Health problems among detainees in Switzerland: a study using the ICPC-2 classification

Abstract

Background: Little is known about the health status of prisoners in Switzerland. The aim of this study was to provide a detailed description of the health problems presented by detainees in Switzerland's largest remand prison.

Methods: In this retrospective cross-sectional study we reviewed the health records of all detainees leaving Switzerland's largest remand prison in 2007. The health problems were coded using the International Classification for Primary Care (ICPC-2). Analyses were descriptive, stratified by gender.

Results: A total of 2195 health records were reviewed. Mean age was 29.5 years (SD 9.5); 95% were male; 87.8% were migrants. Mean length of stay was 80 days (SD 160). Illicit drug use (40.2%) and mental health problems (32.6%) were frequent, but most of these detainees (57.6%) had more generic primary care problems, such as skin (27.0%), infectious diseases (23.5%), musculoskeletal (19.2%), injury related (18.3%), digestive (15.0%) or respiratory problems (14.0%). Furthermore, 7.9% reported exposure to violence during arrest by the police.

Conclusion: Morbidity is high in this young, predominantly male population of detainees, in particular in relation to substance abuse. Other health problems more commonly seen in general practice are also frequent. These findings support the further development of coordinated primary care and mental health services within detention centers.

Figure 1

ICPC-2 coded health problems in 2195 of detainees in a remand prison in Geneva, Switzerland, 2007.

Figure 2

Symptoms coded without precise diagnosis (42.2%, 95%CI 40.1-44.3)

Figure 3

Health problems coded as substance abuse (71.2%; 95%CI 69.3-73.1)

Figure 4

Health problems coded as infectious diseases (23.5%; 95%CI 21.7-25.3)

Figure 5

Health problems coded as general internal medicine (29.9%; 95%CI 28.0-31.8)

Figure 6

Health problems coded as psychiatry (16.4%; 95%CI 14.8-17.9)

Figure 7

Health problems coded as injuries (18.3%; 95%CI 16.7-19.9)