Prevalence of psychiatric disorders among juvenile offenders in Malaysian prisons and association with socio-demographic and personal factors

The Effectiveness of the Super Skills for Life (SSL) Programme in Promoting Mental Wellbeing among Institutionalised Adolescents in Malaysia: An Interventional Study

Background: Mental health issues have become more prevalent among institutionalised adolescents. Therefore an effective intervention programme is needed to improve their mental health. Objective: To evaluate the effectiveness of the Super Skills for Life (SSL) programme in improving the mental wellbeing of institutionalised adolescents and determine the factors associated with their mental wellbeing. Methods: A quasi-experimental study involving 80 female institutionalised adolescents divided into intervention and control groups was conducted. Intervention involved implementation of the SSL programme. The effectiveness of the programme was evaluated based on several outcome parameters. Results: Factors including age, number of family members, perceived social support and self-esteem had significant correlations with mental wellbeing of participants. The SSL programme significantly improved the anxiety and stress levels of participants. Conclusion: SSL programme exclusively improves the mental wellbeing in institutionalised adolescents.

Exploring the Decisional Drivers of Deviance: A Qualitative Study of Institutionalized Adolescents in Malaysia

Adolescents who break the law or deviate from social norms are often criminalized as their behavior is perceived as resulting from conscious choices. However, it is likely that such choices result from their circumstances, namely the failure of their proximal environment to safeguard their wellbeing. The purpose of this study was to gain an in-depth understanding of the background variables and choices that led these institutionalized adolescents down the road of deviance. We conducted a qualitative study using semi-structured in-depth interviews, conducted between March and May 2018, with 18 participants aged between 15 to 19 years. Participants were purposefully sampled from various welfare institutions in the states of Kuala Lumpur and Selangor, Malaysia. Audio recordings of interviews were transcribed verbatim and analyzed thematically. We found three core themes, (i) Sources of Distress, (ii) Drivers of Deviance, and (iii) Adjustment Strategies for Coping with Distress, which appeared to have influenced participants’ life trajectories and eventual institutionalization. The findings showed that participants were disadvantaged by backgrounds of risk and vulnerability, characterized by a lack of social support and opportunities for personal development, negative schooling experiences, and negative peer interactions. Substance abuse, which provided a coping strategy for the participants, may have further contributed to their delinquency. Drawing upon the socio ecological model (SEM), we systematically identify interventional opportunities at the individual, community, and policy levels to safeguard the wellbeing of at-risk adolescents. We make recommendations aimed at improving the family dynamics, promoting a healthy schooling experience, and transforming neighborhoods into a safe and nurturing environment.

Mental health problems and suicidal expressions among young male prisoners in Cambodia: a cross-sectional study

Background

incarceration and mental health problems are known to have a strong empirical association. Many studies have confirmed the high prevalence of mental health problems among young prisoners in particular, yet none has been conducted in Cambodia.

Objectives

this study aimed to assess the level of mental health problems and suicidal expressions, and determine the associated risk factors among young prisoners in Cambodia.

Method

this was a cross-sectional study among 572 young prisoners between the ages of 15 and 24 from three prisons. Sociodemographic data and detailed information on participants’ profiles were gathered, and mental health problems and suicidal expressions were assessed using the Youth Self-Report (YSR) and the Attitude Towards Suicide (ATTS) questionnaires, respectively.

Results

Mental health problems as revealed by the mean YSR scores were: 25.97 for internalizing and 18.12 for externalizing problems; 11.88 for anxiety/depression, 9.97 for aggressive behaviours and 7.53 for somatic complaints. Social problems, attention problems and rule breaking behaviour were in the range of 8.10 to 8.49. Withdrawal depression and thought problems mean scores were 6.55 and 6.66, respectively. Mental health problems were associated with younger age, lower educational background, and shorter duration of incarceration. Around 16% had thought about their own death, and 12% expressed wish to die. Suicide ideation, planning, and attempts were reported by almost 7%, 2%, and 3% of participants respectively. Prior drugs users thought about death significantly more than their counterparts while suicide ideation was significantly lower among prisoners with higher education.

