Background

Prisoners have general health needs similar to those found in the general population, although there is a higher incidence of substance misuse and mental health problems as well as a range of health issues which are consequences of imprisonment.

In 2007, a Prison Reform trust paper ‘No One Knows‘ suggested that between 20 and 30% of offenders in UK prisons had learning difficulties or learning disabilities that interfered with their ability to cope within the criminal justice system. These additional issues can make it more difficult to recognise and diagnose medical conditions.

The researchers in this Australian study set out to identify demographic, health and health-related characteristics of adult prisoners who screened positive for learning disabilities.

Method

What they did was to collect cross-sectional data through administering a structured questionnaire in seven prisons between 2008 and 2010. They used the questionnaire is adult prisoners who had been released from custody within 6 weeks.

The presence of learning disability was established though a pragmatic screening approach.

Those participants who scored less than 85 on the Hayes Ability Screening Index and either:

• reported having attended a special school

or

• reported having been diagnosed with a learning disability

were considered by the researchers to have screened positive for learning disabilities.

The researchers were then able to make comparisons of the characteristics of participants who screened positive and those who screened negative for learning disabilities.

They did this using uni-variable and multi-variable logistic regression techniques.

Results

What they found was that those screening positive for learning disabilities was associated with younger age, identifying as Indigenous Australian and having lower educational achievement.

Those prisoners who screened positive for learning disability were also more likely to have been diagnosed with medical conditions such as heart disease and hearing problems.

They were also less likely to have received preventive care interventions such as testing for hepatitis A infection and immunisation for tuberculosis.

They were also more likely to be obese.

Conclusions

The authors conclude that those adult prisoners who screened positive for learning disabilities in their study had significantly worse health outcomes than their non-disabled peers, leading them to describe this group as ‘profoundly disadvantaged.’

They recommend work to improve understanding of the physical health characteristics of prisoners with learning disabilities prior to release to inform transitional planning of health services.

Links

Physical health outcomes in prisoners with intellectual disability: a cross-sectional study, Dias S et al., in Journal of Intellectual Disability Research, 57, 12, 1191-1196

No One Knows, Prison Reform trust, 2007