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“Prison life can make you go crazy”: Insights into the situation for people with a mental illness in the Malawi prison system

Van Hout, MC, Kaima, R, Magwejani, C, Kasunda, V, Nyson, K, Khoviwa, P, Phiri, M, Mhango, V and Kewley, S (2024) “Prison life can make you go crazy”: Insights into the situation for people with a mental illness in the Malawi prison system. International Journal of Forensic Mental Health. pp. 1-13. ISSN 1499-9013

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Little is known with regard to due process and forensic assessment capacities in Africa, where over one million are deprived of their liberty on any given day. A rapid situation assessment explored multi-stakeholder perspectives regarding the situation of people with a mental illness in the Malawi prison system. In-depth interviews were conducted with 10 regional professional stakeholders, 18 former prisoners, and five prison staff from two maximum-security prisons. Reflexive thematic analysis yielded five themes; Occurrence of mental illness among people living in prison; Prison environment exacerbating harm and levels of mental illness; Security responses to the presence of psychiatric disorders; Availability and coverage of specialist psychiatric and psychological care; and Diversion, other non-custodial measures and continuity of care on release. Narratives highlight the substantial causal impact of the prison environment in amplifying existing and new mental illness, vulnerability and exploitation of people with a mental disorder. Malawi prisons are hampered by lack of specialist forensic capacity nationally; centralized mental health surveillance system; and insufficient skilled staff to conduct evidence-based screening and care. Security operations implement the use of pharmacological and physical restraint measures at times. Faith-based organizations play an important role in providing psychological and spiritual support. Release and reintegration require family involvement. A cross departmental intersectoral partnership response spanning government ministries, key civil society organisations, the Malawi Prison Inspectorate and Malawi Human Rights Commission is warranted. Recommendations include alleviation of prison congestion, prison staff capacity building and investment in forensic mental health services with adequate geographic coverage.

Item Type: Article
Uncontrolled Keywords: 1103 Clinical Sciences; 1701 Psychology; 1801 Law
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
H Social Sciences > HV Social pathology. Social and public welfare. Criminology > HV8301 Penology. Prisons. Corrections
Divisions: Psychology (from Sep 2019)
Public Health Institute
Publisher: Taylor and Francis Group
SWORD Depositor: A Symplectic
Date Deposited: 04 Apr 2024 08:18
Last Modified: 25 Apr 2024 10:00
DOI or ID number: 10.1080/14999013.2024.2338429
URI: https://researchonline.ljmu.ac.uk/id/eprint/22941
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