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Foreign National Patients in German Prison Psychiatry
- Source :
- Frontiers in Psychiatry, Vol 10 (2020)
- Publication Year :
- 2020
- Publisher :
- Frontiers Media S.A., 2020.
-
Abstract
- IntroductionOver the past few years, the share of foreign national prisoners in the European and American justice systems has increased at a disproportionately high rate, yet studies on mental health issues among this diverse group are rare. Recent research suggests a range of factors leading to mental health vulnerability in foreign national prisoners, including language barriers, isolation, cultural misunderstanding, and legal standing. Relevant findings of topic-related studies indicate that under-referral to mental health services due to missed or misinterpreted symptoms is a major risk for foreign national prisoners.AimsWe aimed to investigate the disparities regarding the percentage of foreign national patients who were treated in high-security hospitals compared to the psychiatric ward of prison hospitals—after adjusting for diagnosis, age, marital status, and substance abuse. We hypothesized that foreign national patients were underrepresented in compulsory, high-security mental health care. We also aimed to explore citizenship-related institutional disparities concerning diagnoses and self-harmful behavior.MethodFrom 2010 to 2015, data collected from high-security hospitals in the federal state of Baden-Wurttemberg and the psychiatric ward of a Berlin prison hospital was evaluated by comparing nationality, diagnosis, and self-harm using Fisher’s exact test and χ²-test. The odds ratios for citizenship-related differences in diagnosis and institution of treatment were evaluated by using logistic regression.ResultsMentally ill foreign national patients were significantly less likely to be treated in high-security hospitals rather than prison hospital psychiatry (adjusted for diagnosis, age at admission, marital status, and substance abuse; adjusted OR = 0.5). Foreign nationals and Germans in prison hospital psychiatry showed no significant disparities in diagnosis; however, in high-security hospitals, foreign nationals were more likely to have been diagnosed with schizophrenia/psychotic or neurotic/stress-related disorders and were less likely to have been diagnosed with personality disorders than German patients. Additionally, foreign nationals were more likely to commit self-harm than Germans in prison hospital psychiatry, but significant citizenship-related differences could not be verified in high-security hospital patients.ConclusionTreatment conditions of foreign national patients in prison psychiatry must be improved. To achieve this, the psychiatric assessment and (mental) health-related aspects of these patients should be further investigated.
Details
- Language :
- English
- ISSN :
- 16640640
- Volume :
- 10
- Database :
- Directory of Open Access Journals
- Journal :
- Frontiers in Psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.114652d967ba4226815ba311ba2e5578
- Document Type :
- article
- Full Text :
- https://doi.org/10.3389/fpsyt.2019.00988