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Mental illness in New Zealand prisons quantified

A study on the level of mental illness in New Zealand prisons launched today provides for the first time information on the prevalence of mental illness among inmates in New Zealand prisons.

The National Study of Psychiatric Morbidity in New Zealand Prisons was commissioned by the Department of Corrections in 1997, and co-sponsored by the Ministries of Health and Justice.

The study is a critical part of a Ministry of Health/Health Funding Authority review of forensic services currently underway.

The Director of Mental Health, Dr Janice Wilson and the Department of Corrections' Chief Advisor on Policy Development, Terry Craig, welcomed the report.

"Not only is it a first in New Zealand; the quality and the scale of research mean that the report is an authoritative document that will be of international interest," said Mr Craig.

"The findings give us the detailed information required for us to move forward with the health sector in the further development of services for inmates with a mental illness."

The results confirm international findings of higher rates for many mental disorders in prisons relative to the community.

Examples of the findings include rates of two to four percent of inmates with schizophrenia, six to eleven percent suffering from depression and nine to sixteen percent with post traumatic stress disorder. All of these rates are significantly higher than corresponding rates for the general population.

This study also found that around a third of the prison sample met the criteria for past or present alcohol or drug dependence, and that around twenty percent had frequent suicidal thoughts.

Of particular concern is that fewer than half of those identified with a mental disorder had received some form of treatment in prison.

Mr Craig said the Department of Corrections was focusing on these problems.

"We are implementing a national system for better assessment of inmates to improve the identification and management of mental illness. We are also making considerable effort to minimise the risk of suicide in prisons, encouraging staff awareness training and active management of at-risk inmates. "Furthermore, we have a forensic psychiatric nurse working four days a week at each of Mt Eden and Auckland Prisons, which both have special needs units for inmates unable to be managed in the mainstream prison.

Mr Craig said the report also validated the Department of Corrections efforts with the drug strategy.

"The report shows that 90 percent of those inmates who have mental illness, also have a drug and/or alcohol abuse problem. This illustrates why it's so important for us reduce drug use and treat drug addiction amongst inmates."

Dr Janice Wilson said this new evidence would be fed into a Ministry of Health/Health Funding Authority review which will identify areas of the forensic services which need improving.

"Our forensic mental health services are considered to be leaders in the world, but it is timely for us to review them given demand.

"Mental health services are responsible for the specialist needs of those inmates with mental illness, and this research gives us excellent information to feed into the development of forensic policy and services," said Dr Wilson.

"We are committed to improving our forensic services. In 1998/99 mental health funding on forensic services was $48.5 million (GST exclusive), a four percent increase over the previous year.

"Furthermore in 1999/00 the HFA will purchase an estimated additional $1.2 million forensic services in Auckland, Hamilton and in Wellington. There will also be an increase nationally in the numbers of extended secure beds, from 35 to 42 beds. These extra seven beds should be in place by March 2000.

"The recently released National Mental Health Strategy: Review of Progress 1994-1999 illustrated that progress towards more and better mental health services has been made. It showed that service growth since 1994 had been dramatic with increasing community mental health services for adults, development of mental health services for Maori, improved collaboration and co-ordination between services and increased workforce training.

"But this report is a clear indicator that we need to keep improving and increasing the level of service we provide. The review of forensic services is just one part of this drive to improve New Zealand's mental health services."

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