The Criminal Sanctions Agency

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The Criminal Sanctions Agency

• Viitanen P, Vartiainen H, Tyni S, Joukamaa M
• The health, working capacity and health care
  needs of Finnish female prisoners

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Why a health study on female prisoners?

• Very little is known about Finnish female
  prisoners
• The morbidity of female prisoners is higher
• Distinctive features of females (e.g.
  gynaecology, pregnancy, children)?
• Female prisoners are a minority in prisons ?
  problems e.g. in arranging healthcare
• Longer sentences

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Objective of the study

• Somatic morbidity and infections of HIV, HCV,
  HAV, HBV
  
• Mental health (mental disorders and symptoms)
  
• Substance use
  
• Working capacity (in- and outside prison)
  
• Healthcare needs

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Methods

• Questionnaires (somatic morbidity, mental
  problems, substance use, quality of life)?
• Interview (socio-demographic information, somatic
  and mental health, substance use, use of health
  services, working capacity)?
• SCID interview
• Clinical medical examination and summary of
  diagnoses, working capacity and need of treatment
• Laboratory tests

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Material and timetable

• 101 female prisoners in Hämeenlinna Prison
• 51 just entering the prison and 50 already in
  prison
• The field study started in October 2005 and ended
  in June 2006
• Recording and analysing the results is in
  progress
• Average age 35.7 years (youngest 20.4 years and
  oldest 62.2 years )?

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Results

• The following results are preliminary and
  indicative

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Regular use of medication (N101)?

• No medication 19
• Medication for mental disorder 48
• Medication for insomnia 45
• Medication for lung disease 19
• Medication for cardiovascular disease 16
• Substitution treatment medication 4

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Smoking (N101)?

• Of the participants 91 smoke regularly

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Lifetime diseases and traumas (questionnaire)?

• 9 arterial hypertension
• 33 chronic bronchitis / cough
• 3 diabetes mellitus
• 
  
• 50 concussion / brain contusion
• 3 skull fracture
• 30 other head injury
• 
  
• 37 stab lesion
• 4 shooting injury

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Psychiatric hospital care (N100)?

• 43 had been earlier in a psychiatric hospital or
  a
• psychiatric ward of some other hospital

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Alcohol and drug dependence (N100)?

• Alcohol dependence 53
• Drug dependence (narcomania) 67
• Drug dependence is normally combined use,
  about 46 were assessed to be mainly
  dependent on amphetamine, 21
  on sedatives/anxiolytics and
  16 on opioids

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Personality disorder by SCID II (N88)

• 72 have some type of personality disorder

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Personality disorder by SCID II (N88)?

• Asocial 58
• Unstable 25
• Avoidant 14
• Unspecified 14

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Psychiatric illnesses by SCID I (N90)Mood
disorders

• Bipolar disorder 8
• (three cases of type I,
• three cases of type II,
• one case unspecified)?
• Major depressive disorder 32
• (recurrent 66, current 24)?

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Psychotic disorders

• Psychotic disorder 11
• 1 schizoaffective disorder
• 3 delusional disorders
• 2 brief psychotic disorders (both lifetime)?
• 4 unspecified psychoses F29 (one lifetime)?

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Need for follow-up treatment (N100)?

• Assessment made by a physician
• The need for follow-up treatment was found in 94
  of the cases
• Due to substance disorder 73
• Due to psychiatric illness 63
• Due to somatic illness 52

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Conclusions

• The results are still preliminary in nature
• The prevalence of mental disorders is high -
• It seems that mental disorders and substance use
  are
• more common than 20 years ago when the first
• Finnish prison health study was done
• Many have head injuries
• Respiratory symptoms are common
• 9 out of 10 women smoke regularly
• HCV prevalence is high

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