Mental and physical healthcare utilization among young prisoners: a longitudinal study

Abstract

The present longitudinal study describes changes in and covariates of healthcare utilization in 75 young males (aged 17-22 years) during their first year in a Portuguese prison. The prisoners were assessed 1, 3, 6, and 12 months after their arrival in custody. Multilevel negative binomial regression analyses were conducted to examine the effect of time in prison as well as several clinical, socio-demographic, and criminological characteristics on: (a) treatment for mental health problems and (b) treatment for physical health problems. Although healthcare utilization for mental health issues remained stable over 12 months of imprisonment, visits for physical health problems were highest during the first month and then declined significantly. Patterns of healthcare utilization were associated with time spent in prison, mental health symptoms, Portuguese nationality, older age at the onset of imprisonment, criminal history, and severe disciplinary infractions. Strikingly, prisoners who initially reported more mental health symptoms upon arrival to the prison facility received less mental health services for the first six months of imprisonment. The limitations of this study and its implications for correctional research and practice are discussed.