Abstract

The prison officer profession is characterized by working in risky situations, which can harm officers’ mental health. This research aimed to analyze prison officers’ working conditions associated with Common Mental Disorders (CMD). This cross-sectional study was conducted with prison officers in four penitentiary units in the inland region of the State of São Paulo, Brazil, from January to August 2019. The Self-Reporting Questionnaire (SRQ-20) tool was employed to quantify the presence of CMDs. Poisson regression verified the association between variables with robust variance and adjusted for confounding factors to estimate the prevalence ratio (PR) and 95% confidence interval (CI). The study population comprised 331 prison officers (ASP), with a 33.5% frequency of CMDs. CMDs were higher among prison officers with a worse perception of working conditions (PR: 1.13; 95%CI%: 1.03-1.24), who suffered insults (PR: 1.18; 95%CI: 1.08-1.29), psychological harassment (PR: 1.23; 95%CI: 1.11-1.36) and sexual harassment (PR: 1.20; 95%CI: 1.03-1.40) in the last 12 months. CMDs were associated with work-related variables, such as worse environmental conditions within the prison and psychological and sexual violence.

Key words:
Mental health; Prison; Work conditions; Occupational health

Introduction

Common mental disorders (CMD) comprise a series of symptoms, such as insomnia, fatigue, somatic complaints, forgetfulness, irritability, difficulty concentrating, and feelings of worthlessness¹1 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). Arlington: American Psychiatric Association; 2013.. While CMDs can be classified as less severe problems than depression and anxiety¹1 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). Arlington: American Psychiatric Association; 2013., they are prevalent disorders in the global population, contributing to the burden of mental illness²2 World Health Organization (WHO). Depression and other common mental disorders: Global estimates [Internet]. Geneva: WHO; 2017 [cited 2022 jun 8]. Available from: http://apps.who.int/iris/bitstream/handle/10665/254610/WHOMSD?sequence=1.
http://apps.who.int/iris/bitstream/handl... and generating functional disability, psychosocial impairments, and high social and economic costs³3 Goldberg DP, Huxley P. Common mental disorders: a bio-social model. New York: Tavistock/Routledge; 1992.

4 Stansfeld SA, Fuhrer R, Head J. Impact of common mental disorders on sickness absence in an occupational cohort study. Occup Environ Med 2011; 68(6):408-413.^-55 Santos GBV, Alves MCGP, Goldbaum M, Cesar CLG, Gianini RJ. Prevalência de transtornos mentais comuns e fatores associados em moradores da área urbana de São Paulo, Brasil. Cad Saude Publica 2019; 35(11):e00236318.. These disorders may be more evident in populations or workers who concentrate on activities with a more significant impact on psychological distress, such as prison officers (ASP), the leading professional category that works in the Brazilian prison system⁶6 Albuquerque DR, Araújo MRM. Precarização do Trabalho e Prevalência de Transtornos Mentais em Agentes Penitenciários do Estado de Sergipe. Rev Psicol Saude 2018; 10(1):19-30..

The ASPs mostly perform their work in contact with the prison population⁷7 Bezerra CM, Assis SG, Constantino P. Sofrimento psíquico e estresse no trabalho de agentes penitenciários: Uma revisão da literatura. Cien Saude Colet 2016; 21(7):2135-2146.. Additionally, these workers must play the conflicting role of promoting the reintegration and resocialization of convicted felons and, simultaneously, maintaining and preserving order and discipline in the penitentiary⁸8 Lourenço AS. O espaço de vida do agente de segurança penitenciária no cárcere: entre gaiolas, ratoeiras e aquários [tese]. São Paulo: Universidade de São Paulo; 2010.^,99 Jaskowiak CR, Fontana RT. O trabalho no cárcere: reflexões acerca da saúde do agente penitenciário. Rev Bras Enferm 2015; 68(2):235-243.. Thus, the professional environment of ASPs is an essential source of tension due to frequent threats and potential abuse⁷7 Bezerra CM, Assis SG, Constantino P. Sofrimento psíquico e estresse no trabalho de agentes penitenciários: Uma revisão da literatura. Cien Saude Colet 2016; 21(7):2135-2146., which can directly affect the mental health of these workers.

