Written by Jennifer Kwong, Executive Web Administrator/ Creative Assistant

Jennifer Kwong, Executive Web Administrator/ Creative Assistant

What do the majority of the prison population have in common? Certainly, they have been convicted of a crime and are mostly male. However, what is not so obvious is the alarming prevalence of mental illness in the prison population.

Imagine you are mentally ill. You have been charged with committing a crime for which the penalty is imprisonment. If you are found guilty, you might seek an acquittal by reason of mental illness and then be admitted to a psychiatric institute to receive treatment. Sounds reasonable, no? However, in practice, this defence is successfully raised in only a small minority of cases. The bulk of the evidence suggests that you will face imprisonment.

A study of the NSW prison population by the Corrections Health Service in 2003 confirms the over-representation of the mentally ill in prisons internationally: the prevalence of mental illness stands at more than three times that in the general community (74% vs. 22%).¹

Anecdotal evidence suggests that even 74% is an underestimation, as a large number of inmates who indicate drug use as a contributing factor to their offending are not assessed for a concurrent mental illness.

In NSW, prison is a community where:

• Psychosis is experienced at a rate thirty times higher than in the general community
• 1 in 10 attempt suicide
• 3 in 10 experience anxiety disorder
• 6 in 10 have a substance use disorder
• 4 in 10 are diagnosed with opioid use disorder

So, why is there such a high prevalence of mentally ill people in prisoner populations?

The most obvious explanation is the lack of diversionary options and deinstitutionalisation. The Australian Institute of Health and Welfare reports that 77,700 mental health patients visited NSW emergency departments in 2006-7.² Only 21,000 patients (27%) were later admitted to hospital. The 56,700 patients who were turned away deteriorated to such an extent that many ended up in prison for committing crimes.

Prison is probably the least conducive place for the rehabilitation of the mentally ill; the isolation and pressure experienced in prison exacerbates mental illness. Without support systems in the community for the mentally ill, does it still surprise you that 74% of inmates have a mental illness?

Where does the answer to reducing the prevalence of mental illness in the prison population lie? The Mental Health Council of Australia suggests that by investing in community-based residential care rather than hospital-run psychiatric beds, emergency visits can be reduced by 40%.³

Unlike hospitals, residential care provides trained on-site staff that rehabilitate, treat and care for patients for up to 24 hours/day. Hospitals will be forced to turn away fewer mental health patients. It will relieve these patients of a likely future caught in crime, and of the social dysfunction experienced after their release from prison.
These are sobering statistics, when we consider that mental health has been considered a national health priority area for the past 10 years. The answer lies in the government diverting the existing money to more effective options like community-based residential care that divert the mentally ill away from the courts towards rehabilitation, rather than necessarily spending more money.

There is no doubt that mental health must be a national health priority area. At Utopia Research Institute, our aim is to ensure the needs and concerns of the mentally ill are provided for in the most effective manner available.

1. Butler, Tony, and Stephen Allnutt. “Mental Illness among NSW Prisoners 2003.” Matraville: NSW Corrections Health Service, 2003.
2. Australian Institute of Health and Welfare. “Mental Health Services in Australia 2006-07, Part 3: Mental Health-Related Care in Emergency Departments”: Australian Institute of Health and Welfare, 2006-07, p 2.
3. Crosbie, David. “Lack of services mean mentally ill sent to prison, not treated.” Mental Health Council of Australia. January 19, 2010. Web. November 14, 2010. <www.mhca.org.au>

Victor Hom, Spokesperson for the Utopia Research Institute

It is not easy being a fourteen year old, in the eighth grade of high school and what is meant to be an enjoyable time with friends, study and social life. This is how it should be for many people this age. After all, a lot of people tell you that you should enjoy yourself while you’re young and that it can be the best time of your life.

While I was dealing with high school, there were a lot of troubles in my life at the time. Sometimes I felt I didn’t fit in with the rest of my peers, you get picked on sometimes by those who feel you are different to them. Yes, there a lot of problems young teenagers go through in high school but I felt I could deal with them. After all, these are normal things high school kids go through on a daily basis.

That should be enough for that time. My problems at home were just like most kids – dealing with family issues such as who would wash the dishes etc. Nothing too major.

That was until my father was diagnosed with depression.

We knew that there was something wrong with my father as he was having a lot of problems with his stomach, he seemed a lot less active than usual and after seeing many doctors, the solution still seemed far away. Of course, we knew little about mental illnesses back then, and since my father like most men, do not want to admit there is something wrong with them mentally, tried desperately to ignore the issue.

My mother did not believe that anyone could get depressed. It was a new experience for us. My father was admitted to the psychiatric ward in the Royal Randwick Hospital. Luckily it was only up the road for us so I could go visit my father regularly. However, after I left each time, I felt a great emptiness inside myself that stayed with me for a long time.

Visiting the psychiatric ward, I was exposed to a world that was very new to me. I had never realised how many other people besides my own father were suffering from mental illnesses such as depression and how serious it was. The looks on some of these people’s faces almost looked ghostly; like they were staring into a far away land that was invisible to everyone except them. It was something I could not understand.

My father was treated with medication and eventually released to come back home. I was so happy to have him back and my Mum and sister were overjoyed. We hoped that he had finally gotten better, though we were told to keep a close eye on him.

Yes I thought our problems were finally coming to an end and things could go back to the way they were before.

That was until my father suddenly told us that he kept having thoughts of jumping off the balcony.

We then realised that this would be a slow process of recovery, that mental illnesses are not just a quick fix. My father was admitted back to the psychiatric ward for a few more months for treatment.

Even after several years, with my father back home and a whole lot better, you really have to watch out for those who have been diagnosed with a mental illness. While I am grateful for my father’s slow but steady recovery, there are many out there who are unfortunate to have inadequate treatment or any at all. Many succumb to self harm or suicide, and our revolving door system for treating mental illness is inadequate to accommodate the needs of those who need long term treatment.

As humans I believe we have a right to look out for each other. No matter where you come from or who you are, the well being of our society is vital for all of us to prosper and be united as a community.

There are many more out there, in particular young teenagers who are having to deal with a relative with a mental illness. I would like to think that as a society, we can help prevent this from happening and offer a sense of hope for those brave battlers out there.

Victor Hom, Spokesperson
Utopia Research Institute – Public Relations