Mental health literacy of prisoners in Norway

Abstract

Introduction

While nine out of ten prisoners in Norway meet the criteria for at least one psychiatric illness or personality disorder (1), it has been a challenge that mental health services for inmates have been insufficient and fragmented. Many prisoners are reluctant to seek professional help, possibly because of a lack of awareness or a fear of stigma. Mental health literacy (MHL) represents a person’s knowledge and beliefs about mental disorders. A person with a sufficient level of MHL can better recognise, manage, and prevent mental health problems (2,3). Recent definitions of MHL have incorporated knowledge of how to gain positive mental health.

Theory/Methods

This study will examine MHL among prisoners in Norway. While there is some knowledge of help-seeking attitudes and behaviour among prisoners, the broader concept of MHL is unexplored in a prison context. Participants will be recruited from prisons in Northern Norway. Data will be collected using qualitative interviews. In a first sample, the questions will focus on the prisoners' knowledge and beliefs about positive mental health, and their experiences of factors in the prison context that promote well-being. In a second sample, the questions will focus on prisoners' knowledge, beliefs, and attitudes towards mental illness and its causes. In addition, prisoners will be asked about where they could gain information about mental health, how they would prefer to manage mental distress, and about their opinions on professional treatment for mental illness. An organisation for the welfare of prisoners participates in the project.

Results and Discussion (Expected outcomes)

Knowledge of MHL among prisoners will contribute to a greater understanding of how prisoners conceptualize mental health, and the grounds for the decisions prisoners make regarding mental health issues. This knowledge will be useful for tailoring information and programs on the subject of mental health for people in prison and might also help improve clinical communication and the therapeutic alliance (4,5). Also, the knowledge gained from this project will be useful for designing interventions aimed at enhancing the effectiveness of self-management strategies, help-seeking behavior, and adherence to treatment among prisoners.

Conclusions/lessons learned, limitations and suggestions for future research

Improving the mental health of prisoners is a major challenge and the services provided so far in Norway have been insufficient and fragmented. This study represents a central step in tailoring mental health interventions to prisoners in Norway by drawing on the concept of mental health literacy.

References

1. Cramer V. Forekomst av psykiske lidelser hos domfelte i norske fengsel. Prosjektrapport 2014-1. OUS, Norway, 2014.

2. Jorm AF, Korten AE, Jacomb PA, Christensen H, Rodgers B, Pollitt P. “Mental health literacy”: a survey of the publics’ ability to recognize mental disorders and their beliefs about the effectiveness of treatment. Med J Australia. 1997;166:182–186.

3. Mitchell J, Latchford G. Prisoner perspectives on mental health problems and help-seeking. J Forensic Psychiatry Psychol. 2010;21:773–788.

4. Wynn R. Provider-patient interaction. Norwegian Academic Press. Oslo, Norway, 1998.

5. Littauer H, Sexton H, Wynn R. Qualities clients wish for in their therapists. Scand J Caring Sci. 2005;19:28-31.