THE ROLE OF PSYCHIATRIC EPIDEMIOLOGY IN CORRECTIONAL MEDICINE

Epidemiology is the basic science of public health. Since WWII, epidem iology has changed its focus from infectious diseases to an understand ing of organic and functional problems, including psychiatric illness, within various social and organizational contexts. More recently, epi demiologists have studied special populations. However, the authors ar gue that correctional populations have, as yet, been neglected. For ex ample, the purpose of psychiatric epidemiological investigations is to discover etiological associations between biological, social, psychol ogical, and environmental risk factors to disease. While many authors have described the effects of prisonization on mental health, socioenv ironmental factors present in correctional settings have not been syst ematically studied as risk factors for mental illness. Current knowled ge of the epidemiology of mental disorders must be extended beyond tha t gathered in mental hospital and normal populations to correctional s ettings. In order to accomplish this, there is a need to resolve sever al basic issues so that comparable data can be identified across diffe rent populations. First, there must be agreement on what constitutes a case. Second, standardized case findings methods that are appropriate to the range of pathology in correctional settings must be developed. Third, in addition to studying prevalence and incidence, we must begi n to compare differences in the duration, disability, and outcome of i llness across different populations. Finally, there is a need to evalu ate the effects of policy decisions on the flow of mental patients to justice and correctional settings.