International Journal of Prisoner Health

Van Hout, Marie Claire; Mhango, Victor; Kaima, Ruth; Bigland, Charlotte; Mariniello, Triestino

2023 International Journal of Prisoner Health

doi: 10.1108/ijph-10-2021-0108pmid: 35294830

The first case of COVID-19 in the Malawi prison system was reported in July 2020. Human rights organisations raised concerns about the possibility of significant COVID-19 outbreaks and deaths in the prison system, because of the poor infrastructure, lack of healthcare and adequate COVID-19 mitigation measures, existing co-morbidities (tuberculosis, HIV and hepatitis C), malnutrition and poor health of many prisoners.Design/methodology/approachThe authors conducted a legal-realist assessment of the Malawian prison system response to COVID-19 during state disaster measures, with a specific focus on the right to health and standards of healthcare as mandated in international, African and domestic law.FindingsThe Malawi prison system was relatively successful in preventing serious COVID-19 outbreaks in its prisons, despite the lack of resources and the ad hoc reactive approach adopted. Whilst the Malawi national COVID plan was aligned to international and regional protocols, the combination of infrastructural deficits (clinical staff and medical provisions) and poor conditions of detention (congestion, lack of ventilation, hygiene and sanitation) were conducive to poor health and the spread of communicable disease. The state of disaster declared by the Malawi Government and visitation restrictions at prisons worsened prison conditions for those working and living there.Originality/valueIn sub-Saharan Africa, there is limited capacity of prisons to adequately respond to COVID-19. This is the first legal-realist assessment of the Malawian prison system approach to tackling COVID-19, and it contributes to a growing evidence of human rights-based investigations into COVID-19 responses in African prisons (Ethiopia, South Africa and Zimbabwe).

Van Hout, Marie Claire; Bigland, Charlotte; Mariniello, Triestino

2023 International Journal of Prisoner Health

doi: 10.1108/ijph-10-2021-0104pmid: 35439405

The first prison system case in Zimbabwe was notified in July 2020 shortly after State declaration of disaster. A legal-realist assessment was conducted of the Zimbabwean correctional system response to COVID-19 during state disaster measures, with a focus on assessing right to health, infectious disease mitigation and the extent to which minimum state obligations complied with human and health rights standards.Design/methodology/approachThe Zimbabwean correctional system operations during COVID-19 disaster measures are scrutinized using a range of international, African and domestic human rights instruments in relation to the right to health of prisoners. This study focused particularly on standards of care, environmental conditions of detention and right of access to health care.FindingsSystemic poor standards of detention are observed, where prisoners experience power outages, water shortages and a lack of access to clean drinking water and water for ablution purposes, a severe lack of safe space and adequate ventilation, poor quality food and malnutrition and a lack of sufficient supply of food, medicines, clothing and bedding. Whilst access to health care of prisoners in Zimbabwe has greatly improved in recent times, the standard of care was severely stretched during COVID-19 due to lack of government resourcing and reliance on non-governmental organisation and faith-based organisations to support demand for personal protective equipment, disinfection products and medicines.Originality/valuePrison conditions in Zimbabwe are conducive to chronic ill health and the spread of many transmissible diseases, not limited to COVID-19. The developed legal-realist account considers whether Zimbabwe had a culture of respect for the rule of law pertinent to human and health rights of those detained during COVID-19 disaster measures, and whether minimum standards of care were upheld.

Kwan, Ada; Sklar, Rachel; Cameron, Drew B.; Schell, Robert C.; Bertozzi, Stefano M.; McCoy, Sandra I.; Williams, Brie; Sears, David A.

2023 International Journal of Prisoner Health

doi: 10.1108/ijph-12-2021-0116pmid: 35678718

This study aims to characterize the June 2020 COVID-19 outbreak at San Quentin California State Prison and to describe what made San Quentin so vulnerable to uncontrolled transmission.Design/methodology/approachSince its onset, the COVID-19 pandemic has exposed and exacerbated the profound health harms of carceral settings, such that nearly half of state prisons reported COVID-19 infection rates that were four or more times (and up to 15 times) the rate found in the state’s general population. Thus, addressing the public health crises and inequities of carceral settings during a respiratory pandemic requires analyzing the myriad factors shaping them. In this study, we reported observations and findings from environmental risk assessments during visits to San Quentin California State Prison. We complemented our assessments with analyses of administrative data.FindingsFor future respiratory pathogens that cannot be prevented with effective vaccines, this study argues that outbreaks will no doubt occur again without robust implementation of additional levels of preparedness – improved ventilation, air filtration, decarceration with emergency evacuation planning – alongside addressing the vulnerabilities of carceral settings themselves.Originality/valueThis study addresses two critical aspects that are insufficiently covered in the literature: how to prepare processes to safely implement emergency epidemic measures when needed, such as potential evacuation, and how to address unique challenges throughout an evolving pandemic for each carceral setting.

