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However, ex-prisoners have never previously been identified in representative population surveys to establish how far this excess persists after release. Our purpose was to provide the first community-based estimate of ex-prisoners\u2019 mental health in England using the data from the 2014 Adult Psychiatric Morbidity Survey (APMS).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>APMS 2014 provides cross-sectional data from a random sample (<jats:italic>N<\/jats:italic>\u2009=\u20097546) of England\u2019s household population aged 16 or above. Standardised instruments categorised psychiatric disorders and social circumstances. Participants who had been in prison were compared with the rest of the sample.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>One participant in seventy had been in prison (1.4%; 95% CI 1.1\u20131.7; <jats:italic>n<\/jats:italic>\u2009=\u2009103). Ex-prisoners suffered an excess of current psychiatric problems, including common mental disorders (CMDs), psychosis, post-traumatic disorder, substance dependence, and suicide attempts. They were more likely to screen positive for attention-deficit\/hyperactivity disorder and autistic traits, to have low verbal IQ, and to lack qualifications. They disclosed higher rates of childhood adversity, including physical and sexual abuse and local authority care. The odds (1.88; 95% CI 1.02\u20133.47) of CMDs were nearly doubled in ex-prisoners, even after adjusting for trauma and current socioeconomic adversity.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Prison experience is a marker of enduring psychiatric vulnerability, identifying an important target population for intervention and support. Moreover, the psychiatric attributes of ex-prisoners provide the context for recidivism. Without effective liaison between the criminal justice system and mental health services, the vulnerability of ex-prisoners to relapse and to reoffending will continue, with consequent personal and societal costs.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00127-021-02066-0","type":"journal-article","created":{"date-parts":[[2021,3,22]],"date-time":"2021-03-22T10:03:03Z","timestamp":1616407383000},"page":"2083-2093","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["The mental health of ex-prisoners: analysis of the 2014 English National Survey of Psychiatric Morbidity"],"prefix":"10.1007","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6030-7456","authenticated-orcid":false,"given":"Paul E.","family":"Bebbington","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally","family":"McManus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy W.","family":"Coid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Garside","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terry","family":"Brugha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,22]]},"reference":[{"key":"2066_CR1","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1177\/002580247601600407","volume":"16","author":"M Faulk","year":"1976","unstructured":"Faulk M (1976) A psychiatric study of men serving a sentence in Winchester Prison. 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Our secondary analyses were approved by the National Centre for Social Research\u2019s ethical review committee.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Consistent with standard practice on official surveys of the general population, after provision of advance written information and face-to-face explanation of survey process and data uses, verbal consent for voluntary participation was obtained on the doorstep.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"NHSD provided permission for data use, which allows for publication of aggregated results. The current analyses include independent research funded by the National Institute for Health Research (NIHR) Policy Research Programme (PHPEHF50\/27). NIHR\/DHSC has provided permission for publication. However, the views expressed in this publication are those of the authors and not necessarily those of the NIHR or the DHSC. The funder had no role in the study design, data collection, data analysis, data interpretation, or writing of this paper.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The Adult Psychiatric Morbidity Surveys datasets are in the UK Data Service archive. Requests for access to the 2014 dataset should be made to the Data Access Request Service at NHS Digital.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Availability of data and material (data transparency)"}},{"value":"Survey data collection was programmed in Blaise, a computer-assisted interviewing (CAI) system and survey processing tool for the Windows operating system. The system is developed by Statistics Netherlands and has been designed for use in official statistics. It is available to National Statistical Institutes and related research institutes. Data management and descriptive analyses were conducted in SPSS (v21.0) and regression analyses were carried out in Stata (v14.1). Analysis syntax is available from the authors on request.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Code availability\u00a0(software application or custom code)"}},{"value":"The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1965, as revised in 2008.","order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standards"}}]}}