Are Prisoners in Ethiopia Getting the Proper Psychological Healthcare

Abstract

This article examines the provision of psychological healthcare to prisoners within the Ethiopian correctional system. While Ethiopia has established a large amount of legal framework ensured in its Constitution and reinforced by international human rights instruments and proclamation No 1174/2019 a significant gap between provision and their practical implantation can be seen. The article analyzes the the current state of mental health service in Ethiopia prisons highlight high prevalence rate of mental disorder alongside low service utilization and a critical shortage of mental health professionals. Through a comparative lens it tries to explore rehabilitative models from jurisdiction like the United Kingdom and Norway. The article concludes by proposing recommendations including enhanced resource allocation, systematic mental health screening, integration service and implementation of existing laws to bridge this gap and uphold the right to health and dignity for all inmates

Introduction

Ethiopia’s criminal justice system mostly gives attention to the retribution and deterrence aspects of punishment. This often gives way to the ignorance of the rehabilitative aspect of the punishment, particularly psychological support for the inmate. Even though the country has made improvements in its legal reforms, the provision of mental health care for inmates is still in question. This research will delve into the question of whether offenders are receiving the proper psychological help through examining legal frameworks, institutional capacities, and comparison of Ethiopian legal system to other countries regarding inmates psychological health.

Legal Frameworks governing prisoners right and mental health in Ethiopia 

Ethiopian legislation, the country’s approved international human rights instruments, and the country’s constitution all regulate the rights and mental health of prisoners. If we see the FDRE constitution, it has some laws that guarantee the protection of the prisoners rights. Article 41 obligated the state to provide mental health services to the people, which includes offenders too[1]. In addition, Article 21 prohibits cruel, inhuman, or degrading treatments, which could also involve psychological neglect.[2] Despite the FDRE constitution clearly having provisions to safeguard inmates rights to psychological treatments, it’s not enforced in prison. Other regional constitutions have also ratified provisions that protect the right of inmates to have professional psychological help. We could take the SNNPRS constitution, for example, which includes provisions ensuring the right to adequate living standards for prisoners, including health care.[3] Other declarations were also approved; the most notable of these being Prison Proclamation No. 1174 (2019). This proclamation aims to restructure the federal and regional correctional systems, combining measures for the security, rehabilitation, reintegration, and dignity of inmates, while also reforming regulations and mandates.[4] Ethiopia has further strengthened the legal protection of prisoner rights, including the right to health, by signing international agreements such as the African Charter on Human and Peoples’ Rights (ACHPR), the International Covenant on Civil and Political Rights (ICCPR), and the International Covenant on Economic, Social, and Cultural Rights (ICESCR).

Psychological Support in Ethiopian Prison: Current State

As a leader in implementing the WHO’s Mental Health Gap Action Programme (mhGAP) in correctional facilities, Ethiopia is seeing an increase in attention to the improvement of mental health services within prisons.  Despite the fact that there is evidence of high incidence of mental health conditions among prisoners, including depression, anxiety, and stress, as well as a deficiency of proper mental health care in many facilities, initiatives are being made to close this gap. Ethiopian prisons continue to have low rates of psychiatric service use, despite high incidence of mental health disorders like depression (53.4% among inmates).[5]  According to a Northwestern Ethiopian survey, just 13.3% of prisoners sought mental health care.[6] Research shows that better mental health care delivery in correctional facilities is required, as are focused interventions.

In Ethiopia, there are several obstacles to overcome while offering psychological support to prisoners. The incidence of mental health disorders, especially depression, and the precise risk factors for these diseases among Ethiopian convicts are little understood.  Because mental illness is viewed as a stigma, inmates may be deterred from seeking help from both inside and outside of the court system.  Insufficiently many trained professionals, including psychologists, counselors, and psychiatrists, are available to provide mental health care in prisons.  The type of offense committed, social isolation, and prison overcrowding can all exacerbate mental health conditions.

Comparative Viewpoint: Practices from Different Fields

A range of psychiatric treatments, often tailored to the individual and focused on rehabilitation and reintegration into society, are employed for prisoners in a number of countries.  Group and individual therapy, medication, and even specialized programs that focus on specific issues like substance abuse or trauma can be part of these therapies.  The goals are to improve mental health, lower recidivism, and help prisoners become productive members of society.

Inmates who are brought to the facility are screened in many systems, including the UK, and directed to in-reach programs (managed by mental health specialists) for assessment and treatment.[7]  Treatment options include individual therapy, group therapy, and specialized programs like cognitive behavioral therapy (CBT) for issues like substance abuse or anger management. Inmates are able to handle mental health disorders with medicines when needed.              

Inmates who need intensive mental health care may sometimes be sent to secure mental health facilities for treatment; if their condition improves, they may then be returned to prison.[8] Rehabilitating prisoners through education and vocational training is a major priority in countries like Norway, which aim to help them gain the skills they need for work and a seamless return to society.  The idea of equivalence, which holds that prisoners should have unrestricted access to healthcare of the same standard as the general public, is generally acknowledged.  Inmates who are vulnerable, like those with mental health issues, who may require extra protection and assistance are often given special consideration. A clean, polite jail atmosphere is also proven to have a favorable effect on the mental health and general well-being of inmates.

