Mental health disparities between Spanish and foreign prison inmates: reasons for referral from prison to a specific unit in a general hospital.

Foreign inmates represented a majority of the sample admitted for psychiatric decompensation in a Spanish prison psychiatric module.

• Total sample consisted of 106 persons deprived of liberty admitted between 2009 and 2022.
• Immigrants represented 51.9% of the sample.
• Foreign inmates were predominantly young, unmarried males.
• The study period spanned 13 years (2009–2022).

Suicidal behavior was the primary reason for psychiatric admission among foreign inmates.

• 43.6% of foreign inmates were admitted primarily for suicidal behavior.
• Foreign incarcerated persons were described as 'particularly vulnerable to suicidal behavior.'
• This was identified as the predominant reason for admission in the foreign inmate group.

Foreign inmates had fewer psychiatric histories and less mental health follow-up prior to admission compared to Spanish inmates.

• Foreign inmates had fewer psychiatric histories than Spanish inmates.
• Foreign inmates had less mental health follow-up in the previous six months compared to Spanish counterparts.
• This pattern suggests less prior engagement with psychiatric services among foreign inmates.

Spanish inmates were older and had higher rates of bipolar disorder and personality disorders compared to foreign inmates.

• Spanish inmates were older than foreign inmates.
• Spanish inmates showed higher rates of bipolar disorder.
• Spanish inmates showed higher rates of personality disorders.
• Spanish inmates received more psychotropic prescriptions than foreign inmates.

Spanish inmates presented with more cardiovascular risk factors and physical comorbidities than foreign inmates.

• Spanish inmates had higher rates of cardiovascular risk factors.
• Spanish inmates had more physical comorbidities compared to foreign inmates.
• These differences were observed alongside greater psychotropic medication use in the Spanish inmate group.

The prison population in Spain shows a significantly higher prevalence of mental illness and substance use disorder compared to the general population.

• Spain has one of the highest incarceration rates in Europe.
• The prison population presents a higher prevalence of mental disorders and toxic substance use disorders compared to the general population.
• The authors noted a lack of studies focused on mental disorders in Spanish prisons.

Social precarity was identified as a likely explanatory factor for mental health disparities between foreign and Spanish inmates.

• The authors attributed part of the observed differences to 'social precarity' affecting the foreign prison population.
• Foreign inmates' vulnerability was framed within conditions of social vulnerability.
• Overrepresentation of foreign inmates in psychiatric admissions was noted as a key disparity.