Inequalities in victims and offenders
Information taken from Health Inequalities National Support Team - Offender Health published by the Department of Health in 2011
Ill health has a detrimental impact on offending. It leads people into reoffending. Offenders face real health inequalities. They are often drawn from the most unhealthy sections of our communities.
Offenders serving community sentences, prisoners and ex-offenders are a marginalised group who experience significant health inequalities. Attention to the issues affecting offenders is likely to bring about social benefits, including a reduction in re-offending, as well as health benefits in terms of health improvement and life expectancy. A reduction in re-offending is in itself likely to bring health benefits to a wider population. Moreover, there is an opportunity to engage with offenders while they are within the CJS in a way that might be more difficult to achieve after release/ discharge and resettlement.
The Social Exclusion Unit report Reducing re-offending by ex-prisoners in 2002 identified nine key factors the link between offending, re-offending and wider factors that influence offending and re-offending:
- education;
- employment;
- drug and alcohol misuse;
- mental and physical health;
- attitudes and self-control;
- institutionalisation and life skills;
- housing;
- financial support and debt; and
- family networks.
The work of the IMPACT programme in Avon and Somerset helps define pathways for Somerset’s most high risk offenders. http://www.impactpathways.org.uk/About-IMPACT/
Women Offenders
- Two-thirds of the women who go to prison are on remand and more than half of them do not go on to receive a custodial sentence, with one in five acquitted.
- Between 1992 and 2002, there was a 196% increase in the number of women remanded to custody, compared to 52% for men
- Half of all women on remand receive no visits from their family, compared with one in four men.
- 40% (female) prisoners have a long-standing physical disability
- 50% (female) prisoners have suffered abuse, a third physical, a third sexual and a third both
- 33 per cent of male and 51 per cent of female prisoners suffer from depression.
- Women in custody are more than five times likely to have a mental health concern than women in the general population
- 78% of women exhibit some level of psychological disturbance when measured on reception into prison, compared with a figure of 15% for the general adult female population.
- 44% of women on remand have attempted suicide in their lifetimes; the comparable figure for men is 27%
Taking action:
The Safer Somerset Partnership have approved funding allocated by the Police and Crime Commissioner to fund a specialist worker dedicated to diverting female offenders from the criminal justice system taking account of individual needs and vulnerabilities.
Mental health
- In all age groups, suicide rates are higher in recently released prisoners than in the general population.
- The 1998 publication of a survey for the Office for National Statistics on psychiatric morbidity among prisoners referred to in the Bradley Report19 identified:
- over 90% of prisoners had one or more of the five psychiatric disorders (psychosis, neurosis, personality disorder, hazardous drinking and drug dependence)
- remand prisoners had higher rates of mental disorder than sentenced prisoners
- rates of neurotic disorder in remand and sentenced prisoners were much higher in women than in men.
- 9% of prisoners have severe and enduring mental health illness
- 64% (male) and 50% (female) prisoners have personality disorder
Learning disabilities
People with a learning disability who are either accused of a crime or witnesses to a crime may be at a disadvantage within the criminal justice system as it stands. Factors such as their suggestibility, their ability to deal with questions or their decision-making can all mean that the process of obtaining justice can be more difficult for them.
- 10% of prisoners have learning disability
- 7% of prisoners have an IQ of under 70
For young people in contact with the CJS:
- One in two young people known to the YOT are under-achieving in school.
- One in three needs help with reading and writing.
- 15 per cent have statements of special educational needs
Substance misuse
- 80% of prisoners smoke
- 24% of prisoners with a drug problem are injecting drug users
- Of these:
- 20% have hepatitis B
- 30% have hepatitis C
- 63% (male) and 39% (female) prisoners are hazardous drinkers
Physical health
- 33% (male) and 40% (female) prisoners have a long-standing physical disability
Ethnicity
- BME groups are currently over-represented in the youth justice system and in the general CJS
- An estimated 40% of the female prison population are foreign nationals
- On 30th September 2007, there were 11,211 foreign nationals in prison establishments in England and Wales. This compares to 3,446 in 1993. The largest single group is Jamaican
- In June 2006, members of BME groups accounted for 26% of the male prison population and 28% of the female population (including foreign nationals). For British nationals, the proportion of Black prisoners relative to the population was 7.3 per 1,000 population compared to 1.3 per 1,000 population for White persons. In contrast, people from Chinese or other ethnic backgrounds were least likely to be in prison with a rate of 0.4 per 1,000 population. The rate for people from Asian groups was higher than for White persons but lower than that for the Mixed or Black groups (i.e. 1
Young people
- 43% of children on community orders have emotional and mental health needs, and the prevalence amongst children in custody is much higher (prison reform trust)
Older people
People aged over 60 is the fastest growing prisoner group. Older people make up a smaller proportion of offenders but may have more severe health and social care needs. It is known that they:
- age up to 10 years more than their biological age whilst in prison
- are likely to have been in prison before (50%)
- are likely to have a long-standing chronic illness or disability (80%) and of these, more than 35% suffer from a cardiovascular disease more than 20% from a respiratory disease
- are likely to suffer from a mental disorder (50%) -mostly depression
- are often more vulnerable because they find it difficult to cope with the physical and mental stresses and demand of prison life.