Prevalence of severe mental illness among people in prison across 43 countries: a systematic review and meta-analysis
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View abstract on PubMed
Summary
This summary is machine-generated.This meta-analysis reveals a high prevalence of depression and psychosis in global prison populations. Addressing the mental health needs of incarcerated individuals remains a significant public health challenge requiring further research and improved services.
Area Of Science
- Global public health
- Psychiatry
- Epidemiology
Background
- Prison populations are growing globally, with existing research indicating a substantial burden of mental health conditions.
- Previous meta-analyses on the prevalence of psychiatric morbidity in incarcerated individuals are over a decade old, necessitating an updated synthesis of current data.
Purpose Of The Study
- To determine the pooled prevalence of depression, psychosis, bipolar disorder, and schizophrenia spectrum disorders among individuals in correctional facilities worldwide.
- To provide an updated, comprehensive overview of mental illness prevalence in prison populations.
Main Methods
- An updated systematic review and meta-analysis of quantitative studies published globally, with no language restrictions, from database inception to August 8, 2024.
- Inclusion criteria focused on studies reporting prevalence using validated diagnostic instruments and standardized criteria (ICD/DSM) for depression and psychosis in unselected prison populations.
- Random-effects meta-analysis was employed, with heterogeneity explored through meta-regression and subgroup analyses. The protocol is registered with PROSPERO (CRD42022378568).
Main Results
- The analysis included 131 publications covering 58,838 individuals across 43 countries.
- Estimated pooled prevalence rates were: depression 12.8% (95% CI 11.1-14.6), any psychosis 4.1% (3.6-4.7), bipolar disorder 1.7% (1.0-2.6), and schizophrenia spectrum disorders 3.6% (1.3-7.1).
- Substantial heterogeneity was observed. Higher depression prevalence was noted in low- and middle-income countries (16.7%) compared to high-income countries (10.8%). Psychiatrists diagnosed psychosis less frequently (3.5%) than non-psychiatrists (4.7%).
Conclusions
- Severe mental illness is considerably prevalent among incarcerated individuals globally.
- Meeting the mental health treatment needs of this population presents an ongoing public health challenge.
- Further research is required to enhance assessment, treatment, and post-release service linkage, necessitating more research-friendly prison environments.
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