Conclusion

Mental health problems and suicidal expressions among young prisoners warrant well-planned mental health services that are integrated into the current prison health system. A contextualised intervention that takes into account age, education, duration of incarceration and previous drug use may contribute to improve the mental well-being of young prisoners in Cambodia.

An Updated Systematic Review and Meta-regression Analysis: Mental Disorders Among Adolescents in Juvenile Detention and Correctional Facilities

OBJECTIVE

To synthesize evidence on the prevalence of mental disorders in adolescents in juvenile detention and correctional facilities and examine sources of heterogeneity between studies.

METHOD

Electronic databases and relevant reference lists were searched to identify surveys published from January 1966 to October 2019 that reported on the prevalence of mental disorders in unselected populations of detained adolescents. Data on the prevalence of a range of mental disorders (psychotic illnesses, major depression, attention-deficit/hyperactivity disorder [ADHD], conduct disorder, and posttraumatic stress disorder [PTSD]) along with predetermined study characteristics were extracted from the eligible studies. Analyses were reported separately for male and female adolescents, and findings were synthesized using random-effects models. Potential sources of heterogeneity were examined by meta-regression and subgroup analyses.

RESULTS

Forty-seven studies from 19 countries comprising 28,033 male and 4,754 female adolescents were identified. The mean age of adolescents assessed was 16 years (range, 10-19 years). In male adolescents, 2.7% (95% CI 2.0%-3.4%) had a diagnosis of psychotic illness; 10.1% (95% CI 8.1%-12.2%) major depression; 17.3% (95% CI 13.9%-20.7%) ADHD; 61.7% (95% CI 55.4%-67.9%) conduct disorder; and 8.6% (95% CI 6.4%-10.7%) PTSD. In female adolescents, 2.9% (95% CI 2.4%-3.5%) had a psychotic illness; 25.8% (95% CI 20.3%-31.3%) major depression; 17.5% (95% CI 12.1%-22.9%) ADHD; 59.0% (95% CI 44.9%-73.1%) conduct disorder; and 18.2% (95% CI 13.1%-23.2%) PTSD. Meta-regression found higher prevalences of ADHD and conduct disorder in investigations published after 2006. Female adolescents had higher prevalences of major depression and PTSD than male adolescents.

CONCLUSION

Consideration should be given to reviewing whether health care services in juvenile detention can address these levels of psychiatric morbidity.

Prevalence of psychiatric disorders, comorbidity patterns, and repeat offending among male juvenile detainees in South Korea: a cross-sectional study

BACKGROUND

High rates of psychiatric disorders and comorbidities have been reported in juvenile detainees, and both phenomena are thought to contribute to repeat offending. However, research on this topic has been limited in Asian countries, like South Korea. The purpose of this study was to examine the prevalence of psychiatric disorders, comorbidity patterns, and the relationship between psychiatric disorders and repeat offending among a cross-section of youths detained in a male juvenile detention center in South Korea.

METHODS

One hundred seventy-three juvenile detainees were recruited. The distribution of psychiatric disorders within the sample was estimated by applying criteria from the Diagnostic and Statistical Manual of Mental Disorders IV. Logistic regression was used to assess significant comorbidity patterns and relationships between psychiatric disorders and repeat offending.

RESULTS

In all, 90.8% of the detainees had at least one psychiatric diagnosis, and 75.1% had psychiatric comorbidities. The most common psychiatric disorder was alcohol use disorder, followed by conduct disorder and attention-deficit hyperactivity disorder. Among the comorbidities present, alcohol use disorder with disruptive behavior disorder was the most common combination. The presence of two psychiatric disorders was associated with a higher rate of recidivism, and alcohol use disorder was also associated with repeat offending when combined with disruptive behavior disorders, but not with anxiety disorders, major depression, or psychotic disorders.

CONCLUSIONS

Juvenile detainees evidence high rates of psychiatric disorders and comorbidities. Assessment of and intervention in psychiatric disorders, especially alcohol use disorder and comorbid alcohol use disorder with disruptive behavior disorders, may help prevent further offenses.