Mariyam Riaz
University of Gujrat, Gujrat, Pakistan
University of Gujrat, Gujrat, Pakistan
University of Gujrat, Gujrat, Pakistan
The aim of current study was to explore the prevalence of psychological disorders among juvenile offenders in central jails of Gujrat, Gujranwala and Sialkot district of Punjab, Pakistan. By using cross-sectional study design, 125 juvenile offenders which comprised of whole population selected from targeted jails through census sampling technique. It was conducted in two phases. In the first phase the demographic and screening questionnaire were administered on all the participants. In the second phase, the relevant diagnostic questionnaires were administered on vulnerable cases for targeted psychological disorders screened at first phase. Results revealed that the prevalence of targeted psychological disorders (major depression & anxiety disorders) was 29% among juvenile offenders in targeted cities. There were 53% juveniles who had moderate level of psychological disorders following the severe (28%) and mild level (19%) of psychological disorders among total diagnosed juveniles. It is concluded that there was high prevalence of psychological disorders among juvenile offenders.
Keywords: Prevalence, psychological disorders, prisoners, diagnostic criteria, anxiety, major depression
For a fully functioning society, it is important to ensure a sound rehabilitative recovery of the prisoners. In developing countries, there is a lack of sufficient resources to provide health related facilities to juvenile prisoners. Juvenile offenders are most vulnerable to developing psychological disorders; considering they are coming up with complex mental health needs and emotional and behavioral problems. According to the historical background, the research focusing on the the need to study and deal with the increasing tendencies of psychiatric disorders among prisoners was initiated approximately 60 years back (Sarhandi, 2004). The present study aims to check the prevalence of psychological disorders amongst a sample of juvenile offenders in Pakistan.
In Pakistan, the living conditions of most of the prisons are not healthy. Most of the prisons are overcrowded, having little facilities and health issues have always been ignored (Khan et al., 2012). According to the report of the Human Rights Commission of Pakistan, there were total 75,444 prisoners in those prisons of Pakistan which had a total sanctioned capacity of 44, 5786 by the end of 2012 (Shahid et al., 2014). As there is an increasing population of mentally ill inmates being inadequately identified and cured, there is a need to investigate the prevalence of psychological disorder among them.
According to the Punjab Juvenile Justice System Rules (National Assembly of Pakistan, 2002) juvenile are those individuals who have not attained the eighteen years of age when he/she has committed the offense or misconduct. It includes child and young delinquents. Furthermore, there are two types of research that describe the relationship between psychiatric disorders and delinquency. The one type examines all offending youth in the community. However, the second type of study focuses only on delinquent youth that develop psychological disorders within juvenile justice facilities after commission of offense (Grisso, 2008).
Numerous researches have been conducted all over the world to investigate juveniles with mental health problems. The studies found that prevalence of psychological disorders is higher among juveniles as compared to general youth (King, 2020). The psychological disorders were also reviewed in adolescent offenders using meta- analysis (King, 2020). The findings showed that 36% (10% males & 26 % females) out of 32,787 adolescents met the diagnostic criteria of depressive disorders (47 studies samples). There was high prevalence of anxiety and depression among offenders (11-16 years) amongst sample of youth in Pittsburgh (Jolliffe et al., 2019). Similarly, 80% of young offenders had psychiatric comorbidities of illness (Livanou & Singh, 2016). The prevalence and gender differences in mental disorders among juvenile offenders who were imprisoned for nine months were also investigated (Karnik et al., 2009). Their results revealed that 88% of male and 92% of female juveniles met the criteria for having at least one psychological disorder. Clinical, social, legal and inter systemic conditions are the key factors that collectively play role in the development of psychological disorders in juvenile offenders in juveniles’ detention centers (Grisso, 2008). Similarly, in Mississippi, it was found that juveniles are at higher risk to develop psychological disorders as compared to general population (Robertson et al., 2004).
