Aggressive behaviour and suicidal concerns during remand imprisonment and the relation to mental health(care)

Prisoners display high levels of suicide risk and aggression and prisoners report unmet needs. The relation to mental healthcare is unclear. The current study analysed 226 prisoners on aggressive behaviour and suicidal concerns during general remand imprisonment in the Netherlands, in relation to mental health(care). Aggressive behaviour and suicidal concerns were assessed every four weeks during the first four months of remand imprisonment by the Social Dysfunction and Aggression Scale and Brief Psychiatric Rating Scale. Psychiatric disorders (Mini International Neuropsychiatric Interview - Plus) and unmet needs (Camberwell Assessment of Needs - Forensic Version) were assessed as was provided mental healthcare during imprisonment. The levels of aggressive behaviour and suicidal concern were consistent over time and overall displayed by 18% and 15% of the prisoners, respectively. Aggressive behaviour appeared related to psychiatric symptoms and prior mental health treatment, as was suicidal concern. However, in contrast to individuals with suicidal concerns, prisoners with aggressive behaviour less often received mental healthcare in prison. This appears to be related to the finding that aggressive prisoners do not report more unmet needs compared to non-aggressive prisoners. In conclusion, aggressive behaviour is more strongly related to mental health than might be expected. Prisontime perhaps could initiate mental healthcare.