To assess the prevalence of common mental disorders, the impact of the prison environment was extensively examined in this study. Numerous earlier studies have suggested that there may be a considerable unmet need (18). For instance, studies indicate that 46–64% of prisoners’ mental health needs are not being satisfied (18). The findings of this study showed that common mental disorders are present in 54.5%, 95% CI: (50.2,58.8) of prisoners. The output from the multivariable analysis identifies past mental illness, self-harming behavior, level of social support, prison food, and comorbid medical illness as the factors positively associated with common mental disorders.
The results of this finding are similar to those of other studies conducted in Iran, South Africa, Nigeria, and Brazil (55.4%, 57%,56.1%, and 57%, respectively) (3, 19, 20). This finding was also consistent with a prior study performed in Ethiopia, which found 58.4% [95% CI 53.70, 63.00] (4). Compared to many prior studies, our finding is lower than the prevalence of CMD among the study population in Spain (84.4%), Canada (73%), Uganda (86%), Ethiopia at Gojam prison (73.25%), and Kality prison (61.9%) (21) (22) (23).
The change may be due to variations in the method used to gather the data, the sample size, and the interval between two investigations. For instance, the clinical version of the Structured Clinical Interview for DSM IV, Axis 1 Disorder was used to assess mental disorders in the United States, Canada and Spain(24) (25).
MINI Version 6.0 was also administered in Uganda (26). In Debre Markos, the prevalence of CMDs was 67.6%, and the SRQ-20 had a cutoff point of ≥ 6 to determine prisoners mental health (27). Another study in Northwest Ethiopia found that the prevalence of CMDs was 74.6% and employed a Kessler Psychological Distress Scale as an assessment instrument on a sample of 608 people(28).
The current study was greater in the USA, Taiwan, and Jima, at 28.9%, 50%, and 35.9% respectively, (29, 30) (31). The decrease in the prevalence of CMD in American prisons is linked to better prison service, and accessibility to personalized programs thorough rough admission paperwork (31). According to the current study, 58.8% of prisoners who had CMDs, which is a drop in politically unstable ethnicity, particularly those who fought in a war, such as Tigrayan ethnicity. On the one hand the COVID − 19 pandemic that occurred before the study may have had an impact on the high prevalence of CMDs.
Several factors contribute to the high rate of CMDs in prisons. In the current study, the majority of those who had a prior history of mental illness were two times more likely to develop CMDs. For several of reasons, including treatment disruption and insufficient care, the study is similar to earlier research done in Kality Prison (16). As a result, both past and present mental health issues in prison require treatment services, rehabilitation, and community reintegration.
Prisoners who are unable to handle circumstances display hostile behavior, suicidal thoughts, stress, sadness, and other mental health issues (42). In the current study, CMDs were 2.1 times more likely to develop in prisoners who had engaged in self-harming behavior in the past. First, we suggested that being placed in the prison be included in the risk assessment of mental health and those components may have causal relationships but cannot establish causality. In England's prisons, the suicide prevention and management policy was changed in 2004 and now emphasizes identification and risk assessment. The recommendations to prevent suicide therefore include early screening, risk monitoring, and appropriate mental health care.
The results of the study indicated that respondents with high social support had 62.7% lower odds of developing CMDs. Respondents who had moderate social support were 67.8% those who less likely to develop CMDs than had poor social support. Losing family connections can cause much of stress, loneliness, worry, and despair, all of which are frequent mental health issues. The results of the current investigation showed that respondents with moderate and high social support were less likely to experience CMD. This finding is consistent with those of comparable studies conducted in Jima, Iran, and Egypt(32, 33). Some of the findings are to increase the possibility of positive interactions with peers and negatively affect prisoners improving and social support is an issue that should be addressed to reduce the burden of mental illness, and it also sheds light on the options available to prisoners(34, 35).
The likelihood of developing CMDs had decreased by 52.8% among respondents who have a diet. Adequate and good prison diet in prison was proven to be a preventive factor against CMDs. Therefore, improving prisoner ratios and adequately diversifying them help to reduce CMDs.
Prisoners with a comorbid medical condition increased a prisoner’s likelihood of developing CMDs by 44%. Comparable research has been done in South Africa on comorbid medical problems that are known to be linked to CMDs (21). Comorbid medical illness may develop in prisons as a result of gangsterism, overcrowded quarters, a bad diet, poor hygiene, a sedentary lifestyle, drug use, and other types of conflicts. Overall, prisoners’ mental health state is strongly tied to their access to wholesome diets, medical care, and mental health services.
This study may provide insights for primary care providers working together to improve the mental health of prisoners. Social support would overcome the barriers as well as early screening and continued risk monitoring to ensure the prevention of suicide. Therefore, further, research is needed on the positive impact of the prison environment on mental health among prisoners.