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Mental Health Experiences Among Inmates Serving Life Sentences in Ghana Prisons
Abstract
In Ghana, a convicted person is not entitled to parole. The only hope for their return into the community is either completing the sentence or government amnesty. However, recidivists on life sentences are completely denied the chance of returning into the community. This coupled with the demand of adjusting to the country’s prison conditions affects the mental well-being of life-sentenced inmates. This study explored the mental health experiences of life-sentenced inmates. An interpretive phenomenological approach guided the analysis of qualitative data collected from 21 life-sentenced inmates who were serving terms in three selected prisons. We employed the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ( DSM-5) and International Classification of Diseases 11th Revision ( ICD-11) mental disorder symptomologies to situate the participants’ narration of their experiences. The participants reported feeling sad, hopelessness, and having sleepless days and nights due to thinking about their perceived spoiled plight. They also experienced stress and were fearful of uncertainties due to perceived prison officer apathy and harsh prison conditions. Additionally, the participants resorted to drug use as a means to cope with their mental health experiences. The participants’ descriptions of their experiences were consistent with some symptomologies of mental disorders as provided in the DSM-5 and ICD-11 and call for the creation of mental health treatment services in the country’s prisons to improve the mental health of inmates.
... Even though overcrowding continues to be one of the main problems confronting prisons in Africa (Baffour, 2021;Martin, 2014;Topp et al., 2016), research on its impact on fundamental human rights and health is limited. For example, in ghana, researchers have focused on the impact of prison conditions and administration on recidivism and rehabilitation (Baffour, 2021;Boakye et al., 2022;Dako-gyeke & Baffour, 2016), life-sentence and mental health (Baffour et al., 2022b), persons in custody's access to health care (Adomah-Afari et al., 2021), and prison officers' understanding and knowledge about international guidelines that protect the rights of persons in custody (golo, 2022). we acknowledge the contributions of previous researchers but also prioritize the need for an extended body of knowledge in the area of overcrowding, particularly for a continent where prison congestion poses unique questions while an empirical understanding of its consequences is limited. ...
... In addition to tuberculosis, the current study has reported other diseases persons in custody and prison staff were confronted with. while the cause of this malice could partly be attributed to overcrowding and structural failures, the current analysis agrees with ghanaian-based studies that suggested persons in custody were largely responsible for their health care due to little to no medical services in the prison facilities (Baffour, 2020;Baffour et al., 2022b). we agree with the statement by walter et al. (2021) that "the detention of people in an environment with an extraordinarily high risk of tuberculosis infection, without access to adequate preventive measures or health care, constitutes a systematic violation of national and international human rights laws . . ...
... The poor health care system is attributed to inadequate funding and skilled health care staff and overcrowding in studies conducted in ghana and Zambian prisons (Baffoe-Bonnie et al., 2019;Topp et al., 2017). Another study conducted among individuals serving life sentences in ghana reported that participants' mental health symptoms were left undiagnosed and untreated due to the little to no mental health services and expertise in the country's prisons (Baffour et al., 2022b). we argue that keeping people in a deplorable condition and ignoring their health and well-being needs is tantamount to torture, degrading and inhuman treatment, and human rights violations, which must be resolved urgently. ...
The article explored overcrowding in Ghana prisons and sought to understand its impact on the health and well-being of persons in custody and prison officers. Qualitative data from 38 participants who were serving terms or working in three prison facilities in Ghana revealed three themes, including (a) fear over the spread of communicable diseases, (b) limited access to basic resources, and (c) psychological and emotional burden, attributing them to overcrowding in the prisons. We discussed the findings from human rights and prison and public security perspectives and concluded that addressing overcrowding in prisons would ensure a healthy prison environment, which may have implications for the well-being and human rights of persons in custody, as well as public safety and the health of prison officers and the community. To achieve a healthy prison, policies should target prison depopulation and commitment from stakeholders to implement local and international prison rules and conventions.
... The older prison population, exacerbated by longer sentences, contributes to a higher mortality rate, with many older inmates suffering prolonged illnesses without adequate medical care or access to palliative care and compassionate release options. Inadequate provisions for mobility assistance and poor nutrition further hinder the well-being of older prisoners [40][41][42]. ...
As the global population ages, understanding the implications of older persons within correctional facilities has become increasingly urgent. This study explores the complex relationships between ageing and mortality among older prisoners in Ghana, focusing on qualitative semi-structured interviews conducted with 26 prison officers. The research highlights the interplay of age-related vulnerabilities and systemic factors that exacerbate health risks. The findings identify critical factors influencing mortality, including underlying health conditions, the psychological impacts of incarceration, and social isolation. While some forms of care are available, they are often fragmented and reactive, lacking a comprehensive, preventative strategy to address the ongoing health needs of older inmates. Additionally, the study underscores the necessity of psychosocial support and the importance of creating age-responsive policies within the prison system. By illuminating the challenges older prisoners face, this research contributes to the growing discourse on health care in correctional settings and calls for targeted interventions to improve the well-being of this vulnerable population. The study also suggests avenues for further research to enhance understanding and inform effective policy development aimed at addressing the unique needs of older inmates.
... Studies have identified overpopulation and overcrowding as a common problem in Ghanaian prisons. 7 For example, the total population of incarcerated persons in Ghana had more than doubled from 4852 in 1982 to an estimated 14,000 in 2018. 8 The current occupancy level based on the official prison capacity is 141.7%, ranking Ghana on the 56th position on the world's most overcrowded prison system list. ...
Background and Aims
The environment within prisons, such as overcrowding, lack of access to portable water, poor sanitation, and hygiene predisposes inmates to infections, including intestinal parasitic infections (IPIs). This study therefore determined the prevalence and associated factors of IPIs among prison inmates in Southern Ghana.
Methods
A cross‐sectional study using the stratified sampling technique was employed. The study recruited 461 prison inmates across three notable prisons, with 50 inmates from Ho Central, 357 inmates from Nsawam Medium Security, and 54 inmates from Sekondi Central Prisons all in Southern Ghana. A structured closed‐ended questionnaire was administered to collect data on sociodemographics, lifestyle/behavioral characteristics, and signs and symptoms of IPIs. In addition, stool samples were collected and analyzed for the presence of various stages of intestinal parasites (trophozoites, cysts, ova, and larva) using formol‐ether concentration, and the modified Ziehl–Neelsen techniques.
Results
The prevalence of IPIs among inmates of the three selected prisons was 38.2% (95% confidence interval [CI]: 33.72%–42.79%). The prevalence of IPIs among inmates of the three prisons, the Ho Central, Nsawam Medium Security, and Sekondi Central were 46% (95% CI: 31.82%–60.68%), 37.5% (95% CI: 32.49%–42.79%), and 35.2% (95% CI: 22.68%–49.38%), respectively. After adjusting for confounders, the following factors; handwashing after defecation (adjusted odds ratio [AOR]: 0.05 [0.00–0.67]; p = 0.024), trimmed fingernails (AOR: 0.32 [0.13–0.76]; p = 0.011), itchy skin (AOR [95% CI]: 5.99 [3.43–10.43]; p < 0.001), anal itching (AOR [95% CI]: 0.35 [0.19–0.62]; p < 0.001), nausea (AOR [95% CI]: 5.57 [3.22–9.65]; p < 0.001), and worm expulsion (AOR [95% CI]: 3.80 [1.42–10.18]; p = 0.008) were found to be associated with intestinal parasitic infections.
Conclusion
The study revealed that the prevalence of intestinal parasitic infections among prisons in Southern Ghana is high and is therefore an important public health concern. The Public Health Department of Ghana Health Service should therefore embark on health promotion and deworming exercise in all prisons in Ghana.
