Academic journal article Indian Journal of Psychiatry

Psychiatric Morbidity in Prisoners

Academic journal article Indian Journal of Psychiatry

Psychiatric Morbidity in Prisoners

Article excerpt

Byline: Vinod. Kumar, Usha. Daria

Background: Prisoners are having high percentage of psychiatric disorders. Majority of studies done so far on prisoners are from Western countries and very limited studies from India. Aim: Study socio-demographic profile of prisoners of a central jail and to find out current prevalence of psychiatric disorders in them. Materials and Methods: 118 prisoners were selected by random sampling and interviewed to obtain socio-demographic data and assessed on Indian Psychiatric Interview Schedule (IPIS) with additional required questions to diagnose psychiatric disorders in prisoners. Results: Mean age of prisoners was 33.7 years with 97.5% males, 57.6% from rural areas and 65.3% were married. Average education in studied years was 6.6 years and 50.8% were unskilled workers. 47.4% were murderers while 20.3% of drugs related crimes. 47.5% were convicted and history of criminal behavior in family was in 32.2% prisoners. Current prevalence of psychiatric disorders was 33%. Psychotic, depressive, and anxiety disorders were seen in 6.7%, 16.1%, and 8.5% prisoners respectively. 58.8% had history of drug abuse/dependence prior to imprisonment. Conclusion: One prison of Hadoti region of Rajasthan is full of people with mental-health problems who collectively generate significant levels of unmet psychiatric treatment need. Prisons are detrimental to mental-health. Beginning of reforms is the immediate need.

Introduction

Prisoners live their life behind bars and this takes them away from their families, marriages, heterosexual contact, jobs, friends, communities, and religious activities and puts them in an extremely bad moral environment for years at a time. Social organization in prison revolves around vicious prison gangs and no good role models in jails to be followed. Many prisoners are beaten, raped, brutalized or made to live in fear. Overcrowding makes environment worse for prisoners. As per data of 2006 by National Human Rights Commission, [sup][1] prisons of India having a total capacity of 248,439 while actual number of prisoners living in prisons was 358,177. Most of the prisons have limited sunlight and fresh air and full of bad odors and poor health services. Bland and unappealing food, clothing and extremely confining shelter makes life more measurable to prisoners. In a study published in 2003 Nurse et al . [sup][2] examined the influence of environmental factors on the mental-health of people in prison found that participants reported lengthy periods of isolation with little mental stimulation contributing to poor mental-health and feelings of anger, frustration, and anxiety. Prisoners spend on average around 8-9 h unlocked, however, it is not uncommon to find in higher-security prisons that some prisoners spend 19-20 h and sometimes up to 23 h a day locked in their cells. According to Singleton et al ., [sup][3] those who are male, on remand and psychotic are likely to be locked up longer than other inmates.

Prisons have high percentage of mentally-ill prisoners. [sup][4],[5],[6],[7],[8] Firstly, mentally-ill persons are more frequently than others involved in crime due to symptoms like impaired judgment, lack of impulse control, suspiciousness, loss of inhibitions, paranoid ideas, inability to trust others, delusions, and hallucinations and most of them are less smart, so easily caught by police. Secondly, prisoner's living conditions in prison make them more susceptible to psychiatric disorders. Because conditions in prison are not conducive to good mental-health, prisoners with mental-illness are at risk of experiencing deterioration in their mental state. In 2004, Anderson [sup][9] pointed in a review that psychiatric morbidity including, schizophrenia is higher and perhaps increasing in prison populations compared with general populations and also with dependence syndromes being the most frequent disorders. He further added that early phase of imprisonment is a vulnerable period with a moderately high incidence of adjustment disorders and twice the incidence in solitary confinement compared with non-solitary confinement. …

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