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Pre- and post-sentence mental health service use by a population cohort of older offenders (≥45 years) in Western Australia

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Abstract

Purpose

Information on older offenders’ mental health service (MHS) used before and after sentence is sparse. We therefore aimed to determine the 1-year prevalence of MHS use before sentence, and the likelihood and predictors of MHS use in the 5-year post-sentence period by first-time older adult offenders (≥45 years).

Methods

Pre- and post-sentence MHS use by a cohort of 1,853 first-time offenders over 45 years in Western Australia was determined through whole-population linked administrative data. Logistic regression models compared the 1-year pre-sentence MHS contacts between offenders and matched non-offenders. Cox proportional hazards regression models identified the socio-demographic, offending and pre-sentence health service variables that determined post-sentence MHS use.

Results

Older offenders were six times more likely to have used MHSs than non-offenders before sentence. Substance use was the most commonly treated disorder. Non-custodial offenders were twice more likely than prisoners to have been treated for any mental disorder and substance use disorders, and violent offenders were four times more likely to have attempted self-harm than non-violent offenders before being sentenced. The strongest predictors of post-sentence MHS contact were past psychiatric diagnosis in offenders with a pre-sentence MHS contact, and pre-sentence hospitalisation for attempted self-harm or physical illness, or being a male in those without. Discontinuity in MHS use after sentence by over half of the offenders with a prior contact was prominent.

Conclusion

Better detection and treatment of mental disorders in older offenders to ensure continuity of care at all transition points through age-sensitive correctional and community-based MHSs is needed.

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Acknowledgments

This study was supported by a NHMRC Grant (No. 403909) and the first author was supported by the UWA-SIRF scholarship. We thank the Data Linkage Branch for linkage and client support services aspects of data provision. We also thank the WA Department of Corrective Services, the custodians of the Inpatient and Mental Health Data Collections of the WA Department of Health and the WA Registry of Births, Deaths and Marriages for the provision of service data.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Disclaimer

The results and discussions of this study are not an expression of the views or policies of the Department of Corrective Services, the Department of Health or the Department of the Attorney General.

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Authors and Affiliations

  1. Centre for Health Services Research, School of Population Health, The University of Western Australia (M431), 35 Stirling Highway, Crawley, WA, 6009, Australia

    Nita Sodhi-Berry & David B. Preen

  2. School of Population Health, The University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia

    Matthew Knuiman

  3. Curtin Health Innovation Research Institute, Curtin University, Bentley, Australia

    Janine Alan

  4. Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia

    Vera A. Morgan

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  1. Nita Sodhi-Berry
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  2. Matthew Knuiman
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  4. Vera A. Morgan
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  5. David B. Preen
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Correspondence to Nita Sodhi-Berry.

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Sodhi-Berry, N., Knuiman, M., Alan, J. et al. Pre- and post-sentence mental health service use by a population cohort of older offenders (≥45 years) in Western Australia. Soc Psychiatry Psychiatr Epidemiol 50, 1097–1110 (2015). https://doi.org/10.1007/s00127-015-1008-3

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