The full spectrum of clinical stages of psychosis among mentally ill prisoners in New South Wales (NSW), Australia

Abstract

Research on the association between psychosis and criminal offending has typically focused on violent offenders with chronic psychotic illness. This stages of psychosis in prison (SOPP) study used a clinical staging approach to identify adult men referred to prison mental health services who had an at-risk mental state (ARMS), first episode of psychosis (FEP) or an established psychotic illness. Of the 105 participants included, 6% were determined to have FEP, 6% met ARMS criteria and the remainder had an established psychotic illness. Compared to a prison control sample, individuals on the psychosis spectrum were found to have higher levels of social disadvantage and other co-occurring mental health and substance use problems but were not more likely to have committed a violent offence. These findings support the notion that risk of criminal justice contact and complex illness burden exist across the full spectrum of psychotic illness.

Keywords:

• psychosis
• offending
• crime
• clinical staging
• at-risk mental state
• ultra high risk
• first-episode psychosis
• violence
• prisoners

Acknowledgements

The authors would like to thank the Justice Health and Forensic Mental Health Network, Corrective Services New South Wales, the Stages of Psychosis Aboriginal reference group and the study’s participants.

Ethical standards

Declaration of conflicts of interest

Natalia Yee has declared no conflicts of interest.

Prabin Chemjong has declared no conflicts of interest.

Daria Korobanova has declared no conflicts of interest.

Suki Scade has declared no conflicts of interest.

Matthew Large has declared no conflicts of interest.

Olav Nielssen has declared no conflicts of interest.

Vaughan Carr has declared no conflicts of interest.

Kimberlie Dean has declared no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Justice Health and Forensic Mental Health Network Human Research Ethics Committee, the Aboriginal Health & Medical Research Council Human Research Ethics Committee and the Corrective Services New South Wales Ethics Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Funding

This work was supported by a fellowship from the New South Wales Institute of Psychiatry (NY), funding (participant payments) and in-kind support from Justice Health and Forensic Mental Health Network, and salary support from the NHMRC Centre for Research Excellence in Offender Health (PC).