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The pathways to offending and mental health needs of ex-armed forces personnel in prison: a mixed methods study
[Thesis]. Manchester, UK: The University of Manchester; 2017.
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Abstract
Background: Ex-armed forces personnel constitute 3.5% of the prison population in England and Wales but we know little about why some former service personnel end up in prison. Furthermore, understanding what the mental health needs of this group are and how to meet them will inform service delivery and offending prevention strategies. Therefore, this study aimed to assess the mental health needs, and explore the pathways to offending, of ex-armed forces personnel in prison. Methods: A mixed methods design was used. A researcher administered questionnaire collected demographic information; details of pre-service; military experience; circumstances post-armed forces; and a detailed assessment of mental health of 105 male ex-armed forces personnel in prison. Their healthcare and offending records were accessed to record any formal mental health diagnoses and details of previous offending. Two studies made up the qualitative arm of the study: study 1 used semi-structured interviews (n = 20) to explore the pathways to offending of ex-armed forces personnel in prison from their perspective and study 2 employed semi-structured interviews with prisoners (n = 10) and a focus group with professionals (n = 5) to explore the service needs and treatment barriers of former service personnel in prison. Results: Of 105 participants, 40 (38%) screened positively for a current common mental health (CCMH) problem (i.e. depression, anxiety or post-traumatic stress disorder [PTSD]) and a high prevalence of alcohol misuse was assessed (n = 59, 56%). Over half of the sample were serving their first custodial sentence (n = 58, 55%). Violent offences were the most common index offence (n = 34, 32%) and the majority of the sample had previous convictions recorded (n = 70, 71%). Participants considered their pathways to offending as complex and incorporating pre-service, military service and post-service factors. Perceived influences on offending included mental health and substance misuse problems, impulsivity and problem solving difficulties. Prison was considered an opportunity to access help and staff having military awareness was thought to encourage help-seeking. However, stigma and previous negative experiences were perceived to make asking for help difficult and the variability in support across the prison estate was considered a barrier to support by all.Discussion: The findings of this study add to the literature and our knowledge of ex-armed forces personnel in prison. The study found that the mental health needs of the group are largely similar to the general prison population but that potential nuances exist regarding alcohol misuse and PTSD. The pathways to offending of the group are complex and are influenced by a number of factors in veterans’ lives. Based on the findings of the study implications and directions for future work are discussed.