Intellectual disability in Irish prisoners: systematic review of prevalence

• DOI: https://doi.org/10.1108/IJPH-01-2017-0003
• Published date: 10 September 2018
• Pages: 188-196
• Date: 10 September 2018
• Author: Gautam Gulati,Valerie Murphy,Ana Clarke,Kristin Delcellier,David Meagher,Harry Kennedy,Elizabeth Fistein,John Bogue,Colum P. Dunne
• Subject Matter: Health & social care,Criminology & forensic psychology,Prisoner health,Sociology,Sociology of crime & law,Public policy & environmental management,Policing,Criminal justice

Intellectual disability in Irish prisoners:

systematic review of prevalence

Gautam Gulati, Valerie Murphy, Ana Clarke, Kristin Delcellier, David Meagher, Harry Kennedy,

Elizabeth Fistein, John Bogue and Colum P. Dunne

Abstract

Purpose –While individuals with an intellectual disability form a significant minority in the worldwide prison

population, their healthcare needs require specialist attention. In Ireland, services for prisoners with

intellectual disabilities need development. However, there is little substantive data estimating the prevalence

of intellectual disabilities within the Irish prison system. The paper aims to discuss these issues.

Design/methodology/approach –The authors systematically review published data relating to the

prevalence of intellectual disabilities in prisons in the Republic of Ireland. The authors searched four

databases, governmental websites and corresponded with experts.

Findings –Little published data were elicited from searches except for one nationwide cross-sectional

survey which reflected a higher prevalence than reported in international studies. Studies from forensic

mental health populations are narrated to contextualise findings.

Originality/value –This study found that there is little data to accurately estimate the prevalence of

intellectual disabilities in the Irish prison system and the limited data available suggests that this is likely to be

higher than international estimates. The authors highlight the need for further research to accurately estimate

prevalence in this jurisdiction, alongside the need to develop screening and care pathways for prisoners with

an intellectual disability.

Keywords Ireland, Prison, Learning disability, Intellectual disability, Forensic mental health, Cognitive disability

Paper type Literature review

Introduction

The prevalence of intellectual disabilities in Ireland is 6.13 per 1,000 population. This is based on

National Intellectual Disability Database data from 2015 and population census data from 2011.

The prevalence rate for mild intellectual disability is 1.99 per 1,000 while the rate for moderate,

severe or profound intellectual disability is 3.59 per 1,000 (Doyle and Carew, 2016).

Considerable confusion exists worldwide over the appropriate use of terms such as mental

handicap, learning disability, mental retardation and intellectual disability. These are terms

derived variously from current or superseded legislation in various jurisdictions and nosological

terms from various international classifications. The term “developmental disorder”also has

medical currency. Whilst “pervasive developmental disorder”is often used for autistic spectrum

disorder (ASD), “global developmental delay”is used for intellectual disability. For this study, we

use the terms mental handicap, learning disability, mental retardation, intellectual disability

interchangeably but specified as necessary where defined based on a diagnostic classification or

when used in a study.

“Learning disability”is the term commonly used in the UK, whereas this term is more used to

describe thosewith specific learning difficultiesin the USA. “Mental Handicap”,a terminology used

in the latetwentieth century has now beenphased out due to pejorativeconnotations but has been

included in the study strategy to avoid publication bias.“Mental retardation”is a term used in The

International Classification of Diseases (ICD), 10th Edition (World Health Organization, 1992)

and “Intellectual disability”is used in Diagnostic and Statistical Manual of Mental Disorders,

Received 9 January 2017

Revised 2 August 2017

Accepted 30 October 2017

Gautam Gulati is based at

University Hospital Limerick,

Limerick, Ireland.

Valerie Murphy is based at the

University College Cork, Cork,

Ireland.

Ana Clarke is based at

University Hospital Limerick,

Limerick, Ireland.

Kristin Delcellier and

David Meagher are both based

at Graduate Entry Medical

School, University of Limerick,

Limerick, Ireland.

Harry Kennedy is based at

Trinity College, Dublin, Ireland.

Elizabeth Fistein is based at

University of Cambridge,

Cambridge, UK.

John Bogue is based at the

National University of Ireland

Galway, Galway, Ireland.

Colum P. Dunne is based at the

Graduate Entry Medical

School, University of Limerick,

Limerick, Ireland.

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VOL. 14 NO. 3 2018, pp. 188-196, © Emerald Publishing Limited, ISSN 1744-9200 DOI 10.1108/IJPH-01-2017-0003