Screening for mental disorder using the UK national offender assessment system

Abstract

Probation officers have large caseloads with high levels of psychiatric morbidity but receive minimal training in recognising/managing mental health problems. In the UK, there is no national screening procedure for mental illness among offenders that is considered effective. This study’s aim was to develop a screening system for mental/personality disorders using the Offender Assessment System. Seven screens for mental disorder were developed using items from assessments on 574 prisoners: alcohol misuse, drug dependence, antisocial personality disorder, psychopathy, learning difficulties, psychosis and severe mood disturbance. Internal validation showed that the screens performed well across accuracy estimates. Prevalence of mental disorders identified with the screens in test and validation samples was similar. However, the psychopathy and severe mood disturbance screens may be more effective in screening for true negatives. The screens are an economical method for prioritising mental health needs of the UK prison and probation population using routinely collected data.

Keywords:

• Mental illness
• offender populations
• personality disorder
• screening

Acknowledgement

This report represents independent research commissioned by the UK National Institute for Health Research (NIHR) under its Program Grants for Applied Research funding scheme (RP-PG-0407-10500). The views expressed in this manuscript are those of the authors and not necessarily those of the UK National Health System (NHS), the NIHR or the UK Department of Health. There was no editorial direction or censorship from the funders.

Notes

1. Several OASys items used in the study have been discontinued as of 2009 (National Offender Management Service, 2010): violent behaviour related to drug use (drug dependence); convictions for burglary (adult criteria for ASPD); breach probation/parole and five or more convictions (psychopathy).