People with mental illnesses are understood to be overrepresented in the U.S. criminal justice system, and estimates of the prevalence of mental illnesses in corrections settings are crucial for planning and implementing preventive and diversionary policies and programs. Despite consistent scholarly attention, two federal self-report surveys are typically cited, and these may not represent the extent of relevant data. This systematic review identifies studies that assess the prevalence of mental illnesses in U.S. state prisons, in order to develop a broader picture of prison prevalence and identify methodological challenges to obtaining accurate and consistent estimates.
Medline, PsycInfo, the National Criminal Justice Reference Service, Social Services Abstracts, Social Work Abstracts, and Sociological Abstracts were searched. Studies were included if they were published between 1989 and 2013; focused on U.S. state prisons; reported prevalence of diagnoses/symptoms of DSM Axis I disorders; and identified screening/assessment strategies.
Twenty-eight articles met inclusion criteria. Estimates of current and lifetime prevalence of mental illnesses varied widely; however, the range of prevalence estimates for particular disorders was much greater—and tended to be higher—in prisons than community samples.
Operationalizations of mental illnesses, sampling strategies, and case ascertainment strategies likely contributed to inconsistency in findings. Other reasons for study heterogeneity are discussed, and implications for public health are explored.
Full article at: http://goo.gl/4K5YlM
By: Seth J. Prins, MPH
Seth J. Prins, Columbia University Department of Epidemiology Mailman School of Public Health 722 W. 168th Street, 720-C Department of Epidemiology New York, New York 10032
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