Thursday, January 21, 2016

Links Between Depressive Symptoms & Unmet Health & Social Care Needs among Older Prisoners

BACKGROUND:
Absolute numbers of older prisoners and their proportion of the total prison population are increasing. They have multiple health and social care needs that are prominent on entry into prison. No previous studies have identified older prisoners' health and social care needs at this crucial point.

OBJECTIVE:
To examine unmet health and social care needs among older men entering prison and their links with depressive symptoms.

METHODS:
A cross-sectional survey across nine prisons in the North of England was completed. One hundred male prisoners aged between 60 and 81 were interviewed, using the Camberwell Assessment of Need-Forensic short version (CANFOR-S) and Geriatric Depression Scale-Short Form (GDS-15). Descriptive statistics were generated and χ(2) tests performed.

RESULTS:
Participants reported high levels of unmet needs as measured with the CANFOR-S, notably in the domains of knowledge about their condition and treatment (38%); psychological distress (34%); daytime activities (29%); benefits (28%); food (22%) and physical health (21%). The mean total number of unmet needs was 2.74, with a median of 2.0. More than half the sample (56%, 95% CI 45-66%) exhibited clinical signs of depression. A significant association between depressive symptomology and an unmet physical health need, as measured by the CANFOR-S, was detected (χ(2) = 6.76, df = 1, P < 0.01).

CONCLUSIONS:
High levels of depressive symptoms were experienced by older prisoners on entry into prison. Personalised health and social care needs assessment and discrete depression screening are required on prison entry to facilitate effective management of unmet needs.

Below:  Distribution of GDS-15 scores (n = 86).


  
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  • 1School of Languages, Law and Social Sciences, Dublin Institute of Technology (http://www.dit.ie/llss/), Dublin, Ireland.
  • 2Offender Health Research Network, University of Manchester, Manchester, UK.
  • 3Institute of Brain Behaviour and Mental Health, University of Manchester, Manchester, UK.
  • 4University of Warwick-Medicine, Medical Teaching Centre, Coventry CV4 7AL, UK.
  • 5School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK.
  • 6Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.
  •  2016 Jan;45(1):158-63. doi: 10.1093/ageing/afv171. 




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