Vulnerabilities of prisoners with autistic traits

Background: There is increasing recognition of people with autism spectrum disorders (ASDs) across the criminal justice system. Prevalence studies of prisoners found rates of 1% to 4% for ASD with rates up to 18% in specialist juvenile courts. More recently, there has been an increasing recognition of the vulnerabilities of offenders with ASD including their risk for self-harm behaviour and mental illness. Methods: A total of 240 male prisoners were recruited in a prison in London and screened for an ASD using the autism-spectrum quotient (AQ-20). The Mini International Neuropsychiatric Interview was used to assess for depression, anxiety, self-harm behaviour and suicide. Results: A total of 46 male prisoners had significant autistic traits and 12 met the diagnostic threshold for ASD using the Autism Diagnostic Observation Schedule. Those with autistic traits were significantly more likely to have a current episode of depression (30% vs. 6%, p < 0.001) and generalized anxiety disorder (27% vs. 11%, p = 0.019) and 15% injured themselves on purpose in the past month (vs. 1.5%, p < 0.001). Conclusion: In order to support offenders with ASD at different points of their journey, we need to improve approaches to the identification of such offenders across the criminal justice system, including correction services