Above mentioned discussion has revealed the presence of numerous psychological disorders among prisoners across the globe. It showed that juvenile offenders are also at immense risk of developing psychological problems. There is a lack of empirical data on psychiatric illnesses among juvenile in Pakistan. The present study was designed to find the prevalence of targeted psychological disorders (Major Depressive Disorder & Anxiety Disorders) among juvenile offender in Gujrat, Gujranwala, and Sialkot districts.
Research Design
A cross-sectional survey research design was used to explore the prevalence of anxiety disorders and Major Depressive Disorder among juvenile offenders. The data were collected from central jails of district Gujrat, Gujranwala, and Sialkot. The total targeted population was
125 and there were 34, 20, and 71 juvenile offenders in Gujrat, Sialkot, and Gujranwala, respectively.
Census sampling technique was used to select the study sample.
SCID (Structured Clinical Diagnostic Interview) based on DSM-5
SCID (Structured Clinical Diagnostic Interview) based on DSM-5 (APA, 2013) was used for the purpose of data collection. There were four parts of research instrument. The screening and diagnostic tools were translated into Urdu language by using Lexicon Equivalence Method. Procedure
After following the ethical considerations, the research was initiated. At first phase, demographic and screening questionnaires were administered on all participants, while at the second phase only those participants were met the criteria of Depression and Anxiety in screening questionnaire were contacted. The structured clinical diagnostic interview was conducted individually by the researcher with all the screened participants. The cut off scores were determined based on DSM-5 diagnostic criteria of each targeted disorder. The cut off scores of 8 was used for major depressive disorder and panic attack, cut off of 7 was used for specific phobia and 9 for social anxiety disorder. The first and second phase of data collection took almost six months. Both screening and diagnostic questionnaire were filled in 20 and 30 minutes on average respectively. At the end, the responses were calculated, analyzed, interpreted, and tabulated with the help of SPSS 21.0 (Statistical Package for Social Sciences) version. The descriptive statistics were used to find frequencies and percentages. The cut off scores of each disorder was employed and the vulnerable cases were identified from the total targeted participants. Later based on diagnostic criteria, vulnerable cases were assessed for fulfilling the diagnostic criterion of relevant psychological disorder.
Results indicated that, overall, 47% of participants showed symptoms of mood disorders as compared to 53% of participants who did not have any symptoms of mood disorders. Table 1 further indicated that there were 36 (61%) participants from screened cases who were diagnosed with any category of targeted psychological disorders. Overall, majority of diagnosed cases had the symptoms at moderate level of severity (n=19, 53%). Moreover, 10 (28%) juveniles, from diagnosed cases, reported to have the symptoms at severe level. On the other hand, 7(19%) juveniles reported to have the symptoms at mild severity level.
Juvenile offenders at Phase 1, Phase 2 and Phase 3
|
Variables |
f |
% |
|
Screening (n=125) |
|
|
|
Vulnerable cases for targeted psychological disorders |
59 |
47 |
|
Non vulnerable Cases |
66 |
53 |
|
Screened Cases (n=59) |
|
|
|
Diagnosed |
36 |
61 |
|
Non-diagnosed |
23 |
39 |
|
Severity of Diagnosed cases (n=36) |
|
|
|
Mild |
07 |
19 |
|
Moderate |
19 |
53 |
|
Severe |
10 |
28 |
Note. f= Frequency, %= Percentages
The result also indicated that anxiety disorders (20 participants) were the most frequently diagnosed disorder among juveniles with the percentage of 55.6 (16% of target population) from total diagnosed sample whereas 16 were diagnosed with major depressive disorder with the percentage of 44.4 (13% of target population) from diagnosed sample. Further, 30.6% (9% of target population) had specific phobias, 19.4 % (6% of target population) had social anxiety disorder and 5.6 % (2% of target population) had panic disorder.
