Majority of young male prisoners have mental health issues, research finds

More than three-quarters of young male prisoners in Scotland have reported having mental health issues, according to research.

The University of Glasgow study found 88.5% of young offenders surveyed said they are experiencing mental health conditions, but less than 3% have received a proper clinical assessment.

The research involved 110 male inmates aged 16 to 23 at Polmont Young Offenders Institution.

It examined the prevalence of, and associations between, adverse childhood experiences, neurodevelopmental and mental health conditions.

The research included two conditions specifically associated with abuse and neglect – reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) – for the first time.

Prisoners were also screened for conditions including mood and anxiety disorders, psychotic symptoms, obsessive compulsive disorders, eating disorders, autism and ADHD.

The study showed more than half of those surveyed (53.6%) had RAD and/or DSED symptoms, along with a wide range of other psychiatric and neurodevelopmental conditions.

Nearly 75% had experienced abuse and neglect, and almost all (96%) had one or more lifetime neurodevelopmental or mental health condition.

In addition, the study found that while only 2.7% of participants had received a comprehensive clinical assessment in prison, 44.6% had received input from mental health services.

It found 10% had been counselled for drugs and alcohol, 14.5% had received medication, 8.2% had a trauma-related service such as psychotherapy, and 15.5% received advice from a mental health nurse.

Professor Helen Minnis, of child and adolescent psychiatry at the university’s School of Health and Wellbeing, said: “Sadly we know that a high proportion of young male offenders in prison have a history of abuse and neglect, a high prevalence of adversity, especially maltreatment, and it’s common to see neurodevelopmental or psychiatric conditions.

“By including conditions specifically associated with abuse and neglect in our study (RAD and DSED), we were able to see a comprehensive picture of the high prevalence of these conditions, alongside other mental health conditions, within this group.

“We hope these new findings can help pave the way for more comprehensive clinical assessments for these young men in prison, and to help develop appropriate support and staff training – all of which is vitally needed to ensure that the full implications of the high prevalence of these mental health conditions are understood as part of trauma informed care to enable treatment and rehabilitation.”

Dr Kate Moran, an assistant professor in psychology, added: “Our study shows that the most commonly unmet need for mental health intervention in young men in prison is that of an assessment.

“Given the knowledge that abused and neglected children are at much higher risk of having heritable neurodevelopmental problems, which increases their risk of severe mental illness, our study demonstrates yet another strong argument for offering the prison population a comprehensive neurodevelopmental and mental health assessment.

“Building on this research, we are fortunate to be currently collaborating with Polmont to develop an understanding of mental health and relationships from the young person’s perspective.

“This will inform future intervention to ensure a greater awareness of the specific and nuanced needs of this population.

“Going forward, if we can address this unmet need, and provide a robust psychological assessment to these young men, we may be able to reduce the high suicide rate in this population, as well as improve recidivism and societal costs.”

A Scottish Prison Service spokesperson said: “The provision of healthcare services, including mental health services, transferred from the Scottish Prison Service to NHS Scotland in 2011.

“The mental health and wellbeing of those who live in our establishments is a key priority for the SPS. Where there is an identified concern for a person in our care, we work alongside our NHS partners to support the individual.

“Our new mental health strategy is nearing completion and has been subject to wide consultation with key experts in mental health, including those working with young people, and will reflect the Scottish Government’s national mental health, suicide prevention and self-harm strategies.”