April 30, 2008
Mental and addictive disorders high among offenders entering state prisons
A University of Iowa study on men and women entering Iowa's prison system found that more than 90 percent met the criteria for a current or lifetime mental health condition or an addictive disorder, and 30 percent of the offenders were rated as being at risk for suicide.
UI researchers interviewed 320 randomly selected, nonviolent offenders (264 men and 56 women) newly committed to the reception and evaluation center of the Iowa Medical and Classification Center (IMCC) located in Oakdale. The average age of the study participants was 31, and over 70 percent of the offenders were Caucasian.
"Because there has been terrific concern about mental health issues among prisoners, we thought that we ought to collect high-quality data to confirm the extent of the problem. This data is essential for planning purposes in the correctional system," said Donald Black, M.D., professor in the UI Department of Psychiatry and one of the study authors. "We now know just how common these conditions are, and the figures suggest that we ought to be concerned."
The researchers collected demographic and criminal history information and used the Mini International Neuropsychiatric Interview-Plus (MINI-Plus), an established research tool that allows for the coding of more than 60 variables, including current, past or lifetime mental health disorders and suicide risk.
The most frequent charges among study participants were substance-related charges, which included drug manufacturing/delivery and driving under the influence.
Over 93 percent of the men and women met criteria for at least one lifetime psychiatric disorder when assessed with the MINI-Plus, and nearly two-thirds of the participants had three or more disorders in their lifetimes. The most frequent were substance abuse and dependence (90 percent), followed by mood disorders such as depression, psychotic disorders (many of which were substance-related), antisocial personality disorder, anxiety disorders such as panic, and attention-deficit hyperactivity disorder.
Approximately 85 percent of the men and 91 percent of the women met the criteria for a current MINI-Plus disorder, with substance abuse or dependence occurring within the last year being the most frequent (68 percent of women and 75 percent of men).
Most of the study participants had prior involvements with the criminal justice system, noted Tracy Gunter, M.D., assistant professor and director of the forensic psychiatry program in the UI Department of Psychiatry, and one of the study authors.
"Recidivism is a chronic problem for most correctional systems, and the presence of a mental health or addictive disorder seems to increase the risk even more," Gunter said. "Therefore, finding and treating these problems not only has import for the prison stay, but may have significance for decreasing recidivism after release from confinement."
The take-away message of the study, Black said, is that "these conditions are present in the prisons at an alarming frequency, so we must continue to refine our methods to identify and treat offenders in need. Providing effective treatment will relieve suffering and likely improve outcomes both inside prison and after release."
The IMCC serves as a reception facility for the Iowa Department of Corrections, where new prisoners are admitted for intake activities and orientation to the state's prison system, health screenings and risk assessments before being assigned to one of Iowa's nine correctional facilities.
The study was published in the March 2008 issue of the Journal of the American Academy of Psychiatry and the Law. The research was supported through the Nellie Ball Trust Research Fund administered by Iowa State Bank and Trust and the Iowa Department of Corrections, where Black and Gunter serve as consultants.
STORY SOURCE: University of Iowa Health Science Relations, 5139 Westlawn, Iowa City, Iowa 52242-1178
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