Relationships Between Mental Health Problems, Unmet Needs and Aggressive Behaviour During Remand Imprisonment With a New Criminal Conviction After Release

ABSTRACT

Background

Reconviction after imprisonment is common. Findings on its association with mental health problems are mixed and need further exploration. Unmet social needs and a pattern of aggressive behaviour may explain part of the association but have rarely been examined alongside mental health.

Aims

To test for associations between mental health problems, unmet social needs and aggressive behaviour recognised while in prison and postrelease criminal convictions.

Methods

We prospectively followed 188 men consecutively received into prison on pretrial remand for up to 10 years after release from this imprisonment. Mental health problems (MINI-Plus and BPRS), unmet needs (CANFOR) and in-prison aggression (SDAS) were all assessed during the index remand. Kaplan–Meier and Cox regression analyses tested for independent associations between scale scores and postrelease convictions. A final survival analysis with a four-group comparison based on the presence of mental disorder and unmet need risk factors was conducted.

Results

Most participants (155, 82%) sustained at least one new conviction within 10 years of the index release, including 78 (42%) within the first year after release. Indicators of mental disorder with substance use disorders (dual diagnosis) and preimprisonment unmet needs regarding food and/or company had the highest risk of new conviction. By contrast, dual diagnosis alone was not associated with an increased risk compared with prisoners without either risk factor.

Conclusions

This study suggests that the link between mental disorder and postrelease conviction is largely concentrated among prisoners with unmet social needs. Future prevention strategies should address social and mental health vulnerabilities.