Mental health of people detained within the justice system in Africa: systematic review and meta-analysis

Abstract

Worldwide, people with mental disorders are detained within the justice system at higher rates than the general population and often suffer human rights abuses. This review sought to understand the state of knowledge on the mental health of people detained in the justice system in Africa, including epidemiology, conditions of detention, and interventions. We included all primary research studies examining mental disorders or mental health policy related to detention within the justice system in Africa. 80 met inclusion criteria. 67% were prevalence studies and meta-analysis of these studies revealed pooled prevalence as follows: substance use 38% (95% CI 26–50%), mood disorders 22% (95% CI 16–28%), and psychotic disorders 33% (95% CI 28–37%). There were only three studies of interventions. Studies examined prisons (46%), forensic hospital settings (37%), youth institutions (13%), or the health system (4%). In 36% of studies, the majority of participants had not been convicted of a crime. Given the high heterogeneity in subpopulations identified in this review, future research should examine context and population-specific interventions for people with mental disorders. Electronic supplementary material The online version of this article (10.1186/s13033-019-0273-z) contains supplementary material, which is available to authorized users.

Depression and Experience of Incarceration in North Central Nigeria: A Situation Analysis at Makurdi Medium Security Prison

“…5%); the perception that the government has been unfair to them (24.7%); the conviction that nobody cared (19%); and anger and bitterness toward society (16.4%). The prevalence of depression (37.8%) as measured via the PhQ-9 screening tool is higher than the pooled prevalence of mood disorders in the African region (22%) [5]. However, it is similar to that reported by Armiya'u et al [9,10] in Jos (30.8%), but higher than the reported prevalence of depression of 20.8% in a similar prison population from Ibadan [17].…”

“…The authors called for more studies from prison populations in low-and middle-income countries (LMICs) [3]. Lovett et al's subsequent meta-analysis of prevalence studies among prison inmates in Africa specifically estimates the pooled prevalence of mood disorders to be 22% [5].…”

“…It is also a common problem in the African region more broadly. A systematic review of 80 studies on the mental health of prisoners in sub-Saharan Africa found that in 36% of studies, the majority of participants had not been convicted of a crime [5]. This is a major source of psychosocial stress for prison inmates which could be contributing to high rates of depression.…”

Psychiatric Expertise in Benin Penal Justice Context: What Do They Reveal?

“…The metaanalysis conducted in 2019 by Lovett et al revealed that the prison population in sub-Saharan Africa consisted of men in proportions ranging from 93% to 100% [7]. The average ages fell primarily in the age group of 31 -37 years [7]. In our series, the accused are most commonly married (72%) individuals who did not receive formal education (59%).…”

“…In Nigeria, those charged with homicide are men in 93% of cases [6]. The metaanalysis conducted in 2019 by Lovett et al revealed that the prison population in sub-Saharan Africa consisted of men in proportions ranging from 93% to 100% [7]. The average ages fell primarily in the age group of 31 -37 years [7].…”