Women who challenge - Nacro

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CHAPTER 2indicated above, it is difficult to draw inferencesfrom differences in the survey findings becauseof differences in methodology. For example, thesurvey by Maden et al was of sentencedprisoners, whereas the ONS survey includedboth sentenced and remand prisoners. However,it is important to note that the level is alsosignificantly higher than that found in maleprisoners, which was 7% for male sentenced and10% for male remand prisoners.C e rtain features of illnesses such ass c h i z o p h renia-like delusions or hallucinations,which may take the form of hearing voices, cana ffect an individual’s judgment and lead tobehaviour which results in criminal damage orpublic order offences. Dell et al 1 9 note criminaldamage as the most common offence among thepsychotic group. The ONS survey found that thel a rgest pro p o rtions of women assessed as havingfunctional psychosis were among those held forcrimes of violence (20%), ro b b e ry (19%) and‘ o t h e r’ offences (18%), while among those heldfor burg l a ry and drug offences, the pro p o rt i o n sw e re much smaller at 4% in each case.Neurotic disordersNeurotic symptoms are the symptoms of mentaldisorder most likely to be found in the generalpopulation, so it is instructive to see how theprevalence rates for women prisoners comparewith those for women in the householdpopulation. In overall terms, the difference isstartling, with 66% of women prisoners assessedas suffering from a neurotic disorder, such asdepression, anxiety or phobia, compared to 16%of women in the household population 20 .Looking at individual symptoms, such as sleepproblems where the rates vary from 28% ofwomen in the general population to 62% ofsentenced women and 81% of women remandprisoners, some difference may beunderstandable in terms of the relativediscomfort of prison living conditions withshared cells or dormitory accommodation,higher levels of noise and so on. The prevalenceof other symptoms such as worry anddepression may also be relevant factors whichcontribute to difficulties in sleeping, especiallyconsidering that symptoms of depression werefound in 54% of the female prisoners, comparedto 11% of women in the household population.The rates of neurotic disorder generally aresubstantially higher for female prisoners than formale prisoners, as the following figures show:Chart 4 Prevalence of neurotic disorder byprisoner type and sex% 80604020059%Maleremand40%MalesentencedNo clear association was shown between neuro t i cd i s o rders and particular types of off e n c e .Other mental disordersO’Brien et al (2001) 21 also found that about 6% ofwomen prisoners were suffering from posttraumaticstress and that they were about twiceas likely to be suffering from this as maleprisoners. The same proportion of womenprisoners was found to suffer from anorexia,while the proportion with bulimia was 14%.As the above examination of prevalence ratesshows, the levels of psychiatric morbidity inboth male and female prisoners are worryinglyhigh. Nevertheless, certain key differencesbetween them can be identified. Womenprisoners are more likely than men:• to have received help or treatment for amental health problem• to have been admitted to a mental hospital orward• to be suffering from functional psychosis• to be suffering from a neurotic disorder• to be dependent on opiates.76%FemaleremandWomen prisoners are less likely than men:• to be suffering from personality disorder• to report drinking at hazardous levels.FemalesentencedSource: Office for National Statistics (1998) Psychiatric MorbidityAmong Women Prisoners in England and Wales London: Office forNational Statistics63%19 Dell S et al (1993) op cit20 Meltzer H, Gill B, Petticrew M and Hinds K (1995) OPCS Surveys ofPsychiatric Morbidity in Great Britain Report 1: The Prevalence ofPsychiatric Morbidity Among Adults Living in Private HouseholdsLondon: HMSO21 O’Brien et al (2001) op citpage 12
