Social-cognitive determinants of help-seeking for mental health problems among prison inmates

Crim Behav Ment Health. 2006;16(1):43-59. doi: 10.1002/cbm.54.


Background: Prisoners experience high rates of mental health problems and suicidal behaviours. Failure to seek help may exacerbate these problems and limit opportunities to participate in offending-related programmes.

Aims: To assess whether prisoners'; intentions to seek help for a personal-emotional problem, including suicidal feelings, can be predicted using variables from the Theory of Planned Behaviour (TPB). These TPB variables were supplemented by measures of emotional distress, prior contact with a psychologist and demographic variables.

Methods: Male inmates from six New Zealand prisons were asked to participate, with approximately 50% (n = 527) of those who initially expressed an interest in the study completing the self-report questionnaire. Most participants completed the questionnaire in small-group meetings in the prison units and returned them to the researchers immediately after completion.Results On average, participants reported higher levels of current emotional distress than comparison student samples. TPB variables predicted help-seeking intentions for suicidality and personal-emotional problems. Those with prior contact with prison psychologists had lower intentions to seek help for suicidal feelings than prisoners without such contact. Older prisoners, those with more years of education, and those who had previous contact with a psychologist outside prison tended to have higher intentions to seek psychological help.

Conclusions: Social-cognitive factors predicted intentions to seek help among New Zealand prisoners but prison-specific issues, such as relative reluctance to seek help when suicidal and reluctance to seek help from prison psychologists, were also identified. Implications for practice Prisoners'; access to services could be improved, for example, through directly working on attitudinal barriers. Strategies to ensure access to specialized forensic mental health in-reach services could also be an alternative or additional route to ensure that this disadvantaged group seeks appropriate help.

MeSH terms

  • Adolescent
  • Adult
  • Affective Symptoms / epidemiology
  • Affective Symptoms / psychology*
  • Affective Symptoms / therapy
  • Aged
  • Awareness*
  • Cross-Sectional Studies
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Middle Aged
  • Motivation
  • New Zealand
  • Patient Acceptance of Health Care / psychology*
  • Patient Acceptance of Health Care / statistics & numerical data
  • Pilot Projects
  • Prisoners / psychology*
  • Prisoners / statistics & numerical data
  • Prisons / statistics & numerical data
  • Referral and Consultation / statistics & numerical data*
  • Secondary Prevention
  • Socioeconomic Factors
  • Suicide / prevention & control*
  • Suicide / psychology
  • Suicide / statistics & numerical data