Hostname: page-component-8448b6f56d-mp689 Total loading time: 0 Render date: 2024-04-23T11:13:23.503Z Has data issue: false hasContentIssue false
  • English
  • Français

A 25-year dynamic ecological analysis of psychiatric hospital admissions and prison committals: Penrose’s hypothesis updated

Published online by Cambridge University Press:  15 November 2018

C. J. O’Neill ,
B. D. Kelly Open the ORCID record for B. D. Kelly [Opens in a new window]  and
H. G. Kennedy
C. J. O’Neill
Affiliation:
National Forensic Mental Health Service, Central Mental Hospital, Dundrum Road, Dublin 14, Trinity College Dublin, The University of Dublin, College Green, Dublin 2, D14 W0V6, Ireland
B. D. Kelly
Affiliation:
Department of Psychiatry, Tallaght University Hospital, Tallaght, Trinity Centre for Health Sciences, Trinity College Dublin, The University of Dublin, D24 NR0A, Ireland
H. G. Kennedy*
Affiliation:
National Forensic Mental Health Service, Central Mental Hospital, Dundrum Road, Dublin 14, Trinity College Dublin, The University of Dublin, College Green, Dublin 2, D14 W0V6, Ireland
*
*Address for correspondence: Professor H. G. Kennedy, National Forensic Mental Health Service, Central Mental Hospital, Dundrum Road, Dublin 14, D14 W0V6, Ireland (Email: kennedh@tcd.ie)
Get access Rights & Permissions [Opens in a new window]

Abstract

Aims

There is renewed interest in the inverse association between psychiatric hospital and prison places, with reciprocal time trends shown in more than one country. We hypothesised that the numbers of admissions to psychiatric hospitals and committals to prisons in Ireland would also correlate inversely over time (i.e. dynamic measures of admission and committal rather than static, cross-sectional numbers of places).

Method

Publicly available activity statistics for psychiatric hospitals and prisons in Ireland were collated from 1986 to 2010.

Results

There was a reciprocal association between psychiatric admissions and prison committals (Pearson r=−0.788, p<0.001), an increase of 91 prison committals for every 100 psychiatric hospital admissions foregone.

Conclusion

Penrose’s hypothesis applies to admissions to psychiatric hospitals and prisons in Ireland over time (dynamic measures), just as it does to the numbers of places in psychiatric hospitals and prisons in Ireland and elsewhere (static, cross-sectional measures). Although no causal connection can be definitively established yet, mentally disordered prisoners are usually known to community mental health services. Psychiatric services for prisons and the community should be linked to ensure that the needs of those currently accessing care through prisons can also be met in the community.

Keywords

Hospitalspsychiatricprisonsmental disorderspatient admissionsubstance-related disordersIreland
Type
Short Report
Information
Irish Journal of Psychological Medicine , Volume 38 , Issue 3 , September 2021 , pp. 182 - 185
Copyright
© College of Psychiatrists of Ireland 2018

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bates, G (2017). The Drugs Situation in Ireland. Centre for Public Health at Liverpool John Moores University: Liverpool.Google Scholar
Blüml, V, Waldhör, T, Kapusta, ND, Vyssoki, B (2015). Psychiatric hospital bed numbers and prison population sizes in 26 European countries: a critical reconsideration of the Penrose hypothesis. PLoS One 10, e0142163.10.1371/journal.pone.0142163CrossRefGoogle ScholarPubMed
Central Statistics Office (2018). Census through history. (https://www.cso.ie/en/census/censusthroughhistory/). Accessed 28 August 2018.Google Scholar
Curtin, K, Monks, S, Wright, B, Duffy, D, Linehan, S, Kennedy, HG (2009). Psychiatric morbidity in male remanded and sentenced committals to Irish prisons. Irish Journal of Psychological Medicine 26, 169–173.CrossRefGoogle ScholarPubMed
Daly, A, Walsh, D, Moran, R (2013). HRB Statistics Series 22. Irish Psychiatric Units and Hospitals Census 2013. Health Research Board: Dublin.Google Scholar
Grove, P, Macleod, J, Godfrey, D (1998). Forecasting the prison population: predicting the consequences of sentencing policy. Operational Research Insight 11, 3–9.Google Scholar
Irish Prison Service (2011). Annual Report 2010. Irish Prison Service: Longford.Google Scholar
Kelly, BD (2005). Structural violence and schizophrenia. Social Science & Medicine 61, 721–730.10.1016/j.socscimed.2004.12.020CrossRefGoogle Scholar
Kelly, BD (2006). The power gap: freedom, power and mental illness. Social Science & Medicine 63, 2118–2128.10.1016/j.socscimed.2006.05.015CrossRefGoogle ScholarPubMed
Kelly, BD (2007). Penrose’s law in Ireland: an ecological analysis of psychiatric inpatients and prisoners. Irish Medical Journal 100, 373–374.Google Scholar
Kelly, BD (2016). Mental Illness, Human Rights and the Law. RCPsych Publications: London.Google Scholar
Mundt, AP, Chow, WS, Arduino, M, Barrionuevo, H, Fritsch, R, Girala, N, Minoletti, A, Mitkiewicz, F, Rivera, G, Tavares, M, Priebe, S (2015). Psychiatric hospital beds and prison populations in South America since 1990: does the Penrose hypothesis apply? JAMA Psychiatry 72, 112–118.10.1001/jamapsychiatry.2014.2433CrossRefGoogle ScholarPubMed
O’Neill, C, Smith, D, Caddow, M, Duffy, F, Hickey, P, Fitzpatrick, M, Caddow, F, Cronin, T, Joynt, M, Azvee, Z, Gallagher, B, Kehoe, C, Maddock, C, O’Keeffe, B, Brennan, L, Davoren, M, Owens, E, Mullaney, R, Keevans, L, Maher, R, Kennedy, HG (2016). STRESS-testing clinical activity and outcomes for a combined prison in-reach and court liaison service: a 3-year observational study of 6177 consecutive male remands. International Journal of Mental Health Systems 10, 67.CrossRefGoogle ScholarPubMed
Penrose, LS (1939). Mental disease and crime: outline of a comparative study of European statistics. British Journal of Medical Psychology 18, 1–15.CrossRefGoogle Scholar
Prins, SJ (2011). Does transinstitutionalization explain the overrepresentation of people with serious mental illnesses in the criminal justice system? Community Mental Health Journal 47, 716–722.CrossRefGoogle ScholarPubMed