Academic journal article Trends & Issues in Crime and Criminal Justice

Mental Disorder Prevalence at the Gateway to the Criminal Justice System

Academic journal article Trends & Issues in Crime and Criminal Justice

Mental Disorder Prevalence at the Gateway to the Criminal Justice System

Article excerpt

Introduction

It has been well recognised, both in Australia and internationally, that poor mental health is more prevalent among prisoners than the general population (AIHW 2010; Butler & Allnutt 2003; Fazel & Danesh 2002). Substance abuse disorders are particularly prevalent among prisoners, and the comorbidity of these with other mental disorders has been found to increase the likelihood of criminal recidivism (Smith &Trimboli 2010). Such evidence has led to renewed government focus on improving mental health services for people in prison, as well as after release, with the intention of reducing recidivism by treating substance dependence and other mental disorders (Australian Government 2009). Although mental disorder does not necessarily contribute to offending behaviour, evidence suggests that, particularly in combination with substance abuse, mental disorders do play a part in criminal behaviour for some offenders (Day & Howells 2008).

Prisoners' vulnerability to poor mental health has been specifically targeted for intensive intervention in Australian Government mental health policy (Australian Government 2009). The challenges of providing appropriate treatment to prisoners with both substance abuse and other mental disorders are well documented (Day & Howells 2008). However, prisoners represent only a proportion of the people who commit criminal offences, as most convicted offenders do not receive a custodial sentence. For example, in New South Wales, from 2004 to 2008, around seven percent of those convicted in local courts and 70 percent of those convicted in higher courts were given a prison sentence (BOCSAR 2008a, 2008b). This highlights the importance of adopting a multi-pronged and comprehensive approach to the identification and treatment of mental disorder among people throughout the criminal justice system - not only those in prison.

Mental disorder among non-incarcerated offenders is increasingly recognised as an issue of concern at various points in the criminal justice system. For example, court liaison services aim to improve the efficiency with which mentally disordered offenders are diverted to health services or supported through criminal justice processes (Bradford & Smith 2009). Specialist problem-solving courts have recently been introduced in many jurisdictions, and such courts consider mental disorder (including drug dependence) as criminogenic and aim to reduce criminal recidivism by legally mandating treatment (Payne 2006). NSW Police have introduced specialist training for frontline officers to improve interactions with mentally disordered people (Herrington et al. 2009). For these and other initiatives to be accurately targeted, good quality prevalence and causal pathway information has been identified as vital (Australian Government 2009).

Ogloff, Davis, Rivers and Ross (2007) recently highlighted the importance of accurately identifying mental disorders among people at the entry point of the criminal justice system. Diagnosis at this point presents a therapeutic opportunity, particularly for people who have concurrent substance abuse and other mental disorders. The authors recommend routine screening of police detainees using a structured and standardised screening instrument, assessment for those who are identified by the screening as mentally disordered, regular reassessment at various stages in the criminal justice system and sharing of health information to ensure continuity of care throughout the criminal justice system (Ogloff et al. 2007). The authors point out that routine screening identifies mentally disordered offenders for treatment provision, can help prevent violent incidents in detention facilities, allows resources to be allocated to the most needy and has the potential to reduce the cycle of admissions to the criminal justice system for people with mental health problems (Ogloff et al. 2007).

Routine screening identifies people who may appear well but who in actual fact are experiencing symptoms and therefore require a comprehensive psychological assessment. …

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