The problems with accurately assessing a prisoner's mental health
amanda thompson, Medical student at The University Of Sheffield
29 September 2006
Although this research provides a number of methods to ensure accurate research I feel that more should and can be done to accurately assess the mental health of those incarcerated within the French prison system. Initially, of 1402 prisoners who were asked to take part a total of 799 agreed to be interviewed. 88% of the 603 who did not take part in the study refused for personal reasons. Did the prisoners who refused have a worry of being considered as so severely ill that they could be incarcerated for a longer period of time? A description of the information provided to prisoners on the reasons for the research would be useful. This may have hidden an even larger rate of illness within the group. Others may have refused to take part because of a previous negative experience within mental health care teams and therefore this could also hide a much larger figure. If someone has disliked previous medical intervention for a psychiatric condition, expecting them to volunteer for another mental health assessment may be a little optimistic.
Another potential discrepancy could have occurred when assessing prisoners considered to be showing signs of de-realisation and ideas of persecution. Although important I do feel that such conditions cannot be accurately assessed within prison walls alone. Permission to gain access to their past medical records and also to follow them up over a period of some time after being reintroduced into the community may prove useful.
As the authors state, assessing a person's mental state within such an environment can prove extremely difficult. Following up those considered as having significant mental pathologies may be helpful to give a more accurate picture of what may be taking place. Without such information findings could be misleading.
The question that needs to be answered is: are the men in prison because of their previous psychiatric history or is there past prison history contributing to a decline in their present mental health?
The problems with accurately assessing a prisoner's mental health
29 September 2006
Although this research provides a number of methods to ensure accurate research I feel that more should and can be done to accurately assess the mental health of those incarcerated within the French prison system. Initially, of 1402 prisoners who were asked to take part a total of 799 agreed to be interviewed. 88% of the 603 who did not take part in the study refused for personal reasons. Did the prisoners who refused have a worry of being considered as so severely ill that they could be incarcerated for a longer period of time? A description of the information provided to prisoners on the reasons for the research would be useful. This may have hidden an even larger rate of illness within the group. Others may have refused to take part because of a previous negative experience within mental health care teams and therefore this could also hide a much larger figure. If someone has disliked previous medical intervention for a psychiatric condition, expecting them to volunteer for another mental health assessment may be a little optimistic.
Another potential discrepancy could have occurred when assessing prisoners considered to be showing signs of de-realisation and ideas of persecution. Although important I do feel that such conditions cannot be accurately assessed within prison walls alone. Permission to gain access to their past medical records and also to follow them up over a period of some time after being reintroduced into the community may prove useful.
As the authors state, assessing a person's mental state within such an environment can prove extremely difficult. Following up those considered as having significant mental pathologies may be helpful to give a more accurate picture of what may be taking place. Without such information findings could be misleading.
The question that needs to be answered is: are the men in prison because of their previous psychiatric history or is there past prison history contributing to a decline in their present mental health?
Competing interests
None declared