The Prevalence of Clinical Depression and Its Associated Factors Among Adult Inmates in Kajang Prison, Malaysia

AuthorYusadilah M. Yaacob,Salmi Razali,Yuhaniz Ahmad
DOIhttp://doi.org/10.1177/00328855221121114
Published date01 November 2022
Date01 November 2022
Subject MatterArticles
The Prevalence of
Clinical Depression and
Its Associated Factors
Among Adult Inmates
in Kajang Prison, Malaysia
Yusadilah M. Yaacob
1
,
Salmi Razali
1
, and Yuhaniz Ahmad
2
Abstract
Information on clinical depression and its associated factors among prison
inmates is especially scarce in countries of lower middle income. This
study aims to investigate the prevalence of clinical depression and its associ-
ated factors among adult inmates in a Malaysian Prison. Clinical depression
was assessed using Patients Health Questionnaire-9 (PHQ-9). Of the total
301 inmate participants, 127 (42.2%) had clinical depression. The associated
factors include male gender, violent offense, and lower social support from
friends. The ndings may inform early intervention to prevent clinical
depression among inmates.
Keywords
gender, depression, social support, prison, violent offense
Introduction
Prison functions to protect the public and provide punishment, deter-
rence, rehabilitation, and resocialization of the offender. According to
1
Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
2
Univesiti Utara Kedah, Sintok, Kedah, Malaysia
Corresponding Author:
Salmi Razali, Universiti Teknologi MARA, Selangor Branch, Sungai Buloh Campus, Jalan Hospital,
47000, Sungai Buloh, Selangor, Malaysia.
Email: drsalmi@uitm.edu.my
Article
The Prison Journal
2022, Vol. 102(5) 586609
© 2022 SAGE Publications
Article reuse guidelines:
sagepub.com/journals-permissions
DOI: 10.1177/00328855221121114
journals.sagepub.com/home/tpj
the World Prison Population data on 233 prison systems published by the
United States Department of Justice National Institute of Corrections,
prison populations have increased over the past decade and are estimated
to be over 10 million. The surge in the number of inmates may predispose
them to various medical diseases (such as HIV/AIDS, sexually transmit-
ted illnesses (STIs), tuberculosis, and viral hepatitis) as well as psycho-
logical disturbances (such as substance abuse, depression, anxiety,
suicide, and violence). Deterioration of physical conditions and mental
health issues as a result of the loss of autonomy, living in incapacitation,
being marginalized, and victimization can hamper the process of rehabil-
itation, resocialization, and later, re-entrance to community difcult (Jack
et al., 2018).
In spite of available evidence-based treatments for mental illness, a
meta-analysis of 42 publications between 1978 and 2015 observed a
pooled increase in the prevalence of mental illnesses globally (Richter
et al., 2019). According to a systematic review of psychiatric illnesses
among inmates by Fazel, Hayes, et al. (2016), the incidence is elevated
among inmates compared to the general population. The gure is higher
in lower-income and middle-income countries (LMIC) with difculty pro-
viding adequate access to services due to economic disadvantages (Gureje
& Abdulmalik, 2019). However, data on mental health problems among
inmates in LMIC are scarce, although 70% of the population are from
these regions (Gureje & Abdulmalik, 2019; Jack et al., 2018; Khamis,
2020).
Depression is one of the most prevalent psychiatric illnesses, with an esti-
mated over 300 million people suffering from depression worldwide(World
Health Organization [WHO], 2017). In prison, the pooled prevalence
among inmates from 2001 to 2009 is between 35% and 38%, which is
higher than the general population (Bedaso et al., 2020). Inmatesdepression
can lead to various complications, including violence, physical and sexual
victimization, near-lethal self-harm (Fazel, Hayes, et al. 2016), and suicide
(Vos et al., 2017). Every year, according to a systematic review of 35 inde-
pendent studies from 20 countries that collected data from 663,735 prisoners,
56% male and 2024% female inmates were reported to have suicidal and
self-harm behaviors (Favril et al., 2020). Among signicant associations
with self-harm in prison is a current psychiatric diagnoses, including depres-
sion (Favril et al., 2020).
In Malaysia, there are 38 prisons, and the headquarter is located at Kajang
Prison Complex(Prison Department Malaysia, 2021). The local prison popu-
lation saw a steady increase over the years, with 74,000 inmates, or 230 per
100 000 population, in 2019 (Walmsley, 2018). The local prison governance
Yaacob et al. 587

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