A meta-analysis on the subject found a global prevalence of CMDs for adults of 17.6% in the last 12 months and 29.2% throughout life¹⁰10 Steel Z, Marnane C, Iranpour C, Chey T, Jackson JW, Patel V, Silove D. The global prevalence of common mental disorders: A systematic review and meta-analysis 1980-2013. Int J Epidemiol 2014; 43(2):476-493.. In the ASP population, the prevalence of CMDs reported in the national scientific literature ranges from 23.57% to 83.3%⁶6 Albuquerque DR, Araújo MRM. Precarização do Trabalho e Prevalência de Transtornos Mentais em Agentes Penitenciários do Estado de Sergipe. Rev Psicol Saude 2018; 10(1):19-30.^,1111 Fernandes RCP, Silvany Neto AM, Sena GM, Leal AS, Carneiro CAP, Costa FPM. Trabalho e cárcere: um estudo com agentes penitenciários da Região Metropolitana de Salvador, Brasil. Cad Saude Publica 2002; 18(3):807-816.

12 Alves V. Condições de trabalho de funcionários penitenciários de Avaré-SP e ocorrência de transtornos mentais comuns [dissertação]. Botucatu: Universidade Estadual Paulista; 2009.

13 Santos DC, Dias JS, Pereira MBM, Moreira TA, Barros DM, Serafim AP. Prevalência de transtornos mentais comuns em agentes penitenciários. Rev Bras Med do Trab 2010; 8(1):33-38.^-1414 Lima AIO, Dimenstein M, Figueiró R, Leite J, Dantas C. Prevalence of common mental disorders and alcohol and substance abse among correctional officers. Psicol Teor Pesqui 2019; 35:e3555.. This variation may be due to exposure to occupational factors⁶6 Albuquerque DR, Araújo MRM. Precarização do Trabalho e Prevalência de Transtornos Mentais em Agentes Penitenciários do Estado de Sergipe. Rev Psicol Saude 2018; 10(1):19-30.^,77 Bezerra CM, Assis SG, Constantino P. Sofrimento psíquico e estresse no trabalho de agentes penitenciários: Uma revisão da literatura. Cien Saude Colet 2016; 21(7):2135-2146. and other individual variables and issues involving the health of these workers³3 Goldberg DP, Huxley P. Common mental disorders: a bio-social model. New York: Tavistock/Routledge; 1992.

4 Stansfeld SA, Fuhrer R, Head J. Impact of common mental disorders on sickness absence in an occupational cohort study. Occup Environ Med 2011; 68(6):408-413.^-55 Santos GBV, Alves MCGP, Goldbaum M, Cesar CLG, Gianini RJ. Prevalência de transtornos mentais comuns e fatores associados em moradores da área urbana de São Paulo, Brasil. Cad Saude Publica 2019; 35(11):e00236318.. Thus, it is crucial to investigate the possible factors associated with CMDs in the ASP population through analyses adjusted for confounding factors, which allow a better understanding of the effect of working conditions on the health of these professionals. Thus, this study aimed to analyze the working conditions associated with common mental disorders, adjusted by health conditions, in penitentiary security agents.

Methods

Design, population, and study location

This is a cross-sectional study nested in the “AGEPEN Study: Working Conditions, Mental Health and Sleep in Prison Officers in the State of São Paulo” project. Data were collected from January to August 2019 in the prison units of Assis, Florínea, Martinópolis, and Paraguaçu Paulista, part of the Coordination of the Western Region of the State of São Paulo¹⁵15 Estado de São Paulo. Secretaria da Administração Penitenciária. Unidades prisionais [Internet]. São Paulo; 2021 [citado 2021 jan 2]. Disponível em: www.sap.sp.gov.br/unidades-mob.html.
www.sap.sp.gov.br/unidades-mob.html... . These prisons were selected by convenience for the present study.

All male prison officers (ASP) who worked in the four selected prison units and had been in the profession for at least six months were eligible to participate in the project. In this study, all ASPs with incomplete records on the CMD outcome variable who refused to participate in the research, could not be located after three attempts, or were on leave during the collection period, regardless of the type of leave, were considered losses.

