Screening and Diagnostic Assessment of Neurodevelopmental Disorders and Mental Health Comorbidity in a Male Prison

ABSTRACT Aims The aim of the study was to identify neurodevelopmental disorders and difficulties (NDD) and comorbidity of mental health diagnoses in a male prison. The study used standardised 10 tools to carry out screening and diagnostic assessment of the attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and intellectual disability (ID). Method The adult ADHD self-report scale (ASRS), 20-item Autism Quotient (AQ-20) and the Learning Disability Screening 15 Questionnaire (LDSQ) were used to screen 240 male prisoners. Prisoners who screened positive on one or more of these scales or self-reported a diagnosis of ADHD, ASD or ID were further assessed using the Diagnostic Interview for ADHD in Adults (DIVA), adapted Autism Diagnostic Observation Schedule (ADOS) 20 and the Quick Test. The Mini-International Neuropsychiatric Interview (MINI) was used to establish mental health diagnoses. Results Of the 87 prisoners who screened positive for NDD and were further assessed, 70 met the study’s diagnostic cri- teria for ADHD, ASD or ID. Most of those with NDD (51%) had 25 previously gone unrecognised with a high proportion (51%) identified through staff- or self-referral to the study. In all groups high rates of mental health comorbidity was also found. Conclusion The study demonstrated that improving aware- 30 ness and providing access to skilled, standardised assessment within a male prison can result in increased recognition and identification of NDD.