Exploring Coping Strategies Among Jail Inmates with Mental and Behavioral Health Disorders in Punjab Prisons, Pakistan: A Cross Sectional Study

Abstract

Background: In prison setting, jail inmates have to face mental and behavioral health disorders due to overcrowding, social isolation, separation from family, legal ambiguity and lack of mental and behavioral health services. These stressors often cause mental and behavioral health disorders so it is vital to know the coping mechanisms that inmates use to adopt for their mental and behavioral health.

Objective: To assess the coping mechanism used by jail inmates for dealing with mental and behavioral health disorders in Punjab Prisons, Pakistan and to compare coping patterns among under trial and convicted jail inmates in Punjab Prisons, Pakistan.

Methods: An analytic cross sectional study was carried out from 1st March-31st March 2026 among 460 inmates recruited by multistage random sampling method from different districts and then different prisons of Punjab, Pakistan and then inmates were selected through stratified random sampling as under-trial and convicted. The data were collected through a structured questionnaire and validated Brief Cope inventory. Frequencies and percentages were calculated for descriptive analysis. Chi square test was used to find the association between coping mechanisms and imprisonment status. A p-value <0.05 was considered statistically significant.

Results: The most commonly used coping strategy turned out to be religious coping (67.8%), followed by acceptance (43.9%), emotional support (40.9%) and positive reframing (33.5%). The maladaptive coping strategies were emotional withdrawal (42.6%), substance-use coping (30.0%) and aggressive coping (27.4%). Religious coping was significantly higher among convicted prisoners (74.5%) than among under-trial prisoners (62.1%) (p=0.003). Emotional withdrawal was significantly higher among under-trial prisoners (53.2%) than among convicted inmates (30.2%) (p=0.001).

Conclusion: Both adaptive and maladaptive coping mechanisms are used by prison inmates in coping with their psychological problems. Religious coping and acceptance were the most common adaptive coping strategies, whereas emotional withdrawal and substance-use coping were the most common maladaptive coping mechanisms. Psychological interventions for inmates in prison need to facilitate adaptive coping mechanisms and inhibit maladaptive ones.