Farrell Michael, Boys Annabel, Singleton Nicola, Meltzer Howard, Brugha Traolach, Bebbington Paul, Jenkins Rachel, Coid Jeremy, Lewis Glyn, Marsden John
Institute of Psychiatry, Kings College London, London, UK.
Aust N Z J Psychiatry. 2006 Jun-Jul;40(6-7):548-53. doi: 10.1080/j.1440-1614.2006.01836.x.
To describe the self-reported history of health service utilization and help-seeking to those who are drug-dependent in the period of time prior to imprisonment.
A cross-section survey of 3142 sentenced or remand prisoners in English prisons completed private, face-to-face interviews with trained Office for National Statistics staff covering a full structured psychiatric assessment interview. Specific questions about service utilization prior to imprisonment were included, as were questions on patterns of drug use and dependence prior to imprisonment.
Receipt of any form of help was demographically most strongly associated with being older, white and female. Women were about twice as likely as men to report having received help for mental or emotional problems. Older age was also consistently associated with greater levels of reporting having received help, for both genders but only for use of general practitioners. Being black was strongly associated with reduced likelihood of receiving help and this was maintained after adjusting for other sociodemographic variables. Opioid dependence alone or opioid dependence with stimulant dependence, psychiatric disorder alone and probable psychosis were all most predictive of service use in the 12 months prior to imprisonment.
In the year prior to imprisonment, the majority of mental health needs of these individual prisoners were not able to access help prior to imprisonment. Future strategies should aim for better health access before, during and after imprisonment.
描述在入狱前一段时间内，有药物依赖的人自我报告的医疗服务利用和求助历史。
对3142名被判刑或还押候审的英国监狱囚犯进行横断面调查，由受过培训的国家统计局工作人员与他们进行面对面的私下访谈，访谈内容涵盖全面的结构化精神病学评估访谈。其中包括关于入狱前服务利用的具体问题，以及关于入狱前药物使用和依赖模式的问题。
从人口统计学角度来看，获得任何形式的帮助与年龄较大、白人以及女性最为密切相关。女性报告因精神或情感问题获得帮助的可能性约为男性的两倍。年龄较大也一直与更高的获得帮助报告水平相关，无论男女，但仅限于使用全科医生服务的情况。黑人与获得帮助的可能性降低密切相关，在调整其他社会人口学变量后，这种情况依然存在。单独的阿片类药物依赖或阿片类药物依赖与兴奋剂依赖并存、单独的精神障碍以及可能的精神病，都是入狱前12个月内服务使用的最强预测因素。
在入狱前一年，这些囚犯中的大多数心理健康需求在入狱前无法获得帮助。未来的策略应旨在在入狱前、入狱期间和出狱后改善医疗服务的可及性。
