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Mental and Physical Health

Why focus on mental and physical health…?

There is often a misconception that mental ill health leads individuals to offend. The link between mental ill health and offending is very complex, in some ways due to the dual diagnosis issue around mental health and substance misuse.

Issues such as mood and anger management can contribute to offending behaviour through poor decision making and reactive behaviour. Equally, issues such as depression, anxiety and low mood are often barriers to individuals successfully engaging in supportive services of any kind. Therefore if intervention can be provided to address these concerns, then engagement in other services may follow more successfully and crime of a reactive nature may reduce.

Poor health of offenders is also a concern and can be due to poor lifestyle choices, long standing substance misuse concerns and chaotic lifestyles.

  • 46% of prisoners having a long-standing illness or disability

By supporting individuals to access health services, not only will their physical health improve but their mental wellbeing will also improve along with their confidence and physical ability to engage in support that will address other negative factors in their life.

The stats

Whether mental ill-health leads to offending behaviour or not, it is acknowledged that levels of mental ill health are substantially higher among offenders than in the general population. Below are some statistics which highlight the need to effectively support this group in accessing appropriate services.

  •  8% of prisoners suffer from schizophrenia or a delusional disorder, compared with 0.5% of the general population. 
  • 45% of prisoners suffer from a neurotic disorder (e.g. depression) compared with 14% of the general population. 
  • More than 70% of the prison population has two or more mental health disorders. 
  • Male prisoners are 14 times more likely to have two or more disorders than men in general, and female prisoners are 35 times more likely than women in general. 
  • The suicide rate in prisons is almost 15 times higher than in the general population: in 2002 the rate was 143 per 100,000 compared to 9 per 100,000 in the general population
  • Approx 50% of adult offenders screen positively for childhood ADHD with 19% displaying persistant symptoms.
  • Offenders with a diagnosis of ADHD or those who present with symptoms are involved in 8x more aggressive incidents than the general offender population.
  • ADHD is most prevelant within the Prolific and Priority Offender population.
  • With appropriate support and treatment for ADHD a 30% reduction in reoffending can be seen.

Appropriate access

Despite the poor mental health profile found within the prison population, levels of service access are often not comparable to the level of need exhibited by this group. Few short-sentence prisoners are able to access prison based mental health services – just one in 15 prisoners reporting receipt of help for a mental health problem while in custody.

Offenders managed in the community also encounter a range of barriers in accessing treatment from community mental health services. Barriers to service access were also encountered by offenders with a dual diagnosis of a mental health and substance misuse problem.

Whether or not offending individuals have a mental health concern prior to substance misuse or not, it is an area which needs to be addressed, if not in relation to reducing reoffending, as a platform from which other positive change can occur.


  1. (Social Exclusion Unit, 2004, quoting Psychiatric Morbidity Among Prisoners In England And Wales, 1998)
  2. (The National Service Framework For Mental Health: Five Years On, Department of Health, 2004; Samaritans Information Resource Pack, 2004)

If you would like to find out where and how to access services for mental and physical health, please use the search functions at the side of this page.

Alternatively, if you are an organisation that provides services under this pathway and would like to be a member of this site, please contact us.

Mental and Physical Health Pathway Services