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FORUM on Corrections Research
A Mental Health Profile of Federally Sentenced Offenders
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A major survey of mental disorders among offenders in the Correctional Service of Canada has shown that
mental health is rapidly becoming one of the major challenges facing federal corrections today. The Research Branch oversaw the completion of the study, which involved interviews with a random sample of over 2,000 federally sentenced male offenders across Canada. The Mental Health Survey represents the first major attempt by the Correctional Service of Canada to estimate the prevalence, nature, and severity of mental health problems among the adult male offender population by applying objective diagnostic criteria commonly used by mental health professionals. The survey relied on the administration of the Diagnostic Interview Schedule (DIS), a survey instrument developed by the National Institute of Mental Health and endorsed by the World Health Organization. The DIS was designed for research on large numbers of the general population, both male and female, and has also been used to diagnose the incidence of mental and behavioural disorders among incarcerated populations. The diagnosis of mental disorder that flows from the DIS primarily involves meeting a set of stringent criteria derived from the American Psychiatric Association's Diagnostic and Statistical Manual III. It is a highly structured interview with a set of probe patterns to reduce, as much as possible, interviewer discretion in coding. The results of the survey revealed some remarkable facts about the lifetime prevalence of mental disorders in the Correctional Service of Canada offender population. Lifetime prevalence is defined as the percentage of the population that showed evidence of a particular disorder at least once in their lifetime. As Table 1 shows, the risk of having had at least one episode of a psychotic disorder (e.g., schizophrenia, schizophreniform, mania) was 10.4%. The incidence for depressive disorders (e.g., major depression, dysthymia, bipolar) was 29.8%; for anxiety disorders (e.g., panic, generalized anxiety, phobia, agoraphobia, somatization) 55%; and for psychosexual disorders (e.g., dysfunction, transsexualism, ego-dystonic homosexuality) 24.5%. Table 1
In devising a more focused approach to examining an offender's mental health, we looked at the lifetime prevalence of antisocial personality, or alcohol and drug abuse/dependence, and sought to determine the extent to which independently, or in combination, these three disorders were found among the offender population. In Table 2, we show how the offenders were distributed according to diagnostic criteria we chose to examine. We note that 37.8% of the total inmate population were found to have met the criteria for antisocial personality while at the same time having alcohol and drug abuse/dependence. Interestingly, nearly one out of five offenders had met the criteria for a dual diagnosis of antisocial personality and alcohol abuse/dependence. Table 2
Table 3
While it is possible that these survey results also reflect other factors, such as differences between inmates who remain in custody and those who are released, the ability of inmates to remember episodes that happened long ago and their willingness to report symptoms, it seems likely that inmates in our institutions have experienced much more mental disorder than was understood before. |
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