indicator 20a: Prevalence of mental illness among people who are remanded or newly sentences to adult correctional facilities

Key messages:

• In 2010, 31% of new entrants to adult prisons reported having been told by a health professional that they had a mental illness, 16% reported that they were currently taking mental health related medication, and 14% reported very high levels of psychological distress.
• These figures indicate that new prisoners have poorer mental health than the general population.
• Ongoing collaborative efforts between the health and justice sectors are required to reduce the prevalence of mental illness among prisoners.

Prisoners are more likely to have poor mental health than members of the general population. The relationship between incarceration and mental illness is a complex one and can operate in both directions. Mental health problems may interact with other forces like drug use and poverty, and act as a risk factor for offending. Once an individual is in prison, the prison environment can have a further deleterious effect on his or her mental health.⁶⁶

Data from the 2010 National Prisoner Health Census sheds some light on the prevalence of mental illness among those remanded or newly sentenced to adult prisons (no equivalent information is available for their counterparts from juvenile correctional facilities).^67,68 Figure 64 shows that almost one third (31%) of new prison entrants reported having been told by a health professional that they had a mental illness (including depression, anxiety and drug and alcohol abuse). Sixteen per cent reported that they were currently taking mental health related medication. Fourteen per cent reported that they were experiencing very high levels of psychological distress according to the Kessler-10 (K-10).⁶⁹ On entry to prison, almost one fifth (19%) of prison entrants were referred to prison mental health services for observation and further assessment following the reception assessment.

Data on the general adult population from the 2007 National Survey of Mental Health and Wellbeing provide a point of comparison to gauge how prison entrants fare relative to the broader community. The National Survey of Mental Health and Wellbeing shows, for example, that 3% of the general adult population experience very high levels of psychological distress.⁷⁰ This means that the rate for prison entrants is around five times greater than that for the general population.

Ongoing efforts are required to reduce the prevalence of mental illness among prisoners. The National Statement of Principles for Forensic Mental Health provides a framework for these efforts, stressing that prisoners are entitled to have the same access to mental health care that others in the community have, and calling for improved collaboration between the health and justice sectors. The National Statement of Principles for Forensic Mental Health also highlights the need to minimise the detrimental impact on mental health of the incarceration process itself, suggesting that community diversion programs and other relevant initiatives should be used in preference to detention wherever possible.⁷¹
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Figure 64: Percentage of prison entrants showing some evidence of mental illness, including substance use disorders, 2010

Text version of figure 64

Percentage of admissions:

• History of a mental illness - 31%
• Currently taking mental health medication - 16%
• Experiencing very high distress - 14%
• Referred to prison mental health services on entry to prison - 19%