Background:There is a considerable lack of scientific estimate of psychiatric morbidity among Indian prisoners.Objective:The objective of the following study is to study the prevalence of psychiatric morbidity among prisoners.Settings and Design:A cross-sectional study at District Jail, Kozhikode, Kerala.Materials and Methods:A total of 255 prisoners who were inmates during the period from mid-April to mid-July 2011 participated in the study. The study subjects included both male and female remand or convict prisoners. Socio-demographic data, clinical history and criminological history were collected from each individual. Psychiatric morbidity was assessed using MINI-Plus.Statistical Analysis:Done by using SPSS version 16 (SPSS Inc, Chicago, USA).Results:A total of 175 subjects (68.6%) had a current mental illness. Substance use disorder was the most common diagnosis (47.1%). Antisocial personality disorder was diagnosed in 19.2%, adjustment disorder in 13.7%, mood disorder in 4.3% and psychosis in another 6.3% of prisoners. A high rate of a current psychiatric disorder was seen in male (69.7%) prisoners. A significant association was noticed for the different nature of crimes with psychiatric diagnoses and previous imprisonment. Nearly 4% of prisoners reported a moderate to high suicide risk.Conclusion:Mental health problems among prisoners were quite high. Mentally ill prisoners are at high risk for repeated incarceration. The increased rate of psychiatric disorders should be a concern for mental health professionals and the policy makers.

Background: For women with perinatal mental illness, phone helplines may be a useful way of accessing help. This study assessed the feasibility, acceptability, limitations, and usage patterns of a helpline service for mothers discharged from a mother-baby psychiatry unit. Methods: Mothers discharged from a mother baby unit during an 18-month period were provided with a helpline number. A social worker answered the calls. Details of the calls, including the reasons and the interventions provided, were recorded. Feasibility and acceptability were assessed by calling all users and nonusers. Satisfaction with the helpline was recorded among users, and reasons for not calling were assessed among nonusers. Results: Among 113 mothers, 51 (45%) made 248 calls. Calls were regarding medication, sleep problems, planning pregnancies, symptom exacerbation, appointments, and suicidal ideation. Some calls were related to domestic violence ( n = 13, 5.24%), and infant health and breastfeeding ( n = 11, 4.44%). Seventy-six (67%, 44 callers and 32 noncallers) were contacted. The majority (41/44) of the callers found it useful: 91% said they got help, and 95% said they would recommend it to others. However, language difficulties (9%) and technical problems (5%) were reported. Among the noncallers, the majority reported having experienced no problem related to mental health or had contacted a doctor. However, of the noncallers, one woman died of suicide, did not have access to a phone, and the family did not choose to call. Conclusions: Helpline phone service appears to be feasible and acceptable and can be adapted in other mother-baby psychiatry units in low and middle-income countries. However, in some women, the nonavailability of a phone may be a limiting factor.

As medical professionals, most of us face professional dilemmas that catch us unawares and are not discussed in medical training. One often learns about these dilemmas on one's own and deals with them with a common sense approach, rather than reflection. The professional dilemmas may concern receiving gifts from patients, handling issues of confidentiality or dealing with personal questions. There is seldom any formal instruction in competencies related to professionalism, especially in India. We adopted a team approach to provide training in these issues to postgraduate trainees in mental health and to engage them in discussion, using team feedback on snapshots of real-life professional situations, which were simulated through role play. We found that the trainees felt that these methods were acceptable and to their liking. However, a more formal method of assessing how this approach actually influences day-to-day practice must be evolved.

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