O impacto da prisão na saúde mental dos presos do estado do Rio de Janeiro, Brasil

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Abstract

Resumo O artigo tem como objetivo analisar as condições de saúde mental dos presos e custodiados do estado do Rio de Janeiro e sua relação com o aprisionamento, através da análise de escala de depressão e do Inventário de Sintomas de Estresse. Amostra: 1573 indivíduos, obtidos por amostragem estratificada proporcional ao tamanho. População estudada: mais da metade possui até 29 anos; 70,6% têm cor da pele preta/parda; 80% têm religião, 77,4% com bom vínculo familiar; 42,9% têm menos de um ano de prisão; 22,9% trabalham no presídio. Estresse: 35,8% dos homens e 57,9% das mulheres. Fatores associados ao estresse entre homens: tempo de prisão e vínculo familiar. Presos com 1 a 9 anos de prisão possuem uma chance igual a 0,55 a daqueles com menos de 1 ano de reclusão; aqueles com vínculo regular e ruim possuem chance maior em relação àqueles com bom vínculo. Entre as mulheres, o vínculo regular/ruim representa maior chance de desenvolvimento dos problemas de saúde mental; trabalho representou proteção contra o estresse. Depressão: 7,5% das mulheres e 6,3 % dos homens apresentam sintomas depressivos graves. Entre os homens, praticar alguma religião, ter bom vínculo familiar e trabalhar na prisão são fatores protetores. Entre mulheres, apenas vínculo familiar associou-se com sintomas depressivos.

Translated abstract

Abstract The aim of this article is to assess the mental health status of inmates and people in custody in the state of Rio de Janeiro and the association between mental health and imprisonment using the Beck Depression Inventory and the Lipp Stress Symptom Inventory for Adults. Sample: 1,573 individuals, via stratified sampling with probability proportional to size. Study population: more than half have up to 29 years old; 70.6% were black/brown; 77.4% had strong family ties; 42.9% had been incarcerated for under a year; and 22,9% performed work tasks in prison. Stress: 35.8% of men and 57.9% of women. Factors associated with stress among men: length of time in prison and family ties. Male prisoners who had been in prison for between 1 and 9 years are 0.55 times less likely to experience stress symptoms than those who had been in prison for less than a year; those with regular/weak family ties are more likely to experience stress than those with strong ties. Women with only regular/weak family ties are more likely to experience stress; work tasks performed in prison was a protective factor. Depression: 7.5% of women and 6.3% of men. Among men, practicing a religion, maintaining strong family ties, and performing prison work tasks are protective factors. Among women, an association was found between depression and family ties.

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Most cited references 62

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Prevalence of psychiatric disorders in New Zealand prisons: a national study.

N Fairley, Clinton T. Laidlaw, F Malcolm … (2001)

The paper describes the methodologies and results obtained on a large cohort of prison inmates in New Zealand who were screened for psychiatric disorder. All women and remanded male inmates in New Zealand prisons, and a randomly selected cohort of 18% of sentenced male inmates were interviewed. Interviewers used the Composite International Diagnostic Interview - Automated to establish DSM-IV diagnoses, and the Personality Disorders Questionnaire to identify personality disorder. All prisons in New Zealand were visited. The results indicate markedly elevated prevalence rates for major mental disorder in the prison population when compared with community samples. This is especially the case for substance misuse, psychotic disorders, major depression, bipolar disorder, obsessive- compulsive disorder and posttraumatic stress disorder. Of particular concern is not only the increased prevalence rates for schizophrenia and related disorders but also the high level of comorbidity with substance misuse disorders demonstrated by this group. While 80.8% of inmates diagnosed with bipolar disorder were receiving psychiatric treatment in the prison, only 46.4% of depressed inmates and 37% of those suffering from psychosis were receiving treatment. Maori inmates were grossly overrepresented in the remand, female and male sentenced inmate population compared with the general population. A significant increase in provision of mental health services is required to cope with the high number of mentally ill inmates. The level of need demonstrated by this study requires a level of service provision that is quite beyond the capacity of current forensic psychiatry services, Department of Corrections Psychological Services or the prison nursing and medical officers. The elevated rates of common mental disorders argues for the use of improved psychiatric screening instruments, improved assessment and treatment capacities in the prison and an increased number of forensic psychiatric inpatient facilities to care for those psychotic inmates who are too unwell to be treated in the prison.