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Most women in Karachi’s jail suffer from poor mental health

Karachi: Most women serving time in Karachi’s prison are suffering from poor mental health, a study has revealed.

Twelve disorders are very common among them – insomnia (19 percent), aggression (17 percent), stress and anxiety (16 percent) and psychosomatic complaints (14 percent).

Disturbances in relationships early in life along with poor financial background and exposure to aggressive patterns of upbringing have generally been the most favoured psychosocial attributes for the making of an offender. Female convicts show a similar trend related to life circumstances.

Some of the common predisposing factors linked with later life illegal activities by women include a history of domestic or partner abuse and even sexual assault, especially in the case of the women and girls who support drug habits with the sex trade, becoming victims as well as defendants in the process.

International data suggests a link between mental health issues and crimes committed by women. Some of these studies reveal that nearly 80 percent of female offenders as meeting the clinical criteria for at least one psychological disorder

Substance abuse disorder, depression and post traumatic stress disorder are some of the most common mental health problems.

Prisoners at the women’s jail in Karachi were interviewed and examined to assess their orientation, sleep pattern, perception, thought process and behaviour including speech, motor movements, mannerism, and posturing.

The clinical interviews and mental status examinations were conducted individually with the respondents.

The women convicted for murder showed signs aggression and facing many problems including insomnia, crying spells, guilt, headaches, tension, suicidal tendency, helplessness, and hallucinations. They were diagnosed as suffering from and depression and its related features.

Those imprisoned for kidnapping were showing symptoms of aggression, insomnia, crying spells, fainting spells, tension, hallucinations, and self harming tendency. Overall, they were having psychotic episodes.

Those in jail for drug trafficking and robberies exhibited similar symptoms. But their symptoms were not so severe.

Neurotic rather than psychotic

The results of the study showed that the most common mental health issues in women prisoners belong to the neurotic rather than psychotic conditions.

The typology may thus be broadly categorized into three distinct groups of neurosis related to depression and its related features, borderline tendencies, and anxiety features.

Neurosis has been found to be a continuing cause of concern prevalent in significantly higher numbers of females than males in prisons, with sleep issues being most prominent. In the study, 18.4 percent of women were facing the problem of insomnia and sleep disturbances – higher than other symptoms.

The nature of mental health symptoms can be linked to the type of crime committed. Female offenders committing murder appeared with predominant symptoms of depression including but not limited to insomnia, guilt and crying spells. Those presenting with severe guilt reported general distress and reduction in daily life functions such as routine religious activities that would culminate eventually in crying spells. In such cases it was the nature of the crime and the memories associated with it rather than the consequences of the crime committed that contributed to the depression of these women.

The women involved in kidnappings for ransom exhibited more aggression than those who had committed murder. The presence of self harming behaviour along with tension and disturbed relationship history reflects borderline tendencies. Similar trends can also be seen in those women who were convicted for drug trafficking but the incidence is lower.

Female offenders involved in robberies and street crimes showed predominantly anxiety-related symptoms with a greater incidence of tension related to their financial and family circumstances at home. They were worried mostly about their children and the effect of their own absence from home on the rest of the family.

Married women in jail on the whole were found to be experiencing tension along with other physical and mental health issues. The majority of female prisoners who had children reported feelings of loneliness, insomnia, symptoms of depression and tension coupled with concern about their children and coping with problems in the jail environment.

Psychosomatic complaints alone showed the greatest incidence of any relationship to the type of crime committed with headaches and pain in the region above the shoulders being related to women who committed murders, fainting spells related to those who kidnapped for ransom, numbness in arms related to trafficking drugs and a host of general psychosomatic complaints related to street crimes and other occurrences.

Recommendations

It was recommended in the study that understanding the symptoms and developing interventions focusing on health care for female prisoners could improve their lives and subsequently reduce repetitive criminal behaviour.

It was suggested that benefits could be obtained from the setting up of remedial and educational programmes that involve both individual and group therapy for each of the symptom clusters with a focus on improving coping strategies

Dealing with depression after committing a murder, focusing on positivity and gaining inner strength in the process might be controversial keeping in mind the anti-punitive aspects of the process but it just may be one of the humanitarian aspects of a reform-based jail setting.

Group therapy interventions for females with borderline tendencies may be based on dialectical behaviour therapy and its skill based modules.

They will help work with the symptoms of aggression, self harming or risky behaviour that have been noted in many females involved in kidnapping and ransom cases and in drug trafficking.

Stress and anxiety are the main symptoms of females involved in robbery and financial issues appear to be the major cause of concern for them.

They need to be taught vocational skills such as weaving or tailoring.

This way, skill development will help them earn their livelihood. They will also benefit emotionally in support groups that are solution focused in nature.

These measures will also help in indirectly addressing the incidence of insomnia, tensions and psychosomatic symptoms being faced by most female prisoners.

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