Are prison systems failing schizophrenics?

Prisoners with schizophrenia are three times more likely to be violent than other prisoners, according to a new study from Queen Mary University of London.

Yet this statistic only holds true if these individuals don't receive treatment or follow-up support from mental health services during and after their prison stay.

"Maintaining psychiatric treatment both during imprisonment and after release can substantially reduce the risk of violent reoffending," a press release on the study stated. "Better screening and treatment of prisoners is therefore essential to prevent violence."

Prison Cohort Study

The research comes from the Prison Cohort Study, which included 967 adult male and female offenders who were imprisoned for sexual or violent offenses.

Researchers looked at the rates of violence among prisoners with schizophrenia, drug-induced psychosis or delusional disorder who didn't receive treatment while in prison or upon release. They compared these individuals with prisoners who received treatment only during prison and those who received treatment during prison and after release.

They found that prisoners with schizophrenia who didn't receive treatment during and after incarceration were more likely to be violent than other prisoners. The violent episodes seemed to be mostly stemmed in the prisoners' idea that someone or something was out to harm them, which is a common symptom of untreated schizophrenia.

'Public health problem'

The research also showed that schizophrenic prisoners who have violent tendencies that are left untreated are much more likely to have future violent episodes. Jeremy Coid, Professor of Forensic Psychiatry, Queen Mary University of London, is calling this phenomenon a public health problem:

Current risk assessment tools do not take treatment into account and we are therefore missing out on this vital part of the puzzle. We need to improve our screening methods and ensure the treatment of prisoners with psychosis, both in prison and following release, if the aim is to manage their risk of violence.

And despite the fact that mental illness rates among prisoners are high, treatment is often scarce. One recent study found that only about 25 percent of prisoners with mental health issues are successfully treated. In the UK, it's estimated that less than 25 percent of prisoners with psychosis will receive an appointment with a mental health professional after they are released.

"This is an important public health problem and at the moment we're failing high-risk people with psychotic disorders and the public by not screening and treating people with severe mental disorders well enough," Professor Coid concluded.

Results of the study are published in the American Journal of Psychiatry.

Source: Queen Mary, University of London

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