Kenya inherited the penal system from the British Colonial government on its independence in 1963. The current running of prisons is regulated by an act of parliament- The Prisons Act 1967, revised in 1977 (The Prisons Act 1967). The Penal Code and Kenya’s old constitution, while having several shortcomings, contain fairy liberal laws with regards to treatment of prisoners. Kenya has also ratified a number of international instruments protecting the rights of prisoners and detainees, including the African Charter on Human and People’s Rights. However, there is a big discrepancy between the legal provisions and the actual conditions in prison.

Media and other reports over the last decade have consistently pointed at prison populations three or more times larger than capacity. A 2001 report placed the population in Kenyan prisons at an average of between 36,000 and 40,000 in institutions the capacity of which is meant for approximately 14,000 (Government of Kenya and Penal Reform International 2001; Amanda, Dissel 2001).

Nearly all prisons in Kenya are characterised by overcrowding and poor living conditions. Although serious attempts have been made to improve the conditions of convicted prisoners in the last few years, the environment in remand prisons remains deplorable. Congestion, inadequate sanitary conditions and poor hygiene lead to quick spread of diseases. There is also inadequate food, clothing and bedding. There is frequent mixing of young offenders and adult offenders leading to abuse of minors. There have even been cases of suffocations and deaths due to overcrowding (Amanda, Dissel 2001; BBC News 2004; Lewis 2008). Medical and psychological/counselling services are highly compromised in these circumstances.

Very few studies have been done on the mentally ill in Kenyan prisons. In fact there is no study looking at the prevalence and pattern of mental disorders in Kenyan prisons.

It is, however, clear that the prevalence of mental illness in Kenyan prisons should not be underestimated. A study done in Nairobi on non convicted prisoners in remand prisons is probably the best that we have to go by.

Conducted in 2006 and using the SCIDI (Structured Clinical Interview for DSM-IVAxis I disorders) and the Modified IPDE (International Personality Disorder Examination), the study found a very high level of undiagnosed psychiatric morbidity among females on remand at 84 %. Out of these, personality disorders accounted for 38 %, mood disorders for 25 %, and anxiety disorders for 29 % (panic disorders 10 %, Posttraumatic stress disorder (PTSD) 6 %, Generalized Anxiety Disorder (GAD) 7 %, social phobia 3 %). Adjustment disorders accounted for 13 %, while Obsessive Compulsive Disorder (OCD), schizophrenia, and somatization disorders constituted 3 % each. The prevalence of psychiatric disorders in males was 77 %. Personality disorders accounted for 42 %, mood disorders 17 %, anxiety disorders 15 % (panic disorders 3 %, PTSD 9 %). OCD accounted for 3 % and somatization disorders for 3 %. No cases of GAD or social phobia were recorded among the males. Surprisingly high prevalence rates of schizophrenia at 12 % and adjustment disorder, also 12 %, were recorded. Although this study did not assess alcohol dependency, it reported 65 % substance use, particularly alcohol, among females and 67 % among males with a 12 % co-morbidity between substance use and other psychiatric disorders (Mucheru 2006).

While these figures may reflect the prevalence of psychiatric disorders among non convicted prisoners, there are certain factors which may contribute to lower figures in the convicted prison population. Among these are that being on remand is often associated with high levels of anxiety related to the uncertainty about the outcome of the court procedure – note the high levels of adjustment disorders (12 %). Secondly, it is not unusual for mentally ill persons to be temporary detained in remand institutions to be released later even without being charged once it becomes clear to the detaining authorities that they are mentally ill. In fact it is not uncommon for large numbers of homeless mentally ill persons to be collected in a kind of ‘clean-up the city’ action only to be released after some time – this may account for the high prevalence of schizophrenia (12 %), which is far above the prevalence of schizophrenia in the general population. Similarly, alcohol and other substance users may be arrested and detained on charges of being drunk and disorderly only to be released after a few days after paying a fine.