Mental Health and Healthcare Provision in Zambian Correctional Facilities

Abstract

Objective: The aim was to determine the prevalence of psychiatric disorders, mental health problems and mental health care service provisions in Zambian correctional facilities
Study sample: 240 inmates interviewed using the MINI, the WEMWBS and demographic questionnaire
Research Design: This was a cross-section point prevalence
Results: Prevalence rates: Current psychiatric disorders 46.2%. Current and past 63.3%. Major depressive episode 47(19.6%), Psychotic disorder current 38(15.8%), Psychotic disorder lifetime 18(7.5%), Major depressive episode past 17(7%), Substance dependence current and Posttraumatic disorder 14(5.8%) each, Manic episode current 5(2.1%) and the rest below 2%. Suicide risks had 49 inmates out of 240(20.4%). Out of 49, 20(40.8%) had high- risk, 8(16.3%) moderate and 21(42.9%) low risk- levels. Medium had the highest prevalence
of inmates at risk of suicide 31(63.3%). Out of 31, 17(54.8%) had low, 6(19.4%) moderate and 8(25.8%) high-risk levels. Second highest was maximum 18(20%): out of 18, 4(22.2%) had low, 2(11.1%) had moderate and 12(66.7%) high- risk levels. Inmates in maximum correctional facility were more likely to have suicidal ideations and attempts than their counterparts in medium. Substance dependence is higher in medium (11%) compared to maximum (3%) and current substance abuse at 2% in both and 1% current alcohol abuse in medium. Mental Well-being WEMWBS mean score (cut-off point) at 50.7, Minimum (50.7) showed good and stable mental Wellbeing compared to Medium and Maximum whose participants recorded poor mental Wellbeing 36.2 and 37.4.
Conclusion: There is a high prevalence of psychiatric disorders and mental health problems with total absence of mental health care services among inmates in the three Zambian correctional facility categories. Majority of these inmates are not screened and treated. Greater mental health awareness and provision of mental health services focusing on staff training programmes to detect mental illnesses are needed and further research is recommended throughout Zambia.