Mental health and self-harm/suicide risk screening at prison entry over 12 months in a total population sample in New South Wales, Australia

Introduction: International research has found high rates of mental illness and self-harm/suicide among people in prison. However, existing studies are often limited by their sample selection methodology, and many do not examine mental health at prison entry specifically. In addition, with smaller samples, previous studies have lacked statistical power to robustly examine and compare subgroups.Method: This study examines a total population sample of 9568 individuals entering public prisons in New South Wales, Australia over a 1-year period, and describes the prevalence of a range of mental health and self-harm/suicide risk indicators collected during routine health screening upon prison entry.Results: In total, 62% of prison entrants reported a lifetime mental health condition and 23% reported a serious mental illness. Lifetime self-harm (14%) and suicide attempts (12%) were also high. Women and First Nations people entering prison had higher prevalence of most mental health diagnoses and of previous self-harm and suicidal ideation/behaviour than men and non-First Nations people.Conclusion: These results establish the scale of mental health need and self-harm/suicide risk among people entering prison, particularly among women and First Nations people. There is a clear need for investment to adequately resource prison-based mental health services to meet the needs of prison entrants, but also in interventions to prevent those with significant mental health needs from entering prison in the first place. These strategies may include targeted and preventive approaches via mental health diversion and community-based mental health services.