Mental health problems of prisoners in South America
Fecha
20172017
Institución
Resumen
The increase of prison population rates in South America was related to psychiatric bed
removals. The aim of the present study was to establish prevalence rates of mental and
substance use disorders of prisoners at the reception in the penal justice system and to followup
the course of severe mental disorders during imprisonment. We conducted structured
interviews of 427 prisoners within the first weeks of imprisonment using the Mini International
Neuropsychiatric Interview MINI to establish prevalence rates of mental and substance use
disorders. We applied the revised version of the Symptom Check List with 90 items to assess the
global symptom severity. Prisoners with major depression at admission and still imprisoned
after one year we reassessed in a follow-up study. Major depression was present in 49% of the
sample at reception. About one third, 34% of the sample had depression with melancholic
features and 28% recurrent depression. Sixteen percent of the sample had any psychotic
disorder. More than half of the sample, 55% had any substance use disorders. There were
significant gender differences: 76% of the male prisoners and 32% of the female prisoners had
substance use disorders. Even though global symptom levels improved on average, in the oneyear
follow-up of prisoners with major depression, 44% still had major depression at follow-up
and 19% had attempted suicide during the year. Psychiatric hospital beds were removed in
South America, while community mental health care was still poorly developed. Severe mental
disorders are common in prisoners. They frequently co-occur with substance use disorders. An
important number of severe mental disorders persists over time after admission to the penal
justice system.