Jack Helen E, Lovett Aish, Weldemariam Hiwot, Alem Atalay, Dali Serge, Muduma Sakios, Micheni Murugi, Pienaar Letitia, Sunkel Charlene, Senter Zoë, Shaban Maryia, Chwastiak Lydia, Walker Sarah, Ogunwale Adegboyega
Division of General Internal Medicine, University of Washington School of Medicine, University of Washington, Seattle, WA, USA.
Division of General Internal Medicine, University of Washington School of Medicine, University of Washington, Seattle, WA, USA.
Lancet Psychiatry. 2025 Aug;12(8):611-618. doi: 10.1016/S2215-0366(25)00067-7. Epub 2025 Apr 15.
People who are incarcerated in Africa are not a focus of global mental health research, and incarceration is absent from many international mental health guidelines. Given the dearth of knowledge and services, priorities for research and practice should be established. The Delphi method was used to identify priority challenges related to mental health and substance use disorders among people who are incarcerated in sub-Saharan Africa. Experts in the field completed four iterative electronic surveys. The first survey was an open-ended question about priorities. In subsequent surveys participants used a Likert scale to rate the importance of each priority. 97 experts from 27 countries (20 in sub-Saharan Africa) completed the first survey (64% of those targeted). The 38 priority challenges fell into ten thematic areas: pathways for care during incarceration; the health-care workforce; alternatives to incarceration; the specific needs of women; acute conditions; involvement of non-health-care staff; policy; infrastructure and carceral conditions conditions; re-entry into the community; and people awaiting trial. These priority challenges can guide the efforts of practitioners, policy makers, and researchers to address mental health conditions and substance use disorders among people in prisons in sub-Saharan Africa. Investment in the health-care workforce, policies, and prison infrastructure, as well as developing non-carceral solutions, are needed to support behavioural health in people who are incarcerated.
非洲被监禁人群并非全球心理健康研究的重点对象，许多国际心理健康指南中也未涉及监禁问题。鉴于相关知识和服务匮乏，应确定研究和实践的重点。采用德尔菲法来确定撒哈拉以南非洲地区被监禁人群中与心理健康及物质使用障碍相关的重点挑战。该领域专家完成了四轮迭代电子调查。首轮调查是一个关于重点事项的开放式问题。在后续调查中，参与者使用李克特量表对每个重点事项的重要性进行评分。来自27个国家（20个来自撒哈拉以南非洲地区）的97名专家完成了首轮调查（占目标对象的64%）。38项重点挑战可归为十个主题领域：监禁期间的护理途径；医疗保健工作人员；替代监禁措施；女性的特殊需求；急性病症；非医疗保健工作人员的参与；政策；基础设施及监禁条件；重新融入社区；以及候审人员。这些重点挑战可为从业者、政策制定者和研究人员努力解决撒哈拉以南非洲地区监狱服刑人员的心理健康状况和物质使用障碍问题提供指导。需要对医疗保健工作人员、政策和监狱基础设施进行投资，并开发非监禁解决方案，以支持被监禁人员的行为健康。