The results also indicated the frequencies and percentages of diagnosed juvenile participants according to levels of severity of psychiatric disorders. Figures depicts that specific phobia has the same frequencies of diagnosed cases at moderate (n=4, 11%) and severe (n=4, 11%) levels of severity follows by mild severity with the frequency of 3(9%).
Presenting the Frequencies of Psychiatric Illnesses Level among Juveniles Offenders
Demographic Characteristics of Diagnosed Juvenile Offenders (n=36)
|
Variables |
f |
% |
|
Diagnosed Cases in Jail |
|
|
|
Gujrat |
12 |
33 |
|
Gujranwala |
17 |
47 |
|
Sialkot |
07 |
19 |
|
Age in years |
|
|
|
12-14 |
09 |
25 |
|
15-17 |
27 |
75 |
|
Gender |
|
|
|
Boys |
36 |
100 |
|
Residential type Village |
24 |
67 |
|
City |
12 |
33 |
|
Family system |
|
|
|
Nuclear |
18 |
50 |
|
Joint |
18 |
50 |
|
Nature of crime Drug smuggling |
11 |
31 |
|
Thievery |
06 |
17 |
|
Robbery |
05 |
14 |
|
Fight |
07 |
19 |
|
Kidnap |
02 |
06 |
|
Attempt to murder |
03 |
08 |
|
Murder |
02 |
06 |
Note. f= Frequency, %= Percentages
Table 2 indicated that the Gujranwala jail has the highest frequency of the diagnosed cases whereas Sialkot jail has the lowest number of diagnosed cases. There are 33% diagnosed juveniles in Gujrat jail. The highest proportion 75% of juvenile offenders fall between the age range of 15 to 17 years following the 25% of juveniles with the age category of 12 to 14 years. The table further indicates that 67% respondents are from rural side following the 33% respondents who are from urban areas; whereas the respondents from nuclear and joint family system share the same percentages among diagnosed cases. Furthermore, drug smuggling was the most common crime among them follows by fight, theft, robbery, attempt to murder, muder, and kidnap respectively.
The present study was conducted to explore the prevalence of anxiety and depression among a sample of juvenile offenders of central jails of Gujrat, Gujranwala and Sialkot districts. On the basis of research objectives, findings of current study are discussed below:
The first objective of the study was to find the prevalence of psychological disorders among juvenile offenders. The result indicated that the prevalence of targeted psychological disorders is 29 % (n=36) in complete targeted juvenile offenders. The findings of the current study are consistent with the finding of previous study who reported that there were high association of depression and anxiety among juvenile delinquents (Jolliffe et al., 2019). Similarly, high prevalence of psychological disorders was also found among juvenile (Teplin, Abram et al., 2002). Results showed that 60% of detained male and two third of female respondents met the diagnostic criteria for one or more psychological disorders. These findings are also consistent with the longitudinal study (Teplin et al., 2012) which indicated occurrence and persistence of psychological disorders in Youth during 5 years after detainees. After five years baseline, 45% of males and nearly 30% of females had 1 or more psychological disorders with related impairment and 1 or more psychological disorder without impairment over time (Teplin et al., 2012).
Another objective of the study was to explore prevalence of Major Depressive Disorder among juvenile offenders. The results showed the prevalence of depressive symptom is 13% in the sample of juvenile offender. The findings of current study are confirmed by the previous study which reported that there were 45 % prisoners who suffered from depression (Alemayehu et al., 2019). The results are also in line with previous study which found high prevalence of psychological disorders among juvenile delinquents (Shufelt & Cocozza, 2006).