... Despite this, the necessity for this study to pinpoint the causes of recidivism in Ghana, where young incarceration rates are still very high, suggests that recidivism is a problem that needs indepth research. Understanding how widespread stigmatisation in Sub-Saharan African (SSA) populations affects recidivism is another knowledge gap (Baffour et al., 2022). It is hoped that this study would fill in these information gaps by applying the critical social work theory, social learning theory, and labelling theory to qualitatively examine contributing variables to recidivism based on the experiences of project participants. ...
Recidivism is the act of relapsing into criminal behaviour, and it is often assessed by a former prisoner’s admission to a new offence while still incarcerated. Identification of recidivism-related contributing factors is the study’s principal goal. The research method used in the study was qualitative. Data were gathered from 20 participants using the purposive sampling technique, including 10 prisoners who had already served two more terms of jail, 5 prison officers, and 5 members of the local community. Semi-structured interviews were used in the study to help with data collecting. The data were analysed using thematic analysis. Data was processed using NVivo. The study concluded that due to severe prison conditions, uneven inmate-to-officer ratios, and insufficient rehabilitation, inmate-to-inmate relationships are reinforced over inmate-officer interactions, which leads to unequal association. Also, it was discovered that conventional beliefs about the purpose of imprisonment and the absence of community re-entry programs had moulded opinions about prisons and convicts, leading to the stigmatization and discrimination of formerly jailed people in the community. Based on the findings, the study recommends that government work with other stakeholders to reduce recidivism, Nsawam Medium Security Prisons (NMSP) should be expanded to improve upon the living conditions of inmates, introduction of annual business award to honour businesses that employs more ex-prisoners.
... With this increase in crime, there are also many new types of crimes which result in more and more recidivism rates for criminals. [ Baffour, 2022]. The implementation of the 4.0 industrial revolution in prisons can not only be carried out in the production process but also in distribution; therefore, it is necessary to carry out an upgrade to help distribute the work of the inmates so that it can help their economy and bring progress to the prison itself. ...
The handling of recidivism crimes is carried out in a series of systems called the criminal justice system, which is a means in society to tackle crime. The components of the criminal justice system in Indonesia are the police, prosecutors, courts and correctional institutions. Correctional institutions provide guidance so that convicts become human beings who are useful in the future. From this, researchers are interested in reviewing the Impact of the Industrial Revolution 4.0 Era on the Development of Prisoners in Indonesian Correctional Institutions. In this research, the authors used an ethnographic study system research approach with a descriptive approach. Ethnography is a social science research method. This research concludes that there are factors related to the lack of success in personality development and recidivism. The main focus of research is to develop a distribution system for the work of channeling prisoners' work through the industrial revolution 4.0.
... This paper, therefore, agrees with the position of the Southern Criminology that the methods, theories, and approaches designed in the Western and Northern countries may not be applicable in developing countries such as Ghana (Carrington et al., 2016). For example, in Ghana and most African countries, conditions such as overcrowding, limited infrastructure and personnel, human rights violation, and disregard for inmates' health and well-being are pervasive (Baffour, 2021;Baffour et al., 2022;Topp et al., 2016). This is not to say that the condition in prisons outside the jurisdiction (particularly in the West and North) is perfect. ...
This paper reflects on the process of undertaking qualitative research with incarcerated individuals and prison staff in selected Ghana prisons. The challenges encountered during the planning, approval, and fieldwork stages, as well as measures adopted to address these challenges, have been discussed. The paper aims to serve as a guide to novel prison researchers in the sub-Saharan African context, given that the majority of studies on challenges and approaches to conducting prison research have come from jurisdictions outside the region. To this end, given the unique nature of the prison governance system in Ghana and other sub-Saharan African countries, this paper contributes to filling a knowledge gap in qualitative prison research.
... The extant literature in Ghana on the prisons, inmates, and ex-convicts has suggested that biopsychosocial assessment of inmates in the prisons is lacking and there is no recidivism risk assessment in place to ensure that high-risk inmates are treated before their release (Adjorlolo & Chan, 2019). A recent study by Baffour et al. (2020a) in three prison facilities in Ghana suggested that the inmates were living in unfavorable conditions (overcrowding, insufficient food, and inadequate physical and mental health care. The few studies that have looked at the experiences of inmates post-prison have reported weak social ties, discrimination, and stigmatization among ex-convicts (Abrah, 2019;Baffour et al., 2020b;Dako-Gyeke & Baffour, 2016). ...
This study explores the causes of recidivism among inmates in a prison facility in Ghana. Eleven men who had served two or more terms of imprisonment, five prison officers who were in charge of rehabilitation, five community members, and two police officers (in Ghana, most offenses are prosecuted by the police) who had prosecuted at least three recidivists were interviewed. Based on the analysis, results suggest that the inmates were reincarcerated due to structural deficiencies (perceived overcrowding and inadequate rehabilitation in the prison), situational factors (perceived weak family ties during and post-prison), and personal or lifestyle factors (perceived laziness and reluctance to change on the part of some inmates). The limitations of the results have been highlighted and the need for future research has been discussed.
Healthcare is crucial for society, economy and politics. Thus, a robust population contributes to progress. However, minority groups including prisoners face challenges in accessing these services. This research aimed to study the access to healthcare among prison inmates in Kumase in the Asante region of Ghana since 1992. To achieve this, a main prison (Prison Y) and a local prison (Prison X) served as study areas. The study used a qualitative method to analyse the data obtained on healthcare accessibility among prison inmates in Asante and Kumase. A purposive sampling technique was adopted in the data collection process. Semi-structured interviews, focus group discussions and spot checks were conducted in these two prisons. By analysing the historical perspectives and public policy perspectives
of healthcare provision in prisons and identifying the factors that influence access to healthcare, this study discovered that some prison infirmaries in Asante aid healthcare access and provision among prisoners. It was also found that prisoners also enjoy free access to healthcare. Indeed, it signifies respective governments’ efforts to ensure universal access to healthcare. It was concluded
that, despite challenges such as overcrowding, inadequate health consumables, untimely healthcare financing, and inadequate healthcare providers, impede access to health care in Prison X and Prison Y. However, the study suggested government and non- governmental organisations’ interventions to support the improvement of the provision of healthcare to prisoners in Asante and Kumase.
Background:
Extant literature has shown that there is a higher prevalence of mental disorders among prisoners compared to the general population. These findings have, however, mostly been from high-income and westernised cultures. In Ghana, little is known about the extent of psychiatric disorders among prisoners, as is consistent with the dearth of scholarly work in low and middle-income countries.
Aims:
Our aim was to determine the prevalence of common mental disorders among sentenced prisoners in the second largest prison in Ghana.
Methods:
A cross-sectional survey research design was used in one prison. The Mini International Neuro-Psychiatric Interview questionnaire was used to collect data from men and women serving prison sentences who volunteered for the study. Socio-demographic characteristics and criminal history data were collected using a questionnaire designed by the researchers.
Results:
Five hundred prisoners participated. Nearly half (246, 49.8%) had at least one psychiatric disorder. The most prevalent disorders were major depression and a range of anxiety disorders (145, 29%, 132, 26% respectively). A smaller proportion recorded high scores on the antisocial personality disorder scale (13%); just 50 (10%) reported using substances in the 12 months before interview, but this is a minimum estimate of such problems as many were already in prison during that time. None of these prisoners, regardless of disorder, had been screened, diagnosed, or treated in prison.
