Prison admission health screening as a measure of health needs.

Abstract

Objective: To assess the validity of routine prison screening admission data for measuring health needs and planning health services.

Design: Retrospective descriptive study of routinely collected admission data.

Setting: The largest Scottish men's prison with an annual throughput of around 20,000 men.

Subjects: All adult male (> or = 21 years) prisoners admitted during January 1998.

Results: Nine hundred and six men were screened in January 1998. Thirty-eight per cent of men entering prison said they currently or had previously used illegal drugs and 22% of all admissions gave a history of intravenous drug use. Six men (0.7%) reported hepatitis C infection and two (0.2%) reported hepatitis B infection. A history of major mental illness was reported by 10% of all prisoners, 7% of drug users and 15% of problem drinkers. Deliberate self-harm was reported by 10% of all prisoners, 9% of drug users and 17% of problem drinkers.

Conclusion: There is a high prevalence of reported substance misuse and its sequelae and mental illness in prisoners. However, mental illness, substance use and some infectious diseases (such as HIV, hepatitis B and hepatitis C) may be under-reported, possibly because of social stigma or low expectations of treatment in prison. Health screening on admission to prison presents a unique opportunity to identify health needs at an early stage. However, there is a need to improve detection of some stigmatized conditions if individual care and health service planning are to be improved.