Regarding the data collection process, ASPs were invited to participate in the research at the onset of their work shift. After explaining the purpose of the research, the ASPs who agreed to participate received the Informed Consent Term and, later, the data collection tool. The tools were returned through unidentified envelopes, thus ensuring anonymity at the end of each work shift. The research was conducted in all working periods.

Study variables

Information on CMDs was measured using the Self-Reporting Questionnaire (SRQ-20), developed by the World Health Organization in 1994 and translated and validated into Portuguese by Mari and Williams¹⁶16 Mari JJ, Williams P. A validity study of a psychiatric screening questionnaire (SRQ-20) in primary care in the city of Sao Paulo. Br J Psychiatry 1986; 148(1):23-26.. The tool includes 20 dichotomous questions, with “yes/no” answers, concerning the mental health condition in the last thirty days. Each “yes” answer scores one point, and each “no” answer scores zero points. The total sum of the scale can range from zero to 20 points. In this research, a cutoff point ≥7 is indicative of CMD¹⁷17 Gonçalves DM, Stein AT, Kapczinski F. Avaliação de desempenho do Self-Reporting Questionnaire como instrumento de rastreamento psiquiátrico: Um estudo comparativo com o Structured Clinical Interview for DSM-IV-TR. Cad Saude Publica 2008; 24(2):380-390..

Aspects related to sociodemographic characteristics were also measured, including age group (27-39, 40-49, 50-59, 60 and over), ethnicity/skin color (white and nonwhite, including black, brown, yellow, and indigenous), marital status (single, separated/divorced, widowed, and married/common law-marriage), schooling (high school, higher education/postgraduate) and monthly household income (up to BRL 5,000, above BRL 5,000).

Regarding occupational variables, information was retrieved on work shifts (daily worker - eight daily hours, day or night shift - 12-hour shift); work sector (administrative, operational-intermediate contact, operational-closest contact); profession seniority (up to 10 years, over 10 years); feeling like an ASP (yes, partially, no); thinking about changing professions (never, sometimes a year, sometimes a day/week/month); physical demand at work (low/moderate and high); mental demand at work (low/moderate and high); substance use to stay awake (yes/no); and perception of having been a victim of violence in the last 12 months (insults or embarrassing situations, threats, moral harassment, sexual harassment, and physical abuse) (yes/no). For the classification of the work sector, we considered ASPs’ sectors within a prison unit, identifying per sector how close they are to people deprived of liberty. We also measured ASPs’ level of satisfaction regarding temperature, noise, ventilation, hygiene, furniture, and facilities in the prison unit, for which the following answers were accepted: 1-good, 2-fair, and 3-poor. The score ranged from seven to 21 points, and the cutoff point adopted for greater dissatisfaction with the work environment was the percentile >75.

Regarding lifestyle and health variables, we adopted physical activity once or more times a week (yes/no); arthritis/arthrosis/rheumatism (yes/no); chronic pain (pain that has been bothering them for six months or more) (yes/no); Body Mass Index (BMI) (calculated based on self-reported weight and height data and categorized into three categories - normal, overweight, and obese); sleep quality (using the Pittsburgh Sleep Quality Index, considering worse sleep quality >5 points¹⁸18 Buysse DJ, Reynolds III CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989; 28:193-213.); and health perception (very good/good, fair/poor/very poor).

Processing and analysis

The collected data were double-entered and consolidated in Epi Info, version 3.5.2. The analysis was performed using the Statistical Package for the Social Sciences (SPSS), version 20.0. The prevalence ratio (PR) estimation, 95% confidence interval, between CMDs and working conditions was performed using Poisson regression with robust variance. In addition to estimating the crude parameter, the PR was calculated using a model adjusted for variables of epidemiological importance or that showed a statistically significant association (p<0.05) with the dependent variable. The adjusted models were performed with the inclusion of the variables in a single block: age group, marital status, schooling, physical activity, BMI, sleep quality, self-perceived health, arthritis/arthrosis/rheumatism, and chronic pain.

Ethical aspects

The Research Ethics Committee of the State University of Londrina (CAAE No. 87250718.7.3003.5563) and the Ethics Committee of the São Paulo State Penitentiary Administration (No. 024/2018) approved the project.

