Abstract Details

The Australian national imprisonment rate is 2.2 persons per 1,000 adult population with a 2019 adult prisoner population of 43,028¹. Poor prison health poses significant whole-of-society costs². Achieving health resilience is imperative within this system and contributes to successful community integration. The duty of care for those in detention consists of recognition of human rights, including the right to health. This principle of equivalence is important in reducing health inequalities.

To identify the prevalence of different neurological conditions in the prisoner population and to explore challenges encountered when providing health care to this cohort.

Observational study performed via retrospective review of electronic medical records of patients referred to the Princess Alexandra Hospital neurology correctional clinic between June 2016 – June 2019.

A total of 123 prisoner patients were included in this study. Males constituted 82% of the cohort. The median age of patients was 36 years and 65% of referrals originated from prison medical practitioners. Patients were seen at a median of 110 days from time of referral with 39% conducted via telehealth.
The most common neurological diagnoses were epileptic seizure disorder (28%), headache (16%) and functional neurological disorder (11%) with psychogenic non-epileptic seizures prevailing as the predominant functional disorder. 57% of patients underwent magnetic resonance imaging. There were multiple key findings relating to the challenges associated with the care of this cohort including but not limited to disengagement, lack of health literacy, complications of substance abuse which influenced prescribing strategies.

This pilot study is unique as it represents data from the only dedicated neurology correctional clinic within Queensland. It is first of its kind in Australia and provides insight into the prevalence of neurological diagnoses in the prisoner cohort. Finally, it identifies distinctive barriers to provision of care necessitating adaptation to the clinical assessment and management of this cohort.