1/2010: Health, working capacity and need for treatment of criminal sanction clients
Matti Joukamaa et al., University of Tampere, Tampere School of Public Health; Tampere University Hospital, division 5
The health of Finnish prisoners had previously been studied in 1985 and 1992. The aim of this research was to study the health, the morbidity and related reduced working capacity, and the need for treatment of different subgroups of the Finnish criminal sanction clients in 2006. The sample group consisted of male prisoners (N = 309), female prisoners (N = 101), fine default prisoners (N = 100), life sentence prisoners and prisoners held in preventive detention (N = 100) and offenders serving a community sanction (N = 101). The research methods included questionnaires, interviews carried out by nurses, psychiatric interviews, laboratory tests, and medical examinations.
Mental disorders were very common. Substance dependence was ten times more prevalent in comparison with the general population. In addition to alcohol dependence, amphetamine dependence was also widespread. Two thirds of the studied group had some personality disorder the most common of which were dissocial personality disorder and emotionally unstable personality disorder. Psychosis was the only type of disorder the occurrence of which was no greater among the subject group than among the general population.
Physical illnesses were also typical considering the age distribution of the sample group. Hepatitis and especially hepatitis C was very common. Based on a doctor’s evaluation, only half of the subject group were fit for work, one third had a reduced working capacity, and nearly one fifth lacked working capacity. Merely one third of the female prisoners were capable of work and almost half
of them were completely unfit for work. The incapacity for work was widely unrecognised. In other words, all those who were evaluated to be incapable for work had not received a disability pension.
The health of the fine default prisoners in particular as well as the female prisoners turned out to be especially poor. The fine default prisoners stay in prison for such a short time that rehabilitation is not possible. In their situation, it would be particularly important to ensure the possibility of follow-up care after release. Substance dependence is the main problem among the fine default prisoners:
only some of them did not have any form of dependence. Thus, it is a significant problem in the rehabilitation of this group.
The study revealed no great distinctions in the morbidity rate between different age groups and there was hardly any distinction between different social groups. These exceptional findings were probably caused by the special characteristics of the sample group. In the general population, most illnesses accumulate in the lower social groups and the prevalence of many illnesses varies between different age groups. Most of the prisoners are young or middle-aged and apparently the age does not have a distinct link to the prevalence of illnesses in this group. The social group of the prisoners is also distorted. Because of low education and generally poor work experience, most of the prisoners
belong to the lower social groups. Evaluating the social group based on an occupation may also be misleading in the case of prisoners: in society, an occupation generally refers to long-term employment whereas the previous employment of a prisoner may have been very short.
One of the questions initiating this study was to find out if there had been any change in the state of health of Finnish prisoners during the past 20 years that had passed since the first extensive study on prisoners’ health. The comparison was hindered by several methodical differences between the studies. After taking those into consideration, the results of the comparison could be summed up as follows. The somatic morbidity of prisoners seemed to have increased slightly. In particular, the number of hepatitis cases had risen notably. Mental disorders had become more common. In particular, there were clearly more different substance dependence problems than 20 years ago. In addition to alcohol dependence, drug dependence and apparently combined use of various intoxicating substances and drugs were also common. A positive result was that the incapacity for work had not increased among prisoners.