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Year : 2010  |  Volume : 19  |  Issue : 2  |  Page : 101-104  Table of Contents     

Adjustment and mental health problem in prisoners

Department of Psychology, S.S.L.N.T. Women's College, Dhanbad, Jharkhand, India

Date of Web Publication28-Nov-2011

Correspondence Address:
Sudhinta Sinha
C/O Mr. J. K. Sinha (Retd. Scientist), 2nd Floor; Janki Niwas, P.O. Indian School of Mines, Dhaiya, Dhanbad, Jharkhand
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0972-6748.90339

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Background : "Crime" is increasing day by day in our society not only in India but also all over the world. In turn, the number of prisoners is also increasing at the same rate. They remain imprisoned for a long duration or in some cases for the whole life. Living in a prison for long time becomes difficult for all inmates. So they often face adjustment and mental health problems. Recent findings suggest that mental illness rate in prison is three times higher than in the general population. Objective: The aim of the present study was to investigate the adjustment and the mental health problem and its relation in the prisoners. Materials and Methods : In the present study, 37 male prisoners of district jail of Dhanbad District of Jharkhand were selected on purposive sampling basis. Each prisoner was given specially designed Performa - Personal Data Sheet, General Health Questionnaire-12 and Bell Adjustment Inventory. Appropriate statistical tools were used to analyze the data. Results: The results obtained showed poor adjustment in social and emotional areas on the adjustment scale. The study also revealed a significant association between adjustment and mental health problem in the prisoners. Conclusion: The prisoners were found to have poor social and emotional adjustment which has strong association with their mental health.

Keywords: Adjustment, crime, emotional, mental health, prisoner, social

How to cite this article:
Sinha S. Adjustment and mental health problem in prisoners. Ind Psychiatry J 2010;19:101-4

How to cite this URL:
Sinha S. Adjustment and mental health problem in prisoners. Ind Psychiatry J [serial online] 2010 [cited 2022 Nov 29];19:101-4. Available from: https://www.industrialpsychiatry.org/text.asp?2010/19/2/101/90339

The prisoners are forced to undergo increasingly harsh policies and conditions of confinement in order to survive in the prison. These prolonged adaptations to the deprivations and frustrations of life inside prison lead to certain psychological changes. The person who suffers the acute pains of imprisonment necessarily manifests psychological disorders such as post-traumatic stress disorder or other forms of disability may be in the form of diminished sense of self-worth and personal value. [1]

According to recent studies, [2] the mental illness rate in prisoners is three times higher than in the general population and it is more common in females rather than males. In recent years, this problem has come to the surface and has gained public attention, while most prisons were aware of the problem as early as in the 1980s.

Most mentally ill prisoners find it extremely difficult to adjust in accordance with the prison rules. Most get in trouble for destroying state property and fighting with guards. Others are more prone to be taken advantage of by other inmates. Some are abused, raped and have their belongings stolen. [2]

The adaptation to imprisonment is almost always difficult and, at times, creates habits of thinking and acting that can be dysfunctional. Yet, the psychological effects of life in prison vary from individual to individual. [3],[4],[5]

Johan Hakon Bjorngaard, A. B. Rusted, Eleen Kjelsberg [2],[6] studied and found that prisoners are characterized by elevated mental and physical health related morbidity. The Bureau of Justice Statistics reported [7] that more than half of all prisoner and jail inmates have mental health problems.

A national survey of prison inmates with disabilities conducted in 1987 indicated [8] that although less than 1% suffered from visual, mobility/orthopedic, hearing, or speech deficits, much higher percentages suffered from cognitive and psychological disabilities.

Similar results were obtained in a more recent follow-up study conducted by Veneziano L and Veneziano C. [9] They showed that although less than 1% of the prison population suffered visual, mobility, speech, or hearing deficits, 4.2% were developmentally disabled, 7.2% suffered psychotic disorders, and 12% reported other psychological disorders. So, it can be estimated, based on this and other studies, [7],[8],[9] that 20% of the current prisoner population nationally suffers from either some sort of significant mental or psychological disorder or developmental disability.

A 2005 study conducted by Richard Lamb and Linda Weinberger [10] revealed that as much 24% of the prison population has a severe mental illness.

Kane [11] found in his studies that more than 8 in 10 prisoners have chronic physical, mental or substance abuse conditions. Richard Nakamura and others [10],[12],[13] showed that one million or 8% of jail bookings annually involve persons with severe mental illness. A more recent study of the Chicago jail [10],[12],[13] revealed that 6% of males and 12% of females entering the system had severe mental disorders, including schizophrenia, mania and major depression.

All these international researches consistently show that prisons hold a high proportion of prisoners with mental disorders and adjustmental problems. However, it has been restricted to western settings. The researcher wanted to study and identify the adjustment and mental health problems in prisoners in the Indian setting.

