Psychiatric disorders among older prisoners: a systematic review and comparison study against older people in the community

Objectives: Despite emerging evidence that older prisoners experience poor mental health, literature in this area is still limited. In the present systematic review and meta-analysis, we report on the prevalence of psychiatric disorders among older prisoners and compare our findings against community studies on older people. Methods: We searched on Assia, PsycInfo, MedLine, Embase, Web of Science, Google and Gov.uk. We carried out bias assessments, rated studies for quality and ran a heterogeneity test. We meta-analysed prevalence rates of psychiatric disorders through an aggregate weighted mean and calculated Relative Risk and statistical significance against community studies. Sensitivity analyses were further performed. Results: We reviewed nine studies and obtained the following prevalence: “Any psychiatric disorder” 38.4%, depression 28.3%, schizophrenia/psychoses 5.5%, bipolar disorder 4.5%, dementia 3.3%, cognitive impairment 11.8%, personality disorder 22.9%, alcohol abuse 15.9%, anxiety disorders 14.2%, PTSD 6.2%. Older prisoners were found to have higher RR for every single psychiatric disorder against older people in the community, with the sole exception of alcohol abuse (RR=1) and dementia (RR=.75). The prevalence rates were statistically significantly higher (p<.05) among the prisoners for “Any psychiatric disorder”, depression and personality disorder. Overall, the sensitivity analyses confirmed our original results. Conclusion: Our findings point at a high prevalence of every single psychiatric disorder among older prisoners, who also experience rates of dementia and alcohol abuse comparable to those reported in the community. Our results have relevant implications for policy and practice in this area. Further research is crucial to confirm findings from this study

First-time and recurrent inmates' experiences of imprisonment

The authors surveyed 267 first-time (n = 102) and recurrent (n = 165) adult male inmates from two medium-security prisons in England. The findings revealed significant differences between the two groups of inmates: A relatively higher proportion of recurrent inmates were enrolled in drug treatment programs; a relatively higher proportion of first-time inmates had given up smoking and drinking, whereas more recurrent inmates had given up drugs; recurrent inmates thought about sex significantly more often, whereas first-time inmates were more concerned about being attacked; and finally, the highest proportion of recurrent inmates cited “improved health” as the best thing about being in prison, compared to the highest proportion of first-time inmates who cited “opportunity for rehabilitation.” Results were partially explained by differences in aspects of prisoners’ lives before prison and their differential exposure to imprisonment, and not by prison security, prison regime, or sentence variables. The findings can inform the development of prison regimes and policies that facilitate adjustment to imprisonment