Prevalence Of Psychiatric Morbidity Among Juvenile Offenders Committed To Borstal Institutions In Kenya
Introduction: Studies in several countries have repeatedly shown that young offenders have higher rates of psyiatric disorders than youth in the same community. Kenya has about 800 young offenders in the two Borstal Institutions. Youth with psychiatric disorders among those incarcerated in these Borstal Institutions, have been documented in other countries. No such study has been carried out in Kenya. A common view is that these psychiatric disorders are a result of vulnerability exacerbated by peer pressure stresses. This implies that young offenders need psychiatric care during their incarceration to reduce recidivism and improve their health. One of the recent studies (Karnik N, S et al 2009) shows that between 65% - 85% of the youth in correctionals facilities have major psychiatric diagnoses with 31% to 45% having substance use disorder. These numbers are significantly higher than those found among age-matched youths in the community. Youth with psychiatic disorders pose a challenge for the youth justice system and after release in the larger community. Objective: To establish the prevalence of psychiatric disorders among juvenile offenders committed to Borstal Institutions in Kenya. Sampling Methods: Systematic Random Sampling. Design: A Descriptive Cross-sectional Study. Study Site: Borstals in Kenya: Shimo la Tewa in Mombasa and Shikutsa in Kakamega. Study population: All juvenile male offenders who were aged between 15 – 17 years at the time of admission to the Borstal Institutions. Sample size: The study sampled 345 participants. Instruments: Mental International Neurological Interview for children/adolescent (Scheehan et al., 2008) (MINI-KID) and a Social Demographic Questionnaire. Data Analysis: The collected data was analyzed using Statistical Package for Social Science (SPSS) and presented in tables, pie charts, bar charts and narrative. Results: 345 young male offenders aged between 15 and 20 years of a mean age of 17.4 years were interviewed. Youths in single parenthood formed 53.3% and 86.4% for primary level of education while 37.1% and 32.8% respectively were in informal employment or were students before their arrest. Majority were Christians (84.1%) while 15.1% were Muslims. 3.2% of the offenders had been admitted in rehabilitation centre previously and 12.8% had been placed previously on non-custodian sentences. Two thirds of the offenders (66.7%) committed crimes against property; stealing being the most common (63.2 %). Sexual assault, an offence against persons accounted for 15.4% of the offences committed. In addition, 7.8% were offences without victim, mainly drug-related. Majority (59.7%) of the young offenders had at least one psychiatric disorder, and the disorders were mainly conduct disorder (30.4%), alcohol/substance abuse disorder (13%), PTSD (11.6%), MDD (11.3%), GAD (11.3%), and adjustment disorder (11%). Some offenders had co-morbid disorders with 16.5 % having two disorders, 9.6 % having three disorders, and 11.3 % having four or more co-morbid disorders. Conduct disorder was found to be more prevalent in youth from separated parents and those from single parents (p=0.030). Also, the youth who committed offences on property were more likely to have conduct disorders (p=0.025). Similarly, bipolar disorder was found to be significantly associated with learning of skills with the youth with the disorder being less likely to learn skills in the institution (p=0.009). Conclusions: Psychiatric disorders were highly prevalent (59.7%) among young offenders in Borstal Institutions and the most common disorders included conduct disorder, substance abuse disorder, major depression, PTSD, GAD and adjustment disorders among others. This therefore calls for screaning, assessment, and treatment of young offenders during admission, stay and while on after-care supervision. Recommendation: The presence of psychiatric disorder in Borstal Institute calls for training of law enforcement agency and equipping them with the necessary tools and developing a programme for psychological support in the borstal institution.