Prevalence and Factors Associated with Depression among Prisoners in a Rural Setting in Kisii County, Kenya

Abstract

BACKGROUND Compared to the general population, mental disorders, particularly depression, are prevalent among prisoners. Depression among prisoners has been linked to individual factors such as marital status, trauma history, age, history of mental illness, gender, and education, as well as environmental factors like violence, bullying, overcrowding, duration of incarceration, and social support. Despite high depression rates, there is limited data from Kenyan prisoners, particularly in medium-security prisons. This study assessed the prevalence and factors associated with depression among prisoners at Kisii Main and Women's Prison, addressing this gap in medium-security settings.

METHODOLOGY A cross-sectional approach was utilised at Kisii Main and Women's Prisons, with 289 prisoners selected through systematic random sampling. Depression prevalence and severity were evaluated using the Patient Health Questionnaire. Bivariate and multiple logistic regression analyses were performed in STATA 15.1.

RESULTS Depression prevalence among inmates was high at 51.4%, with 51.8% in males and 50.6% in females. Among males, having chronic illness (AOR = 26.951), being bullied (AOR = 4.176), being physically violated (AOR = 22.056), and experiencing more than ten traumatic events (AOR = 15.804) increased depression risk, whereas receiving moderate (AOR = 0.238) or high (AOR = 0.043) social support decreased the risk. Among females, past drug use (AOR = 45.502) and experiencing more than ten traumatic events (AOR = 22.308) increased depression risk, while a history of alcohol use (AOR = 0.044), and receiving high social support (AOR = 0.035) decreased the risk.

CONCLUSION AND RECOMMENDATIONS There was a high burden of depression among the prisoners, for the males, physical violence, chronic illness, trauma history, social support, and bullying were significant predictors of depression, while for females, trauma history, social support, and a history of substance abuse were important factors. The high depression prevalence highlights the urgency for enacting effective prevention and intervention strategies.