Systematic review of available data and gaps on the prevalence of adults who require forensic mental health care in Australia

This systematic review aimed to identify the prevalence of justice-involved adults requiring mental health care in Australia. Sources providing estimates of diagnosed mental illness and psychological distress within prisons and courts/watch-houses, and service referral and/or utilisation data from bed-based and community forensic mental health services were sought. Within prisons, the prevalence of mental illness was high, ranging from 38–58.4% (n = 7 estimates). Estimates of very high psychological distress (n = 5) were variable by gender and highest for First Nations females (39%). One prevalence estimate of mental illness in watch-houses was located (51.3%). Bed-based service demand rates varied from 0.58 to 12.36 admissions per 100,000 adult population (n = 13). Community-based service demand rates ranged from 2.99 to 99.51 people per 100,000 adult population (n = 4). Estimates had substantial heterogeneity. Issues with data availability were identified and recommendations for improvement made. This information contributes to the development of a needs-based model for planning forensic mental health services in Australia.