Inside the nation’s largest mental health institution: a prevalence study in a state prison system

BMC Public Health

Research Article

Bruce Sieleni¹  Harbans Deol²  Linda Rubenstein³  Robert B. Wallace³  Tala Al-Rousan⁴ 

[1] Department of Corrections, Iowa Medical and Classification Center, Coralville, IA, USA;Department of Corrections, Iowa Medical and Classification Center, Coralville, IA, USA;Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA;Department of Epidemiology, University of Iowa School of Public Health, Iowa City, IA, USA;Department of Global Health, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Building 1, Room 1107, 02115, Boston, MA, USA;

关键词: Aging;    Prisoners;    Inmates;    Correctional;    Mental health;   

DOI  :  10.1186/s12889-017-4257-0

 received in 2016-08-23, accepted in 2017-04-11,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe United States has the highest incarceration rate in the world which has created a public health crisis. Correctional facilities have become a front line for mental health care. Public health research in this setting could inform criminal justice reform.We determined prevalence rates for mental illnesses and related comorbidities among all inmates in a state prison system.MethodsCross-sectional study using the Iowa Corrections Offender Network which contains health records of all inmates in Iowa. The point prevalence of both ICD-9 and DSM-IV codes for mental illnesses, timing of diagnosis and interval between incarceration and mental illness diagnosis were determined.ResultsThe average inmate (N = 8574) age was 36.7 ± 12.4 years; 17% were ≥50 years. The majority of inmates were men (91%) and white (65%).Obesity was prevalent in 38% of inmates, and 51% had a history of smoking. Almost half of inmates were diagnosed with a mental illness (48%), of whom, 29% had a serious mental illness (41% of all females and 27% of all males), and 26% had a history of a substance use disorder. Females had higher odds of having both a mental illness and substance use disorder. Almost all mental illness diagnoses were first made during incarceration (99%). The mean interval to diagnosis of depression, anxiety, PTSD and personality disorders were 26, 24, 21 and 29 months respectively. Almost 90% of mental illnesses were recognized by the 6th year of incarceration. The mean interval from incarceration to first diagnosis (recognition) of a substance abuse history was 11 months.ConclusionsThere is a substantial burden of mental illness among inmates. Racial, age and gender disparities in mental health care are coupled with a general delay in diagnosis and treatment. A large part of understanding the mental health problem in this country starts at prisons.

【 授权许可】

CC BY   
© The Author(s). 2017