"People living with mental illness are not only significantly over-represented in the justice system in NSW, they are also over-represented as victims of crime." Mental Health Commission of NSW
Read about Shiree Talbot who works in a mentoring program for women released from prison.
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A matter of justice
Research tells us about people with mental illness and prison
Inadequate and unacceptable
Research tells us about people with mental illness and the corrective justice system
Research tells us about common mental health issues in prison
People living with mental illness are not only significantly over-represented in the justice system in NSW, they are also over-represented as victims of crime.
They are over-represented in the system not because having a mental illness makes you behave in a criminal way, but because of the complex interaction between mental illness and a variety of factors such as disrupted family backgrounds, family violence, abuse, use of drugs and alcohol, and unstable housing.
The vast majority, almost three-quarters, of people in the justice system are supervised in the community on either probation or parole. Probationers and parolees with mental health or drug and alcohol issues are substantially more likely to return to prison within a year of release compared with people without those issues.
The reasons for this are also complex. According to a review, people with mental health issues:
- can have functional impairments, such as memory difficulties, that make adhering to community-based sentence conditions difficult
- end up having to abide by more conditions than those without mental health or drug and alcohol issues because, for example, they might be subject to a community treatment order which involves medication and regular visits to health staff
- are monitored and controlled more closely and this means infractions are more likely to be observed and acted upon.
- People in NSW with a mental health disorder are 3 to 9 times more likely to be in prison than their non-disabled counterparts in the general population
- Young people in NSW with mental health disorders and/or cognitive impairment are at least 6 times more likely to be in prison than young people without a disability in the general population
- Up to 65% of people living with mental illness reoffend within 2 years of release from prison
Access to services that recognise a complex mix of needs is limited. Not much progress has been made in addressing combinations of issues, such as mental health and drug and alcohol issues, faced by people on remand, people on short sentences, or the much larger population of people on community-based sentences.
Poor planning, inadequate identification and referral, lack of commitment from – and integration with – psychiatric services, inadequate resources, and a lack of suitable accommodation have made it difficult to keep people already arrested out of the system and to prevent them reoffending.
It is unacceptable that people living with mental illness often end up in custody because we don’t have appropriate settings that cater for a range of interacting needs, such as mental health, intellectual disability and drug and alcohol issues.
- Elements of mental health support such as care co-ordination are often not available.
- The skills and experience of custodial staff regarding mental health interventions are severely limited.
- There is a lack of acute health care access for people at times of crisis.
- A majority of services are available only in Sydney, with limited access to appropriate health care in rural and regional correctional facilities.
A criminal response to a health matter is no response and does nothing to address the two-pronged stigma people suffer on return to the community: of having offended and of living with mental illness.
- There are 10,000 people in the corrective justice system - 7,700 of those have a mental health condition
- Of those with a mental health condition, 900 have a psychotic disorder, 800 have an intellectual disability, 4,900 have a brain injury
The justice system story is further complicated for groups with particular needs, for example:
- Women have higher rates of mental illness and suicidal thoughts than male inmates. They also tend to cycle in and out of custody more often than men, though on shorter sentences.
- Each year, 3% of children and young people aged 10-17 will come to the attention of the police. Those in contact with the juvenile justice system are vulnerable and disadvantaged. It’s estimated about 70% of them are living with mental illness.
- Aboriginal people are already over-represented in the criminal justice system. This is compounded by the fact that many of them are also living with mental illness and have poorer physical health than the general population. Aboriginal women have demonstrated the highest rate of social and emotional wellbeing issues of any group of inmates.
- Forensic patients are those people who have been found unfit to be tried or not guilty by reason of mental illness. These consumers are frequently placed in environments, including correctional settings, that do not adequately address their mental health, physical health, or the factors that led them to commit crime. There is an added burden for those patients with intellectual, cognitive and other disabilities.
Probationers and parolees frequently have complex mental health or intellectual disability and drug and alcohol issues. Mainstream services addressing these needs traditionally operate independently of each other. Care and support is often unco-ordinated.
Mental health cannot be separated from the experience of multiple disabilities, alcohol and drug use, and social disadvantage among Aboriginal people and communities.
This, along with the added stigma of a person’s criminal history – regardless of the type of offence – can leave service teams misunderstanding needs or feeling ill equipped to meet a person’s needs.
We need to acknowledge, as part of the mix, the value of alternative cultural approaches, such as Circle Sentencing in Aboriginal communities. This takes the sentencing process out of its traditional court setting and into the community. Community members and the magistrate sit in a circle to discuss the offence and the offender, the background and effects of the offence, to develop a sentence that is tailored to the offender and those affected.
- Three most common mental health issues in the prison population are depression, anxiety and drug dependence
- 47% of men in prison are being treated for mental health issues
- 54% of women in prison are being treated for mental health issues
- 21% of the prison population have attempted suicide - 27% of women and 19% of men
- 15% of the prison population have self-harmed
Source material for content on this page is from the Living Well Report