African Caribbean men remanded to Brixton prison: psychiatric and forensic characteristics and outcome of final court appearance

AIMS: This study aims to examine the influence of ethnic origin on the range of diagnoses, past psychiatric and forensic contacts, and outcome of final court appearance in a random sample of men remanded in Brixton prison health care centre for a psychiatric assessment. METHOD: 277 men were randomly sampled from all men to HMP Brixton and referred to prison health care centres for a psychiatric assessment over a one year period. Men were interviewed immediately after remand to establish their socio-demographic profiles, their psychiatric diagnoses, alcohol and substance misuse histories, criminality, seriousness of index offence and violence involved in their index offence, past psychiatric and forensic contacts and outcome after court appearance. CONCLUSIONS: In this sample, a greater percentage of black men who were remanded in custody had a diagnoses of schizophrenia. They were remanded despite more stable housing and fewer criminal convictions than the white group. Custodial remands could be avoided if community services (psychiatric diversion) were especially sensitive to the needs of black men with severe mental illness.(AU)

An epidemiological study of the health concerns of the imprisoned women in Jamaica

Holistic health care does not stop when someone is incarcerated. It may well be that, at such a crucial time in their lives, inmates may be more receptive to anyone who displays a genuine concern for them. This cross-sectional study addressed the health concerns of imprisoned women in Jamaica. The eighty-six inmates studied represented 91.5 percent of the total population; 7.4 percent declined to participate and one person had to be excluded because of mental illness. The inmates were mostly Jamaicans, incarcerated for a variety of crimes including murder. The non-Jamaicans were imprisoned exclusively for drug-related crimes. The mean age was 32.6 years with a range of 17-62 years. Eighty-eight per cent of these women were in the child-bearing age group and three of them were pregnant. Biochemical indicators revealed that 16 percent of the inmates had positive VDRL tests and 32 percent were anaemic, i.e., 10g/100/ml and below. Obesity was observed in 52 percent of the inmates. Elevated diastolic bloodpressure was noted in 22 percent and elevated random blood glucose detected in 7 percent. Of those with elevated random blood sugar, 2.4 percent had elevated blood glucose on fasting. It is being recommended that all female inmates have routine physical assessments, including HIV testing and Pap Smears on admission to prison. In addition to the existing rehabilitative efforts, physical education and peer counselling are among the recommendations being made. For the control of sexually transmitted diseases, contact tracing is also recommended (AU)

The distribution of psychiatric disorders among the inmates in jail in a given geographical area in Jamaica

Since many of the prisoners referred from police lock-ups for psychiatric assessment did in fact show psychiatric disorder, it was decided to examine them over a three month period to ascertain what percentage had a major psychiatric disorder. 121 men and 19 women were examined using two sets of questionnaires. 64.3 percent of the study population had a diagnosable major mental disorder. Two main groups of disorders were identified, (1) substance abuse disorder and (2) psychotic disorders. 54.3 percent of the study subjects had diagnosable psychoactive substance use disorders, whilst 18.6 percent had psychotic disorders. The substances abused in order of decreasing frequency were cannabis, cocaine and alcohol. There were 26 psychotics, 12 of whom had a dual diagnosis. There was an association between crimes of theft and substance abuse, while the psychotic groups was associated with violent crimes (65.4 percent). The vast majority of the prisoners with a psychiatric diagnosis accused of violent crimes were aged 21 to 35 years, suggesting a possible high risk age group for psychiatric disorder and violent crimes. These results have important implications for the future planning and management of the psychiatric prisoners within the jail system in this parish. Since over 50 percent of the jail population are substance abusers and 18.6 percent are psychotics with no direct provisions for therapy for these persons, the Ministry of Health and the Ministry of National Security should work together to put plans in place for an improved health care scheme for these prisoners.(AU)

An epidemiological study of the health concerns of imprisoned women in Jamaica

Holistic health care does not stop when someone is incarcerated. It may well be that, at such a crucial time in their lives, inmates may be more receptive to anyone who displays a genuine concern for them. This cross-sectional study addressed the health concerns of imprisoned women in Jamaica. The eighty-six inmates studied represented 91.5 percent of the total population; 7.4 percent declined to participate and one person had to be excluded because of mental illness. The inmates were mostly Jamaicans, incarcerated for a variety of crimes including murder. The non-Jamaicans were imprisoned exclusively for drug related crimes. The mean age was 32.6 years with a range of 17 - 62 years. Eighty-eight percent of these women were in child bearing age group and three of them were pregnant. Biomedical indicators revealed that 16 percent of the inmates had positive VDRL tests and 32 percent were anaemic. Obesity was observed in 52 percent of the inmates. Elevated diastolic blood pressure was noted in 22 percent and elevated random blood glucose detected in 7 percent. It is being recommended that all female inmates have routine physical assessments including HIV testing and Pap Smears on admission to prison. In addition to the existing rehabilitative efforts, physical education and peer counselling are among the recommendations being made. For the control of sexually transmitted diseases, contact tracing is also being recommended (AU)

A comparative KAP study on AIDS/STDs in three prison population in St. Vincent and the Grenadines - abstract

This study was initiated to identify and compare needs for STD/HIV information among three population groups within the prison, in order to plan effective educational programmes. A pretested questionnaire conducted by individual interview, was administered to (i) 20 prison staff, (ii) long-term inmates and (iii) 46 soon-to-be-released inmates. The last group also received a condom skills module with a pretest of condom use skill, demonstration of correct use, and a post-test of skill. High AIDS/HIV awareness and knowledge contrasted with a low knowledge of STD's. There was considerable risk of STDs both within and outside of the prison, based on reported behaviours. Condom use skills were low among inmates. Staff demonstrated higher overall knowledge. All groups expressed concern about contact with HIV-positive inmates. Clearly, previous interventions have achieved a considerable degree of success. Further education inputs should focus on information about other STDs and should include condom skills training (AU)

A review of persons referred by the police and the courts for psychiatric evaluation in Western Jamaica - abstract

A review of 114 persons, half referred by the Courts and half brought directly by the Police for psychiatric evaluation over a two year period in Western Jamaica, shows the majority (54 percent) were labouring class males aged under 30 years. 59 percent had previous hospital admission for psychiatric illness, and 95 percent were charge with offences relating to disturbed behaviour in public. All of the referred persons were being detained in custody. All of them did prove to be psychiatrically disturbed, with 75 percent of the males exhibiting schizophreniform illness (vs. 21 percent affectively) while of the 10 females half were schizophreniform, half manic and noe depressed. The charges brought against these persons (assault, trespassing, malicious destruction of property, treatening behaviour) the fact that they all proved to be ill and that almost invariably the charges were withdrawn suggests that the police use arrest as a way of bringing psychiatrically ill persons to treatment. Only 28 of these persons were admitted to hospital, the remainder being discharged back to police custody where they depended on the staff of the lockup to dispense their medication to them. These findings highlight the inadequate provision curently made for the management of distured persons whose behaviour brings them to the attention of the police and who are arrested and awaiting "trial". The high percentage of patients with previous admission for psychiatric illness suggests that among sentencing options, our magistrates should include compulsory psychiatric follow-up more frequently (AU)