Social determinants of health in male forensic patients admitted at a tertiary psychiatric hospital in South Africa

Abstract

Introduction:

Social factors are increasingly being used to determine health outcomes. The concept of social determinants of health has been used to shape policies that address disparities. There is a paucity of such studies in the forensic setting. This study aimed to use social determinants of health to identify social factors that are associated with being a male forensic patient.

Methods:

The study was a retrospective two-group (forensic and non-forensic) comparison clinical record review. Association was identified through independent and multivariate statistical analysis.

Results:

The study sample comprised of 296 patients, 56.4% (n = 167) of which were non-forensic. The majority of the sample was black African, 50 years and older, single, unemployed and had attended main-stream schooling. Race (p < .01), employment status (p < .02), not completing high school (p < .01), previous imprisonment (p < .01), drug use (p < .01) and not being on medication prior to admission (p < .01) were significantly associated with being a forensic patient. Multivariate logistic regression analyses also confirmed these associations.

Conclusion:

Social determinants of health ought to be targeted to improve health outcomes of psychiatric patients. Collaborations between mental health, public health, law and policy makers as well as non-/governmental agencies may lead to change. Human rights of individuals with mental illness may thus be enhanced in the long run.

Keywords

State patients social determinants of health social factors social disparities social injustice Criminal Procedure Act Mental Health Care Act

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