Conclusions:
This study contributes to the gap in scholarly literature in low- and middle-income countries on psychiatric disorders in the prison population. It will be important to explore further the extent to which the internationally recognised screening tools used led to under-estimation of psychiatric disorders. The findings are of immediate practical importance nationally as they highlight the need to implement reforms anticipated by the new mental health legislation of 2012 and strategies for interagency working to improve health services and their uptake in the criminal justice system.
Since the Royal Commission into Aboriginal Deaths in Custody (RCIADIC), over thirty years ago, there have been over 400 Indigenous deaths in custody, with 30% of the Australian prison population identifying as Indigenous. Indigenous over-representation in the criminal justice system continues to be an unresolved issue despite varying attempts to mitigate it. This thesis presents the outcomes of a research project that applied a fresh approach to analysing the violence of Indigenous incarceration using the theory of necropolitics and related concepts. This thesis unveils the forms of, and extent of, violence experienced by Indigenous Australians and the extent to which unequal relations of power between Indigenous Australians and the criminal justice system contribute to this violence.
This thesis makes an important contribution to research and theory by bridging a gap in Indigenous incarceration research; expanding the current understanding of the experiences of violence by Indigenous Australians in the criminal justice system; using the ‘criminological imagination’ by elevating the voices of Indigenous Australians; and finally, by expanding the theory of necropolitics through the concept of deific authority. Using a mixed method approach, this study used primary (semi-structured interviews with Indigenous Australian former offenders) and secondary (coroner’s reports and official statistics) data to conduct thematic and theoretical analysis.
The results of the thematical analysis revealed themes revolving around the early lives of the participants, such as family life, family violence, childhood trauma, educational attainment, and family involvement in the criminal justice system. Further, the thematic analysis unveiled themes around the police (necro-enforcers2), courts (soul-destroyers), prisons (death-producers), and community corrections (disintegrators). In respect to the necro-enforcers these included fear and distrust, a dichotomy of policing, juvenile delinquency, and experiences of violence. For the soul-destroyers it was the pressure to plead guilty, racism in sentencing, and a sense of despondency towards the courts. Regarding the death-producers the themes included disconnection from culture, the psychological effects of prison, and power and violence. Finally, the themes emerging from the disintegrators were lack of reintegration support, lack of use of discretion, and difficulties meeting compliance-based parole.
2 That were given necropolitical identifiers shown here in brackets, which will be explored in further detail in Chapter Five.
Running head: Black Lives Matter: The Violence of Indigenous Incarceration in Australia
6
The outcomes of the thematical analysis suggest that Indigenous Australians are being ‘necropolitically targeted’, ‘zombified’ and transmogrified into homo sacer by the criminal justice system. Furthermore, the research has unveiled how the unequal relations of power between Indigenous Australians and the criminal justice system leads to a sense of Deific Authority, and because of this, how criminal justice employees3 can become more prone to inflicting symbolic, systemic, and subjective violence on Indigenous Australians.
This research has elevated, and listened to, the voices, lived experiences, and insights of Indigenous Australians in respect to the criminal justice system. In doing so, this research has identified some key recommendations that can assist policymakers, as well as criminal justice staff to achieve a shift from punitive to rehabilitative within the criminal justice system that focus on four core areas, namely: intervention, rehabilitation, reintegration of former prisoners, and adoption of some key findings from deaths in custody to address the forms of violence highlighted in this study.
Recidivism is on the increase as ex-convicts who are expected by the society to be reformed in prison and reintegrated to lead meaningful lives, only return to crime shortly after their release and find themselves back into prison in spite of the harsh punishment and counselling services received while incarcerated. The study aimed to identify the adequacy and effectiveness of the Guidance and counselling services offered prisoners in Kumasi Central Prison, Ghana. Qualitative research method was primarily used to obtain data. The investigation revealed that the major setback in the Guidance and Counselling section of the Ghana Prisons is the lack of competent and adequate professional counsellors in the prison. Further findings indicated that there are no separate offices for the counsellors, neither are there counselling rooms, thus there is no privacy during counselling sessions. Besides, the prison is overcrowded making it very difficult for counsellors to meet counselling demands of inmates. The government should resource the Prison Service to attract qualified youth to reduce the problem of recidivism.
Interpretive phenomenology presents a unique methodology for inquiring into lived experience, yet few scholarly articles provide methodological guidelines for researchers, and many studies lack coherence with the methodology’s philosophical foundations. This article contributes to filling these gaps in qualitative research by examining the following question: What are the key methodological and philosophical considerations of leading an interpretive phenomenological study? An exploration of interpretive phenomenology’s foundations, including Heideggerian philosophy and Benner’s applications in health care, will show how the philosophical tradition can guide research methodology. The interpretive phenomenological concepts of Dasein, lived experience, existentialia, authenticity are at the core of the discussion while relevant methodological concerns include research paradigm, researcher’s stance, objective and research question, sampling and recruitment, data collection, and data analysis. A study of pediatric intensive care unit nurses’ lived experience of a major hospital transformation project will illustrate these research considerations. This methodological article is innovative in that it explicitly describes the ties between the operational elements of an interpretive phenomenological study and the philosophical tradition. This endeavor is particularly warranted, as the essence of phenomenology is to bring to light what is taken for granted, and yet phenomenological research paradoxically makes frequent assumptions concerning the philosophical underpinnings.
The frequency with which assessment for risk of criminal offending is requested across mental health and criminal justice systems in Western countries is historically unprecedented. However, information concerning risk assessment practices and research in Sub-Saharan Africa is virtually nonexistent. In filling this gap, the present study discusses the prospects and challenges of risk assessment for criminal offending in Ghana, focusing on the criminal justice system, mental health system, and institutional record keeping. Secondly, data obtained from interviewing prisoners, their parents/legal guardians, and prison officers were used to score the Historical-Clinical-Risk Management-20 version 3 (HCR-20V3) to discriminate between recidivists (n = 60) and non-recidivists (n = 60). The results reveal significant and positive correlations between HCR-20V3 ratings and recidivism that ranged from 0.35 (clinical presence) to 0.69 (historical relevance). The area under curve (AUC) values of the HCR-20 ratings similarly ranged from 0.69 (clinical presence ratings) to 0.88 (historical presence ratings). The historical presence and relevance ratings achieve good and a near-balanced sensitivity and specificity (e.g., 75 versus 88), with the latter also adding incrementally to the discrimination. The clinical and risk management ratings, however, did not add incremental validity to the discrimination. Although the exclusion of the items measuring mental and personality disorders, the small sample size and the use of retrospective design have the potential to undermine the findings reported here, this preliminary study on structured risk assessment in Ghana demonstrates the feasibility of administering risk assessment instruments by interviewing multiple informants.
Individualization of the family system in Ghana has implications for residential housing access particularly in urban areas. In this paper, the authors examined the effects of the changing family system on access, demand and supply of rental housing. The cross-sectional study design was adopted with Offinso Municipality as a case study. Through a multi-stage sampling approach, structured and unstructured questionnaires were used to collect data from 100 renters and 100 landlords. Findings revealed a reduction in the supply of rental housing while increasing demand as a result of the changing family system. Rental housing prices were also found to have increased by 86.17% between the years 2010 and 2015. Findings from the study based on preferences of new family systems for privacy and comfort are also likely to address the problem of scarcity of rental housing and associated escalating rental housing prices .