   Aims and Objectives Top

The aim of this study was to investigate the adjustment and mental health problem and its relation in the prisoners.

   Materials and Methods Top


A sample of 37 male convicted prisoners of district jail of Dhanbad (Jharkhand) was included in this study on purposive sampling basis. Their crimes were of different kinds such as murder, rape, theft, kidnapping, forgery, dowry death, and dacoity, as per IPC. The age ranged from 20 to 65 years. The mean age was 36.7 years. Prisoners having addiction to alcohol, history of any psychiatric illness and less than two years of imprisonment were excluded from the study.


Three tests were used in the present study.

Personal data sheet

A designed proforma was used to collect socio-demographic variable.

Bell adjustment inventory

It is a widely used adjustment inventory and it was developed by H. M. Bell in the year 1934 and its Hindi adaptation was done by Mohsin-Shamshad [14] in 1968. The inventory measures adjustment in four different areas - home, health, social, and emotional - separately and also yields a composite score for overall adjustment. Its reliability ranges from 0.70 to 0.92 and validity is also very high.

The General Health Questionnaire-12

The General Health Questionnaire is a self-administered screening test designed for quick and easy identification of possible psychiatric cases in the target population. It was developed by Goldberg in 1972. [15] It has 12 items. It has been validated in India in Hindi by Gautam et al.[16] in 1987. Its reliability ranges from 0.88 to 0.91.


After obtaining permission from the concerned authority, the criminals were interviewed and the questionnaires were administered after establishing a good rapport with them.

   Result Top

The results are shown in [Figure 1] and [Figure 2].
Figure 1: Mean score of obtained score on Bell Adjustment Inventory for different areas of adjustment

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Figure 2: Mean scores of the obtained score on GHQ-12

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   Discussion Top

Results are given in tabular form. [Table 1] shows the mean of the obtained scores on Bell Adjustment Inventory for different areas of adjustment. Prisoners obtained very high score on Social and Emotional areas of adjustment as compared to the Home and Health related adjustment, which indicates their poor adjustments in Social and Emotional areas. This finding can also be seen in the figure. This finding is also supported by Lynne Goodstein, [17] who reported in his study that Inmate assimilation in to the formal prison culture, and the relationship between mode of adjustment and the process of transition to community life affect their post release adaptation. Specifically, inmate conformity to the formal prison culture may lead to difficulties after release, while non-conformity may enhance short-term post release adaptation.
Table 1: Mean scores of the obtained score on Bell Adjustment Inventory of prisoner's adjustment in four different areas

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[Table 2] shows the mean of the obtained scores on GHQ for its 12 items separately. Prisoners obtained very high score on item no. 7, i.e., "No enjoying", as compared to other items of the GHQ, which indicates their very low feeling about the enjoyment of life.
Table 2: Mean scores of the obtained score on GHQ-12 of prisoners

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Further, they scored high on item no. 9, 12 and 8, i.e., Unhappy and distressed, Not feeling happy and Could not face problem, respectively, which again revealed their depressive feeling, distress and inability to face the challenges of life. Comparatively, their scores were also high on item no. 6, i.e., "Could not overcome difficulties", which revealed their anxiety and stress related past traumatic experience and inability to overcome these experiences.

Apart from this, their obtained score on other items of GHQ such as item no. 1, 2, 3, 4, 5, 10 and 11 were within normal range. This can also be seen in the figure. The cutoff point of the score is 1.5, as the Likert method of scoring was used to score the response. Overall picture in the figure representation of mean score of obtained score on GHQ revealed the prisoners' depressive feeling, anxiety, distress and inability to enjoy life, which was above the demarcation line of the normal range. This indicates their tendency to develop mental disorders such as post-traumatic stress disorder in the near future. This finding is also supported by the study of Johan, Bjorngard, Rustad, and Kjelshberg, [2],[6] who found that prisoners are characterized by elevated mental and physical health related morbidity. Kane [11] reported in his study that more than 8 in 10 prisoners have chronic physical mental or substance abuse conditions.

Further correlation was calculated to see the association between adjustment and mental health in the prisoners. [Table 3] shows the correlation between obtained scores on Bell Adjustment Inventory for four areas of adjustment and obtained scores on GHQ for 12 items separately. Findings revealed no association between the score on GHQ and the score on adjustment scale for Home and Health areas of adjustment. But the Social and Emotional areas of adjustment were found to be strongly associated with GHQ scores. Particularly, item no. 7, 10, and 11 of GHQ, i.e., No enjoying, Lost confidence and Felt worthless, respectively, were found to be strongly associated with Social adjustment as the correlation was significant at 0.05, and 0.01 levels. Also, the scores on item no. 5, 6, 7, 9, and 12 of GHQ, i.e., Felt under strain, Could not overcome, Not enjoying, Unhappy and distressed and Not feeling happy, respectively, highly correlated with the score of Emotional adjustment, as the correlation was highly significant at 0.05 and 0.01 levels.
Table 3: Pearson product moment correlations between the score on adjustment scale and GHQ-12

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There was also a strong association between total adjustment scores and the scores on item no. 5, 6, 7, 9, 12 of GHQ, which revealed that as the problem in adjustment increases the mental health problems such as strenuous feeling, inability to enjoy, inability to overcome difficulties and feeling unhappy also increase.

