PhD student, Kirby Institute, University of New South Wales, Australia
Olayan Albalawi
PhD student, Kirby Institute, University of New South Wales, Australia Tabuk University, Department of Statistics, Science Faculty, Saudi Arabia
Handan Wand
Associate Professor, Kirby Institute, University of New South Wales, Australia
Armita Adily
Research Fellow, Kirby Institute, University of New South Wales, Australia
Azar Kariminia
Senior Lecturer, Kirby Institute, University of New South Wales, Australia
Stephen Allnutt
Forensic Psychiatrist and Conjoint Senior Lecturer, University of New South Wales, Australia
Grant Sara
Director, InforMH, NSW Ministry of Health; and Clinical Associate Professor, University of Sydney Northern Clinical School, Australia
Kimberlie Dean
Associate Professor, Forensic Mental Health, School of Psychiatry, University of New South Wales, Australia
Julia Lappin
Psychiatrist, School of Psychiatry, University of New South Wales, Australia
Colman O'Driscoll
Executive Director, Lifeline Australia; and Conjoint Lecturer, University of New South Wales, Australia
Luke Grant
Assistant Commissioner, Corrections Strategy & Policy, Corrective Services NSW, Australia
Peter W. Schofield
FRACP Clinical Director, Neuropsychiatry Service, Hunter New England Local Health District; and Conjoint Professor, University of Newcastle, Australia
David Greenberg
Director, New South Wales State-Wide Clinical Court Liaison Service, New South Wales Justice and Forensic Mental Health Network; and Conjoint Lecturer, University of New South Wales, Australia
Tony Butler
Program Head, Justice Health Research Program, Kirby Institute, University of New South Wales, Australia
BackgroundPsychosis is more prevalent among people in prison compared with the community. Early detection is important to optimise health and justice outcomes; for some, this may be the first time they have been clinically assessed.AimsDetermine factors associated with a first diagnosis of psychosis in prison and describe time to diagnosis from entry into prison.MethodThis retrospective cohort study describes individuals identified for the first time with psychosis in New South Wales (NSW) prisons (2006–2012). Logistic regression was used to identify factors associated with a first diagnosis of psychosis. Cox regression was used to describe time to diagnosis from entry into prison.ResultsOf the 38 489 diagnosed with psychosis for the first time, 1.7% (n = 659) occurred in prison. Factors associated with an increased likelihood of being diagnosed in prison (versus community) were: male gender (odds ratio (OR) = 2.27, 95% CI 1.79–2.89), Aboriginality (OR = 1.81, 95% CI 1.49–2.19), older age (OR = 1.70, 95% CI 1.37–2.11 for 25–34 years and OR = 1.63, 95% CI 1.29–2.06 for 35–44 years) and disadvantaged socioeconomic area (OR = 4.41, 95% CI 3.42–5.69). Eight out of ten were diagnosed within 3 months of reception.ConclusionsAmong those diagnosed with psychosis for the first time, only a small number were identified during incarceration with most identified in the first 3 months following imprisonment. This suggests good screening processes are in place in NSW prisons for detecting those with serious mental illness. It is important these individuals receive appropriate care in prison, have the opportunity to have matters reheard and possibly diverted into treatment, and are subsequently connected to community mental health services on release.Declaration of interestNone.
