Hi all,
I must say I was struck by the absence of discussion about the impact of drug/etoh on the large numbers of people in jail/prison, including large numbers of people with other psychiatric disorders.
Since a jail/prison is, by definition, not a community of choice, it is very important to understand how people end up there. I don't know about Australia, but here in the US, people are in jails/prisons in large numbers because of our so-called "war on drugs". It just so happens that this war hits certain layers/sectors of our economy- layers/sectors that contain large numbers of people with psychiatric disorders in addition to their substance use. If not for the current implementation of the drug laws, many of the people with mental illness would not be in jail/prison. Is this true in Australia?
What to do about it?
1) maybe incarceration is not the way to address substance use in our society. Is there some other way eliminate the attractions of addiction?
2) if no change is made in the process that leads people to drugs or to prison, can't we at least begin to specifically provide substance use treatment in jails/prisons? There is no mention of this idea in the editorial.
Kenneth S. Thompson MD
Associate Professor of Psychiatry and Public Health
University of Pittsburgh
412-760-8483 cell
-----Original Message-----
From: The Health Equity Network (HEN) [mailto:[log in to unmask]] On Behalf Of David McDaid
Sent: Sunday, September 17, 2006 8:56 AM
To: [log in to unmask]
Subject: Prisons: mental health institutions of the 21st century?
FYI - Editorial from the latest issue of the Medical Journal of Australia that may be of interest to some of you. Freely available on-line
Best wishes
David McDaid
LSE Health and Social Care
Prisons: mental health institutions of the 21st century?
Paul White and Harvey Whiteford.
Med J Aust 2006; 185 (6): 302-303.
http://www.mja.com.au/public/issues/185_06_180906/whi10502_fm.html
Deinstitutionalisation in Australia has seen the number of public and private psychiatric hospital beds fall from 30 000 in the early 1960s to 8000 today. The population of Australia doubled during this time. There is no doubt that many people with serious mental illness are not being managed well in the community. Some mental health researchers,as well as the popular press, argue that there has been a recent related transmigration of people from psychiatric beds to remand centres (which house prisoners who have been charged with an offence but not yet convicted) and prisons. Australian remand centres often contain more seriously mentally ill people than general hospital mental health inpatient units. However, it is unclear whether the apparent rise in prevalence of mental illness among prisoners reflects a genuine increase or an improvement in detection rates. Statistical modelling of the effect of deinstitutionalisation on the number of prisoners with mental health problems is fraught with methodological challenges and the absence of longitudinal data. This debate has tended to overshadow other major areas of concern about mental illness among prisoners. As Herrman et al pointed out 15 years ago, whatever the cause, services for people with mental illness in Australian prisons are inadequate and in need of urgent reform........
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