Robinson, Martin; Templeton, Michelle; Kelly, Carmel; Grant, David; Buston, Katie; Hunt, Kate; Lohan, Maria

2023 International Journal of Prisoner Health

doi: 10.1108/ijph-02-2022-0008pmid: 35833902

Young incarcerated male offenders are at risk of poorer sexual health, adolescent parenthood and lack opportunities for formative relationship and sexuality education (RSE) as well as positive male role models. The purpose of this paper is to report the process of co-production and feasibility testing of a novel, gender-transformative RSE programme with young male offenders to encourage positive healthy relationships, gender equality, and future positive fatherhood.Design/methodology/approachUsing a rights-based participatory approach, the authors co-produced an RSE programme with young offenders and service providers at two UK prison sites using a sequential research design of: needs analysis, co-production and a feasibility pilot. Core components of the programme are grounded in evidence-based RSE, gender-transformative and behaviour change theory.FindingsA needs analysis highlighted the men’s interest in RSE along with the appeal of film drama and peer-group-based activities. In the co-production stage, scripts were developed with the young men to generate tailored film dramas and associated activities. This co-production led to “If I Were a Dad”, an eight-week programme comprising short films and activities addressing masculinities, relationships, sexual health and future fatherhood. A feasibility pilot of the programme demonstrated acceptability and feasibility of delivery in two prison sites. The programme warrants further implementation and evaluation studies.Originality/valueThe contribution of this paper is the generation of an evidence-based, user-informed, gender-transformative programme designed to promote SRHR of young male offenders to foster positive sexual and reproductive health and well-being in their own lives and that of their partners and (future) children.

Perrett, Stephanie E.; Craddock, Christie; Dunseath, Gareth; Shankar, Giri; Luzio, Stephen; Gray, Benjamin J.

2023 International Journal of Prisoner Health

doi: 10.1108/ijph-02-2022-0012pmid: 35687323

Smoking rates are known to be higher amongst those committed to prison than the general population. Those in prison suffer from high rates of comorbidities that are likely to increase their risk of cardiovascular disease (CVD), making it more difficult to manage. In 2016, a tobacco ban began to be implemented across prisons in England and Wales, UK. This study aims to measure the effect of the tobacco ban on predicted cardiovascular risk for those quitting smoking on admission to prison.Design/methodology/approachUsing data from a prevalence study of CVD in prisons, the authors have assessed the effect of the tobacco ban on cardiovascular risk, using predicted age to CVD event, ten-year CVD risk and heart age, for those who previously smoked and gave up on admission to prison.FindingsThe results demonstrate measurable health gains across all age groups with the greatest gains found in those aged 50 years and older and who had been heavy smokers. Quitting smoking on admission to prison led to a reduced heart age of between two and seven years for all participants.Originality/valueThe data supports tobacco bans in prisons as a public health measure to reduce risk of CVD. Interventions are needed to encourage maintenance of smoking cessation on release from prison for the full health benefits to be realised.

Mommaerts, Katherine; Lopez, Nanette V.; Camplain, Carolyn; Keene, Chesleigh; Hale, Ashley Marie; Camplain, Ricky

2023 International Journal of Prisoner Health

doi: 10.1108/ijph-02-2022-0009pmid: 35916664

Using a seven-day cycle menu and commissary items at a rural county jail, this study aims to describe provisions of micronutrients known to be associated with mental health disorders and if they meet dietary guidelines.Design/methodology/approachThe nutritional content of a seven-day cycle menu and four available commissary food packs were evaluated using NutritionCalc® Plus software (McGraw-Hill Education version 5.0.19) and compared to Dietary Reference Intakes (DRI).FindingsMenu mean values of Vitamin B6, Vitamin B12, Vitamin C and zinc met DRI recommendations. However, Vitamin D (for men and women), magnesium (for men only) and omega-3s (for men only) did not meet the DRI recommendations.Originality/valueAs deficits of Vitamin D, magnesium and omega-3s are known to exacerbate bipolar disorder, anxiety and depression, small changes to food would increase the offerings and potential intake of nutrients that may improve mental health.

