Understanding individual-level changes in mental health
status after prison release is crucial to providing targeted and effective mental
health care to ex-prisoners. We aimed to describe trajectories of psychological
distress following prison discharge and compare these trajectories with mental
health service use in the community.
The Kessler Psychological Distress Scale (K10) was
administered to 1216 sentenced adult prisoners in Queensland, Australia, before
prison release and approximately 1, 3 and 6 months after release. We used
group-based trajectory modeling to identify K10 trajectories after release.
Contact with community mental health services in the year following release was
assessed via data linkage.
We identified five trajectory groups, representing
consistently low (51.1% of the cohort), consistently moderate (29.8%), high
increasing (11.6%), high declining (5.5%) and consistently very high (1.9%)
psychological distress. Mood disorder, anxiety disorder, history of self-harm
and risky drug use were risk factors for the high increasing, very high and
high declining trajectory groups. Women were over-represented in the high
increasing and high declining groups, but men were at higher risk of very high
psychological distress. Within the high increasing and very high groups, 25% of
participants accessed community mental health services in the first year
post-release, for a median of 4.4 contact hours.
For the majority of prisoners with high to very high
psychological distress, distress persists after release. However, contact with
mental health services in the community appears low. Further research is required
to understand barriers to mental health service access among ex-prisoners.
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By:
- 1Melbourne School of Population and Global Health,University of Melbourne,Parkville,VIC,Australia.
- 2School of Medicine,University of Queensland,Herston,QLD,Australia.
- 3Criminology,Law & Society,College of Humanities and Social Sciences,George Mason University,Fairfax,VI,USA.
- 4School of Public Health and Centre of Youth Substance Abuse Research,University of Queensland,Herston,QLD,Australia.
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