Correctional institutions in the United States witness higher rates of suicide compared with the general population, as well as a higher number of attempted suicides compared with completed cases. Prison research focused little attention on investigating the combined effects of inmate characteristics and prison context on suicide, with studies using only one level of analysis (prison or prisoner) and neglecting the nested nature of inmates in prisons. To extend this literature, multilevel modeling techniques were employed to investigate individual- and prison-contextual predictive patterns of attempted suicide using a nationally representative sample of 18,185 inmates in 326 prisons across the United States. Results revealed that several individual-level factors predicted odds for attempted suicide, such as inmate characteristics/demographics, prison experiences, having a serious mental illness, and symptoms of mental health issues. Some prison-contextual variables, as well as cross-level interaction effects, also significantly predicted odds for attempted suicide. Policy and research implications are discussed.
In 2012 Ghana passed a new Mental Health Act, which aimed to create a new system of mental healthcare in Ghana. The Act includes provisions for the creation of a modern, community-based mental health system and for the protection of the rights of persons with mental disorders. This article discusses the implications of the Act and the progress which has been made towards its implementation.
We performed external autopsies and examinations on two inmates who had committed suicide by hanging themselves with their underwear and using the window bars of their cells as ligature points after they had been placed in solitary confinement. In one case, the inmate had even been deprived of her clothing (with the exception to her underwear). Underwear has been rarely described as a means for self-harm and, to the best of our knowledge, no previous study has focused on cases of prison suicides committed using this garment, even though it is available to every inmate. The two cases were very similar; both inmates were young, physically aggressive and in their first week at a new facility; both had been affected by mental disorders, had been prescribed psychotropic medications and had histories of psychiatric hospitalisation. In each case, the psychiatric evaluations had highlighted significant suicidal risk. We discuss these two cases in an attempt to describe the complexity of and contradictions within the management of suicidal inmates at correctional facilities. We aim to propose new strategies and emphasise the need to introduce evidence-based standardised protocols over inhumane, ineffective and simplistic punitive measures in the management of these individuals.
The United States has become a country that is constantly at war. This situation has created a crisis amongst our veterans. The current uneven access to appropriate mental health services that returning U.S. veterans encounter echoes the disparities in access to quality mental health services for the general population. The information presented here shows that the shortcomings of our health care system in addressing the mental health needs for our returning veterans may lead to the high suicide rates. Addressing the problem of inadequate access to quality mental health services is critical in any efforts to reforming the U.S. health care system. Our findings suggest that mental health disparities are often a leading factor to the high suicide rates among veterans who experience depression and Post-Traumatic Stress Disorder. To improve the health and well—being of our veterans who have served this nation, requires a collaboration between public and non—profit mental health providers at the State and local levels. It is imperative that we increase the availability of crisis intervention and mental health services for all veterans that have served this nation.
Unprecedented numbers of mentally ill persons are now housed in prisons and jails in the United States and elsewhere in the world. In many jurisdictions penal institutions have become the default placement for the mentally ill, in lieu of more humane and appropriate facilities in which to treat them. This article briefly reviews some of the causes of the unprecedented influx of the mentally ill into prisons and jails, examines the characteristics of these environments that render them singularly inappropriate placements in these cases, and discusses the various ways that the pains of imprisonment can exacerbate rather than alleviate various forms of mental illness and psychological vulnerability.
In this paper we explore crystallization in terms of its contribution to qualitative management research. This exploration of crystallization is based on a postmodern view where we utilize triangulation as a point of departure. Currently, the use of crystallization is under developed in the management discipline. Qualitative literature and metaphors are utilized to develop a focus on moving qualitative management research away from positivist terms. To do this we crystalize crystallization with an emphasis on the embodiment of the qualitative researcher as the primary tool in addition to the development of rigor through credibility and trustworthiness. This conceptual approach can benefit qualitative management researchers by drawing upon development and advancement of other disciplines. It is the practice of theory rather than the presentation of theory. The alignment of qualitative management research through a multi-genre approach follows the evolution of qualitative research methods. We aim to stimulate the conversation and position crystallization within the field of qualitative management research as a method for obtaining deeper and richer understanding of phenomena whilst building rigor, allowing creativity and developing intuition for the interpretivist qualitative management researcher.
In this article, I try to think through the question, “What distinguishes phenomenology in its original sense?” My intent is to focus on the project and methodology of phenomenology in a manner that is not overly technical and that may help others to further elaborate on or question the singular features that make phenomenology into a unique qualitative form of inquiry. I pay special attention to the notion of “lived” in the phenomenological term “lived experience” to demonstrate its critical role and significance for understanding phenomenological reflection, meaning, analysis, and insights. I also attend to the kind of experiential material that is needed to focus on a genuine phenomenological question that should guide any specific research project. Heidegger, van den Berg, and Marion provide some poignant exemplars of the use of narrative “examples” in phenomenological explorations of the phenomena of “boredom,” “conversation,” and “the meaningful look in eye-contact.” Only what is given or what gives itself in lived experience (or conscious awareness) are proper phenomenological “data” or “givens,” but these givens are not to be confused with data material that can be coded, sorted, abstracted, and accordingly analyzed in some “systematic” manner. The latter approach to experiential research may be appropriate and worthwhile for various types of qualitative inquiry but not for phenomenology in its original sense. Finally, I use the mythical figure of Kairos to show that the famous phenomenological couplet of the epoché-reduction aims for phenomenological insights that require experiential analysis and attentive (but serendipitous) methodical inquiry practices.
Job stress, which has been found to have numerous negative effects on U.S. correctional staff, occurs as a result of stressors in the work environment. Recent research in the U.S. suggests that work-family conflict (e.g., time-based conflict, strain-based conflict, behavior-based conflict, and family-based conflict) may contribute to job stress for correctional staff. This exploratory study examined how different dimensions of work-family conflict were associated with job stress by surveying 322 staff at two Chinese prisons, one for male inmates and one for female inmates, in Guangzhou. An Ordinary Least Squares regression equation was computed with the job stress index as the dependent variable, and the personal characteristics (i.e., age, tenure, gender, educational level, and marital status) and the four work-family conflict variables as the independent variables. The independent variables explained about 49% of the observed variance in the job stress variable. The personal characteristics, time-based conflict, and family-on-work conflict did not have a statistically significant association with job stress in the multivariate analysis, but both strain-based conflict and behavior-based conflict had negative associations.
In this paper we explore crystallization in terms of its contribution to qualitative management research. This exploration of crystallization is based on a postmodern view where we utilize triangulation as a point of departure. Currently, the use of crystallization is under developed in the management discipline. Qualitative literature and metaphors are utilized to develop a focus on moving qualitative management research away from positivist terms. To do this we crystalize crystallization with an emphasis on the embodiment of the qualitative researcher as the primary tool in addition to the development of rigor through credibility and trustworthiness. This conceptual approach can benefit qualitative management researchers by drawing upon development and advancement of other disciplines. It is the practice of theory rather than the presentation of theory. The alignment of qualitative management research through a multi-genre approach follows the evolution of qualitative research methods. We aim to stimulate the conversation and position crystallization within the field of qualitative management research as a method for obtaining deeper and richer understanding of phenomena whilst building rigor, allowing creativity and developing intuition for the interpretivist qualitative management researcher.
Background:
Experts have suggested that intersectoral partnerships between prayer camps and biomedical care providers may be an effective strategy to address the overwhelming shortage of mental health care workers in Africa and other low-income settings. Nevertheless, previous studies have not explored whether the prayer camp and biomedical staff beliefs and practices provide sufficient common ground to enable cooperative relationships. Therefore, we sought to examine the beliefs and practices of prayer camp staff and the perspective of biomedical care providers, with the goal of characterizing interest in-and potential for-intersectoral partnership between prayer camp staff and biomedical care providers.
