Understanding help seeking behaviour among male offenders: qualitative interview study
- 12 January 2007
- Vol. 334 (7588), 303
- https://doi.org/10.1136/bmj.39059.594444.ae
Abstract
Objective To explore the factors that influence help seeking for mental distress by offenders. Design Qualitative study based on in-depth interviews with prisoners before and after release. Setting One category B local prison in southern England. Participants 35 male offenders aged 18-52, a quarter of whom had been flagged as being at risk of self harm. Results Most respondents reported that they would not seek help from a general practitioner or other healthcare professional if experiencing mental distress. When followed up after release, none had sought medical help despite the fact that many had considerable emotional problems. Many participants were hesitant to seek help because they feared being given a formal diagnosis of mental illness. Some of these men feared the stigma that such a diagnosis would bring, whereas others feared that a diagnosis would mean having to confront the problem. Lack of trust emerged as the most prominent theme in prisoners' discourse about not seeking help from health professionals. Distrust towards the “system” and authority figures in general was linked to adverse childhood experiences. Distrust directed specifically at healthcare professionals was often expressed as specific negative beliefs: many perceived that health professionals (most often doctors) “just don't care,” “just want to medicate,” and treat patients “superficially.” Those men who would consider going to a general practitioner reported positive previous experiences of being respected and listened to. Conclusions Distrust is a major barrier to accessing health care among offenders. Like most people, the respondents in this study wanted to feel listened to, acknowledged, and treated as individuals by health professionals. By ensuring that a positive precedent is set, particularly for sceptical groups such as ex-prisoners, general practitioners and prison doctors may be able to encourage future help seeking. Information specifically designed for prisoners is needed to help to de-stigmatise mental illness, and preparation for release should include provision of information about access to health and social services. Awareness training for health professionals is recommended: trust might be fostered in this population by seemingly trivial gestures that indicate respect.This publication has 18 references indexed in Scilit:
- Suicide in recently released prisoners: a population-based cohort studyThe Lancet, 2006
- Making sense of qualitative data analysis: an introduction with illustrations from DIPEx (personal experiences of health and illness)Medical Education, 2006
- Trust relations in health care—the new agendaEuropean Journal of Public Health, 2006
- Fragmented Pathways to CareCrisis, 2006
- New arrangements for prison health careBMJ, 2005
- Help-seeking behaviour in men and women with common mental health problems: cross-sectional studyThe British Journal of Psychiatry, 2005
- Continuity, Care, and Commitment: The Course of Patient-Clinician RelationshipsAnnals of Family Medicine, 2004
- Factors influencing help seeking in mentally distressed young adults: a cross-sectional survey.2004
- Suicide and 'violent' death in a six-year cohort of male probationers compared with pattern of mortality in the general population: evidence of accumulative socio-psychiatric vulnerability.Journal of the Royal Society of Health, 1997
- The concept of illness behaviorJournal of Chronic Diseases, 1962