A first comprehensive picture of the mental health issues of female prisoners in Paraguay: Prevalence and associated factors

This is the first study to examine mental health issues, substance use, and suicide risk among incarcerated women in Paraguay, aiming to identify factors associated with these conditions, such as age and medical history. A cross-sectional study was conducted on 215 incarcerated women. Participants were assessed using the Symptom Checklist-90-Revised (SCL-90-R) to evaluate mental health symptoms, Columbia Suicide Severity Rating Scale (C-SSRS) for suicide risk, and MULTICAGE CAD-4 to measure alcohol and drug addiction. The chi-square test and odds ratios were applied to identify associations between mental health outcomes and associated factors, with a significance level of 5%. Our findings revealed that 40% of the participants had some level of suicide risk. Alcohol consumption was reported by 36.7% of the participants; 59.5% screened positive for alcohol-related problems, and 45.6% used drugs, with 73.5% screening positive for drug-related problems. Depression (23.7%) and somatization (21.4%) were the most frequent dimensions of mental health symptoms. Younger women (aged 18-38 years) were significantly more vulnerable to hostility, psychoticism, and interpersonal sensitivity. The study also identified a significant relationship between substance use and suicide risk, with substance users more likely to exhibit suicidal tendencies. Our study highlights the urgent need for integrated mental health and substance use interventions in Paraguayan prisons, especially for younger women who are at higher risk of mental health disorders. Suicide prevention strategies should be prioritized by incorporating mental health and substance use treatments. Further research is needed to explore these issues longitudinally and in different prison environments.