Recommendations

Ethiopia has improved inmate psychological care by establishing a new Prison Proclamation (No. 1174/2019) and implementing the WHO’s Mental Health Gap Action Programme (mhGAP) in prisons.  Strengthening mental health services in jails, expanding access to mental health specialists, and putting preventative measures in place against mental health conditions like depression and suicidal thoughts are some suggestions, but there are still obstacles to overcome.

Enhancing mental health care in prisons should be the nation’s foremost priority.  Increasing the inmates’ access to mental health specialists is one way to do this.  The amount of qualified counselors, psychologists, and psychiatrists that the prisoners would have access to may be increased.  The adoption of regular mental health screening could be ordered.  To do this, they may establish regular screening for mental health problems, especially for high-risk inmates.  Providing adequate mental health treatment alongside physical medical care for prisoners would be one way to integrate mental health into medical services.  For instance, they might provide specialized treatment for specific needs or focused support for inmates who have severe mental illnesses, substance abuse problems, or are in danger of suicide.  Prison staff may be equipped with the knowledge and skills necessary to identify and manage mental health issues, including identifying the initial indications of distress and offering basic support.

Additionally, they could focus on reintegration and rehabilitation.  They can use evidence-based programs like cognitive behavioral therapy (CBT), employment training, and educational activities that promote positive changes to address this.  They might promote relationships with their families and the community in addition to creating a structure that would facilitate inmates’ seamless reintegration into society.  They may discuss subjects including how criminal behavior and mental health problems are influenced by economic, social, or personal factors.

Ethiopian prisons need to improve on a number of areas related to their legal and policy frameworks.  First and foremost, prison procedures should be in line with international human rights norms for the care of inmates, particularly those who require mental health services.  Harmonizing the law and practices is the second step to take.  In Ethiopia, the majority of laws are only written down and are not correctly applied when they are put into practice.  This imbalance unfortunately applies to the Prison Proclamation (No.1174/2019).  It would be a good idea to implement this announcement consistently throughout the entire region.  In order to encourage responsibility and transparency, the other is creating an appropriate check and balance for the prisoner staff.

I want to conclude by talking about how to deal with particular difficulties.  Both civil society and the legal system bear some of the responsibility for the convicts’ mental health.  In addition to encouraging prisoners to seek mental health care without worrying about criticism, they must endeavor to lessen the stigma and discrimination associated with mental illness.  The other is to carry out more thorough research, including qualitative and longitudinal studies, on the incidence and consequences of mental health disorders among prisoners.  Last but not least, women, young people, and other vulnerable groups inside the institution should receive special attention.

Conclusion

Although Ethiopia has a legal framework that, in theory, promotes the mental health of convicts, there is a dearth of practical application.  Recidivism rates could stay high in the absence of appropriate psychological assistance, weakening efforts at rehabilitation.  Important first efforts are tightening legislative requirements and funding mental health facilities.

Bibliography

Legislation

1. Constitution of the Federal Democratic Republic of Ethiopia (1995), Article 21
2. Constitution of the Federal Democratic Republic of Ethiopia (1995), Article 41
3. Constitution of the Southern Nations, Nationalities and peoples’ Regional State (2001)
4. Prison Proclamation No 1174/2019, Federal Negarit Gazeta (2020), No.14

Journal Articles

5. Hailemariam, Solomon and Fasil Tessema, ‘The Prevalence of Depression and Associated Factors in Ethiopia: Findings from the National Health Survey’ (2012) 6 International Journal of Mental Health Systems
6. Necho, M et al, ‘A Meta-Analysis of Depressive Symptoms Among Ethiopian Prisoners and a Narrative Description of Its Associated Factors: A Country Based Systematic Review and Meta-Analysis Study’ (2020) 20(1) BMC Psychiatry
7. Handuleh, Jibril I M and Ronan J Mclvor, ‘A Novel Prison Mental Health In-Reach Service in Somaliland: A Model for Low-Income Countries?’ (2014) 11(3) BJPsych International

Online Source

8. UK, ‘Prison Life: Vulnerable Prisoners’ https://www.gov.uk/life-in-prison/vulnerable-prisoners accessed 7 July 2025.

[1] The Federal Democratic Republic Constitution of Ethiopia 1995, Article 41

[2] The Federal Democratic Republic Constitution of Ethiopia 1995, Article 21

[3] Constitution of the Southern Nations, Nationalities and Peoples’ Regional State 2001

[4] Prison Proclamation No 1174/2019, Fed Neg Gaz 2020, No 14 

[5] Solomon Hailemariam and Fasil Tessema, ‘The prevalence of depression and associated factors in Ethiopia: findings from the National Health Survey’ (2012) 6 Int J Mental Health Systems 23.

[6] M Necho et al, ‘A meta-analysis of depressive symptoms among Ethiopian prisoners and a narrative description of its associated factors: a country based systematic review and meta-analysis study’ (2020) 20 (1) BMC Psychiatry 1.

[7] Jibril I M Handuleh and Ronan J Mclvor, ‘A novel prison mental health in-reach service in Somaliland: a model for low-income countries?’ (2014) 11(3) BJPsych International 61.

[8] GOV.UK, ‘Prison life: Vulnerable prisoners’ https://www.gov.uk/life-in-prison/vulnerable-prisoners accessed 7 July 2025.