Methods:
We conducted 50 open-ended, semi-structured interviews with prophets and staff at nine Christian prayer camps in Ghana, and with staff within Ghana's three public psychiatric hospitals. We used the purposive sampling method to recruit participants and the constant comparative method for qualitative data analysis.
Results:
Prayer camp staff expressed interest in collaboration with biomedical mental health care providers, particularly if partnerships could provide technical support introducing medications in the prayer camp and address key shortcomings in their infrastructure and hygienic conditions. Nevertheless, challenges for collaboration were apparent as prayer camp staff expressed strong beliefs in a spiritual rather than biomedical explanatory model for mental illness, frequently used fasting and chained restraints in the course of treatment, and endorsed only short-term use of medication to treat mental illness-expressing concerns that long-term medication regimens masked underlying spiritual causes of illness. Biomedical providers were skeptical about the spiritual interpretations of mental illness held by faith healers, and were concerned by the use of chains, fasting, and the lack of adequate living facilities for patients in prayer camps; many, however, expressed interest in engaging with prayer camps to expand access to clinical care for patients residing in the camps.
Conclusions:
The findings demonstrate that biomedical care providers are interested in engaging with prayer camps. Key areas where partnerships may best improve conditions for patients at prayer camps include collaborating on creating safe and secure physical spaces and delivering medication for mental illness to patients living in prayer camps. However, while prayer camp staff are willing to engage biomedical knowledge, deeply held beliefs and routine practices of faith and biomedical healers are difficult to reconcile Additional discussion is needed to find the common ground on which the scarce resources for mental health care in Ghana can collaborate most effectively.
Mental health professionals' attitudes toward offenders with mental illness have significant implications for the quality of care and treatment rendered, making it imperative for these professionals to be aware of their attitudes. Yet, this topical issue has received little research attention. Consequently, the present study investigates attitudes toward offenders with mental illness (insanity acquittees) in a sample of 113 registered mental health nurses in Ghana. Using a cross-sectional survey and self-report methodology, the participants respond to measures of attitudes toward offenders with mental illness, attitudes toward mental illness, conviction proneness, and criminal blameworthiness. The results show that mental health nurses who reportedly practiced for a longer duration (6 years and above) were more likely to be unsympathetic, while the male nurses who were aged 30 years and above were more likely to hold offenders with mental illness strictly liable for their offenses. Importantly, the nurses' scores in conviction proneness and criminal blameworthiness significantly predict negative attitudes toward the offenders even after controlling for their attitudes toward mental illness. Yet, when the nurses' conviction proneness and criminal blameworthiness were held constant, their attitudes toward mental illness failed to predict attitudes toward the offenders. This initial finding implies that the nurses' views regarding criminal blameworthiness and conviction may be more influential in understanding their attitudes toward offenders with mental illness relative to their attitudes toward mental illness.
This study employed a qualitative research design to explore the perceptions and experiences of stigmatization and discrimination against recidivists in Ghana. Data were gathered through in-depth interviews with 20 adults and analyzed to identify emerging themes that addressed the objectives of the study. The findings indicated that the community members had negative perceptions about recidivists. Additionally, evidence showed that recidivists included in this study had experiences of stigma and discrimination in areas, such as employment, housing, and romantic relationships. The findings suggest the need for a collaborative effort that aims at removing barriers that hinder formerly incarcerated persons’ reintegration into society.
The involvement of mentally disordered offenders (MDOs) in the criminal justice system (CJS) is currently a major public health concern. This has culminated in several empirical researches over the years, with a particular focus on addressing the problem. The present study examines the criminal and the mental health legislations available to offenders raising fitness to stand trial issues, as well as those pleading insanity at the time of the offense (insanity defense) in Ghana. The legislations are examined within a framework of reducing the overrepresentation of MDOs in the CJS. In doing so, comparisons are made to similar legislations in other commonwealth jurisdictions, when necessary. Regarding fitness to stand trial, it is evident that the Ghanaian legislation does not contain discrete fitness indicators, relative to, for instance, Canada. Yet, it is interesting that the terminologies 'unsound mind' and 'incapable of making a defence' used in the proviso convey similar meaning and requirements to those used in other jurisdictions. The insanity defense standard, on the other hand, is also heavily influenced by the M'Naughton Rules in England. The defense consists of two separate cognitive tests, each of which can result in an acquittal. One of the tests strictly emphasizes knowledge of the nature and consequences of the act while knowledge of the wrongness of the criminal act is implied in the other. However, none of the tests takes into consideration uncontrollable impulse arising from mental disorder. The study proposes some revisions and amendments to the insanity legislation in its current formulation. Recommendations are also offered for critical areas that warrant research attention in relation to MDOs in Ghana, and in Africa as a whole.
The confinement of capital punishment (death-sentenced) inmates nationwide is typified by marked interpersonal isolation and activity deprivation on segregated death rows. These supermaximum security measures are ostensibly based on an assumption that capital punishment inmates are at high risk for violence. Supermaximum confinement on death row has high costs: fiscal, staffing, and psychological. Prior research on capital punishment inmates mainstreamed in the general prison population or under conditions approximating this confinement has reported low violence rates. This study provided a 25-year follow-up on the Missouri Department of Corrections unique policy of "mainstreaming" capital punishment inmates into the general population of the Potosi Correctional Center (PCC). Findings remained consistent in showing that mainstreamed capital punishment inmates (N =85) had equivalent or lower rates of violent misconduct than inmates serving life-without-parole (N = 702) or term-sentences (N = 3,000). The failure of assumptions of high violence risk undergirding death row has important public policy and correctional implications.
AimTo explore carers’ experience of caring during a mental health crisis.Background
Community mental health care including crisis care relies increasingly on carers. The relationship between carers and professionals is at times fraught due to issues of what constitutes a crisis, confidentiality and a perception of lack of empathy. The caring experience can lead carers to feel isolated and neglected.DesignA qualitative study with a phenomenological approach. Eight carers participated and were interviewed individually using a semi-structured approach.Method
Analysis used the Interpretive Phenomenological Analysis method including transcribing of interviews, initial noting, searching for connections and patterns across the transcripts and cases. The themes were checked with the participants for their views on the emerging themes. The data were collected from November 2011–May 2012.FindingsCarers experienced ‘double deprivation’ by not receiving support from professionals and protecting their social network from the trauma of the crisis. The caring in crisis invoked complex feelings of guilt and loyalty which made discussing aggression difficult. Caring was described as a terrifying experience not just because of the aggression but also because of the perception of abandonment by professionals.Conclusion
The experience was an overwhelmingly negative one with a wish for acknowledgement of the crisis and support from mental health services. For most of the participants the caring during crisis was traumatic which left the carer feeling isolated and unsupported. The study should be used to help educate professionals on the complexities of caring during a crisis.
Accessibility of quality healthcare across the globe has generated a lot of attention among public health practitioners.
This study explored the background characteristics of female prisoners and how it influences their assessment of the quality of accessible healthcare in the Kumasi Female Prison.
This descriptive cross-sectional survey was conducted at the Female section of the Kumasi Central Prisons from June to December 2011. We used pretested questionnaires to obtain quantitative data from all 39 inmates of the female Prisons. An in-depth interview was used to obtain qualitative data from the prison healthcare giver. Data were analyzed with Epi Info Version 3.5.1, (Centers for Disease Control and Prevention), Excel, and Graph Pad Prism version 5.00 for Windows (Graph Pad software, San Diego California USA, www.graphpad.com).
