Schizophrenia Daily News Blog

Women and Prison - Brain Disorders Not Identified

A new report out of New Zealand suggests that women prisoners are not being properly identified and treated for brain disorders. A similar problem is likely in most countries, other reports have suggested. The Press (of Christchurch, New Zealand) states:

"Two-thirds of women prisoners suffering mental disorders such as psychosis and suicidal depression are not being picked up by the Corrections Department, says a leading forensic psychiatrist.

Mark Earthrowl, clinical leader of Canterbury's regional forensic service, said the current Corrections screening process "is not effective".

"Only about one-third of people with mental disorders are picked up."

In a single year at Christchurch Women's Prison, one inmate committed suicide and five inflicted serious harm on themselves, Earthrowl said. Four of the six women were not picked up by the Corrections screening programme when they entered prison.

This threatened to compound the apparent lack of care offered while they were in the community.

Earthrowl said the majority of those suffering a major mental disorder at the time of their arrest were not being treated.

Only one-third of those suffering psychosis, which included schizophrenia, were in treatment at the time of their arrest, and less than half of those who suffered depression.

The exception was bipolar disorder, particularly mania, where about 80% of sufferers were in treatment.

Earthrowl's team embarked on a one-year project at Christchurch Women's Prison to trial a new way of screening for mental disorders and suicide risk.

Nearly one in four of about 500 women seen during the trial year tested "positive".

These were referred to a forensic nurse for triage, and referral on to other agencies. Nearly half (45%) were referred for psychiatric help.

Earthrowl believed the new screening tool was a success.

It doubled the number of patients needing follow-up treatment for mental health problems or suicide risk, and tripled the number for triage.

During the year, only 11 women, not picked up during screening, were referred to mental health services for help.

None of the 11 were at risk of self-harm or suffering a mental disorder.

A number needed sexual abuse or post- traumatic stress counselling.

Anecdotally, prison staff reported fewer prisoners reaching crisis and drop-in use of the prison's at-risk unit.

"We felt it worked," said Earthrowl of the screening tool. "We think it's improved significantly the detection of mental disorders."

Earthrowl said Christchurch Women's staff had continued using the new screening tool after the trial ended, and work was under way to improve screening nationally.

An effective screening programme was crucial with the rate of mental health problems in the prison community "tremendously high".

Nearly 60% of prisoners suffered at least one diagnosable mental disorder, and 10% needed mental health care.

"This is much much higher than the community population," he said.

Up to one in 20 inmates suffered psychosis -- five to 10 times the rate seen in the community -- and up to 14% suffered depression. About 17% suffered from post- traumatic stress disorder.