Results

Two hundred thirty-five (37.6%) of the 566 eligible prison officers (ASP) in the four prisons studied were considered losses: leave (n=82), refusal (n=95), not located after three attempts (n=36), and because they did not fill in the items of the SRQ-20 scale (n=22), resulting in a final population of 331 (56.2%) ASPs. The prevalence of CMDs (SRQ-20≥7) was 33.5% (n=111). The mean of the SRQ-20 was 5.1 (standard deviation: 4.7).

Regarding sociodemographic variables, the mean age was 45.1 years (standard deviation: 7.8), ranging from 27 to 73 years. We observed a significant association between the higher frequency of CMDs among ASPs who engaged in physical activity occasionally or did not practice physical activity (≥1 time/week) with evidence of arthritis, arthrosis, rheumatism, chronic pain, and health perception (Table 1).

The ASPs who showed greater dissatisfaction with the working conditions inside the prison, having suffered insults and moral and sexual harassment, showed a higher prevalence of CMD signs (Table 2).

Discussion

This study found a prevalence of 33.5% of common mental disorders (CMD) among prison officers (ASP), which was associated with the perception of worse conditions in the work environment, having suffered insults or embarrassing situations, and moral or sexual harassment in the last 12 months.

We observed that the frequency of CMDs in this study, as reported in other studies involving ASPs⁶6 Albuquerque DR, Araújo MRM. Precarização do Trabalho e Prevalência de Transtornos Mentais em Agentes Penitenciários do Estado de Sergipe. Rev Psicol Saude 2018; 10(1):19-30.^,1111 Fernandes RCP, Silvany Neto AM, Sena GM, Leal AS, Carneiro CAP, Costa FPM. Trabalho e cárcere: um estudo com agentes penitenciários da Região Metropolitana de Salvador, Brasil. Cad Saude Publica 2002; 18(3):807-816.^,1313 Santos DC, Dias JS, Pereira MBM, Moreira TA, Barros DM, Serafim AP. Prevalência de transtornos mentais comuns em agentes penitenciários. Rev Bras Med do Trab 2010; 8(1):33-38.^,1414 Lima AIO, Dimenstein M, Figueiró R, Leite J, Dantas C. Prevalence of common mental disorders and alcohol and substance abse among correctional officers. Psicol Teor Pesqui 2019; 35:e3555.^,1919 Carleton RN, Ricciardelli R, Taillieu T, Mitchell MM, Andres E, Afifi TO. Provincial correctional service workers: The prevalence of mental disorders. Int J Environ Res Public Health 2020; 17(7):2203., is higher than that observed in the general population⁴4 Stansfeld SA, Fuhrer R, Head J. Impact of common mental disorders on sickness absence in an occupational cohort study. Occup Environ Med 2011; 68(6):408-413. and teachers²⁰20 Ferreira RC, Silveira AP, Sá MAB, Feres SB, Souza JGS, Martins AMEB. Transtorno Mental e Estressores no Trabalho entre Professores Universitários da Área da Saúde. Trab Educ Saude 2015; 13(Supl. 1):135-155.. This observation seems to confirm the impact of the prison work environment on the mental health of ASPs⁸8 Lourenço AS. O espaço de vida do agente de segurança penitenciária no cárcere: entre gaiolas, ratoeiras e aquários [tese]. São Paulo: Universidade de São Paulo; 2010..

