by Jason Bantjes
In South Africa (SA) approximately 37% of deaths in prison are due to suicide, making suicide the primary cause of unnatural death. Estimates suggest that the prevalence rate for suicide in SA prisons is 52 per 100,000, more than four times higher than the national suicide rate. A number of factors contribute to high rates of suicides in SA prisons, including endemic psychopathology, substance use, and violence. There are also a number of systemic factors which make SA prisons conducive to suicide, including overcrowding and under-staffing, the easy availability of substances, inadequate access to mental health care, and rampant gangsterism.
In 2015, a total of 161,984 offenders were housed within facilities equipped for 119,134. Offenders are sometimes forced to share beds and there are insufficient bathroom facilities, inadequate supplies of toilet paper and soap, poor ventilation, and inadequately prepared food. Overcrowding also leads to a lack of rehabilitation programmes, and extremely limited recreational or work opportunities, which contributes to feelings of boredom, hopelessness, and being trapped. Living under these circumstances is associated with elevated levels of psychological stress, psychiatric illness, interpersonal violence, physical assault and sexual abuse.
Prison gangs in SA are responsible for bullying, violence, sexual assault, lawlessness, and supplying substances to offenders. A Commission of Inquiry in 2006 reported that sexual abuse and forced sexual activities occur regularly in all SA prisons and are perpetrated mainly by prison gangs. Approximately 70%–80% of all awaiting-trial prisoners are sodomised before they are officially charged.
The legal framework is already in place to make SA prisons more human environments. The country subscribes to the retribution and safe custody objectives for imprisonment. The country’s constitution affirms offenders’ right to life, privacy, equal protection, and dignity. Legislation requires the state to provide for safe custody of prisoners under conditions of human dignity. However it would seem that the state is falling woefully short of its constitutional obligation to ensure that correctional centres are safe environments which protect human dignity, safeguard lives, and promote rehabilitation.
Relevant related publications:
Bantjes, J., Swartz, L., & Niewoudt, P. (2017). Human rights and mental health in post-apartheid South Africa: lessons from health care professionals working with suicidal inmates in the prison system. BMC International Health and Human Rights, 17(1), 29. https://doi.org/10.1186/s12914-017-0136-0
Nieuwoudt, P. & Bantjes, J. (in press). Health professionals talk about the challenges of suicide prevention in two correctional centres in South Africa. South African Journal of Psychology. https://doi.org/10.1177/0081246318758803
Bantjes, J. (2017). “Don't push me aside, Doctor”: Suicide attempters talk about their support needs, service delivery and suicide prevention in South Africa. Health Psychology Open, 4(2). https://doi.org/10.1177/2055102917726202
Goldstone, D. & Bantjes, J. (in press). Mental health care providers talk about their experiences preventing suicide in people with substance use disorders in South Africa: Implications for clinical practice. International Journal of Psychiatry in Clinical Practice. https://doi.org/10.1080/13651501.2018.1438628
Bantjes, J., Swartz, L., & Cembi, S. (2018). “Our lifestyle is a mix-match”: Traditional healers talk about suicide and suicide prevention in South Africa. Transcultural Psychiatry, 5(1), 73-93. https://doi.org/10.1177/1363461517722065
Goldstone, D., & Bantjes, J. (2017). Mental health care providers’ perceptions of the barriers to suicide prevention amongst people with substance use disorders in South Africa: a qualitative study. International Journal of Mental Health Systems, 11(1), 46. https://doi.org/10.1186/s13033-017-0153-3
Bantjes, J., & Swartz, L. (2017). The cultural turn in critical suicidology: What can we claim and what do we know? Death Studies, 4(8). 512-520. https://doi.org/10.1080/07481187.2017.1333355
Prisons in South Africa
Approximately 160,000 people are imprisoned in South Africa, giving a prison population rate of 280 per 100,000 of national population. About one quarter of imprisoned people are pre-trial detainees and only 2.6% are women. For more on South African prisons see http://www.prisonstudies.org/country/south-africa