Prisoners with neurodevelopmental difficulties: Vulnerabilities for mental illness and self-harm

Jane McCarthy; Eddie Chaplin; Andrew Forrester; Lisa Underwood; Hannah Hayward; Jess Sabet; Susan Young; Richard Mills; Philip Asherson; Declan Murphy

doi:10.1002/cbm.2132

Prisoners with neurodevelopmental difficulties: Vulnerabilities for mental illness and self-harm

Crim Behav Ment Health. 2019 Dec;29(5-6):308-320. doi: 10.1002/cbm.2132.

Authors

Jane McCarthy¹, Eddie Chaplin², Andrew Forrester^{3

4}, Lisa Underwood⁵, Hannah Hayward⁴, Jess Sabet⁴, Susan Young^{6

7}, Richard Mills⁸, Philip Asherson⁴, Declan Murphy⁴

Affiliations

¹ Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
² London South Bank University School of Health and Social Care, Ringgold Standard Institution, 103 Borough Road, London, SE1 0AA, United Kingdom of Great Britain and Northern Ireland.
³ Greater Manchester Mental Health NHS Foundation Trust and South London and Maudsley NHS Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland.
⁴ King's College London, London, United Kingdom of Great Britain and Northern Ireland.
⁵ University of Auckland, Auckland, New Zealand.
⁶ Institute of Psychiatry, De Crespigny Park, London, SE5 8AF, United Kingdom of Great Britain and Northern Ireland.
⁷ Broadmoor Hospital West London Mental Health Trust, London, RG45 7EG, United Kingdom of Great Britain and Northern Ireland.
⁸ Research Autism, London, United Kingdom of Great Britain and Northern Ireland.

PMID: 31912971
DOI: 10.1002/cbm.2132

Abstract

Background: Research into neurodevelopmental disorders in adult offenders has tended to be disorder specific, so hindering service planning for a group of offenders with similar vulnerabilities.

Aim: To examine vulnerabilities for mental illness and self-harming behaviours among male prisoners screening positive for a range of neurodevelopmental difficulties-including but not confined to disorders of intellectual ability, attention deficit hyperactivity, and in the autistic spectrum.

Method: In a cross-sectional study, prisoners who screened positive for neurodevelopmental difficulties were compared to prisoners who screened negative for the same on indicators of suicide-related and self-harm behaviours, mental illness, and substance misuse using the Mini International Neuropsychiatric Interview (MINI).

Results: Of 87 prisoners who screened positive for neurodevelopmental difficulties, 69 had full MINI mental health data. In comparison with 69 neurotypical men in the same prison, the neurodevelopmental difficulties group was significantly more likely to have thought about self-harm and suicide in the last month and to have significantly higher rates of concurrent mental disorders including psychosis, anxiety, depression, personality disorder, and substance dependency disorders.

Conclusions: This is one of the first studies to examine the mental health of adults with neurodevelopmental difficulties in a prison setting. This group, unlike those who meet diagnostic threshold, is not routinely considered by mental health or correctional services. The study found prisoners with neurodevelopmental difficulties showed greater vulnerability to mental disorder and thoughts of suicide and suicide-related behaviours than other prisoners. Accordingly, we recommend routine early screening across the criminal justice system for any neurodevelopmental difficulties to inform decision-making on the most appropriate disposal and support.

Keywords: MINI; mental illness; neurodevelopmental difficulties; neurodevelopmental disorders; prisoners; screening.

MeSH terms

Adult
Cross-Sectional Studies
Humans
Male
Mental Disorders / psychology*
Middle Aged
Neurodevelopmental Disorders / psychology*
Prisoners / psychology*
Self-Injurious Behavior / psychology*

Abstract

MeSH terms

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