The majority of ex-prisoners do not receive the mental health care they need, despite displaying persistent symptoms of high psychological distress after being released.
A study of 1216 ex-prisoners, conducted by researchers from Griffith University and the University of Melbourne was published in the international journal Psychological Medicine.
It found more than half of former prisoners experienced moderate to very high psychological distress following release from prison, compared with less than one third in the Australian community.
Senior author Professor Stuart Kinner from the Griffith Criminology Institute and Menzies Health Institute Queensland said it was critical to understand the demand for and access to mental health services among former prisoners.
“Given the link between mental illness and a host of poor outcomes following release, including risky drug use, homelessness, unemployment and reoffending, it is imperative that we discover and dismantle the barriers that prevent ex-prisoners from accessing these services.”
The researchers interviewed prisoners six weeks prior to their release with follow-up interviews one, three and six months after release from prison. Participants were assessed for psychological distress, a non-specific measure of poor mental health.
They found that 83% of participants experienced minimal changes in psychological distress in the first six months after release, while roughly one in ten experienced a decrease in symptoms of distress.
“This suggests that, for most people who are distressed prior to release, transition back to the community is likely to remain a challenging time,’’ Professor Kinner said.
Women were more likely to experience high distress, consistent with previous research showing higher psychological distress in women entering Australian prisons.
However, men were at a higher risk of persistently very high psychological distress.
Indicators of mental disorder, and a history of self harm and high-risk drug use, were strong predictors of distress after release.
Few participants (12%) accessed public mental health services in the first year after release and among those who did, the vast majority (75%) had no more than 6.3 cumulative hours of contact with these services — equating to just over one hour of clinical contact every two months.
Among those with persistently high psychological distress after release, the figures were not much better. Only 25% used public mental health services in the first year after release from prison, for a median of 4.4 cumulative contact hours.
“Our study suggests the need for a broad range of mental health supports for ex-prisoners, including not only management of major mental disorder, but also support for securing housing and employment, and substance misuse management,’’ Professor Kinner said.
“Further research is needed to better understand the causes of high psychological distress and the barriers to mental health care access in ex-prisoners.”
The study was funded by the Australian National Health and Medical Research Council and an Australian Research Council Discovery Project.