Mental Health Behind Bars: Evidence from Pakistani Prisons

This study examines mental health outcomes among incarcerated adults using primary survey data in a developing country correctional system. Using validated mental health scales for depression, anxiety, and well-being, the study documents a high prevalence of psychological distress among incarcerated individuals. The empirical findings show that perceived overcrowding, exposure to violence, and social isolation are strongly associated with worse mental health outcomes, while regular family contact is associated with reduced psychological distress. These relationships persist after controlling for demographic characteristics and prison fixed effects. Heterogeneity analysis indicates that pre-trial detainees and long-term inmates are particularly vulnerable to institutional stressors. The findings highlight the role of prison environments as determinants of psychological well-being. In LMICs where mental health infrastructure is limited, prisons serve as critical components of public health systems. The results suggest that low-cost screening programs, violence reduction strategies, and policies that reduce overcrowding and facilitate family contact may generate meaningful improvements in inmate well-being. By providing systematic survey-based evidence from a developing economy context, the study contributes to the global literature on incarceration and health and informs policy debates on correctional reform and public health investment.