Using a 12-point scale inventory questionnaire, inmates with no formal education gave the highest mean health provision assessment score (6.0) whereas those with tertiary education gave the lowest (4.5). Females serving prison sentences gave the highest mean health assessment score whereas remand prisoners gave the lowest. Single females' mean health assessment score was 5.7 whereas that of married inmates was 4.9. Unemployed inmates scored 5.8, informal 5.4 while civil servants scored 5.0.
Access to quality healthcare was poor and demographic characteristics, marital status, educational background, and occupation influenced inmates' perceptions of accessibility to quality healthcare. Inmates should be encouraged to be proactive in seeking healthcare irrespective of their background characteristics.
Applying global estimates of the prevalence of mental disorders suggests that about 2.4 million Ghanaians have some form of psychiatric distress. Despite the facts that relatively little community-based treatment is available (only 18 psychiatrists are known to actively practice in Ghana), and that mental disorders are more concentrated among the incarcerated, there is no known research on mental disorders in Ghana prisons, and no forensic mental health services available to those who suffer from them. This study sought to determine the rate of mental distress among prisoners in Ghana.
This cross-sectional research used the Kessler Psychological Distress Scale to estimate the rates and severity of non-specific psychological distress among a stratified probability sample of 89 male and 11 female prisoners in one of the oldest correctional facilities in the country. Fisher's exact test was used to determine the rates of psychological distress within the study population.
According to the Kessler Scale, more than half of all respondents had moderate to severe mental distress in the four weeks preceding their interviews. Nearly 70% of inmates with only a primary education had moderate to severe mental distress. Though this was higher than the rates among inmates with more education, it exceeded the rates for those with no education.
The high rate of moderate to severe mental distress among the inmates in this exploratory study should serve as baseline for further studies into mental disorders among the incarcerated persons in Ghana. Future research should use larger samples, include more prison facilities, and incorporate tools that can identify specific mental disorders.
This study assesses the likelihood of rearrest among a cohort of all adults (N = 1,438) released from the Massachusetts state prison system who received mental health services while they were incarcerated. All individuals were followed for 24 months. The analysis focused on four classes of variables: demographic characteristics, clinical history, criminal justice history, and postrelease supervision. These analyses showed that criminal history factors-a juvenile record and a history of multiple previous incarcerations-were significant risk factors, but that clinical factors, including a history of substance abuse, were not. Overall, the models developed here look much like the ones that would be observed in the general offender population. The implications of these findings for criminal justice and mental health policy are discussed.
This chapter seeks to explore the role that a criminal justice social worker will play when dealing with either mentally ill offenders or victims of crime with mental disorders. The prevalence of mental illness or disorders raises quite distinct challenges for social work practice and it is therefore intended that this study will go some way towards demystifying such issues by making more explicit: (1) the nature and prevalence of the types of mental illnesses commonly suffered by offenders and victims of crime; (2) the justification for social work intervention; (3) the benefits that would accrue from such involvement; (4) the specific non-psychiatric mental health services that social workers may offer to mentally ill prison inmates and victims of crime; and finally (5) some of the challenges faced by criminal justice social workers, and the potential solutions thereto.
This survey provides data on the Mental Health System in Ghana for the year 2011. It supplies essential planning information for the implementation of Ghana's new Mental Health Act 846 of 2012, a renewal of the Ghana 5 year plan for mental health and it contributes to international knowledge base on mental health. It provides a baseline from which to measure future progress in Ghana and comparison data for use in other countries. In addition to reporting our findings we describe and analyse deficiencies and strengths of the Ghana mental health system.
We used the World Health Organization's Assessment Instrument for Mental Health Systems (WHO-AIMS) to collect, analyse, and report data on the mental health system and services for all districts of the ten regions of Ghana. Data was collected in 2012, based on the year 2011.
In 2011, Ghana was a lower middle income country with a population of approximately 25 million. A mental health policy, plan and legislation were in place. Mental health legislation was outdated and no longer in line with best practice standards. Services were significantly underfunded with only 1.4% of the health expenditure going to mental health, and spending very much skewed towards urban areas. There were 123 mental health outpatient facilities, 3 psychiatric hospitals, 7 community based psychiatric inpatient units, 4 community residential facilities and 1 day treatment centre, which is well below what would be expected for Ghana's economic status. The majority of patients were treated in outpatient facilities and psychiatric hospitals and most of the inpatient beds were provided by the latter. There were an estimated 2.4 million people with mental health problems of which 67,780 (ie 2.8%) received treatment in 2011. The were 18 psychiatrists, 1,068 Registered Mental Nurses, 19 psychologists, 72 Community Mental Health Officers and 21 social workers working in mental health which is unbalanced with an unbalanced emphasis on nurses compared to what would be expected.
The main strength of the mental health system was the presence of a long established service with staff working across the country in outpatients departments and hospitals. The main weakness was that government spending on mental health was very low and the bulk of services, albeit very sparse, were centred around the capital city leaving much of the rest of the country with almost no provision. Service provision was dominated by nurses with few other professions groups present.
In this article I propose a method of interviewing for descriptive phenomenological research that offers an explicit, theoretically based approach for researchers. My approach enables application of descriptive phenomenology as a total method for research, and not one just focused on data analysis. This structured phenomenological approach to interviewing applies questions based on themes of experience contextualization, apprehending the phenomenon and its clarification. The method of questioning employs descriptive and structural questioning as well as novel use of imaginative variation to explore experience. The approach will help researchers understand how to undertake descriptive phenomenological research interviews.
For women serving life sentences, adjustments to prison are often marked by thoughts of suicide. Many enter prison with specific vulnerabilities that place them at risk for suicide. Using data on 214 female lifers, the authors examined the extent of suicide ideation prior to incarceration as well as current suicide ideation. The relationships between preprison abuse, mental health indicators, prison adjustment factors, prison and family supports, and time served along with sociodemographic variables were analyzed with respect to four categories of preprison and current suicide ideation. Multinomial logistic regression results indicated significant group differences in suicide ideation for abuse histories, depression, family and prison supports, and education level. Among the preprison ideation groups, current depression—not abuse history—distinguished between women with or without current ideation. That is, the way women coped with past abuse was a stronger predictor of current suicide ideation than abuse itself.
In this article, a qualitative method for research is offered that clearly incorporates Heideggerian philosophy into an interpretive phenomenological research design. Several unique contributions to interpretive research are provided. Tested Hermeneutical Principles for Research (HPR) are outlined. These frame the design and method, and practically integrate the underlying philosophy.
Ghana successfully passed a Mental Health Act law in March 2012. The passing of the Act was a culmination of a lot of work by various individuals and institutions spanning several decades. Finally there is a raised prospect of the delivery of a better quality mental healthcare and also the protection of human rights of people with mental disorders in Ghana. This paper identifies and describes clusters of related potential problems referred to as 'challenges' involving different aspects of service delivery, which are anticipated to be encountered during the implementation of the law. Finally, it cautions against the risk of allowing the new mental health law to add a new 'legal' burden to a list of perennial 'burdens' including underfunding, serious levels of understaffing and plummeting staff morale, which bisected earlier attempts at implementing a similar law that laid fallow for forty years.
The lack of trained mental health workers is a primary contributor to the mental health treatment gap worldwide. Despite the great need to recruit and retain mental health workers in low-income countries, little is known about how these workers perceive their jobs and what drives them to work in mental health care. Using qualitative interviews, we aimed to explore factors motivating mental health workers in order to inform interventions to increase recruitment and retention.
We conducted 28 in-depth, open-ended interviews with staff in Ghana's three public psychiatric hospitals. We used the snowballing method to recruit participants and the constant comparative method for qualitative data analysis, with multiple members of the research team participating in data coding to enhance the validity and reliability of the analysis. The use of qualitative methods allowed us to understand the range and depth of motivating and demotivating factors.
