A social identity approach to mental health help-seeking behaviour in prisoners: A systematic review

Prevalence of mental health difficulties is demonstrably higher in prison rather than general populations. Compounding this, prisoners often display a reluctance to seek help, which can undermine rehabilitation. Recent years has seen an increase in studies exploring the factors involved in help-seeking behaviours amongst prisoners. However, many of these studies come from different disciplines and do not use an overarching theoretical approach. Consequently, policymakers face a difficult task of synthesising and interpreting the findings from different perspectives. Using a deductive thematic analysis informed by a social identity framework, this current study aims to synthesis the existing research and provide an overarching theoretical perspective. Eleven databases were systematically searched for studies exploring help-seeking behaviours in prisoners with mental health difficulties. Results indicate that prisons represent sites of enactment of a specific institutionalised identity that inhibits help-seeking behaviour. Three themes relating to (1) the maintenance of positive group identity, (2) ‘us’ and ‘them’, and (3) inhibiting prison context were identified. This review provides an overarching coherent narrative of the experiences and perspectives of prisoners help-seeking behaviour. This can enable policymakers develop theory-based approaches to support this vulnerable cohort. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.