Browsing by Author "Delhey, Sabine"
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Item Changes in rates of psychiatric beds and prison populations in sub-Saharan Africa from 1990 to 2020(2022) Delhey, Sabine; Mundt, Adrián; Jabulanis, Maphisa; Sourabié, Oumar; Nguendo, Blaise; Rozas, Enzo; Bukasa, Jean; H Te, Jeronimo; Bitta, Mary; Mathe, Lipalesa; Liwimbi, Olive; Fortunato, Palmira; Atilola, Olayinka; Jansen, Stefan; Diegane, Jean; Akran, Clementina; Jalloh, Abdul; Kagee, Ashraf; Van Wyk, Elizabeth; Forry, Jimmy; Liamunga, Mwiya; Chigiji, Handrick; Priebe, StefanBackground: Psychiatric bed numbers (general, forensic, and residential) and prison populations have been considered indicators of institutionalization. The present study aimed to assess changes of those indicators across sub-Saharan Africa (SSA) from 1990 to 2020. Methods: We retrospectively obtained data on psychiatric bed numbers and prison populations from 46 countries in SSA between 1990 and 2020. Mean and median rates, as well as percentage changes between first and last data points were calculated for all of SSA and for groups of countries based on income levels. Results: Primary data were retrieved from 17 out of 48 countries. Data from secondary sources were used for 29 countries. From two countries, data were unavailable. The median rate of psychiatric beds decreased from 3.0 to 2.2 per 100 000 population (median percentage change = -16.1%) between 1990 and 2020. Beds in forensic and residential facilities were nonexistent in most countries of SSA in 2020, and no trend for building those capacities was detected. The median prison population rate also decreased from 77.8 to 71.0 per 100 000 population (-7.8%). There were lower rates of psychiatric beds and prison populations in low-income and lower-middle income countries compared with upper-middle income countries. Conclusions: SSA countries showed, on average, a reduction of psychiatric bed rates from already very low levels, which may correspond to a crisis in acute psychiatric care. Psychiatric bed rates were, on average, about one twenty-fifth of countries in the Organization for Economic Co-operation and Development (OECD), while prison population rates were similar. The heterogeneity of trends among SSA countries over the last three decades indicates that developments in the region may not have been based on coordinated policies and reflects unique circumstances faced by the individual countries.Publication Need estimates of psychiatric beds: a systematic review and meta-analysis(2024) Mundt, Adrian; Rozas, Enzo; Delhey, Sabine; Siebenförcher, Mathias; Priebe, StefanThis study aimed to review and synthesize the need estimates for psychiatric beds, explore how they changed over time and compare them against the prevalence of actually existing beds. We searched PubMed, Embase classic and Embase, PsycINFO and PsycIndex, Open Grey, Google Scholar, Global Health EBSCO and Proquest Dissertations, from inception to September 13, 2022. Publications providing estimates for the required number of psychiatric inpatient beds were included. Need estimates, length of stay, and year of the estimate were extracted. Need estimates were synthesized using medians and interquartile ranges (IQRs). We also computed prevalence ratios of the need estimates and the existing bed capacities at the same time and place. Sixty-five publications with 98 estimates were identified. Estimates for bed needs were trending lower until 2000, after which they stabilized. The twenty-six most recent estimates after 2000 were submitted to data synthesis (n = 15 for beds with unspecified length of stay, n = 7 for short-stay, and n = 4 for long-stay beds). Median estimates per 100 000 population were 47 (IQR: 39 to 50) beds with unspecified length of stay, 28 (IQR: 23 to 31) beds for short-stay, and 10 (IQR: 8 to 11) for long-stay beds. The median prevalence ratio of need estimates and the actual bed prevalence was 1.8 (IQR: 1.3 to 2.3) from 2000 onwards. Historically, the need estimates for psychiatric beds have decreased until about 2000. In the past two decades, they were stable over time and consistently higher than the actual bed numbers provided.Item The prevalence of comorbid serious mental illnesses and substance use disorders in prison populations: a systematic review and meta-analysis(2022) Mundt, Adrián; Baranyi, Gergő; Fazel, Seena; Delhey, SabineSummary Background Comorbid mental illnesses and substance use disorders are associated with adverse criminal, social, and health outcomes. Yet, their burden is not reliably known among prison populations. We therefore aimed to estimate the prevalence of comorbid serious mental illnesses and substance use disorders (dual disorders) among people in prison worldwide. Methods In this systematic review and meta-analysis, we searched 15 electronic databases (ASSIA, CAB Abstracts, Criminal Justice Database, Embase, Global Health, Global Index Medicus, IBSS, MEDLINE, NCJRS, PAIS Index, PsycINFO, Russian Science Citation Index, Scielo, Social Services Abstracts, and Web of Science) and the grey literature (Open Grey and ProQuest Dissertations & Theses Global) for studies reporting the prevalence of serious mental illnesses and substance use disorders in prison populations published between Jan 1, 1980, and Sept 25, 2021, and contacted the authors of relevant studies. Empirical studies among unselected adult prison populations that applied representative sampling strategies and validated diagnostic instruments, and either reported the prevalence of dual disorders or had authors who could provide prevalence data in correspondence, were included. Two reviewers(GB and SDL) independently extracted data from the eligible studies; both current (up to 1 year) and lifetimeprevalence were extracted, if available. We sought summary estimates. Our primary outcomes were comorbid nonaffective psychosis with substance use disorders and comorbid major depression with substance use disorders. Weconducted a random-effects meta-analysis, explored between-sample heterogeneity with meta-regression, andcalculated odds ratios (ORs) to assess bidirectional relationships between mental and substance use disorders. Risk ofbias was assessed by use of a standard tool. The study protocol was registered with PROSPERO, CRD42020207301