An Examination of Mental Health and Psychiatric Care among Older Prisoners in the United States

ABSTRACT

Despite that prisons in the United States (and other high-income countries) have witnessed an increase in the proportion of older inmates, and that prison populations exhibit high rates of psychiatric illness, there is limited knowledge on the nature of older inmates’ psychological health and use/provision of psychiatric care. The present study addresses these gaps, analyzing a nationally representative sample of 1,907 male and female older inmates (age range = 50–84 years; M = 56) housed in U.S. state and federal prisons. The results highlight: (a) the prevalence of psychological issues among older prisoners; (b) factors associated with certain mental disorders and symptoms of mental health issues; (c) the prevalence of psychiatric treatment before and during imprisonment for those with (and without) reported psychological health issues; (d) similarities and differences between male and female older inmates in relation to psychological health, factors associated with psychological issues, and the use/provision of psychiatric care. Discussion points toward recommendations for managing inmate mental health, as well as direction for further research on older inmate mental health and psychiatric care.

KEYWORDS:

• Older prisoners
• mental health
• psychiatric care

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. Other researchers have also merged and analyzed both state and federal data included in the 2004 SISFCF survey cycle. See Felson, Silver, and Remster (2012); Pare and Logan (2011); Stoliker (2018); Stoliker and Varanese (2017); Teasdale, Daigle, Hawk, and Daquin (2016).

2. “Depressed mood” was based on whether inmates had given up hope for life or the future, or if there were periods when they felt numb/empty inside. “Change in appetite” was based on whether inmates had noticeable increases or decreases in their appetite for a period of 2 weeks or more. “Sleep disturbance” was based on whether inmates had noticeable increases or decreases in the amount of time they slept. “Worthlessness” was based on whether there had been periods when inmates felt like no one cares about them. “Suicidal ideation or attempt” was based on inmates reporting whether they had ever considered or attempted suicide in their lifetime. Cronbach’s a = .694; mean inter-item correlation = .233; correlation with “depressive disorder,” rs = 0.265, p < .001. Because SPSS (version 24) does not provide Cronbach’s alpha or mean inter-item correlation for the aggregated imputed dataset, the estimates presented here were derived by averaging the values for the 10 separate imputed datasets.

3. “Elevated or irritable mood” was based on whether inmates have lost their temper easily and had a short fuse more often than usual, or had been angry more often than usual. “Racing thoughts” was based on whether inmates had experienced times when their thoughts raced so fast that they had trouble keeping track of them. “Increased activity or agitation” was based on whether inmates had experienced periods when they could not sit still. Cronbach’s a = .705; mean inter-item correlation = .375; correlation with “mood disorder,” rs = 0.205, p < .001.

4. “Delusions” was based on whether inmates believed other people could read their mind; believed other people had been able to control their brain or thoughts; or, felt that anyone other than corrections staff had been spying on, or plotting against, them. “Hallucinations” was based on whether inmates could see things other people say are not really there, or could hear voices other people cannot hear. Cronbach’s a = .719; mean inter-item correlation = .344; correlation with “schizophrenia/psychotic disorder,” rs = 0.215, p < .001.

5. The “total mental disorder” and “total mental health symptoms” measures were used in gender-based regression analyses in lieu of the disaggregated mental health measures, as cell counts for some mental health variables were quite low once the sample was further stratified according to gender.