The full spectrum of clinical stages of psychosis among mentally ill prisoners in New South Wales (NSW), Australia

Psychiatr Psychol Law. 2022 Jul 31;30(5):600-617. doi: 10.1080/13218719.2022.2073284. eCollection 2023.

Abstract

Research on the association between psychosis and criminal offending has typically focused on violent offenders with chronic psychotic illness. This stages of psychosis in prison (SOPP) study used a clinical staging approach to identify adult men referred to prison mental health services who had an at-risk mental state (ARMS), first episode of psychosis (FEP) or an established psychotic illness. Of the 105 participants included, 6% were determined to have FEP, 6% met ARMS criteria and the remainder had an established psychotic illness. Compared to a prison control sample, individuals on the psychosis spectrum were found to have higher levels of social disadvantage and other co-occurring mental health and substance use problems but were not more likely to have committed a violent offence. These findings support the notion that risk of criminal justice contact and complex illness burden exist across the full spectrum of psychotic illness.

Keywords: at-risk mental state; clinical staging; crime; first-episode psychosis; offending; prisoners; psychosis; ultra high risk; violence.

Grants and funding

This work was supported by a fellowship from the New South Wales Institute of Psychiatry (NY), funding (participant payments) and in-kind support from Justice Health and Forensic Mental Health Network, and salary support from the NHMRC Centre for Research Excellence in Offender Health (PC).