Mental health disparities between Spanish and foreign prison inmates: reasons for referral from prison to a specific unit in a general hospital.

Objectives: Spain has one of the highest incarceration rates in Europe, and its prison population shows a significantly higher prevalence of mental illness and toxic substances use disorder compared to the general population. Despite this, there is a lack of studies focused on mental disorders in Spanish prisons. This study aims to explore the differences between Spanish and foreign persons deprived of liberty with severe mental disorders. Material and method: We evaluated the sociodemographic (Spanish Results: Immigrants represent 51.9% of the sample, predominantly young unmarried males, primarily admitted for suicidal behavior (43.6%). Compared to Spaniards, they have fewer psychiatric histories and less mental health follow-up in the previous six months. In contrast, