Mental illness and HIV amongst female inmates in Durban, South Africa

Abstract

Background: There is limited data regarding the prevalence of mental illness and human immunodeficiency virus (HIV) amongst female inmates in South Africa. Rehabilitation programmes can only be formulated once the needs of this population have been identified.Aim: This study aimed to measure the prevalence of mental illnesses, borderline and antisocial personality disorders and HIV amongst female inmates. Setting:The study was based at a correctional centre in Durban, KwaZulu-Natal, South Africa.Methods: This study forms part of a larger two-phased, mixed methods, sequential, explanatory design study. In phase one, 126 female inmates were interviewed using a clinical questionnaire and the Structured Clinical Interview for Diagnostics and Statistical Manual (DSM)-5 diagnoses -Research Version. Results:The following lifetime prevalence rates were found: depressive disorder 70.6%, alcohol use disorder 48.4%, post-traumatic stress disorder (PTSD) 46.8%, borderline personality disorder 33.3%, substance use disorder 31.7%, antisocial personality disorder 15.1% and psychotic disorder 4.8%. The prevalence of current adult attention-deficit and hyperactivity disorder was 9.5%. A total of 39% of the participants admitted to past suicide attempts, whilst 64.3% reported past suicidal ideation and 36.5% had a current episode of a psychiatric disorder. A total of 64.3% of the participants were living with HIV. Although 90.4% had a lifetime psychiatric disorder, only 16.7% were previously diagnosed with a mental illness. The majority of inmates with lifetime disorders had psychiatric comorbidities. Conclusion:The high prevalence of mental illness and HIV amongst female inmates, and the fact that most with mental illness remain undiagnosed, is concerning. Improved screening, identification and treatment of mental illnesses in this population is needed to ensure optimal mental health outcomes and decreased recidivism.

Prevalence and characteristics of mental and physical disorders among female prisoners: a mixed-methods systematic review

“…Mental disorders constitute the main area of investigation in the studies included in this review, represented by 17 single studies of which 7 are based on gender-mixed samples, see Table 2. Of the ten studies of mental disorders including female inmates only, one is from South Africa (Naidoo et al , 2022), three are from China (Zhong et al , 2021; Zhong et al , 2020; Zhu et al , 2017), three from the USA (Fogel & Martin, 1992; Harner et al , 2015; Jordan et al , 1996), two from Sweden (Edvinsson et al , 2010; Konstenius et al , 2015) and one from Germany (Rösler et al , 2009). The three studies from China, the one from South Africa, as well as one of the US studies (Jordan et al , 1996) investigated a broad spectrum of mental disorders, examined according to current diagnostic standards.…”

“…The three studies from China, the one from South Africa, as well as one of the US studies (Jordan et al , 1996) investigated a broad spectrum of mental disorders, examined according to current diagnostic standards. The prevalence of any current mental disorder varied from 26.1% (Zhong et al , 2020) (depression being the most prevalent), to 36.5% (Naidoo et al , 2022) (borderline personality disorder being the most prevalent), to 46.3% (Jordan et al , 1996) (drug and alcohol abuse being the most prevalent diagnostic categories). Zhu and coworkers (2017) report only on the overall prevalence of borderline personality disorder (10.6%).…”

Human immunodeficiency virus care and management in incarcerated populations in Sub-Saharan Africa between 2010 and 2022: A narrative review

“…The only study that focused on comorbidity between HIV and mental health problems 10 showed a high prevalence of mental illnesses among female inmates living with HIV. In particular, most (70.6%) of the female inmates with HIV reported depressive disorder, and nearly half reported alcohol use disorder (48.4%) and post-traumatic stress disorder (46.8%).…”

“…8 Also, the double stigma of being incarcerated and living with HIV has significant mental health implications. 9,10 Incarcerated persons often receive insufficient attention in their HIV care compared to PLHIV in the general population in Africa. 3 Additionally, guidelines and policies on HIV care are not routinely followed in prisons in Africa.…”

“…8 Also, the double stigma of being incarcerated and living with HIV has significant mental health implications. 9,10…”