Serious mental health issues (SMI) in the general population present a range of problems on both community and personal levels. People with SMI face challenges in relationships, careers, and social settings, making financial and personal pursuits difficult. They may also be confronted with health care obstacles that prevent them from receiving adequate treatment.
On a community level, untreated SMI can raise the rate of crime, and violence, and put a significant burden on healthcare resources. When SMI is neglected, it can lead to legal problems and even incarceration. When in prison, inmates are screened for SMI, but according to the results of a recent study conducted by J. Senior of the University of Manchester in the United Kingdom, they rarely receive the care they need.
Senior examined data from mental health issues in-reach programs designed to identify and provide treatment to inmates with SMI. The study included data from 3,492 prisoners. In all, 23% of the inmates had some form of SMI, and yet only one quarter of these individuals with SMI were adequately evaluated by in-reach personnel.
Even more alarming was the finding that only 13% of those who had SMI were actually taken on as clients. In other words, the majority of inmates with SMI did not receive any evaluation from the in-reach members, and an even larger number received no treatment for mental health issues. This is astonishing, considering the link between criminal activity and mental illness. Senior believes that these results clearly show a void of care in the prisoner population.
One of the ways in-reach members assess inmates on intake is to determine if they received mental health care immediately preceding incarceration. If not, they are not assessed further. However, in this study, only half of those who reported prior mental health contact before incarceration were referred to in-reach mental health care.
“This suggests a fundamental problem in using past contact with services as an indicator to ensure continuity of care for a large proportion of severely mentally ill prisoners,” said Senior. Overall, this study clearly shows that efforts to identify prisoners with SMI should be strengthened.
Perhaps the addition of repeated in-reach evaluations, or more private and thorough screenings could better identify those with SMI and those in need of mental health care. Further, Senior believes that community mental health services could help reduce incarceration for those with SMI by making avenues of treatment more accessible and available.
Senior, J., et al. (2013). Identification and management of prisoners with severe psychiatric illness by specialist mental health services. Psychological Medicine 43.7 (2013): 1511-20. ProQuest. Web.
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