Mental disorders among offenders in correctional settings
Incontrovertible evidence now exists to show that the prevalence of mental disorders among prisoners far exceeds that found in the general community. A surprising concordance is emerging from several large international studies to show that, in western developed societies at least, the rates of major mental disorders in prisons are quite consistent. This chapter will provide an overview of relevant research examining rates of mental illness in prisons with those found in the community. Some observations regarding trends and implications for prisons also will be provided. At the outset it is useful to reflect on the scope of illnesses which have been subsumed under the ‘mental disorder’ umbrella as it has been applied to the prison research. Most of the research that exists has focussed serious mental illnesses within the Axis I disorders—namely psychotic illnesses, mood disorders, and anxiety disorders. Considerable attention has been paid regarding the prevalence of personality disorders within prisons. Over the past 20 years much of that work has investigated antisocial or dissocial personality disorder and psychopathy. By comparison, relatively little attention has been paid to other personality disorders. A growing area of importance concerns substance abuse and dependence disorders and, of course, co-occurring substance use and mental illness disorders. Considerable research also exists exploring the prevalence of mental retardation or intellectual disabilities in prison. Thereafter, fragments of research exist exploring any number of mental syndromes and conditions. The focus of this chapter will be on the major mental disorders which fall into Axis I. Some mention will be made of substance use disorders and personality disorders. In addition, with the growing number of women in prisons, information will be provided regarding this important group.