DSpace Repository :: Browsing by Author "Rozas, Enzo"

Browsing by Author "Rozas, Enzo"

Now showing 1 - 5 of 5

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, Stefan
Background: 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.
Incidence of all-cause mortality in prisons: research protocol for a global registry study and systematic literature review with meta-regression analyses
(2025) Mundt, Adrian; Rozas, Enzo; Asencio, Benjamín; Morales, Antonio; Cifuentes, Pablo; Alvarado, Sofia; Baranyi, Gergő; Borschmann, Rohan; Faze, Seena; Kinne, Stuart
Introduction: People in prison experience disproportionate health burdens compared with community-based populations, including elevated rates of infectious and non-communicable diseases, mental illness and substance use disorders. Previous studies have consistently shown increased rates of mortality following release from incarceration, particularly from external (unnatural) causes such as suicide and violence. However, evidence on mortality incidence during imprisonment is scarce, and many deaths may be preventable through targeted health and prevention interventions. This study aims to synthesise worldwide evidence on all-cause mortality incidence in prisons. Methods and analysis: We will conduct a worldwide registry study combined with a systematic literature review and meta-regression analysis. Eligible sources will report deaths among incarcerated people between 2005 and 2025 at the national or, where more appropriate, the subnational jurisdictional level. Mortality data will be retrieved from official reports of prison administrations and direct contact with prison authorities. Also, data from international databases and the scientific literature will be reviewed. Incidence rates of all-cause mortality per 100 000 person-years will be calculated and reported for each jurisdiction, alongside standardised mortality ratios comparing imprisoned populations with general population estimates. Ethics and dissemination: Since the study relies on anonymised routine data registries available from different sources, an exemption certificate was granted by the Ethics Committee of Diego Portales University (UDP) in Santiago, Chile. Findings will be submitted for publication in a peer-reviewed academic journal.
Indicators of psychiatric institutionalization in Southeast Asia between 1990 and 2024
(2025) Mundt, Adrian; Arafat, S. M. Yasir; Dorji, Chencho; Desousa, Avinash; Chadda, Rakesh; Gowda, Guru; Orus, Cristian; Kesavan, Muralidharan; Ibrahim, Athifa; Luitel, Nagendra; Gambheera, Harischandra; Kittirattanapaiboon, Phunnapa; Priebe, Stefan; Rozas, Enzo
Background: This study aimed to assess indicators of psychiatric institutionalization and their changes over time across the Southeast Asia Region (SEAR). Methods: We collected numbers of psychiatric beds, specialized forensic psychiatric beds, beds in residential facilities for people living with chronic mental illness and prison populations in the 11 SEAR member states between 1990 and 2024 using primary and secondary data sources. We calculated median rates per 100,000 population, as well as percent changes of the median rates between the first and last available data points. We also compared findings in SEAR with OECD countries. Findings: Psychiatric bed numbers and prison population were available from 10 countries. Bed prevalence increased in seven countries, but decreased in three. The median psychiatric bed prevalence was 1.5 at the first and 2.9 per 100,000 population at the last data point (+94%). The prison population increased in nine countries, with the median rate changing from 60 to 123 (+106%). Data on specialized forensic psychiatric beds were available from seven countries, with a range of 0.0-0.5 beds at the last data point. Based on data from five countries, the median prevalence of beds in residential facilities increased from 1.3 to 2.3. Psychiatric bed prevalence was on average about 5% of that in the OECD, while prison population rates were similar to those in OECD countries. Interpretation: Psychiatric bed provision in the SEAR is among the lowest worldwide. In contrast, incarceration rates are similar to those in high-income regions. Most countries have increased the prevalence of psychiatric beds over the past three decades, but they remain scarce, and further investments need consideration. Funding: Agencia Nacional de Investigación y Desarrollo (ANID), Chile.
Minimum and optimal numbers of psychiatric beds: expert consensus using a Delphi process
(2022) Mundt, Adrián; Rozas, Enzo; rarrázaval, Matías; O'Reilly, Richard; Allison, Stephen; Bastiampillai, Tarun; Musisi, Seggane; Kagee, Ashraf; Golenkov, Andrei; El-Khoury, Joseph; Park, Seon-Cheol; Chwastiak, Lydia; Priebe, Stefan
The required minimum number of psychiatric inpatient beds is highly debated and has substantial resource implications. The present study used the Delphi method to try to reach a global consensus on the minimum and optimal psychiatric bed numbers. An international board of scientific advisors nominated the Delphi panel members. In the first round, the expert panel provided responses exploring estimate ranges for a minimum to optimal numbers of psychiatric beds and three levels of shortage. In a second round, the panel reconsidered their responses using the input from the total group to achieve consensus. The Delphi panel comprised 65 experts (42% women, 54% based in low- and middle-income countries) from 40 countries in the six regions of the World Health Organization. Sixty psychiatric beds per 100 000 population were considered optimal and 30 the minimum, whilst 25-30 was regarded as mild, 15-25 as moderate, and less than 15 as severe shortage. This is the first expert consensus on minimum and optimal bed numbers involving experts from HICs and LMICs. Many high-income countries have psychiatric bed numbers that fall within the recommended range. In contrast, the number of beds in many LMIC is below the minimum recommended rate.
Need estimates of psychiatric beds: a systematic review and meta-analysis
(2024) Mundt, Adrian; Rozas, Enzo; Delhey, Sabine; Siebenförcher, Mathias; Priebe, Stefan
This 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.

Browsing by Author "Rozas, Enzo"

Results Per Page

Sort Options