Disentangling Alcohol-Related Needs Among Pre-trial Prisoners: A Longitudinal Study

  1. Anna Kissell1,*,
  2. Pamela J. Taylor1,*,
  3. Julian Walker2,3,
  4. Emma Lewis4,
  5. Amy Hammond5 and
  6. Tim Amos2,3
  1. 1Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
  2. 2West of England Forensic Mental Health Services, Bristol, UK
  3. 3Centre for Academic Mental Health, Bristol University, Bristol, UK
  4. 4Research and Development Office, Cardiff and Vale University, Local Health Board, Cardiff, UK
  5. 5South London and South East Hub, Mental Health Research Network, London, UK
  1. *Corresponding author: Institute of Psychological Medicine and Clinical Neurosciences, 2nd Floor Hadyn Ellis building, Maindy Road, Cardiff CF24 4HQ, UK. Tel.: +44-02920-688352; E-mail: kissellae{at}cardiff.ac.uk
  • Received February 25, 2014.
  • Revision requested July 24, 2014.
  • Revision received July 28, 2014.
  • Accepted July 29, 2014.

Aims: To disentangle the alcohol-related needs of short stay, revolving door, male prisoners, and offer a theoretically driven but practical approach for allocation of scarce service resources. Methods: A prospective longitudinal interview, questionnaire and records study of pre-trial men newly imprisoned in Wales and SW England. Results: Two hundred and forty-one pre-trial men completed an interview and questionnaires within a week of a new reception into prison; 170 completed follow-up 3 weeks later. Questions about problems with alcohol or illicit drugs revealed that problem drinkers were less likely than problem drug users to recognize their difficulty or seek or get help for this during their first month of imprisonment. Co-morbidity was common, but a third of the men had alcohol problems alone. Use of the Alcohol Use Disorders Identification Test (AUDIT) questionnaire identified 80% (195/241) men likely to require some intervention, twice the number identified by direct questions relying on prisoners' judgment about problem use. Furthermore it allowed categorization according to likely risk (dependency), need (problem recognition) and responsivity (wish for help). Conclusion: Alcohol misuse is recognized, worldwide, as fuelling crime and more common among prisoners than the general population. In England and Wales, it is a particular factor in brief but recurrent periods of imprisonment. There have been calls to pay more attention to its use in this context, albeit without any increase in resources. Adding two questions to standard screening enables application of the risk-need-responsivity model to problem drinkers and may identify those most likely to benefit from treatment.

Webcam Girls