Furthermore, the study was also aimed to explore prevalence of anxiety disorders among juvenile offenders in central jails of Gujrat, Gujranwala and Sialkot districts. Findings showed the prevalence of targeted anxiety disorder was 16% in juveniles at targeted districts. Specific phobia was found as most frequently diagnosed (9%) among anxiety disorders followed by social anxiety disorder with 6% among juvenile offenders. Panic disorder has prevalence of 2%. The findings are consistent with the previous study which conducted on mental disorder among youth in juvenile justice system (Shufelt & Cocozza, 2006). The researchers found that at the time of study, 34% offenders had anxiety disorders. The results of current study also have similarity with the findings of one more study which investigated the prevalence of Mental disorders among imprisoned Juvenile offenders in Mississippi. The findings indicated that 58% of juveniles have one or more of the anxiety disorders (Robertson et al., 2004). Last objective of the study was to find out severity of psychological disorders among juvenile offenders. Table 1 depicted that 53% of juvenile offenders diagnosed with moderate level of psychological
disorders following the 28% and 19% juveniles with severe and mild level of psychological disorders respectively. These results are in line with the previous literature as well (Ryan & Redding, 2004).
Findings of the current study revealed prevalence of psychological disorders was 29% among juvenile offenders. The current study highlighted the need for immediate planning by the government prison administration and the criminal justice system in order to provide the psychiatric services for improving the psychological health of the juvenile offenders.
Alemayehu, F., Ambaw, F., & Gutema, H. (2019). Depression and associated factors among prisoners in Bahir Dar Prison, Ethiopia. BMC Psychiatry, 19(1), 1-7. https://doi.org/10.1186/s12888-019-2071-1
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Grisso, T. (2008). Adolescent Offenders with Mental Disorders. Future Child, 18(2), 143-164. Jolliffe, D., Farrington, D. P., Brunton-Smith, I., Loeber, R., Ahonen, l., Palacios, A. P. (2019).
Depression, anxiety and delinquency: Results from the Pittsburgh Youth Study. Journal of Criminal Justice, 62, 42-49. https://doi.org/10.1016/j.jcrimjus.2018.08.004
Karnik, N. S., Soller, M., Redlich, M., Silverman, M., Kraemer, H. C., Haapanen. R., Steiner, H. (2009). Prevalence of and gender differences in psychiatric disorders among juvenile delinquents incarcerated for nine months. Psychiatric Service, 60(6), 838-841. https://doi.org/10.1176/ps.2009.60.6.838
Khan, M. T., Hussain, H., Khan, G., Khan, A., Badshah, A., Sarwar, R. (2012). Incidence of depression among incarcerated woman in central prison, Peshawar, Pakistan. European Journal of Internal Medicine, 9(1), 33-38.
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Livanou, M., Singh, F. S. (2016). Prevalence and nature of mental disorders among young offenders in custody and community: A meta-analysis. European Psychiatry, 33(S1), S460-S460. https://doi.org/10.1016/j.eurpsy.2016.01.1675
National Assembly of Pakistan. (2002). Punjab juvenile justice system rules. http://www.na.gov.pk/uploads/documents/1519296948_886.pdf
Robertson, A. A., Dill, L. P., Husain, J., Undesser, C. (2004). Prevalence of mental illness and substance abuse disorders among incarcerated juvenile offenders in Mississippi. Springer Science Business Media, 35(1), 55-74
Sarhandi. (2014) Psychiatric morbidity among prison inmates at the Central Prison Karachi, Pakistan. The Health, 5(2),18-21.
Shahid, I., Aftab, A., Yousaf, Z., Naqvi, H. S., Hashmi, M. L. (2014). Prevalence of depression among male prisoners at an urban jail in Pakistan. Journal of Social for develop in new net environment in B & H, 8(6), 699-704.
National Center for Mental Health and Juvenile Justice. (2006). Youth with mental health disorders in the juvenile justice system: Results from a multi-state prevalence study. www.ncmhjj.com
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|
Sr. No. |
Author |
Contribution |
|
1 |
Mariyam Riaz |
Objectives, Planning, Literature Review, Data Collection, Write-up, Manuscript Drafting |
|
2 |
Noreena Kausar |
Topic Selection, Data Analyses, Write-up and Proof Reading of Manuscript |
|
3 |
Hafsa Qurban |
Data Analyses, Write-up and Proof Reading of Manuscript |