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.