Depression and experience of incarceration in North Central Nigeria: a situation analysis at Makurdi medium security prison

Abstract

Background Human rights watchdogs have described conditions in Nigerian correctional facilities and detention centers as damaging to the physical and mental health of inmates. While the prevalence of mental disorders is high, access to appropriate healthcare is grossly inadequate. Understanding the current state of prison inmates’ mental health and well-being is an essential first step to addressing this important issue. This study aims to document the mental health and experiences of incarceration of inmates of the largest medium security prison in Nigeria’s Benue State. Methods A cross-sectional survey and descriptive analysis was carried out with a random sample of 381 prison inmates of Benue State Makurdi Medium Security Prison. Survey tools included: (1) a structured questionnaire on participants’ experiences in prison, and (2) the Patient Health Questionnaire (PHQ-9), a screening tool for depression. Results Most participants were young men (95.5%, mean age 27.95) and had completed secondary school (63.5%). While prison authorities had identified only 27 participants as having a mental disorder, 144 (37.8%) screened positive for depression. Twenty six had received professional counseling while in prison. Of the six participants who were already taking a psychotropic medication at the time of imprisonment, four received medication after being imprisoned. Approximately half, (52%) of participants were dissatisfied with prison health care. Conclusions Despite the high prevalence of depression among prison inmates, few cases are detected and treated. Prison staff may not recognize depression as a mental disorder, and the mental health care available is generally poor. Inadequate mental health and social care not only affects prison inmates’ well-being, but may also impact recidivism and health outcomes upon release. Prison inmates should be screened routinely for depression and other less-commonly recognized mental health conditions, and appropriate treatment made available.

Prison Overcrowding and Harsh Conditions: Health and Human Rights Concerns to Persons in Custody, Staff, and the Community

“…Wolff et al (2016), in particular, attributed the increase in self-harm in Switzerland prisons to the struggle over scarce resources. A sub-Saharan African study by Nwefoh et al (2020) attributed the high rate of depression among persons in custody to the poor conditions in the Nigerian prison. The current study has reported similar events, even though it did not set out to measure the relationship between overcrowding and suicide ideation, as well as other mental health conditions, the emotional and psychological consequences of prison congestion if not identified and managed could negatively impact on the mental health of people who live and work in the prison.…”

Determinants of Mental Health in Nigeria

“…planning. They must be more actively engaged in obtaining the budgetary and legislative commitments to achieve this objective [47][48][49]. 4.…”

The Experiences of People Who Are Incarcerated in Accessing Mental Health Care: A Qualitative Meta-Ethnography

“…In a 2020 study conducted in Nigeria, 381 randomly selected people who were incarcerated completed a structured questionnaire regarding their experiences in prison as well as the Patient Health Questionnaire-9, a screening tool for depression. The study found a positive depression screen rate of approximately 38%, whereas the prison authorities had identified a depression prevalence rate of 7% among study participants (Nwefoh et al, 2020). A handful of those with depression ( n = 27) were receiving professional counseling while in prison (Nwefoh et al, 2020).…”

“…The study found a positive depression screen rate of approximately 38%, whereas the prison authorities had identified a depression prevalence rate of 7% among study participants (Nwefoh et al, 2020). A handful of those with depression ( n = 27) were receiving professional counseling while in prison (Nwefoh et al, 2020). Approximately 52% of participants reported being dissatisfied with the prison healthcare system.…”

“…These studies' foci included prevalence estimates of people with mental illness in custodial facilities, the mental healthcare needs of people who are incarcerated, and the impact of targeted mental health interventions among people who are incarcerated. Three studies examined perceptions of mental health services among people who were incarcerated (Morgan et al, 2004(Morgan et al, , 2007Nwefoh et al, 2020). Morgan et al (2004) examined the attitudes and perceptions of 418 men who were incarcerated in the Midwestern United States using a Likert-type scale with items regarding the types of mental health problems for which they would seek professional assistance and barriers that would impact their desire to seek mental health services (Morgan et al, 2004).…”