Out of Sight, Out of Mind: Inmates with Mental Health Conditions


By Zeb Holmes and Ugur Nedim

Recent decades have seen a growing recognition of the need to provide support services to those suffering from mental health conditions.

Sadly, prison inmates are often left out of the discussion, despite rates of mental illness amongst those behind bars being far higher than in the general population.

Mental Health of Inmates

Inmates are two-and-a-half times more likely to have mental health conditions than those in the community; and research by Swinburne University suggests that a whopping one-in-three people taken into police custody are receiving some form of mental health treatment at the time.

Those findings are consistent with statistics from the 2010 National Prisoner Health Census. “I think the overall mental health of prisoners is fairly poor, particularly when they first come into custody, because they’ve either been experiencing untreated mental illness in the community or experiencing drug and alcohol problems,” the report’s author Tim Beard said.

The problem of mental health is magnified in Indigenous communities, with a report by the Select Committee on Regional and Remote Indigenous Communties finding that 26.6% of Indigenous adults experience high to very high levels of psychological distress, while in almost every age group, Indigenous people are approximately twice as likely to experience mental health issues compared with members of the general population.

Dealing with Mental Health in Prison

Prisons across Australia are severely under-resourced when it comes to dealing with the mental health of inmates.

A report published last year by the Victorian Ombudsman found that in the 2012 to 13 financial year, 2,237 Victorian inmates were at psychiatric risk, but only 68 mental health beds were available throughout the prison system. The same report found that prison health services are manifestly inadequate – with primary health care staff spending an average of just 13 minutes on each inmate.

The problem is replicated in NSW, and compounded by the recent influx of prison inmates in our state. A recent report has linked a rise in self-harm incidents to worsening prison conditions, finding 1,617 self-harm incidents over the past two years, as inmates suffering from mental health problems are increasingly put into the general population and denied proper treatment.

Reoffending Rates

A consequence of failing to address mental health issues behind bars is that inmates are more likely to reoffend upon release.

NSW’s re-offending rate rose to 48 percent this past financial year. The rate has increased by nearly one percent every financial year since the government took office in 2011. Only the NT has a worse record.

While it is difficult to separate the effect of incarceration from individual risk factors, there is a great deal of research to suggest that imprisonment increases the likelihood of future offending. In general, 78% of the results from 27 studies from 1961 and 2002 found either that prison has no deterrent effect on inmates, or that it has a criminogenic effect.

Moving Forward

There is a strong argument that increasing spending on prison mental health resources, and placing greater emphasis on diversionary programs and community prevention, will help address underlying mental health issues, thereby reducing reoffending rates.

Increased funding could translate into more specialist mental health professionals and units, allowing troubled inmates to get the help they need.

A greater emphasis on diversionary programs, rather than sending mentally ill people to prison, could keep many away from the harmful prison environment while engaging in treatment plans designed to address their specific problems – potentially reducing the likelihood of further criminal activity.

Given the link between mental health conditions and crime, more spending on general community-based programs may help to nip underlying problems in the bud, decreasing the likelihood of sufferers committing crimes in the first place.

With greater recognition of the impact of mental health on anti-social behaviour, one hopes that state and federal governments will concentrate their efforts on getting people the help they need – rather than just locking them away and leaving them untreated


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About Ugur Nedim

Ugur Nedim is an Accredited Specialist Criminal Lawyer and Principal at Sydney Criminal Lawyers, Sydney's leading firm of criminal and traffic defence lawyers.
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