Medical Faculty, Universidad Diego Portales, Santiago, Chile.
Departamento de Neurología y Psiquiatría, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.
J Glob Health. 2022 Sep 3;12:04054. doi: 10.7189/jogh.12.04054.
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.
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.
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.
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.
精神科床位数量（普通、法医和住院）和囚犯人数被认为是机构化程度的指标。本研究旨在评估 1990 年至 2020 年期间撒哈拉以南非洲（SSA）这些指标的变化。
我们回顾性地获取了 1990 年至 2020 年期间 SSA 46 个国家的精神科床位数量和囚犯人数数据。计算了 SSA 所有国家以及按收入水平分组的国家的平均和中位数率以及两个数据点之间的百分比变化。
从 48 个国家中的 17 个国家获取了原始数据。从 29 个国家获得了二手数据。有两个国家的数据无法获得。1990 年至 2020 年间，精神科床位的中位数率从每 10 万人 3.0 张下降到 2.2 张（中位数百分比变化为-16.1%）。2020 年，SSA 大多数国家的法医和住院设施都没有床位，也没有发现建立这些能力的趋势。中位数囚犯人数率也从每 10 万人 77.8 人下降到 71.0 人（-7.8%）。低收入和中低收入国家的精神科床位和囚犯人数比例低于中高收入国家。
SSA 国家的精神科床位率平均下降，即使从已经很低的水平来看，这可能反映出急性精神科护理的危机。精神科床位率平均约为经济合作与发展组织（OECD）国家的 1/25，而囚犯人数率则相似。过去三十年中 SSA 国家之间的趋势差异表明，该地区的发展可能不是基于协调一致的政策，反映了个别国家面临的独特情况。
