The challenges of treating the mentally ill in a prison setting: the European perspective

Factors associated with depression among prisoners in Mizan prison institute, southwest Ethiopia

PURPOSE

In spite of the vulnerability of prisoners to depression and their increased number, the issue has not been thoroughly investigated in Ethiopia. In particular, the determining factors of depression have not been exhaustively identified. Thus, the purpose of this study is to assess the prevalence of depression and associated factors among prisoners in Mizan prison institute, southwest Ethiopia.

DESIGN/METHODOLOGY/APPROACH

An institution-based cross-sectional study was conducted from April 6-27, 2020. A total of 340 randomly selected prisoners were included. Depression was assessed using the Patient Health Questionnaire-nine and participants were considered to be in a state of depression if they scored five and above. Binary logistic regression was used to assess the association between the outcome variable (depression) and the independent variables (factors). The odds ratio with a 95% confidence interval (CI) was used to measure the strength of association. The final significance was decided using a p-value < 0.05.

FINDINGS

The prevalence of depression was 29.9% (95% CI: 25%, 34.8%). Prisoners whowere not participating in the duty work of the prison had 55% (adjusted odds ratio [AOR] = 0.45; 95% CI: 0.22, 0.93) less odds of depression compared to those who were participating in the duty work. Similarly, physically active respondents had 81% (AOR = 0.19; 95% CI: 0.10, 0.35) less odds of depression than physically inactive respondents. Moreover, undernourished participants had two times (AOR = 2.03; 95% CI: 1.08, 3.82) higher odds of depression than normal participants.

RESEARCH LIMITATIONS/IMPLICATIONS

Considering their risk of exposure compared to the general population and the limitations of cross-sectional study design, special care should be provided to the prisoners' mental health. Moreover, priority attention should be given to the undernourished, physically inactive and those who are participating in duty work in the prison.

ORIGINALITY/VALUE

This study demonstrated important and modifiable factors associated with prisoners' depression. It also evaluated the contribution of new variables (such as participation in the duty work, nutritional status and physical activity) that were not considered in previous local studies.

From Incarceration to Reintegration: Using the Human Services Model to Manage Canadian Prisoner Mental Health

The effective delivery of mental health services in Canadian institutional settings has traditionally posed a challenge to the criminal justice system. Ineffective treatment options and methods of program delivery, inaccurate assessments and security classifications, the conditions in which prisoners live, restricted access to mental health professionals, high levels of individual strain, fragmented service administration, and a lack of continuity of care during the transition back to the community have all been found to have a significant negative impact on inmate mental health. The purpose of this paper is to review, and critique, the current literature on Canadian institutional mental health care and, based on this literature, make suggestions on how to improve the current system.

Forensic Occupational Therapy in Canada: The Current State of Practice

Although occupational therapists have been practicing in forensic settings for many years, there is a paucity of literature regarding the nature of this practice in Canada. The purpose of this study was to describe the practices of Canadian occupational therapists in forensic mental health. An online survey was designed based on the Canadian Practice Process Framework. Following purposive and snowball sampling, responses were analysed with descriptive statistics and content analysis. Twenty-seven clinicians responded (56% response rate). Respondents indicated commonalities in workplaces, client caseloads and practice challenges. The outstanding need in Canada to demonstrate client outcomes through the use of evaluation instruments reflects those practice gaps identified internationally. Education, advocacy and research are critical areas for the development of Canadian forensic occupational therapy. Although findings heavily reflect one provincial context and may not be generalizable to nonhospital settings, a number of priority areas were identified. Future efforts should clarify the role of forensic occupational therapy to stakeholders, and validate their contributions through research that evaluates intervention efficacy and meaningful outcomes. Copyright © 2016 John Wiley & Sons, Ltd.