• Disconnectedness • Bound to regime/rigidity • Irritability • Apathy • Fear and anxiety • Inability to copy with daily tasks • Difficulty concentrating • Sleep problems • Eating problems • Demanding of staff time and attention Cultural perspectives on mental health Across the world there are many different ideas about the causes and diagnoses of mental ill-health and which treatments are the most effective. In some cultures, mental health is associated with religious or spiritual traditions and beliefs. Mental health professionals in many countries use the same clinical diagnosis and treatments; however, the terminology used is not the same in all countries. Culturally-relevant approaches to mental healthcare are important, including for Indigenous people in prison. Types of mental health conditions Common symptoms of mental ill-health Some people have mental health conditions that are never diagnosed. This can be due to a lack of mental health professionals or available expertise. There are many different types of mental health conditions, with a broad range of symptoms which may change over time. Some people experience more than one mental health problem and some symptoms are associated with more than one condition. Common mental health conditions which prison staff are likely to encounter include: Depression Signs of mental ill-health listed below can also be common responses to imprisonment. Many prisoners will display such signs during their imprisonment, but this does not mean they have a specific mental health condition or that they require a medical or clinical response. However, prison staff should be aware that low-level symptoms of mental ill-health may develop into more serious, longer-term conditions, and they should be equipped to deal with both. A prolonged feeling of low mood which can affect everyday life and, in some cases, lead to self-harm or suicide. People with depression often feel hopeless, worthless and unmotivated. Antenatal and postnatal depression are types of depression related to pregnancy and childbirth.7 Anxiety Intense and prolonged feelings of worry or fear which can be overwhelming. People with anxiety may get easily stressed about everyday life or things which are unlikely to happen. Anxiety can lead to sleeplessness, panic attacks and an increased heartbeat. Common symptoms: • Suicide and self-harm • Confused thinking and speech • Experiencing extreme moods • Sudden mood/behaviour changes • Erratic behaviour • Not looking after oneself • Being quiet, sad or withdrawn • Disruptive, impulsive or aggressive behaviour • Drug and alcohol use • Not being able to recognise and communicate problems and needs Personality disorders Those with personality disorders think, feel and behave differently from most people, causing distress or problems functioning. Post-traumatic stress disorder (PTSD) An anxiety disorder caused by traumatic events. PTSD may develop months or years later, often relived through vivid flashbacks and nightmares, and accompanied by physical sensations such as pain, sweating, nausea and trembling. 06 07