Improved support needed for PTSD in Welsh prisons, says study

Prisoners with PTSD and C-PTSD (complex post-traumatic stress disorder) in Wales may be falling through gaps in support because of variations in screening and interventions in Welsh prisons, finds new research.

The study, by Cardiff University and the University of Greenwich in collaboration with Traumatic Stress Wales, has uncovered variations in support for prisoners with PSTD and C-PTSD in Wales, meaning that some prisoners aren't getting the help needed to rehabilitate them or reduce reoffending in the future.

Dr. Natasha Kalebic, Cardiff University's School of Medicine, who led the study, said, "Post-Traumatic Stress Disorder and Complex Post-Traumatic Stress Disorder are prevalent in prison populations. Both often go undetected and untreated, and prisoners who have already suffered previous trauma can be re-traumatized during imprisonment. This can ultimately impact how prisoners are rehabilitated during their prison sentence and their likelihood of reoffending in the future."

The researchers found that while all six male prisons in Wales can provide interventions and relevant medical prescriptions to help with PTSD and C-PTSD, only half are actively screening for mental health conditions, and there are variations in the use of trauma-focused therapies recommended by NICE.

The team says this is leading to prisoners not getting the support needed and wide differences in support between each prison.

Clare Crole-Rees, Consultant Psychologist and Honorary Research Associate at Cardiff University said, "Prisoners are a traumatized population, and often are re-traumatized in prison.

"Our research suggests that some prisoners are serving their sentence without specialist support—and are potentially being released into the community with increased trauma."

"We know that PTSD is a risk factor for reoffending, and therefore, proper intervention and treatment for post-traumatic stress plays an important role in rehabilitating prisoners as well as possibly reducing reoffending in the future."

The research also uncovered a number of barriers that prevent prisoners from being able to access specialist support, including levels of staffing, resources, and access to training.

"Shorter prison sentences can also be a barrier, as prisoners don't have time to complete their therapy, or they would finish their sentence, and the support wouldn't follow them out into the community," added Dr. Kalebic.

The team suggests the development of a pathway for PTSD and C-PTSD in the prison system, involving frontline staff and specialists to help improve the detection and treatment of the condition.

Professor Andrew Forrester from Cardiff University School of Medicine, leader of the POLAR project—a project that is developing integrated intervention pathways in prisons, said, "Post-traumatic stress disorder is a significant issue among people in prison, but historically mental health services have not been fully resourced to meet these needs."

"It is therefore important to understand current service provision in prisons in Wales, including variations within that, if we are to seek to move forward and improve the overall service offer. This study represents the first stage of this work."

Dr. Kalebic said, "More research is needed to understand the UK picture as well as the where and when treatment should be given. However, our study has given us a valuable insight into ways that we can improve support for PTSD and C-PTSD in prisons in Wales."

The paper is published in the Medico-Legal Journal.