Garro, Maria; Schirinzi, Massimiliano; Novara, Cinzia; Ayllon Alonso, Elena

2023 International Journal of Prisoner Health

doi: 10.1108/ijph-01-2022-0004pmid: 35938934

This study aims to highlight how easy it is for immigrants to break Italian law because of the country’s inadequate cultural and linguistic mediation service. Insufficiencies in this service also have a negative impact on both the psychological and physical health of migrant prisoners. Furthermore, Italian is used in legal disputes and prison, and reference is made to Italian culture, preventing migrants from understanding their position regarding the law.Design/methodology/approachThis report concerns the psychological discomfort of migrant incarcerated individuals within Italian prisons due to national laws in force. Consideration is also given to the negative impact on the physical health of incarcerated migrants.FindingsBest practice should include adequate space for linguistic and cultural mediation in reception centres and prisons. It is considered suitable to combat social exclusion, even in prison.Research limitations/implicationsThe report is not research on prisoners, but it focuses on making visible the condition of migrant individuals incarcerated in Italy.Social implicationsEnforced isolation does not allow immigrants to become a community resource but has negative repercussions in terms of financial, social and well-being costs.Originality/valueThis paper is one of few in limited, national or otherwise scientific output, to contribute to migrant inmate visibility in Italy. Taking action for the well-being of migrant prisoners will not only have a positive impact on a social level but should also help reintegrate these individuals after serving their sentence.

Skowroński, Bartłomiej; Talik, Elżbieta

2023 International Journal of Prisoner Health

doi: 10.1108/ijph-10-2021-0102pmid: 36156461

Penal institutions affect their inmates’ mental as well as physical health. Prisoners have higher rates of physical health conditions than the public. While it is known that psychosocial factors determine patients’ quality of life, little research has focused on factors related to prisoners’ psychophysical quality of life (PQoL). The purpose of this study is to analyze the determinants of prisoners’ PQoL.Design/methodology/approachThe sample consisted of 390 prisoners recruited from correctional facilities administered by the Warsaw District Inspectorate of Prisons. This study hypothesized that social support, coherence and self-efficacy would be positive determinants of PQoL and that depression, anxiety and anger would be its negative determinants. The collected data were analyzed by means of structural equation modeling.FindingsThe positive determinants of PQoL in prisoners are coherence, self-efficacy and social support. The negative determinant of PQoL is trait depression.Originality/valueThis study has revealed a list of factors significant for improving prisoners’ PQoL. Factors have also indicated which of the predictors measured are the most significant. The identified set of significant factors should be taken into account in social rehabilitation programs for prisoners as contributing to the preservation of life and health.

Gétaz, Laurent; Wolff, Hans; Gonçalves, Leonel; Togni, Giuseppe; Stringhini, Silvia; Chacowry Pala, Komal; Iten, Anne; Guessous, Idris; Kaiser, Laurent; Chappuis, Francois; Baggio, Stéphanie

2023 International Journal of Prisoner Health

doi: 10.1108/ijph-01-2022-0002pmid: 36269138

Prisons can be epicentres of infectious diseases. However, empirical evidence on the impact of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in prison is still scarce. This study aims to estimate the seroprevalence rates of anti-SARS-CoV-2 in the largest and most crowded Swiss prison and compare them with the seroprevalence rate in the general population.Design/methodology/approachA cross-sectional study was conducted in June 2020, one month after the first wave of SARS-CoV-2 in Switzerland. Groups included: people living in detention (PLDs) detained before the beginning of the pandemic (n = 116), PLDs incarcerated after the beginning of the pandemic (n = 61), prison staff and prison healthcare workers (n = 227) and a sample from the general population in the same time period (n = 3,404). The authors assessed anti-SARS-CoV-2 IgG antibodies.FindingsPLDs who were incarcerated before the beginning of the pandemic had a significantly lower seroprevalence rate [0.9%, confidence interval (CI)95%: 0.1%–5.9%] compared to the general population (6.3%, CI 95%: 5.6–7.3%) (p = 0.041). The differences between PLDs who were incarcerated before and other groups were marginally significant (PLDs incarcerated after the beginning of the pandemic: 6.6%, CI 95%: 2.5%–16.6%, p = 0.063; prison staff CI 95%: 4.8%, 2.7%–8.6%, p = 0.093). The seroprevalence of prison staff was only slightly and non-significantly lower than that of the general population.Originality/valueDuring the first wave, despite overcrowding and interaction with the community, the prison was not a hotspot of SARS-CoV-2 infection. Preventive measures probably helped avoiding clusters of infection. The authors suggest that preventive measures that impact social welfare could be relaxed when overall circulation in the community is low to prevent the negative impact of isolation.

