Mental illness high among prisoners

There is a high prevalence of psychiatric illness among prisoners lodged in Indian jails and it isn't surprising that more than half of them had history of substance abuse.
According to a study published in the latest edition of the Indian Journal of Psychiatry, the psychiatric morbidity among prisoners is substantially higher than in the general population. Most inmates have a number of defined problem areas, with substance use, depression and anxiety disorders most prevalent.
The study conducted by doctors of the Government medical college, Amritsar, and MM College, Haryana, in the Central jail, Amritsar, found psychiatric illness in 23.8% of the 500 convicts lodged there. These figures are similar to some other studies conducted in other jails in the country.
In terms of diagnostic breakup, depression was the most common psychiatric disorder (18%). Dysthymia (a chronic type of depression) was found in 2% of the prisoners. The extent of schizophrenia was 0.4% though some other studies have found much higher incidence of schizophrenia. But authors of this study claimed that this variation was due to different study design as previous studies were done on criminals admitted to mental hospital, or on undertrials who were referred to medical college, while this was done in jail.
Interestingly, 56.4% of these prisoners had history of substance abuse or dependence prior to detention — out of this 39.8% were addicted to alcohol and 5% were multiple substance abusers. At least 11.2% of the prisoners were dependent on various substances.
The authors argued that high rate of common psychiatric disorders calls for the use of improved psychiatric screening instruments, improved assessment and treatment capacities in prison and an increased number of psychiatric inpatient facilities to care for inmates who are too unwell to be treated in prison.
Agreeing with the study, Sunil gupta, spokesperson of the Tihar Jail in Delhi, said that most of those who come in conflict with law are people who are not normal mentally. "They are either in extreme state of depression or anger. No normal person can commit serious crimes," said Gupta. A lack of impulse control, suspiciousness, disinhibition, paranoia, inability to trust others, delusions and hallucinations are some other reasons.
Among prisoners with psychiatric illness, maximum (74%) of the criminals came from lower and middle socio-economic classes. In the current study, 500 convicted prisoners were interviewed, out of which 20 were females, mainly due the fact that majority of the crimes are committed by males.
As much as 76% of the prisoners were from rural areas, 51.4% of them were illiterate or had their education up to primary. The study was carried out from 1, April 2003 to 30 th September 2004. The age of the prisoners ranged from 18-60 years. The mean age of the prisoners was 36.38 years, 50 % of the prisoners belonged to nuclear families.