Maudsley Hospital, Denmark Hill, London SE5 8AZ, UK
While I agree entirely with Fazel et al (2001) that there is an unmet need for psychiatric care for elderly offenders, I wonder whether this need is even greater than is implied by their paper. It is important not to forget those elderly people who do not actually end up in prison but have committed crimes. Yorston (1999) notes that the elderly are less likely than younger offenders to have custodial sentences or fines imposed and are more likely to receive probation orders. Lynch (1988) postulated that the public's sympathy for the perceived frailty of the elderly is likely to lead to this group being treated more leniently. Bergman & Amir (1973) have also noted a tendency for families to hide deviance, which may lead to offending behaviour in this group being underreported.
One revelation to me which emerges from Fazel et al's paper was the relatively high number of offenders imprisoned for drug offences (29/203). Older studies (e.g. Taylor & Parrott, 1988) suggested that drug-related crime was of a much lower incidence: indeed, in their study of elderly custodial remand prisoners none aged 55 and over had been charged with a drug-related offence, although they noted that misuse of alcohol appeared to rise steadily with age. I wonder whether Fazel et al are showing us that the victims of the drugs culture, traditionally thought to have been established in the UK in the 1960s, are now starting to feature among the elderly?
REFERENCES
Bergman, S. & Amir, M. (1973) Crime and delinquency among aged in Israel. Israel Annals of Psychiatry and Related Disciplines, 11, 33-48.[Medline]
Fazel, S., Hope, T., O'Donnell, I., et al
(2001) Hidden psychiatric morbidity in elderly prisoners.
British Journal of Psychiatry,
179,
535-539.
Lynch, S. (1988) Criminality in the elderly and psychiatric disorder. A review of the literature. Medicine, Science and the Law, 28, 65-78.
Taylor, P.J. & Parrott, J. M. (1988) Elderly offenders. A study of age-related factors among custodially remanded prisoners. British Journal of Psychiatry, 152, 340-346.[Abstract]
Yorston, G. (1999) Aged and dangerous. Old age forensic psychiatry. British Journal of Psychiatry, 174, 193-195.[Medline]
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