Mental health problems and suicidal expressions among young male prisoners in Cambodia: a cross-sectional study

ABSTRACT

Background

incarceration and mental health problems are known to have a strong empirical association. Many studies have confirmed the high prevalence of mental health problems among young prisoners in particular, yet none has been conducted in Cambodia.

Objectives

this study aimed to assess the level of mental health problems and suicidal expressions, and determine the associated risk factors among young prisoners in Cambodia.

Method

this was a cross-sectional study among 572 young prisoners between the ages of 15 and 24 from three prisons. Sociodemographic data and detailed information on participants’ profiles were gathered, and mental health problems and suicidal expressions were assessed using the Youth Self-Report (YSR) and the Attitude Towards Suicide (ATTS) questionnaires, respectively.

Results

Mental health problems as revealed by the mean YSR scores were: 25.97 for internalizing and 18.12 for externalizing problems; 11.88 for anxiety/depression, 9.97 for aggressive behaviours and 7.53 for somatic complaints. Social problems, attention problems and rule breaking behaviour were in the range of 8.10 to 8.49. Withdrawal depression and thought problems mean scores were 6.55 and 6.66, respectively. Mental health problems were associated with younger age, lower educational background, and shorter duration of incarceration. Around 16% had thought about their own death, and 12% expressed wish to die. Suicide ideation, planning, and attempts were reported by almost 7%, 2%, and 3% of participants respectively. Prior drugs users thought about death significantly more than their counterparts while suicide ideation was significantly lower among prisoners with higher education.

Conclusion

Mental health problems and suicidal expressions among young prisoners warrant well-planned mental health services that are integrated into the current prison health system. A contextualised intervention that takes into account age, education, duration of incarceration and previous drug use may contribute to improve the mental well-being of young prisoners in Cambodia.

KEYWORDS:

• Mental health problems
• suicide expressions
• young prisoners
• Cambodia

Responsible Editor

Maria Nilsson

Responsible Editor

Maria Nilsson

End materials

Acknowledgments

We thank the staff of the Center for Child and Adolescent Mental Health (Caritas-CCAMH) and the psychology students for their valuable contribution for data collection. We would like to express our gratitude to the prison authorities for allowing access to young prisoners and to all the participants for their voluntary participation and collaboration.

Author contributions

PP designed the study, collected, analysed and interpreted the data and drafted the article. LRS and KE reviewed and commented on the draft article. BJ contributed to the study design, supervised the data collection as well as reviewed and commented on the draft article. MSS was involved in the study design, co-analysed and interpreted the data and commented on the draft. All authors have read and approved on the final version of the draft article.

Disclosure statement

All authors declare no conflict of interest.

Ethics approval and consent to participate

The National Ethics Committee for Health Research (NECHR), the Ministry of Health, Royal Government of Cambodia (RGC) granted ethical clearance (N33NGCHR). In addition, the General Department of Prisons, RGC and the individual prison authorities granted permission to conduct the study. Oral and written consent were sought from each individual participant. In the case of the prisoners who are below 18, the authorities gave consent, as they are the guardians. Voluntary participation and options to choose not to participate or withdraw from the study at any stages with no negative consequences during the detention was emphasised. We assured confidentiality of the personal information to the respondents.

We provided a can of juice at the end of the completion of each survey after permission and scrutiny of refreshments from the prison authorities. Other than this, no materials or monitory incentive were provided.

Paper context

Young prisoners are most vulnerable to mental health problems and suicidal expressions. Yet, no studies have been conducted in Cambodia. The situation of mental health problems and suicidal expressions among young prisoners indicate the need for comprehensive and well-planned mental health services that are integrated within the prison health system in Cambodia.

Additional information

Funding

This work was partly funded by the Swedish Research Council