Moodley, Janice Kathleen; Parry, Bianca Rochelle; Van Hout, Marie Claire

2023 International Journal of Prisoner Health

doi: 10.1108/ijph-05-2022-0033pmid: 36269124

The menstrual health and menstrual hygiene management (MHM) of incarcerated women remains relatively low on the agenda of public health interventions globally, widening the inequitable access of incarcerated women to safe and readily available menstrual health products (MHP). The COVID-19 pandemic has adversely impacted on the MHM gains made in various development sectors in the global North and South, through its amplification of vulnerability for already at-risk populations. This is especially significant to developing countries such as South Africa where the incarcerated female population are an often-forgotten minority.Design/methodology/approachThis viewpoint highlights the ignominious silence of research and policy attention within the South African carceral context in addressing MHM. The ethical and political implications of such silences are unpacked by reviewing international and local literature that confront issues of inequality and equitable access to MHP and MHM resources within incarcerated contexts.FindingsStructural inequalities in various contexts around the world have exacerbated COVID-19 and MHM. Within the prison context in South Africa, women face multiple layers of discrimination and punishment that draw attention to the historical discourses of correctional facilities as a site of surveillance and discipline.Research limitations/implicationsThis study acknowledges that while this viewpoint is essential in rising awareness about gaps in literature, it is not empirical in nature.Practical implicationsThe authors believe that this viewpoint is essential in raising critical awareness on MHM in carceral facilities in South Africa. The authors hope to use this publication as the theoretical argument to pursue empirical research on MHM within carceral facilities in South Africa. The authors hope that this publication would provide the context for international and local funders, to assist in the empirical research, which aims to roll out sustainable MHP to incarcerated women in South Africa.Social implicationsThe authors believe that this viewpoint is the starting point in accelerating the roll out of sustainable MHP to incarcerated females in South Africa. These are females who are on the periphery of society that are in need of practical interventions. Publishing this viewpoint would provide the team with the credibility to apply for international and national funding to roll out sustainable solutions.Originality/valueIt is hoped that the gaps in literature and nodes for social and human rights activism highlighted within this viewpoint establish the need for further participatory research, human rights advocacy and informed civic engagement to ensure the voices of these women and their basic human rights are upheld.

Browne, Christie; Chemjong, Prabin; Korobanova, Daria; Jang, Seyoung; Yee, Natalia; Marr, Carey; Rae, Natasha; Ma, Trevor; Spencer, Sarah-Jane; Dean, Kimberlie

2023 International Journal of Prisoner Health

doi: 10.1108/ijph-12-2021-0115pmid: 36422644

Rates of self-harm are elevated in prison, and there is limited evidence to support the efficacy of brief risk screening at reception to predict and prevent self-harm. This study aims to examine the predictive validity of the self-harm/suicide screening items embedded in a prison mental health screening tool from two key domains strongly associated with risk: previous suicidal/self-harm behaviour, and recent ideation.Design/methodology/approachA sample of men and women were screened on entry to prison, with eight screening items covering the two key domains of risk. Follow-up data on self-harm incidents were collected for 12 months post-screening. The predictive validity of individual screening items, item combinations and cumulative screening score was examined for the overall sample and for men and women separately.FindingsIndividual screening items across the two domains were all strongly associated with self-harm in the follow-up period, with odds ratios varying from 2.34 to 9.24. The predictive validity of both individual items, item scores and item combinations demonstrated high specificity but low to moderate sensitivity, and modest area under the curves (AUCs). Predictive validity was generally better for men than women; however, differences were not statistically significant.Practical implicationsIdentifying those at risk of self-harm in prisons remains challenging and brief universal screening at prison entry should be only one component of a broader prison risk assessment and management strategy.Originality/valueTo the best of the authors’ knowledge, this study is one of very few to prospectively examine self-harm behaviour following risk screening. Predictive validity was examined in a representative sample of individuals in custody, and for men and women separately.

