The management of mentally ill detainees in the correctional system : a comparative study

Abstract

There are approximately 5 million mentally ill detainees across the globe and a further 1 million who suffer from a severe mental illness. Various research has shown that the prevalence of mental illness within the corrections system is more substantive than that of the general population. On average, there is an upsurge by 1 million mentally ill detainees globally per year. Approximately all detainees detained in a correctional facility encounter depression or stress symptoms, however low rates of identification and treatment prevail. Further to this, the quality of the treatment provided to mentally ill offenders is questionable. The aim of the research study is to explore the prevalence of mental illness amongst detainees in South Africa, Nigeria, Germany, and the United States of America. The study investigates the availability of legislation in all four countries using the various international guidelines as a benchmark, the provisioning of rehabilitation programmes, and the challenges in providing rehabilitation, mental health care, and treatment to the mentally ill. Furthermore, the study sets out to ascertain whether the treatment and conditions in detention facilities meet international standards. Whilst considering that not all mentally ill offenders will need specialist psychiatric treatment, differing levels of care should be available on a continuous basis by personnel who are adequately proficient in reducing mental harm and in promoting mental health among offenders. Recommendations include the need to conduct wider-scale national studies to make for easier comparisons and for benchmarking purposes. The availability of mental health legislation in itself is not a panacea for reducing mental health illness, but having to put this into practice is of paramount importance. The corrections system is at the end of the value chain and does not have a choice of closing their doors to offenders. They therefore need to partner with various government departments (criminal justice system, social systems, education systems, and community structures amongst others), to find an integration point to share knowledge and insight into the challenges facing corrections and for the Criminal Justice System to acknowledge that severely mentally ill individuals should never be sent to corrections.

Daar is ongeveer 5 miljoen sielsieke aangehoudenes wêreldwyd en ʼn verdere 1 miljoen wat aan ʼn ernstige geestesversteuring ly. Navorsing toon dat die voorkoms van geestesversteuring in die korrektiewe stelsel meer substantief as by die algemene bevolking is. Daar is jaarliks ʼn gemiddelde styging van 1 miljoen sielsieke aangehoudenes wêreldwyd. Feitlik alle aangehoudenes in ʼn korrektiewe fasiliteit ervaar simptome van depressie of stres, maar die syfers ten opsigte van identifisering en behandeling is laag. Die gehalte van die behandeling wat sielsieke oortreders ontvang, is boonop twyfelagtig. Die oogmerk van hierdie navorsing was om die voorkoms van geestesversteuring onder aangehoudenes in Suid-Afrika, Nigerië, Duitsland en die Verenigde State van Amerika te ondersoek. Die studie het ondersoek ingestel na die beskikbaarheid van wetgewing in al vier die lande, met behulp van die verskillende internasionale riglyne as ʼn maatstaf, die voorsiening van rehabilitasieprogramme en die uitdagings wat met die voorsiening van rehabilitasie, geestesgesondheidsorg en behandeling van die geestesiekes gepaardgaan. Die studie het ook ten doel gehad om te bepaal of die behandeling en toestande in aanhoudingsfasiliteite aan internasionale standaarde voldoen. Met inagneming daarvan dat nie alle sielsieke gevangenes spesialis- psigiatriese behandeling benodig nie, moet verskillende vlakke van sorg deurlopend beskikbaar gestel word deur bekwame personeel wat oor die vermoë beskik om geesteskade te verminder en om gevangenes se geestesgesondheid te bevorder. Aanbevelings sluit die behoefte in om studies op ʼn groter skaal landswyd uit te voer vir doeleindes van makliker vergelykings en vir normstelling. Hoewel die beskikbaarheid van wetgewing oor geestesgesondheid nie opsigself ʼn wondermiddel is vir die vermindering van geestesversteuring nie, is dit uiters noodsaaklik dat die wetgewing in plek moet wees. Die korrektiewe stelsel is aan die einde van die waardeketting, dus is dit nie ʼn opsie om hul deure vir oortreders te sluit nie. Hulle moet dus met verskeie staatsdepartemente (onder andere, strafregsplegingstelsel, maatskaplike stelsels, opvoedingstelsels en gemeenskapstrukture) saamspan om ʼn integrasiepunt te vind om kennis en insig rakende die uitdagings wat die korrektiewe stelsel in die gesig staar te deel, en sodat die strafregsplegingstelsel sal erken dat individue met ernstige geestesversteurings nooit na korrektiewe fasiliteite gestuur moet word nie.

