This research report bears powerful witness to the harsh impact on women and their children of the short custodial sentences too often meted out in the name of justice. It draws attention to the ripple effects of imprisoning mothers, and the turbulence it causes in the lives of their families.
This paper considers how maternal emotions and the maternal role are assembled and challenged through carceral space, and more specifically, how mothers themselves assimilate this experience whilst navigating motherhood post incarceration.
Worldwide, more than 10 million individuals are in prison at any given time, and more than 30 million individuals circulate through prison each year. Research has consistently shown that prisoners have high rates of psychiatric disorders, and in some countries more people with severe mental illness are in prisons than in psychiatric hospitals. Despite the high level of need, these disorders are frequently underdiagnosed and poorly treated. In this structured review, we provide an overview of the epidemiology of psychiatric disorders in prison, summarise information on rates of suicide and violence victimisation and risk factors for these outcomes, and outline evidence-based interventions for mental health care. Based on this review, we propose a series of clinical, research, and policy recommendations. The aim is to provide a broad synthesis of the main issues related to the mental health of adult prisoners, and highlight gaps in evidence and practice. Two special populations are briefly discussed, namely women and older adults. Juveniles in prison have distinct mental health needs, and an overview of these is outside the scope of this Review.
As bipolar disorder is a mental disorder particularly associated with elevated risk of suicide compared to the general population, with reviews suggesting standardized mortality ratios of above 20 and a large population-based study reporting a mortality ratio of 15, one might expect that the combination of imprisonment and the presence of bipolar disorder might be additive or even multiplicative in terms of suicide risk. The previous systematic review did not specifically examine the association between bipolar disorder and prison suicide and thus it remains uncertain if bipolar disorder is a particular risk factor for suicide and suicidal behavior in prisoners.
Suicide rates in prisoners are considerably higher than in the general population, both in the United States and the United Kingdom and internationally. In the United States, the rate of suicide in jails is estimated to be 8 times higher than in the general population, and in England and Wales, the age-standardized rate of suicide among all male prisoners is 5 times higher than in the general population - a proportionate excess that has been increasing since 1978. In addition, these rates remain high after leaving prison - a recent study of all inmates released in 1 U.S state found an increased suicide risk 3- to 4- fold higher than in the general population after adjustment for age, sex, and race.
Adolescents younger than 19 years constitute 5% of all those detained in custody in Western countries, including about 100,000 individuals in the United States. They are usually detained in separate closed facilities or prisons. High prevalence of both undiagnosed and untreated physical and mental health problems have been reported, with current mental disorders estimated to affect 40% to 70% of the adolescents who come into contact with the justice system. Deliberate self-harm and repeat offending are common,and some of these disorders, such as substance misuse and conduct disorder, are risk factors for criminal recidivism. In the United States and the United Kingdom, it has been argued that there is insufficient screening for mental disorders, that sentencing does not account for mental health issues, and that custodial and secure facilities lack qualified staff and appropriate treatment.
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