Freese, Rebekah A.; Canada, Kelli E.; Nichols, Pagena M.; McNamara, Brianna

2023 International Journal of Prisoner Health

doi: 10.1108/ijph-02-2022-0011pmid: 36449448

Suicide prevention and intervention in prisons is a challenge. Prisons were not designed to be clinical facilities, yet with the growing numbers of people who face mental health challenges in prisons, staff require knowledge and skills to adequately address mental health crises, especially suicide. This study aims to: describe trends in suicide attempts and completions within one state’s prison system and measure staff knowledge and preparedness to address suicide.Design/methodology/approachThis research uses a nonexperimental research design and two data sources. Administrative data from 2000 to 2017 on serious suicide attempts and completions were analyzed, and all correctional staff employed in the state’s Department of Corrections were surveyed at one point in time. Univariate and bivariate analyses were conducted.FindingsThe number of serious suicide attempts trended up but completed suicides decreased. Correctional staff demonstrated high suicide knowledge of risk factors and warning signs of suicide. Staff who viewed a media-based suicide training displayed significantly more knowledge of suicide and perceived greater preparedness compared to staff who did not or did not recall viewing the training.Originality/valueCorrections staff play a key role in preventing suicides in prison. Innovative intervention is needed to increase suicide awareness, improve communication and enhance prevention skills.

Zaara, Mohamed Amine; Ben Khelil, Mehdi; Bellali, Mohamed; Gharbaoui, Meriem; Kort, Ikram; Banasr, Ahmed; Zhioua, Mongi; Hamdoun, Moncef

2023 International Journal of Prisoner Health

doi: 10.1108/ijph-02-2022-0015

This study aims to analyze the pattern of deaths in detention in Northern Tunisia as well as the causes of death.Design/methodology/approachThe authors conducted a cross-sectional retrospective study including all the casualties of death in detention examined in the legal medicine Department in the main teaching hospital from 2005 to 2019. The department covers 10 out of the 11 governorates of Northern Tunisia and 13 prisons.FindingsOf a total of 197 casualties, only 2 were females. The mean age was 45.39 ± 14.43 years. A known medical history was reported in 63.5%, mainly cardiovascular disease, mental health disorders and diabetes. Half of the deaths occurred at the hospital. A total of 53 victims spent less than one year in custody before their death. Most deaths occurred due to disease-related causes (78.7%; n = 155); among these, 69 victims died from cardiovascular disease. Suicide accounted for 3.6% of the casualties and homicides for four cases.Research limitations/implicationsSeveral missing data regarding the details of the detention circumstances as well as the absence in some cases of the toxicological and histopathology analysis results, which could bias the study findings.Practical implicationsDeath in detention in Northern Tunisia involved mainly males between their 30s and their 50s who died mainly from cardiovascular or pulmonary disease. These results underscore the importance of empowering the penitentiary health system.Originality/valueTo the best of the authors’ knowledge, this study is one of largest studies with regard to the number of decedents and the number of prisons from the Arab countries allowing to draw a pattern of casualties of death in prison.

Munkholm, Mathilde Carøe

2023 International Journal of Prisoner Health

doi: 10.1108/ijph-03-2022-0018pmid: 36512415

This paper aims to report findings about how prisoners experience and cope with COVID-19 restrictions, which can contribute to an understanding of how pandemic responses, and specifically the COVID-19 response, affect prisoners.Design/methodology/approachData was collected through ethnographic fieldwork involving days of observations (N = 24) and the conduction of semi-structured interviews with prisoners (N = 30) in closed prisons and detentions in Denmark between May and December 2021. The transcribed interviews and field notes were processed and coded by using the software programme NVivo.FindingsThe data analysis reveals that the pains of imprisonment have been exacerbated to people incarcerated during the COVID-19 pandemic. To relieve pains of imprisonment, prisoners turn to censoriousness as an informal coping strategy, where they complain about inconsistency and injustice in the prison’s COVID-19 prevention strategy to reveal the prison system itself as a rule-breaking institution. The prisoners criticise the prison management for using COVID-19 as an excuse, treating prisoners unjustly or not upholding the COVID-19 rules and human rights. Furthermore, principles of justice and equality are also alleged by some prisoners who contemplate the difficulty in treating all prisoners the same.Research limitations/implicationsMore research will be needed to create a full picture of how prisoners cope with pandemic responses. Further research could include interviews with people working inside prisons.Originality/valueIn a Scandinavian context, to the best of the author’s knowledge, this study is the first of its kind to apply an ethnographic approach in exploring prison life during the COVID-19 pandemic.

