Mental health and offending in older people: future directions for research

Background: The number of older people and their proportion of the prison population in high-income countries has increased dramatically in recent years. This pattern is mirrored by the age profile in forensic hospital services and both trends seem counter to the age-crime curve concept. How do we understand this and what are the mental health needs of this growing group?

Aim: To identify existing research robust enough to inform policy and practice in relation to mental health in older offenders and the knowledge gaps which should drive future research.

Methods: A keyword based search strategy of the databases Embase, PsychINFO, Medline and grey literature 2008-2018. Article selection was limited to empirical research with the potential to inform policy or practice and findings synthesised narratively.
Results: Much of the research in this field focuses on prevalence and the increased psychiatric morbidity of the older offender population. Older prisoners and those older patients in secure hospitals have needs which differ in some respects from their younger counterparts and community dwelling older people. There are few studies of interventions for mental health in older prisoners or into the challenges of timely release given their complex needs. Discharge of older individuals from secure settings is also an area where further research is required in order to inform policy and service provision.

Conclusions: The older population in prisons and secure settings is growing and there is much concern as to how far facilities and services have been able to identify and meet the mental health needs of those of older age. Co-operation between researchers and services and between disciplines will be essential if we are to secure a more robust evidence base in this respect. Engaging service users in such research and considering the whole criminal justice pathway including diversion remains a priority.