Mental wellbeing among people in prison in Scotland: an analysis of repeat cross-sectional surveys

Background Mental wellbeing among people in prison is poorly studied, despite featuring in many health and justice policies. We aimed to describe for the first time mental wellbeing among an unselected national prison sample. Methods Since 2013, the Scottish Prisoner Survey-a biennial survey of people in custody in Scotland-has included the Warwick-Edinburgh mental wellbeing scale (WEMWBS), a 14-item scale with higher scores indicating greater wellbeing. We analysed data from sweeps in 2013 (n = 3158), 2015 (n = 2892) and 2017 (n = 2405) using Student's t-test, ANOVA and multiple linear regression. We also used WEMWBS data from the Scottish Health Survey strati ed by age, gender and deprivation to compare with the population at liberty. Results Mean WEMWBS scores overall were 43.4 in 2013 (SD = 12.2), 41.8 (SD = 11.9) in 2015 and 41.2 (SD = 12.3) in 2017. Mean scores were lower among people on remand and with multiple prison episodes. Age-standardized mean scores were lower among people in prison than their peers at liberty. Conclusions Poor mental wellbeing is an important, under-studied facet of the extreme health inequalities associated with imprisonment. These results identify that people on remand or with multiple episodes are particularly disadvantaged and provide a baseline for monitoring impacts of service or policy interventions.

Automated summary

The study reveals that mental wellbeing among people in prison is poor, especially among those who are on remand or have multiple prison episodes. Compared to their peers at liberty, individuals in prison generally have lower levels of mental wellbeing.