Despite the relevance of CMDs, there is a lack of international publications on the topic in ASPs. Among the available studies, we observe several tools and approaches on the subject so that the frequency of CMDs in equivalent populations ranges from 15.2% to 59.6%²¹21 Regehr C, Carey M, Wagner S, Alden LE, Buys N, Corneil W, Fyfe T, Fraess-Phillips A, Krutop E, Matthews L, Randall C, White M, White N. Prevalence of PTSD, Depression and Anxiety Disorders in Correctional Officers: A Systematic Review. Corrections 2019; 6:229-241.. The studies mainly focused on identifying post-traumatic stress disorder, depression¹⁹19 Carleton RN, Ricciardelli R, Taillieu T, Mitchell MM, Andres E, Afifi TO. Provincial correctional service workers: The prevalence of mental disorders. Int J Environ Res Public Health 2020; 17(7):2203.^,2121 Regehr C, Carey M, Wagner S, Alden LE, Buys N, Corneil W, Fyfe T, Fraess-Phillips A, Krutop E, Matthews L, Randall C, White M, White N. Prevalence of PTSD, Depression and Anxiety Disorders in Correctional Officers: A Systematic Review. Corrections 2019; 6:229-241., and anxiety²¹21 Regehr C, Carey M, Wagner S, Alden LE, Buys N, Corneil W, Fyfe T, Fraess-Phillips A, Krutop E, Matthews L, Randall C, White M, White N. Prevalence of PTSD, Depression and Anxiety Disorders in Correctional Officers: A Systematic Review. Corrections 2019; 6:229-241.. The methodological differences, cultural particularities, and the structuring of the prison system in different countries prevent us from adequately comparing the prevalence rates in those countries vis-à-vis those found in our study.

When evaluating the prevalence of CMDs concerning the Brazilian reality, values similar to those found in studies carried out in Rio Grande do Norte (23.6%)¹⁴14 Lima AIO, Dimenstein M, Figueiró R, Leite J, Dantas C. Prevalence of common mental disorders and alcohol and substance abse among correctional officers. Psicol Teor Pesqui 2019; 35:e3555. and Bahia (30.7%)¹¹11 Fernandes RCP, Silvany Neto AM, Sena GM, Leal AS, Carneiro CAP, Costa FPM. Trabalho e cárcere: um estudo com agentes penitenciários da Região Metropolitana de Salvador, Brasil. Cad Saude Publica 2002; 18(3):807-816. can be observed. However, studies with ASPs conducted in Sergipe and São Paulo showed a considerably higher prevalence of CMDs, between 68.0%⁶6 Albuquerque DR, Araújo MRM. Precarização do Trabalho e Prevalência de Transtornos Mentais em Agentes Penitenciários do Estado de Sergipe. Rev Psicol Saude 2018; 10(1):19-30. and 83.3%¹³13 Santos DC, Dias JS, Pereira MBM, Moreira TA, Barros DM, Serafim AP. Prevalência de transtornos mentais comuns em agentes penitenciários. Rev Bras Med do Trab 2010; 8(1):33-38., respectively. These differences are possibly due to the low number of participants⁶6 Albuquerque DR, Araújo MRM. Precarização do Trabalho e Prevalência de Transtornos Mentais em Agentes Penitenciários do Estado de Sergipe. Rev Psicol Saude 2018; 10(1):19-30.^,1313 Santos DC, Dias JS, Pereira MBM, Moreira TA, Barros DM, Serafim AP. Prevalência de transtornos mentais comuns em agentes penitenciários. Rev Bras Med do Trab 2010; 8(1):33-38. included in these studies and the peculiar place of work analyzed. For example, in one of them, ASPs were workers at a Hospital for Custody and Psychiatric Treatment¹³13 Santos DC, Dias JS, Pereira MBM, Moreira TA, Barros DM, Serafim AP. Prevalência de transtornos mentais comuns em agentes penitenciários. Rev Bras Med do Trab 2010; 8(1):33-38., an institution that shelters people deprived of their liberty who are considered incapable; that is, they have committed some type of crime but are unable to recognize or pay for their crimes due to their psychic conditions.