Respondents described many factors that influenced their choice to enter and remain in mental health care. Motivating factors included 1) desire to help patients who are vulnerable and in need, 2) positive day-to-day interactions with patients, 3) intellectual or academic interest in psychiatry or behavior, and 4) good relationships with colleagues. Demotivating factors included 1) lack of resources at the hospital, 2) a rigid supervisory hierarchy, 3) lack of positive or negative feedback on work performance, and 4) few opportunities for career advancement within mental health.
Because many of the factors are related to relationships, these findings suggest that strengthening the interpersonal and team dynamics may be a critical and relatively low cost way to increase worker motivation. The data also allowed us to highlight key areas for resource allocation to improve both recruitment and retention, including risk pay, adequate tools for patient care, improved hospital work environment, and stigma reduction efforts.
Interpretative phenomenological analysis (IPA) is an increasingly popular approach to qualitative inquiry. This handy text covers its theoretical foundations and provides a detailed guide to conducting IPA research.
Extended worked examples from the authors' own studies in health, sexuality, psychological distress and identity illustrate the breadth and depth of IPA research.
Each of the chapters also offers a guide to other good exemplars of IPA research in the designated area. The final section of the book considers how IPA connects with other contemporary qualitative approaches like discourse and narrative analysis and how it addresses issues to do with validity. The book is written in an accessible style and will be extremely useful to students and researchers in psychology and related disciplines in the health and social sciences.
Limited research has been conducted to explore the factors that support or obstruct collaboration between traditional healers and public sector mental health services. The first aim of this study was to explore the reasons underpinning the widespread appeal of traditional/faith healers in Ghana. This formed a backdrop for the second objective, to identify what barriers or enabling factors may exist for forming bi-sectoral partnerships. Eighty-one semi-structured interviews and seven focus group discussions were conducted with 120 key stakeholders drawn from five of the ten regions in Ghana. The results were analysed through a framework approach. Respondents indicated many reasons for the appeal of traditional and faith healers, including cultural perceptions of mental disorders, the psychosocial support afforded by such healers, as well as their availability, accessibility and affordability. A number of barriers hindering collaboration, including human rights and safety concerns, scepticism around the effectiveness of 'conventional' treatments, and traditional healer solidarity were identified. Mutual respect and bi-directional conversations surfaced as the key ingredients for successful partnerships. Collaboration is not as easy as commonly assumed, given paradigmatic disjunctures and widespread scepticism between different treatment modalities. Promoting greater understanding, rather than maintaining indifferent distances may lead to more successful co-operation in future.
Background
Prisons are known to be high-risk environments for the spread of bloodborne and sexually transmitted infections. Prison officers are considered to have an intermittent exposure potential to bloodborne infectious diseases on the job, however there has been no studies on the prevalence of these infections in prison officers in Ghana.
Methods
A national multicenter cross-sectional study was undertaken on correlates of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis infections in sample of prison inmates and officers from eight of ten regional central prisons in Ghana. A total of 1366 inmates and 445 officers were enrolled between May 2004 and December 2005. Subjects completed personal risk-factor questionnaire and provided blood specimens for unlinked anonymous testing for presence of antibodies to HIV, HCV and Treponema pallidum; and surface antigen of HBV (HBsAg). These data were analyzed using both univariate and multivariate techniques.
Results
Almost 18% (1336) of 7652 eligible inmates and 21% (445) of 2139 eligible officers in eight study prisons took part. Median ages of inmates and officers were 36.5 years (range 16–84) and 38.1 years (range 25–59), respectively. Among inmates, HIV seroprevalence was 5.9%, syphilis seroprevalence was 16.5%, and 25.5% had HBsAg. Among officers tested, HIV seroprevalence was 4.9%, HCV seroprevalence was 18.7%, syphilis seroprevalence was 7.9%, and 11.7% had HBsAg. Independent determinants for HIV, HBV and syphilis infections among inmates were age between 17–46, being unmarried, being illiterate, female gender, being incarcerated for longer than median time served of 36 months, history of homosexuality, history of intravenous drug use, history of sharing syringes and drug paraphernalia, history of participation in paid sexual activity, and history of sexually transmitted diseases. Independent determinants for HIV, HBV, HCV and syphilis infections among officers were age between 25–46, fale gender, being unmarried, being employed in prison service for longer than median duration of employment of 10 years, and history of sexually transmitted diseases.
Conclusion
The comparably higher prevalence of HIV, HBV, HCV and syphilis in prison inmates and officers in Ghana suggests probable occupational related transmission. The implementation of infection control practices and risk reduction programs targeted at prison inmates and officers in Ghana is urgently required to address this substantial exposure risk.
Purpose
Differential Coercion and Social Support (DCSS) theory is used to examine whether sources of coercion and social support differ in their effects on inmate adjustment across periods of time served (< 1 year, 1–5 years, and > 5 years).
Method and results
A nationally representative sample of male offenders incarcerated in state prisons is used to examine whether coercion (e.g., confinement in restrictive housing, victimization) and social support (e.g., perceptions of procedural justice and visits) influence assault misconducts, institutionalized resistance, and mental health outcomes across different periods of time served. The analytical strategy includes several binary logistic regressions with robust standard errors in addition to examining differences in predicted probabilities across models through average discrete changes (ADC). Sources of coercion, such as confinement in restrictive housing, largely influence each of the outcomes across periods of time served in prison, whereas sources of social support have mixed effects. However, there is limited variability in the magnitude of the effects across categories of time served.
Conclusion
DCSS provides an understanding of how inmates may adjust differently to the prison environment based upon the amount of time that is served in prison. Interventions and treatment programs should focus on developing prosocial interpersonal relations between inmates and correctional staff.
Dramatic increases in the American imprisonment rate since the mid-1970s have important implications for the life chances of minority men with low educational attainment, including for their health. Although a large literature has considered the collateral consequences of incarceration for a variety of outcomes, studies concerned with health have several limitations: Most focus exclusively on physical health; those concerned with mental health only consider current incarceration or previous incarceration, but never both; some are cross-sectional; many fail to consider mechanisms; and virtually all neglect the role of family processes, thereby overlooking the social roles current and former prisoners inhabit. In this article, we use stress process theory to extend this research by first considering the association between incarceration and major depression and then considering potential mechanisms that explain this association. Results from the Fragile Families and Child Wellbeing Study (N = 3,107) show current and recent incarceration are substantially associated with the risk of major depression, suggesting both immediate and short-term implications. In addition, consistent with stress proliferation theory, the results show the well-known consequences of incarceration for socioeconomic status and family functioning partly explain these associations, suggesting the link between incarceration and depression depends heavily on the consequences of incarceration for economic and social reintegration, not only the direct psychological consequences of confinement.
People with a mental illness often encounter stigma and discrimination from a variety of sources, reinforcing negative self-perceptions and influencing their health and well-being. Even though support systems and attitudes of the general public act as powerful sources of stigma, views and perceptions held by people with mental illness also influence their sensitivity to the experiences they encounter. The aim of the present qualitative study was to examine perceptions of stigma and discrimination and self-stigma in individuals diagnosed with a mental illness. This study adopted a narrative, descriptive method, using a semistructured interview guide to elicit participant perceptions regarding sources of stigma, discrimination, and personal factors that might influence their experiences. Twelve outpatients attending a clinic in Ghana were interviewed. Thematic content analysis was completed and augmented by field notes. Participants' perceptions about personal impacts of stigma were found to be influenced by self-stigma, anticipated stigma and discrimination, perceived discrimination, and their knowledge about their illness. For many participants, their views served to augment societal views, and thus reinforce negative self-perceptions and their future. However, for other participants, their views served as a buffer in the face of environmental situations that reflect stigma and discrimination. Stigma is a complex, socially-sanctioned phenomenon that can seriously affect the health of people with mental illness. As such, it requires coordinated strategies among public policy makers, governmental bodies, and health-care providers to address stigma on a societal level, and to address its potential impacts on broad health outcomes for individuals with mental illness.
