Initiating Change of People With Criminal Justice Involvement Through Participation in a Drama Project: An Exploratory Study

Introduction: Innovative and interdisciplinary approaches are needed to improve mental health and psychosocial outcomes of people with criminal justice involvement and their families. Aim of the study was to assess effects of the participation in a theatre project on the mental health problems of people with criminal justice involvement and relatives. Methods: We conducted structured diagnostic interviews and in-depth qualitative interviews with five participants performing Shakespeare's Richard III in Chile. Three participants had been imprisoned prior to the project, and two were the parents of a person who died in a prison fire. Qualitative interviews followed a topic guide. Data were transcribed, and a six-phase approach for thematic analysis of the data was used. Results: Substance use disorder or major depression was identified in all the participants. Participation in the theatre project was experienced by the respondents as having a positive effect on the mental health conditions. The research registered the positive experiences of role identification, emotional expression, commitment with group processes, improved skills to socially interact, to be heard by the general public and society, and positive perceptions of the audience (including relatives). Discussion: The study raises the possibility that there may be improvements of depression and substance use problems through the participation of people with criminal justice involvement in a drama project. Wider scale research is recommended on the possible effects. The approach may be an alternative to psychotherapy and medication for some individuals

'Maybe It Is Only in Prison That I Could Change Like This' The Course of Severe Mental Illnesses During Imprisonment - A Qualitative 3-Year Follow-Up Study From Chile

Background: Severe mental illness (SMI) among imprisoned individuals is a global health concern. Quantitative research indicates on average mental health symptom improvements during imprisonment, however, it cannot reflect multifaceted factors influencing the course of SMI. This study aimed to explore the subjective course of SMI during imprisonment and to identify influencing factors. Methods: The study has a 3-year-follow-up design of imprisoned individuals in Chile. We conducted semi-structured interviews with 10 men and 9 women at follow-up who had either major depression or psychosis (severe mental illnesses) at baseline. We included individuals who deteriorated, remained stable or improved their mental health according to quantitative assessments. We explored the subjective course of their mental health condition during the follow-up period. Qualitative data was transcribed and coded using NVivo Software for quantitative content analysis. Qualitative data was also manually coded and was subsequently analyzed using the thematic analysis method with an inductive approach. We developed the final themes using the results of this analysis in combination with the inclusion criteria. Results: The mental health of 10 individuals subjectively improved, 6 experienced deteriorations, and 3 did not perceive any change. Good infrastructure, structure/occupation, intrapersonal resources (will to change, spirituality) and supportive relationships were identified as factors improving mental health. Factors deteriorating mental health were identified as bad infrastructure (e.g., no running water and bad housing conditions) and crowding, lack of psychological treatment, exposure to violence, interpersonal stress (conflictive relationships and separation from family), perceived injustice through sentencing, intrapersonal stressors and previous medical conditions. Discussion: SMI in prison can improve in a supportive environment under certain conditions. These conditions include the improvement of infrastructure (housing and healthcare), the opportunity to work or study, protection from violence during imprisonment, and to develop intrapersonal resources and family relationships. To reduce SMI in prisons the improvement of these conditions should become a priority

Expert Arguments for Trends of Psychiatric Bed Numbers: A Systematic Review of Qualitative Data

Introduction: Mental health policies have encouraged removals of psychiatric beds in many countries. It is under debate whether to continue those trends. We conducted a systematic review of expert arguments for trends of psychiatric bed numbers. Methods: We searched seven electronic databases and screened 15,479 papers to identify expert opinions, arguments and recommendations for trends of psychiatric bed numbers, published until December 2020. Data were synthesized using thematic analysis and classified into arguments to maintain or increase numbers and to reduce numbers. Results: One hundred six publications from 25 countries were included. The most common themes arguing for reductions of psychiatric bed numbers were inadequate use of inpatient care, better integration of care and better use of community care. Arguments to maintain or increase bed numbers included high demand of psychiatric beds, high occupancy rates, increasing admission rates, criminalization of mentally ill, lack of community care and inadequately short length of stay. Cost effectiveness and quality of care were used as arguments for increase or decrease. Conclusions: The expert arguments presented here may guide and focus future debate on the required psychiatric bed numbers. The recommendations may help policymakers to define targets for psychiatric bed numbers. Arguments need careful local evaluation, especially when supporting opposite directions of trends in different contexts

Parental practices and their association with alcohol and cannabis use among adolescents in Chile