Physical inactivity was also associated with CMDs, which is corroborated by other studies with prison officers¹¹11 Fernandes RCP, Silvany Neto AM, Sena GM, Leal AS, Carneiro CAP, Costa FPM. Trabalho e cárcere: um estudo com agentes penitenciários da Região Metropolitana de Salvador, Brasil. Cad Saude Publica 2002; 18(3):807-816.^,2222 Reichert FF, Lopes M, Loch MR, Romanzini M. Atividade física e outros aspectos relacionados à saúde de agentes penitenciários de Londrina-PR. Rev Bras Ativ Fis Saude 2007; 12(3):4-11.^,2323 Silva HMM. Perfil sociodemográfico, estilo de vida, condições de saúde e transtorno mental comum de trabalhadores de uma penitenciária feminina do estado de São Paulo [dissertação]. Campinas: Universidade Estadual de Campinas; 2014.. Physical activity reduces tensions, often arising from the work environment²³23 Silva HMM. Perfil sociodemográfico, estilo de vida, condições de saúde e transtorno mental comum de trabalhadores de uma penitenciária feminina do estado de São Paulo [dissertação]. Campinas: Universidade Estadual de Campinas; 2014., and provides significant benefits to the physical and mental health of the population, thus contributing to the promotion of health and quality of life²⁴24 Silva AO, Cavalcante Neto JL. Associação entre níveis de atividade física e transtorno mental comum em estudantes universitários. Motricidade (Portugal) 2014; 10(1):49-59..

Concerning aspects inherent to the physical structure of prisons, working conditions were associated with CMDs. The Brazilian prison environment is generally characterized by buildings surrounded by walls and wires, guarded at all times by heavily armed men, and extensive and damp galleries and corridors⁸8 Lourenço AS. O espaço de vida do agente de segurança penitenciária no cárcere: entre gaiolas, ratoeiras e aquários [tese]. São Paulo: Universidade de São Paulo; 2010.. These physical conditions, inherent to prison, can influence their physical health and psychological distress⁶6 Albuquerque DR, Araújo MRM. Precarização do Trabalho e Prevalência de Transtornos Mentais em Agentes Penitenciários do Estado de Sergipe. Rev Psicol Saude 2018; 10(1):19-30.. The unhealthy work environment can change the feeling of exertion, making the profession even more laborious²⁵25 Ramos EC, Esper MH. Síndrome de Burnout na penitenciária feminina de regime semiaberto [monografia]. Curitiba: Faculdade Anchieta de Ensino Superior do Paraná; 2007. and increasing stress and the likelihood of developing mental disorders⁶6 Albuquerque DR, Araújo MRM. Precarização do Trabalho e Prevalência de Transtornos Mentais em Agentes Penitenciários do Estado de Sergipe. Rev Psicol Saude 2018; 10(1):19-30..

We found that having suffered some type of violence in the last 12 months, such as insults or embarrassing situations, moral harassment, and sexual harassment, was significantly associated with CMDs in the adjusted analysis. A study in other population segments found multiple factors associated with CMDs, including exposure to violence. The risk of violence inside and outside the prison environment is typical of any activity related to prison security. Violence was also demonstrated in another study conducted with ASPs in Avaré-SP, in which 200 (66.4%) of the 301 prison workers reported having suffered at least one verbal or physical abuse event at work, and 108 (35.8%) reported having suffered at least one abuse event outside of work, however, related to it¹²12 Alves V. Condições de trabalho de funcionários penitenciários de Avaré-SP e ocorrência de transtornos mentais comuns [dissertação]. Botucatu: Universidade Estadual Paulista; 2009.. The fear of violence can trigger insecurity and emotional fragility, leading to professional exhaustion, mental illness, and lack of work motivation²⁶26 Costa MSGA, Barbosa ND, Carraro PR. A importância do trabalho do psicólogo escolar aos docentes em escolas públicas. Rev EIXO 2014; 3(2):73-80..

Violence in the work environment is a public health problem²⁷27 Ferreira MJM, Macena RHM, Mota RMS, Pires Neto RJ, Silva AMC, Vieira LJES, Kendall BC, Kerr LRFS. Prevalência e fatores associados à violência no ambiente de trabalho em agentes de segurança penitenciária do sexo feminino no Brasil. Cien Saude Colet 2017; 22(9):2989-3002., and its occurrence is more common in some professions, such as health or education professionals and prison officers, since the intrinsic peculiarities of these professional categories contribute to workers being more exposed to these events²⁸28 Gadegaard CA, Andersen LP, Hogh A. Effects of Violence Prevention Behavior on Exposure to Workplace Violence and Threats: A Follow-Up Study. J Interpers Violence 2015; 33(7):1096-1117.. Therefore, physical, psychological, and sexual violence negatively affect the health conditions of ASPs and compromise their work process²⁷27 Ferreira MJM, Macena RHM, Mota RMS, Pires Neto RJ, Silva AMC, Vieira LJES, Kendall BC, Kerr LRFS. Prevalência e fatores associados à violência no ambiente de trabalho em agentes de segurança penitenciária do sexo feminino no Brasil. Cien Saude Colet 2017; 22(9):2989-3002..

