Connectivity, prison environment and mental health among first-time male inmates in Mexico City

ABSTRACT

Research from high-income countries suggests that prison populations are affected disproportionately by mental illness. However, little research has examined mental health among prisoners in low- and middle-income countries or associations between mental health and contextual factors surrounding the prison experience among susceptible first-time inmates in these settings. The current study examines associations between connectivity, prison environment and mental health (major depression and substance use) among novice male inmates (n = 593) in three Mexico City prisons. Severe depression (46.2%), any substance use (53.8%) and heavy substance use (45.7%) were prevalent. Among key co-variates, recent visitors were protective for severe depression, conjugal visits for any substance use and prison employment for heavy substance use. Physical attacks were associated with increased prevalence of depression, sentence time served with both any and heavy substance use and overcrowding with any substance use. These findings suggest the need for routine health assessments to improve identification and treatment programmes to minimise mental health burden. Addressing demographic risk factors as well as contextual determinants, by decreasing physical violence and overcrowding and supporting outside connections for prisoners, may help improve inmate mental health.

KEYWORDS:

• Prison
• first-time inmates
• connectivity
• depression
• substance use

Acknowledgements

The authors gratefully acknowledge staff of the Penitentiary System in Mexico City, including Celina Oceguera and Clementina Rodriguez whose vision allowed this project to be possible. The authors appreciate the support of everyone who participated in the conception and implementation of the Ponte a Prueba campaign, which enabled data collection for this study. Dr Andrea Gonzalez and Nathalie Gras Allain from the HIV/AIDS Program in Mexico City particularly were instrumental in the development, implementation and supervision of Ponte a Prueba. We also acknowledge the work of the Surveys Division at the National Institute of Public Health (INSP), including the leadership of Aurora Franco. Above all, we appreciate the inmates at the Reclusorios Ceresova, Norte and Sur.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Ministry of Health of Mexico City under contract INSP-2010-340.