Kukhona abantu abacishe babengu 5 miliyoni abagula ngengqondo abavalelwe kuwo wonke umhlaba, kanti kukhona abanye abangu 1 miliyoni abahlushwa yisifo sengqondo. Ucwaningo lukhombise ukuthi ubukhona besifo sengqondo kwinqubo yezamajele bukhulu kakhulu ukudlula kwisizwe sonkana ngokunabile. Ngokwesilingniso, kukhona ukwenyuka kwabantu abagula ngengqondo abavalelwe abangu 1 miliyoni kuwo wonke umhlaba ngonyaka. Cishe bonke abantu abavalelwe ezindawo zamajele babanokuxineka kwengqondo noma izimpawu zingcindezi, kodwa izinga lokuphawulwa kwabo kanye nokuthola ukwelashwa liphansi. Kanti futhi okunye, iqophelo lokwelashwa elihlinzekwa abantu abonile abagula ngengqondo alilihle. Inhloso yalesi sifundo socwaningo, bekuwukuphenya ngobukhona bokugula ngengqondo kubantu abavalelwe eNingizimu Afrika, eNigeria, eGermany nase-United States of America. Ucwaningo luphenyisise ngobukhona bemithetho kuwo womane amazwe ngokusebenzisa imikhombandlela kazwelonke njenge-benchmark, ukuhlinzekwa kwezinhlelo zokwelapha kanye nezinselele ezikhona ngokuhlinzeka ngokwelapha, unakekelo lwezempilo yengqondo kanye nokwelashwa kwabagula ngengqondo. Kanti futhi okunye, ucwaningo belufuna ukuqinisekisa ukuthi ngabe ukwelashwa nezimo ezikhona ezindaweni zokuvalelwa emajele kuhlangabezana namazinga amazwe omhlaba. Ngisho noma kubonelelwa ukuthi akuyibo bonke ababoshiwe abagula ngengqondo abadinga ukwelashwa ngokwengqondo kwezinga le-psychiatric, kodwa amazinga ehlukene onakekelo, kumele atholakale ngokuqhubekela phambili okunikezwa ngabantu abanolwazi nekhono ngokufanele ekuphunguleni ukulimala kwengqondo kanye nokuqhubekisela phambili impilo yezengqondo kwababoshiwe Izincomo zibandakanya isidingo sokwenza ucwaningo olunabile kumazwe ukwenzela ukuthi kubelula ukuqhathanisa kanye nenhloso yokwenza i-benchmarking. Ubukhona bemithetho yonakekelo lwempilo yengqondo akusona isixazululo sakho konke ngokuphungula ukugula ngengqondo, kodwa ukuba nemithetho esebenzayo kubaluleke kakhulu. Inqubo yezamajele isekugcineni, kanti ayinalo ukhetho lokuvala iminyango kubantu ababoshiwe. Ngakho-ke izikhungo zababoshiwe kumele zisebenzisane neminyango ehlukene kahulumeni (inqubo yezobulingiswa yamajele, izinqubo zenhlalakahle yabantu, izinqubo zemfundo kanye nezakhiwo zemiphakathi, phakathi kokunye) ukuthola indawo ehlangene yokwabelana ngolwazi mayelana nezinselele amajele abhekane nazo kanye nenqubo yezobulungisa yamajele ukwamukela ukuthi abantu abagula kakhulu ngengqondo akumele bathunyelwe emajele.

Go na le bagolegwa ba ka bago 5 milione bao ba lwalago ka monaganong lefaseng ka bophara le ba bangwe ba 1 milione ba ba nago ba lwalago kudu ka monaganong. Dinyakisiso di bontshitse gore go ata ga malwetsi a monagano ka gare ga tshepediso ya ditshokollo go bohlokwa kudu go feta ka gare ga setshaba ka kakaretso. Ka kakaretso, go na le koketsego ya bagolegwa bao ba lwalago ka monaganong ba 1 milione lefaseng ka bophara ka ngwaga. Ba e ka bago bagolegwa ka moka bao ba golegilwego lefelong la tshokollo ba itemogela kgatelelo ya monagano goba dika tsa kgatelelo, eupsa dikelo tsa boitshupo le boitshwaro le kalafo di fase. Go feta mo, boleng bja kalafo ye e fiwago basenyi ba ba lwalago ka monaganong bo a belaetsa. Maikemisetso a dinyakisiso tse e be e le go utolla go ata ga bolwetsi bja monagano gare ga bagolegwa ka Afrika Borwa, Nigeria, Germany le United States of America. Dinyakisiso di nyakisisitse go hwetsagala ga melao dinageng ka moka tse nne go somiswa ditlhahli tsa go fapafapana tsa boditshabatshaba bjalo ka motheo, kabelo ya mananeo a tsosoloso le ditlhohlo tsa go abela tshokollo, tlhokomelo ya maphelo a monagano le kalafo go bao ba lwalago ka monaganong. Go feta moo, dinyakisiso di ile tsa ikemisetsa go netefatsa gore kalafo le maemo a dikgolego a fihlelela maemo a boditshabatshaba. Ge re ntse re nagana gore ga se bagolegwa fela ka moka bao ba lwalago ka monaganong ba tla hloka kalafo ye e kgethegilelego ya malwetsi a monagano, tlhokomelo ye e fapanego e swanetse go hwetsagala ka mo go tswelago pele ke bahlankedi ba ba nago le bokgoni bjo bo lekanego bja go fokotsa dikotsi tsa monagano le go tswetsa pele maphelo a monagano gare ga bagolegwa. Ditigelo di akaretsa tlhokego ya go dira dinyakisiso tse di tseneletsego tsa setshaba go dira dipapiso tse bonolo le bakeng sa merero ya go bea maemo. Go hwetsagala ga molao wa maphelo a monagano ka bowona ga se pheko ya go fokotsa malwetsi a mongano, eupsa go somisa molao wo ke selo se bohlokwa kudu. Tshepediso ya ditshokollo e mafelelong a tatelano ya tshepediso gomme ga e na kgetho ya go tswalelela basenyi ka ntle. Ka gona ba hloka go somisana le dikgoro tsa go fapafapana tsa mmuso (tshepediso ya toka go bosenyi, ditshepediso tsa leago, ditshepediso tsa thuto le dikarolo tsa setshaba, gare ga tse dingwe) go humana ntlha ya kopanyo go abelana tsebo le temoso ditlhohlong tse di lebanego le ditshokollo bakeng sa tshepediso ya toka go bosenyi go amogela gore batho bao ba lwalago kudu ka monaganong le gatee ga ba swanela go romelwa ditshokollong.