The association between this type of mental violence is supported by a meta-analysis showing that exposure to bullying is associated with mental health problems, burnout, and lower job satisfaction²⁹29 Nielsen MB, Einarsen S. Outcomes of exposure to workplace bullying: A meta-analytic review. Work Stress 2012; 26(4):309-332., with an impact on job satisfaction³⁰30 Butler HD, Tasca M, Zhang Y, Carpenter C. A systematic and meta-analytic review of the literature on correctional officers: Identifying new avenues for research. J Crim Justice 2019; 60:84-92.^,3131 Marques GS, Giongo CR, Ruckert C. Saúde mental de agentes penitenciários no Brasil: uma revisão sistemática da literatura. Diálogo (Canoas) 2018; (38):89-98., generating work stress³⁰30 Butler HD, Tasca M, Zhang Y, Carpenter C. A systematic and meta-analytic review of the literature on correctional officers: Identifying new avenues for research. J Crim Justice 2019; 60:84-92.^,3131 Marques GS, Giongo CR, Ruckert C. Saúde mental de agentes penitenciários no Brasil: uma revisão sistemática da literatura. Diálogo (Canoas) 2018; (38):89-98., organizational endangerment³⁰30 Butler HD, Tasca M, Zhang Y, Carpenter C. A systematic and meta-analytic review of the literature on correctional officers: Identifying new avenues for research. J Crim Justice 2019; 60:84-92., demotivation, dissatisfaction with the position, anxiety, and emotional exhaustion³¹31 Marques GS, Giongo CR, Ruckert C. Saúde mental de agentes penitenciários no Brasil: uma revisão sistemática da literatura. Diálogo (Canoas) 2018; (38):89-98.. The association between sexual violence and CMDs is well reported for the female population³²32 Santos AG, Monteiro CFS. Domains of common mental disorders in women reporting intimate partner violence. Rev Lat Am Enferm 2018; 26:e3099. or in other professions³³33 Blindow KJ, Paulin J, Hanson LM, Johnell K, Nyberg A. Sexual and gender harassment and use of psychotropic medication among Swedish workers: a prospective cohort study. Occup Environ Med 2022; 79(8):507-513., with no reports on ASPs.

Possible limitations of this study are the use of self-reported information (which may contain memory bias); because it is a self-completed tool (which can generate doubts about the questions); the convenience sampling of the penitentiaries, not allowing the extrapolation of data to all ASPs in the western region or the entire state of São Paulo; the lack of more information about the losses, which hinders the assessment of a possible selective loss of individuals most affected by CMDs; and the small sample size, which, while representative for the population under analysis, may have compromised the accuracy of the association measures studied. However, using a validated tool to identify CMDs in the research population has strengths, in addition to working with a population that is difficult to access, given that the research was developed within prison units. Moreover, ensuring absolute confidentiality concerning ASP responses can minimize the risk of withholding information about their mental health and working conditions.

In summary, this study proved that working conditions, violence, insults, and demands inside prison are associated with CMD signs. Therefore, it would be relevant to conduct longitudinal studies on the subject, especially those assessing the development of CMDs throughout the exercise of the profession. The results can support actions aimed at improving physical spaces within the prison, considering the inherent characteristics of penitentiaries, and actions aimed at reducing psychological violence, such as greater integration between ASPs and specialized psychological support geared to these professionals.

Conclusion

The results showed the complex features of the topic, the many potential interrelationships between the associated variables, and the challenges we face in this outlook. The study showed that approximately one in three ASPs had CMDs, a condition associated with the worse perception of working conditions, having suffered insults, and moral and sexual harassment in the last 12 months, regardless of confounding factors.

Despite the difficulties in improving several conditions of the work environment, the results point to the possibility of formulating policies to reduce the psychological violence suffered by prison officers, which would contribute to consistently curbing the prevalence of CMDs.

References

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History