Depression and Suicide in Nepalese Prisons

 
by Gambhir Shrestha
 
Nepal is a landlocked country situated in South-east Asia, with an area of 147,181 square kilometres. There are 74 jails in Nepal with two government-run juvenile reform homes. According to the Department of Prison Management, there are 19,618 people in prison in Nepal on June 2018 out of which 18,328 (93%) were males and 1290 (7%) were female. This equates to a prison population rate of 67 per 100,000 of national population. The official capacity of the prison system of Nepal is 10,608. This clearly depicts the picture of overcrowding in the prison.
 
Only one remand centre which is located in Kathmandu (Capital of Nepal) is allocated for pre-trial detainees. Usually, pre-trial detainees are accommodated in prison with convicted prisoners. Generally, male and female inmates are housed in separate blocks within the same prison. Only in Central Prison in Kathmandu, there is a fully separated compound for females. All the prisons are closed prisons.
 
In legislation, medical treatment of ill prisoners is to be done by the government doctors serving in prisons. Depending upon the number of prisoners, there is the regular doctors’ service only in some prisons. There is a prison hospital in Kathmandu. In other prisons, health assistants, auxiliary health workers and other health workers oversee the medical section. Inmates get medical treatment in other hospitals near the prison. As most of the Nepalese prisons were built long ago, they lack most of the basic facilities like living conditions, adequate food, health care, recreation, communication facilities, and access to justice, and gainful employment.
 
Like all countries in the world, Nepal also has high rate of depression among inmates in Nepal with limited access to mental health services. In a recent study done in Jhumka prison, largest male prison of eastern Nepal, the prevalence of depression among male inmates was 35.3%. The majority had poor health status, substance abuse disorders and co-morbid diseases. Half of the previously incarcerated individuals had depression symptoms. Suicidal attempt in prison was reported by 0.9%. The reasons for depression and suicides in prison are multifactorial and include the ageing population, overcrowding, lack of proper health services, substance abuse, recreational activities, violence in prison, personal feelings of guilt, lack of family support and other health problems.
 
Prisons should not be seen as dumping places for the incarcerated individuals which further degrades their health, particularly their mental health. Prisons should be taken as correctional centres where inmates’ behaviours are improved and their health conditions are addressed before release. Only if these can be achieved can the prison be regarded as a successful system because the prisoners are from the community and will return to the community. Promotion of preventive measures and availability of mental health services should be ensured to reduce depression and suicide in Nepalese prison. Measures include periodic health assessments including mental health, the provision of rehabilitation facilities, recreational activities, vocational training and employment within the prison, overcrowding management, Yoga and other form of exercises. Furthermore integration of prison services with civilian services should be the integral part of prison system.
 
Relevant publications
Shrestha G, Yadav DK, Sapkota N, Baral D, Yadav BK, Chakravartty A, Pokharel PK. Depression among inmates in a regional prison of eastern Nepal: a cross-sectional study. BMC Psychiatry 201717:348
https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-017-1514-9
 
 
Prisons in Nepal
For further information see http://www.prisonstudies.org/country/nepal

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