Women who challenge: women offenders and mental health issuesFemale mentally disturbed offendersThe primary focus of this report is mentalhealth issues in relation to female offenders. Asmall but significant part of the femaleoffending population comprises thoseoffender/patients detained in the high securityand other psychiatric hospitals under theMental Health Act 1983 (MHA) 22 . In order to bedetained under the MHA, the offender/patientmust be diagnosed as suffering from one of thecategories of mental disorder specified in theAct. These are:• mental illness• arrested or incomplete development of mind(mental impairment or severe mentalimpairment)• psychopathic disorder• any other disorder or disability of mind.Home Office statistics relating to those subjectto a restriction order under Part III of the MHA 23indicate that the total population of restrictedpatients 24 detained at the end of 2000 was2,937, an increase of 3% on the previous year,slightly less than the average annual increase inrecent years. This is a very small populationcompared with the prison population(approximately 68,000 by the end of October2001) and, given the high levels of psychiatricmorbidity we have already seen amongprisoners, perhaps surprisingly so. We shalllook at some of the reasons for this in Chapter3. The female element of this population (330)has remained at between 11% and 12% of thetotal since 1989. Of the 330 female restrictedpatients, 140 were detained in high securityhospitals and 190 in other psychiatric hospitals.The figures in Table 3 show the categories ofmental disorder under which those patients aredetained.Offender/patients can be admitted directly tohospital as a result of a court order or they canbe transferred from prison while on remand orunder sentence. The Home Office figuresshowing admission and detention according tolegal category and offence are not broken downby sex.Department of Health figures 25 do provide abreakdown of formal admissions by legal statusand sex, and also give information aboutTable 3 Restricted patients detained inhospital by type of mental disorderand sex (31 December 2000)Type of mental disorder Female MaleMental illness 185 1,803Mental illness with other disorders 38 117Psychopathic disorder 73 320Mental impairment 16 185Mental impairment withpsychopathic disorder 3 28Severe mental impairment — 13Not known 15 139Total 330 2,607Source: Home Office (2000) Statistics of mentally disorderedoffenders’ Home Office Statistical Bulletin 22/01unrestricted patients and civil admissions.These are set out in Table 4 on page 14. Theyshow that the overall numbers of patientsadmitted under Part III of the Act have beenfalling while, at the same time, the proportionsof those offender/patients of both sexes whoare subject to restriction orders have beenrising. These figures cannot be used for directcomparisons with Home Office figures due todifferences in data collection and accountingprocedures. They serve, nevertheless, toillustrate that the numbers of offender/patients,even including those who are not subject torestriction orders, are still very small comparedboth to the prison population and to thepopulation of patients detained under civilsections of the MHA. A factor which may have abearing on this is the limited resources withinthe secure system which restrict the number ofbeds available and we look further at this inChapter 3.A more detailed profile of the female patientsheld in high security hospital can be obtainedf rom re s e a rch commissioned by Women in22 They may also be placed there under other relevant legislation such asthe Criminal Procedure (Insanity and Unfitness to Plead) Act 199123 Home Office (2001c) ‘Statistics of mentally disordered offenders 2000’Home Office Statistical Bulletin 22/01, London: Home Office24 Restricted patients are those whose detention is subject to arestriction order which means that they can only be discharged fromhospital with the consent of the Secretary of State or a Mental HealthReview Tribunal25 Department of Health (2001b) ‘In-patients formally detained inhospitals under the Mental Health Act 1983 and other legislation,England: 1990-1991 to 2000-01’. Statistical Bulletin 2001/28 London:Department of Healthpage 13
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Page 22 and 23: CHAPTER 32% had a child with foster
Page 24 and 25: CHAPTER 3the frustrations of female
Page 26 and 27: CHAPTER 3women shown by the statist
Page 28 and 29: CHAPTER 3remand and 41% of female s
Page 30 and 31: CHAPTER 3seclusion was used primari
Page 32 and 33: CHAPTER 4What are Government strate
Page 34 and 35: CHAPTER 4schemes - uses drug worker
Page 36 and 37: CHAPTER 4• alternatives to custod
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Page 40 and 41: CHAPTER 4distributed throughout hea
Page 42 and 43: CHAPTER 5Where do we go from here?I
Page 44 and 45: CHAPTER 5Accessing a job and/or tra
Page 46 and 47: CHAPTER 5Evidence from the CARAT pr
Page 48 and 49: BibliographyAllen H (1987) Justice
Page 50 and 51: APPENDIX 2Service modelsForensic me
Page 52 and 53: APPENDIX 2Community-based servicesB
Page 54 and 55: APPENDIX 2The SamaritansThe Upper M

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