Using Linkage-enhancement Strategies to Bridge Treatment Gap among Inmates and Former Inmates in Correctional Settings with Inadequate Mental Health Care.

Service linkage and skill enhancement strategies were devised in Nigerian prisons with inadequate mental health resources to support the provision of psycho-legal services, including the assessments, identification, and care of inmates and former inmates with mental illness. Over the study period, 74 individuals, consisting of 64 (86.5%) males with a mean age of 33.25 (SD=11.2) years received care or psycho-legal services through these strategies. Clinically, 49% of the participants were diagnosed with schizophrenia (International Classification of Diseases, Tenth Revision (ICD-10) diagnosis code: F20.0-9), 66.7% had first formal clinical diagnosis of mental illness, and as many as 56.1% of the participants endorsed using psychoactive substances. Most participants (73.0%) were assessed and treated within the prison's general medical services with support from a multidisciplinary team from a regional psychiatric hospital. Of the 50 psycho-legal assessments conducted, eight (10.8%) and 12 (16.2%) participants were not criminally responsible and unfit to stand trial, respectively. We included an action-plan to support the implementation of collaborative care, skill-enhancement, and linkage of services as viable strategies in correctional settings with inadequate mental health care.

Correlates of depressive illness among the elderly in a mixed urban community in Lagos, Nigeria.

OBJECTIVES: Little is known about the factors associated with depression among elderly Nigerians despite research evidence suggesting that some correlates of depression may be important in early detection, treatment and prognosis. This study aimed to determine the correlates of depression among a community based elderly population. METHODS: The study population made up of 350 consenting participants was selected using multistage stratified random sampling technique. Face-to-face interviews were conducted among the participants using a research instrument consisting of two parts: a self-designed questionnaire to elicit their socio-demographic profile, level of social support as well as their health status and the 30-item Geriatric Depression Scale to diagnose depression using cut-off score ≥11. Both the English and Yoruba versions of the study instruments were used depending on the level of education of the participants. RESULTS: Depression was found to be associated with being younger old (χ(2) = 6.19, p = 0.045), prolonged stay in current residence (χ(2) = 6.62, p = 0.01), living in less developed area of the community and not having children (χ(2) = 0.03, p = 0.01), while higher social support (χ(2) = 4.19, p = 0.041) seems protective. However, only low social support (odds ratio [OR] = 0.573; 95% confidence interval [CI], 0.330-0.994; p = 0.048), living in less developed area (OR = 5.342; 95% CI = 1.027, 27.776; p = 0.046) and prolonged stay in current residence (OR = 0.407; 95% CI = 0.205, 0.806; p = 0.01) independently predicted depression in participants. CONCLUSION: To enhance early detection and treatment of depressive disorders in the elderly, physicians should be alert to the diagnosis of depression in late life, especially among the younger old, elderly not having children, those with low social support as well as prolonged stay in a residence and living in less developed parts of the community. Further research is needed to shed light on the intriguing link between depression and associated factors in geriatric population.