The total score on adjustment scale was significantly correlated (.1 level) with the total score of GHQ, indicating that as the level of adjustment decreases the level of mental health also decreases in the same direction. Further, the correlation between the total score on the Health, Social and Emotional adjustment scale respectively and the total scores on GHQ was found to be significant at 0.05 and 0.01 levels respectively, showing the Health, Social, Emotional and overall poor adjustment affecting their mental health.

All these findings are consistent with the findings of the international research.

   Conclusion Top

This study draws attention to several aspects of the quality of health services from the view of the prisoners as patients. The results suggest that the prisoners' mental health and adjustment problems should be properly addressed and special attention should be paid so that the prisoners are adequately prepared for resettlement in the society because a great majority of prisoners will at some point return to the community and the causes of reoffending can be minimized.

   Acknowledgment Top

Mr. Hamid Akhtar's technical help is acknowledged.

   References Top

1.Sykes G. The society of capatives: A study of a maximum security prison. Princeton: Princeton University Press; 1958. p. 63.  Back to cited text no. 1
2.Bjorngaard JH, Rustad AB, Kjelsberg E. The prisoner as patient: A health services satisfaction survey. BMC Hlth Serv Res 2009;9:176.  Back to cited text no. 2
3.Haney C. From prison to home: The effect of incarceration and reentry on children, families, and communities. University of California; Dec. 2001.   Back to cited text no. 3
4.Mauer M. Americans behind bars: A comparison of international rates of incarceration. In: Churchill W and Vander Wall JJ, editors. Cages of steel: The politics of imprisonment in the United States. Washington, D.C.: Maisonneuve Press; 1992. p. 22-37.   Back to cited text no. 4
5.Mauer M. The international use of incarceration. Prison Jr 1995;75:113-23  Back to cited text no. 5
6.Kjelsberg E, Hartvig P, Bowitz H, Kuisma I, Norbech P, Rustad AB, et al. Mental health consultations in a prison population: A descriptive study. BMC Psychiatr 2006;6:27.  Back to cited text no. 6
7.Bureau of Justice Statistics, Mental Health Treatment in State Prisons, 2000. (NCJ 188215), July, 2001.   Back to cited text no. 7
8.Veneziano L, Veneziano C, Tribolet C. The special needs of prison inmates with handicaps: An assessment. J Off Coun Serv Rehabil 1987;12:61-72.   Back to cited text no. 8
9.Veneziano L, Veneziano C. Disabled inmates. In: McShane M and Williams F, editors. Encyclopedia of American Prisons. New York: Garland; 1996. p. 157-61. See also Long L, Sapp A. Programs and facilities for physically disabled inmates in state prisons. J Off Rehabil 1992;18:191-204.  Back to cited text no. 9
10.Prison mental health crisis continues to grow. Psychiatr News 2006;41:1-30.   Back to cited text no. 10
11.Kane KM. Health and prisoner reentry: How physical, mental, and substance abuse conditions shape the process of reintegration (research report). The Urban Institute 2008. p. 1-4.  Back to cited text no. 11
12.Remedy for prison MH crisis: Community care. Psychiatr News 2006;41:6.  Back to cited text no. 12
13.Bender E. Data confirm MH crisis growing in U.S. prisons. Psychiatr News 2006;41:6-26.   Back to cited text no. 13
14.Mohsin S. Manual for Mohsin-Samshad Hindi Adaptation of Bell Adjustment Inventry. 1968.  Back to cited text no. 14
15.Jacob KS, Bhugra D, Mann AH. General health questionnaire-12: Psychometric properties and factor structure among indian women living in the United Kingdom. Indian J Psychiatry 1997;39:196-9.   Back to cited text no. 15
[PUBMED]  Medknow Journal  
16.Gautam S, Nijhawan M, Kamal P. Standardization of Hindi version of Goldberg's general health questionnaire. Indian J Psychiatry 1987;29:63-6.  Back to cited text no. 16
[PUBMED]  Medknow Journal  
17.Goodstein L. Inmate adjustment to prison and the transition to community life. J Res Crime Delinquency 1979;16:246-72.  Back to cited text no. 17


  [Figure 1], [Figure 2]

  [Table 1], [Table 2], [Table 3]

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