Fatores associados à saúde mental do homem privado de liberdade no sistema penitenciário federal brasileiro

Abstract

The Brazil is the third nation with the highest absolute number of prisoners. Studies show that rates of psychological disorders are higher in the prison environment when compared to the general population, and the factors are associated with restricted freedom, precarious and unhealthy prison infrastructure, overcrowding and lack of actions for social reintegration. However, these studies are often carried out in state prisons, from which the Federal Penitentiary System differs in its reality because the cells are individual, the environments clean and without overcrowding. In this way, the study aimed to analyze the sociodemographic, prison, criminal, legal and clinical profile in association with the prevalence of stress and anxiety, and levels of resilience and self-esteem of men deprived of their liberty in the Brazilian Federal Penitentiary System. Cross-sectional study, with a quantitative approach, carried out at the Federal Penitentiary of Campo Grande, between January and February 2021, using self-administered questionnaires on sociodemographic, prison, criminal, legal and clinical data, in addition to Inventory of Stress Symptoms for Adults, State-Trait Anxiety Inventory, Resilience Scale and Rosenberg’s Self-Esteem Scale. We chose to include all men deprived of their liberty who voluntarily agreed to participate in the study. Descriptive data analysis, centrality and dispersion measures and inferential analysis were performed to detect statistically significant associations (p<0.05). Research approved by the Research Ethics Committee under Opinion number 4,474,856. 84% of men deprived of their liberty participated in the study (n=122). The presence of stress was observed in most participants (64%), as well as high levels of trait anxiety (44.3%) and state anxiety (76.2%). Most had low levels of resilience (58.2%) and self-esteem (63.1%). Stress was associated with a history of self-harm (p=0.001), psychiatric illness (p=0.004) and prison time of less than one year in a state prison (p=0.003). As for trait anxiety, lower scores were observed associated with good family bonding (p=0.005), older age group (p=0.029), good relationships in prison (p=0.003) and resilience (p=0.003). Higher levels of state anxiety associated with insomnia (p<0.001), regular/poor/no family bonding (p=0.001) and lack of good relationships (p=0.021). Better levels of resilience associated with high positive self-esteem (p<0.001) and non-use of psychotropic drugs (p=0.023), while lower levels associated with high trait anxiety (p=0.006), lack of family visits (p= 0.033), lack of religious practice (p=0.023) and lack of request for medical care (p=0.037). Better levels of self-esteem associated with physical activity lasting more than one hour (p=0.006) or more frequently than three times a week (p=0.036), and having a private lawyer (p=0.027), while low levels of self-esteem were associated rare departure to the sunny patio (p<0.001), time in prison for more than 50 years (p=0.029), comorbidity (p=0.006) among others. The research showed relevant results for the mental health practices of the population studied. Interventions to promote mental health in the prison context are recommended. The protection and risk factors identified may support health care in these environments, influence the decision-making of managers and promote reflections on public policies.