The number of incarcerated women serving a life sentence is growing. This subpopulation rarely receives programming in prison or even inclusion in intervention studies’ samples. According to importation theory, characteristics of prisoners’ pre-prison experiences guide the types of interventions provided to prisoners. This study examined the importation factors for a sample of women serving life sentences and used thematic analysis to understand these factors. The primary theme was the dominance of trauma in women’s pre-prison lives with four connected sub-themes that highlight treatment needs pre-and during prison. One implication of this study is improving prison policies to include this subpopulation in treatment opportunities.
Introduction
For an inmate incarcerated for life we could acknowledge factors contributing to the desire to commit suicide, as social isolation, insensitive discipline, lack of privacy, constant threat of violence, fear, guilt, hopelessness, and depression are prominent in the life imprisonment.
Aims
To discuss the ethical issues of prevention suicide in inmates incarcerated for life.
Methods
We performed thorough research of the main medical databases, and web search engines for relevant studies, articles and opinions and reviewed them independently.
Results
Prevalence of mental illness is high among inmates and several common stressors typically herald an inmate's suicide. Suicide is often the single most common cause of death in correctional settings. Even though some suicide victims have consulted a mental health service-provider before their suicide, the majority of suicide victims were not mentally ill. The paradox, particularly for life sentence inmates is that we are trying to persuade an inmate to live within a disciplinary environment, which has as side effect the increase of suicidality of the inmates.
Conclusions
Prisons’ inability to protect the health and safety of inmates could raise ethical issues. We have obligation to adequate suicide prevention for all inmates, and we should be more broad minded as the will to die in mentally healthy individuals is beside an free will expression, a sign of serious lack of support and humane living conditions. We should be vigilant not to use the prevention of suicide programs as another way to increase punishment of life long imprisonment.
This book provides an accessible comprehensive exploration of phenomenological theory and research methods and is geared specifically to the needs of therapists and other health care professionals. An accessible exploration of an increasingly popular qualitative research methodology Explains phenomenological concepts and how they are applied to different stages of the research process and to topics relevant to therapy practice Provides practical examples throughout.
A growing body of research—much of which has focused on male inmates—suggests that religion ameliorates many pains and problems of imprisonment. The purpose of this study is to examine the effects of religious engagement on prison adjustment among a sample of 214 females serving life sentences in a Southern state prison system. Results of multivariate analyses indicate that religious engagement is indirectly related to prison adjustment; however, the role that religious engagement plays seems to be through helping women deal with feelings of depression. Women’s personal accounts of prison adjustment corroborate these findings.
Using a triangulated research design, this research examines the mental health of life without parole (LWOP) inmates. A bivariate analysis of the mental health of two groups of LWOP inmates was conducted, new (n = 72) and veteran (n = 46). New LWOP inmates were defined as those who had served less than the mean number of years of the sample (10.5 years) while veteran LWOP inmates had served greater than the mean time served. Results indicate that the initial stages of incarceration are particularly stressful as a higher prevalence of new LWOP inmates reported mental health disorder than veteran LWOP inmates. Significant differences exist between the two groups in several areas. In-depth interviews with veteran LWOP inmates (n = 25) are further indicative of an inverse relationship between mental disorder and length of incarceration.
Despite the increase in the number of females incarcerated, there is a paucity of research concerning female life-sentenced inmates in the United States. Using a nationally representative data set containing the largest known sample of this population, the present research examines the pre-incarceration traumatic experiences of female life-sentenced inmates. The results indicate that these women are more likely to experience traumatic events, in particular abuse, than either male life-sentenced inmates or female inmates in general. Logistic regression analyses reveal a significant association between abuse and a life sentence in both gender-specific models.
Dramatic increases in the American imprisonment rate since the mid-1970s have important implications for the life chances of minority men with low educational attainment, including for their health. Although a large literature has considered the collateral consequences of incarceration for a variety of outcomes, studies concerned with health have several limitations: Most focus exclusively on physical health; those concerned with mental health only consider current incarceration or previous incarceration, but never both; some are cross-sectional; many fail to consider mechanisms; and virtually all neglect the role of family processes, thereby overlooking the social roles current and former prisoners inhabit. In this article, we use stress process theory to extend this research by first considering the association between incarceration and major depression and then considering potential mechanisms that explain this association. Results from the Fragile Families and Child Wellbeing Study (N = 3,107) show current and recent incarceration are substantially associated with the risk of major depression, suggesting both immediate and short-term implications. In addition, consistent with stress proliferation theory, the results show the well-known consequences of incarceration for socioeconomic status and family functioning partly explain these associations, suggesting the link between incarceration and depression depends heavily on the consequences of incarceration on economic and social reintegration, not only the direct psychological consequences of confinement.
Research on translation processes using think-aloud protocols (TAPs) as the research design has recently received increasing attention. Such studies over the past two decades have produced many interesting yet by no means definitive findings about mental activities during the process of translation. As the research community strives for more in-depth investigations into translation processes, some researchers have rightly expressed concerns over the rigor and trustworthiness of such studies. To address this concern, the article first summarizes important safeguards that must be put in place in data-based qualitative research to ensure this critical element of trustworthiness. These safeguards are then used to evaluate the research designs of 15 published reports on investigations of translation processes using TAPs. It was found that many of the safeguards were not incorporated in most of the surveyed studies, thus leaving much to be desired in their designs and reports. Implications for future TAP research and publishing are also discussed.
Previous research on suicide in United States prisons focused on the characteristics of inmates who commit suicide while largely ignoring the prison context surrounding these suicides. The following analyses used national data on 1,082 state prisons in the United States to examine how prison conditions (deprivation) and inmate composition (importation) predict prison suicide. Results of a negative binomial regression model showed that the number of suicides was significantly increased in supermaximum and maximum security prisons (relative to minimum), under conditions of overcrowding and violence, and in prisons where a greater proportion of inmates received mental health services. Although deprivation variables were overwhelmingly predictive of suicide, the results pointed to the combined effects of institutional conditions and inmate composition on prison suicide.
In this article, as two researchers from different traditions in qualitative research (consensual qualitative research and grounded theory), the authors present their shared views on the critical elements of trustworthiness in qualitative data. In addition to making specific recommendations about the integrity of data, the balance between participant meaning and researcher interpretation, and clear communication and application of the findings, they identify ways in which these issues are difficult to negotiate within and across different qualitative approaches. The authors present examples from various qualitative studies, emphasize the need for a shared language to reduce confusion between qualitative traditions and with researchers from a more strictly quantitative orientation, and recommend particular approaches to establishing trustworthiness in qualitative research.
Counselling needs of Ghanaian prisoners: The case of Ankaful and Kumasi Central prisons
- B N Ayamba
- A K Arhin
- J A Dankwa
Ayamba, B. N., Arhin, A. K., & Dankwa, J. A. (2017). Counselling needs of Ghanaian prisoners: The case of
Ankaful and Kumasi Central prisons. IFE PsychologIA, 25(2), 195-209.
Assessment of mental health distress among prison inmate sin Ghana’s correctional system: A cross-sectional study using the Kessler Psychological Distress Scale