BackgroundAdolescent alcohol and cannabis use are common in Chile. The present study aimed to assess the relationship between perceived parenting practices and alcohol and cannabis use among adolescents in a Latin American context.MethodsWe adapted and implemented a substance use prevention strategy in Chile, which included surveys of tenth-grade students from six municipalities in the Metropolitan Region of Greater Santiago. We assessed the reliability and factorial structure of the parenting scale with 16 items, which formed part of the survey. We dichotomized parenting scores into high (above the median) and low. The association of parenting practices with alcohol and cannabis use in adolescents was assessed using multivariate multilevel regression models.ResultsA total of 7,538 tenth-grade students from 118 schools were included in the study. The 16-item scale of parenting practices showed good internal consistency (Omega total = 0.84), and three factors representing Relationship between parents and adolescents, Norms and monitoring, and Parents knowing their children’s friends and the parents of their children’s friends. High total scores of parenting were associated with lower odds of lifetime alcohol use (OR 0.57; 95% CI: 0.49–0.65), past-month alcohol use (OR 0.63; 95% CI: 0.57–0.70), lifetime drunkenness (OR 0.64; 95% CI: 0.58–0.72), and lifetime cannabis use (OR 0.54; 95% CI: 0.47–0.61). Above median scores on each parenting subscale were associated with significantly lower odds of substance use. The strongest associations were observed for the subscale Norms and monitoring. Interactions between parenting and gender showed a significantly stronger effect of parenting practices on alcohol and cannabis use among girls.ConclusionDifferent types of parenting practices were associated with a lower prevalence of adolescent alcohol and cannabis use. Improving parenting practices has the potential to prevent adolescent substance use in Chile, especially among girls

Mental health in prisons in Latin America: The effects of COVID-19

Latin America is a vast region of the world. In 2022, it is estimated that nearly 620 million people live in 33 countries spanning almost 20 million km2 across North, South and Central America, and the Caribbean.1 These countries are united by their common historic cultural origins.2 It is estimated that Spanish is spoken by 400 million, and Portuguese by 200 million people in the region.2 Quechua is the most widely spoken indigenous language in the region, with around 8 million speakers; smaller numbers speak around 560 other indigenous languages such as Mayan, Guarani, and Nahuatl.2,3 The region was described as having a total gross domestic product (GDP) of almost 4.7 trillion US dollars in 2020, with substantial contributions from the four largest economies—Brazil, Mexico, Argentina, and Chile.4,5 However, Latin American countries are mainly considered developing nations.

Did female prisoners with mental disorders receive psychiatric treatment before imprisonment?

© 2015 Mundt et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.BackgroundThroughout the world, high prevalence rates of mental disorders have been found in prison populations, especially in females. It has been suggested that these populations do not access psychiatric treatment. The aim of this study was to establish rates of psychiatric in- and outpatient treatments prior to imprisonment in female prisoners and to explore reasons for discontinuation of such treatments.Methods150 consecutively admitted female prisoners were interviewed in Berlin, Germany. Socio-demographic characteristics, mental disorders, and previous psychiatric in- and outpatient treatments were assessed by trained researchers. Open questions were used to explore reasons for ending previous psychiatric treatment.ResultsA vast majority of 99 prisoners (66%; 95% CI: 58¿73) of the total sample reported that they had previously been in psychiatric treatment, 80 (53%; 95 CI: 45¿61) in inpatient treatment, 62 (41%; 95 CI: 34¿49) in outpatient treatment and 42 (29%; 21¿39) in both in- and outpatient treatments. All prisoners with psychosis and 72% of the ones with any lifetime mental health disorder had been in previous treatment. The number of inpatient treatments and imprisonments were positively correlated (rho¿=¿0.27; p¿<¿0.01). Inpatient treatment was described as successfully completed by 56% (N¿=¿41) of those having given reasons for ending such treatment, whilst various reasons were reported for prematurely ending outpatient treatments.ConclusionThe data do not support the notion of a general `mental health treatment gap¿ in female prisoners. Although inpatient care is often successfully completed, repeated inpatient treatments are not linked with fewer imprisonments. Improved transition from inpatient to outpatient treatment and services that engage female prisoners to sustained outpatient treatments are needed

Prevalence Rates of Mental Disorders in Chilean Prisons

PMCID: PMC371883

Mental health intervention research in Latin American correctional settings: A scoping review

Background: The Latin American prison population has grown faster than anywhere else globally over the past two decades, reaching a total of 1.7 million people at any given time. However, research on mental health prevention and treatment interventions in Latin American prisons remains scarce. Aims: This study aimed to systematically review and synthesize research on prison mental health interventions conducted in the region. Methods: We used a two-stage scoping review design guided by the JBI Manual for Evidence Synthesis. Searches took place in December 2021 in nine databases using descriptors and synonyms. First, all prison mental health research in Latin America was retained. Secondly, using title and abstract screening, all research possibly related to interventions was retained for full text evaluation. Studies reporting interventions were assessed by country, language, institution, population, intervention type, intervention focus and outcomes. Results: N = 34 studies were included in this review. These were 13 case reports, seven expert consensus papers and 14 quantitative studies (four randomized controlled trials, nine cohort studies, one quasi-experimental study). Fourteen interventions were targeted at promoting prosocial behavior, seven studies each aimed to improve mental health and to treat substance use disorders. Six studies involved the treatment of sexual offending behavior, and 3 focused on reducing criminal recidivism. Psychoeducation (n = 12) and motivational interviewing (n = 5) were the most frequent intervention types studied. Promising data from trials showed that anger management, depression, substance use and reoffending could be successfully addressed through interventions. Conclusions: Implementation and effectiveness research of mental health interventions in Latin American prisons is scarce. Addressing mental health, substance use and prosocial behavior outcomes should be considered in future research. There is a particular dearth of controlled trials describing quantifiable outcomes