At risk mental state : a comparison between prisoner and community self-report groups

• Main Author: Jarrett, Manuela
• Other Authors: Valmaggia, Lucia Rita
• Published: King's College London (University of London) 2018
• Online Access: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.754914

Background: Previous research has shown a high prevalence of psychosis in the prisoner population. The aim of this study was to examine feasibility of introducing an early detection service into a prison setting. It is the first study to examine prevalence and correlates of At Risk Mental State in a prison population, and to carry out a comparison between prisoners and a help seeking male community population. Hypothesis: We hypothesised that prisoners with an At Risk Mental State would have higher rates of i) social exclusion, ii) childhood adversity iii) substance misuse and iv) Black Ethnicity compared to prisoners without an at risk mental state and compared to their community counterparts. Method: A two stage procedure was used. New receptions meeting inclusion criteria were screened. Those that screened positive and 7% of those that screened negative underwent further assessment to establish they met criteria for being at high risk of psychosis. In addition, we collected data on socio-demographic variables, childhood adverse life events, alcohol and substance misuse, current criminal justice system information, and history of self harm and attempted suicide. The community sample was comprised of a subset of help seeking males who had sought help for mental health issues from various sources and were consequently assessed by the community early detection team. Results: Of 891 prisoners who were screened, 44% screened positive. We identified a prevalence of 5% at risk mental state and 3% first episode psychosis as well as a large proportion of prisoners with other mental disorder. The prison group did not differ greatly from the community group but did differ from the prison group that were negative at both screen and at second stage assessment. Conclusion: An at risk mental state service in a prison is both feasible and useful, in particular if the remit of identification is broadened to other mental disorder as well as the psychotic spectrum.