Gang members in prison could be suffering from severe mental health problems.

Sebastian Henagulph, forensic psychiatrist at the Mid-Atlantic Wellness Institute and Westgate Correctional Facility, cited British research that reported gang membership can lead to mental illness.

Dr Henagulph said: “It’s a two-way thing. A lot of people who end up in prison have antisocial personality disorder or other personality disorders. Usually 5 to 10 per cent of the population has a personality disorder, but if you go into a prison, you’ll find 60 to 80 per cent with a personality disorder.”

One study found that nearly 90 per cent of gang members had antisocial personality disorder, compared with 30 per cent of violent men with no gang affiliations and only 10 per cent of non-violent men.

“Some people get involved in these gangs because of the general stressful environments they’re in,” Dr Henagulph said.

He added that the racial divide played a part in gangs in Bermuda, with the majority made up of young black men.

He said: “It tends to be people on the margins of society. The disenfranchised don’t have money and don’t see hope in their lives, and drift into the gang lifestyle.”

Dr Henagulph added: “I would see it more as a socioeconomic issue here in Bermuda, and it is the same in the United States — historically, the black population has been at the lower end of the socioeconomic spectrum.

“Generally, most of us deal with stress in a healthy way whereas other people might not have these same coping skills and resort to drugs and alcohol, blaming other people and fighting other people.”

Research by Public Health England suggested that young people may be drawn to gangs for a sense of support, self-worth and belonging, particularly if they are from broken homes.

The British study said: “Supporting mental wellbeing in vulnerable young people is therefore a multiagency interest and is fundamental to preventing gang-related violence.”

Dr Henagulph added that in addition to poor mental health contributing to gang affiliation, membership could contribute to a deterioration in mental condition.

He said: “Some of the people in gangs, because of the violence they’re committing and the stressful environments they’re in, are paranoid all the time because someone is actually probably coming to get them.

“Just being in the gang gives you anxiety, depression, post-traumatic stress disorder and high rates of suicide.”

But Dr Henagulph, backed by other mental health organisations on the island, said the entire mental healthcare system was out of date and that there was insufficient research on illness rates, while prisons lacked suitable treatment programmes.

Jodi Lewis of the Bermuda Mental Health Foundation, said: “Our legislation is outdated and our system in Bermuda is archaic.”

She added that mental healthcare needed “a complete overhaul”.

Ms Lewis said that the high rate of reoffending in Bermuda proved offenders were not being helped, while repeat offenders cost the taxpayer.

She added: “It’s costly to send someone back to prison. Jail might not be the best place.”

Dr Henagulph said: “Keeping someone locked up in prison for 20 years is expensive, whereas people whose mental health is related to their offending can be sent to a hospital where they can be treated and be better in two or three years and come out and function in society.”

The psychiatrist, who spent 12 years working in hospitals in the UK with large multidisciplinary teams on call around the clock, said a forensic wing at MWI should be considered.

He said: “We have patients upstairs in MWI who are vulnerable and you don’t want people with lots of antisocial personality traits coming into the hospital.

“It would be detrimental to the people that we already have here.”

He added that an agreement had been struck earlier this year to send some patients to St Andrew’s Healthcare in the UK for treatment and other options were being considered.

The former government opened the Mental Health Treatment Court last year, with the aim of using psychiatric care where needed by offenders.

Dr Henagulph said that prison officers would benefit from better training in mental health and that a course run by the BHB was introduced last year.

He added: “The more people that have that sort of training to be able to pick things up and tell us that this person might need some help makes it a lot easier than things getting out of hand before people step in.”

He added that Westgate mental health professionals had a heavy workload.

Dr Henagulph said: “We could use more resources. I have the clinic up there once a week and we can just about manage the caseload.”

However, Lieutenant-Colonel Edward Lamb, the Commissioner for Corrections, said gang affiliation and mental health were separate issues.

He added: “In one or two instances there might be some psychological mental health issues but not for the most part. They are two separate issues.”

Lieutenant-Colonel Lamb said: “Staff are keenly aware of signs of psychological issues.”