Park, Hyejin; Linthwaite, Blake; Dussault, Camille; Halavrezos, Alexandros; Chalifoux, Sylvie; Sherman, Jessica; Del Balso, Lina; Buxton, Jane A.; Cox, Joseph; Kronfli, Nadine

2023 International Journal of Prisoner Health

doi: 10.1108/ijph-06-2022-0038pmid: 36519779

People who use drugs (PWUD) have been disproportionately affected by the COVID-19 pandemic. This study aims to examine changes in illicit opioid use and related factors among incarcerated PWUD in Quebec, Canada, during the pandemic.Design/methodology/approachThe authors conducted an observational, cross-sectional study in three Quebec provincial prisons. Participants completed self-administered questionnaires. The primary outcome, “changes in illicit opioid consumption,” was measured using the question “Has your consumption of opioid drugs that were not prescribed to you by a medical professional changed since March 2020?” The association of independent variables and recent changes (past six months) in opioid consumption were examined using mixed-effects Poisson regression models with robust standard errors. Crude and adjusted risk ratios with 95% confidence intervals (95% CIs) were calculated.FindingsA total of 123 participants (median age 37, 76% White) were included from January 19 to September 15, 2021. The majority (72; 59%) reported decreased illicit opioid consumption since March 2020. Individuals over 40 were 11% less likely (95% CI 14–8 vs 18–39) to report a decrease, while those living with others and with a history of opioid overdose were 30% (95% CI 9–55 vs living alone) and 9% (95% CI 0–18 vs not) more likely to report decreased illicit opioid consumption since March 2020, respectively.Originality/valueThe authors identified possible factors associated with changes in illicit opioid consumption among incarcerated PWUD in Quebec. Irrespective of opioid consumption patterns, increased access to opioid agonist therapy and enhanced discharge planning for incarcerated PWUD are recommended to mitigate the harms from opioids and other drugs.

Al-kassab-Córdova, Ali; Silva-Perez, Claudia; Quevedo-Ramirez, Andres; Mendoza Lugo, Marco Gonzalo; Azcarruz-Asencios, Jonathan; Castañeda-Montenegro, Giancarlo; Bravo-Cucci, Sergio; Maguina, Jorge L.

2023 International Journal of Prisoner Health

doi: 10.1108/ijph-03-2022-0025pmid: 36573688

Depression has become a major health concern, particularly in developing countries. This disorder is highly prevalent among certain vulnerable populations, such as prisoners. In Peru, prisons are overcrowded, and the health of prisoners is neglected. Thus, this study aims to estimate the prevalence of depression diagnosed during incarceration in male inmates from all Peruvian prisons and assess its associated factors.Design/methodology/approachA cross-sectional study was conducted based on the secondary data analysis of the National Census of Prison Population 2016 in Peru. This study included records of prisoners who reported whether they were diagnosed with depression by a health-care professional after admission into the prisons. Descriptive, bivariate and multivariable analyses were performed.FindingsOf the 63,312 prisoners included in this study, 1,007 reported an in-prison diagnosis of depression by a health-care professional, which represents a prevalence of 1.59%. Substance use disorder (adjusted prevalence ratio [aPR] 3.10; 95% confidence interval [CI]: 1.91–5.03), hypertension (aPR 7.20; 95% CI: 6.28–8.24) and previous discrimination (aPR 1.97; 95% CI: 1.62–2.40) were strongly associated with depression, even when adjusting for multiple confounders. Other directly associated variables were, for example, violence during childhood, infrequent visits in prison and diabetes.Originality/valueThe right of prisoners to adequate health care is being neglected in Peru. Mental health is a cornerstone of health quality. Acknowledging which factors are associated with depression in prison is important to implement strategies to improve the mental health of prisoners.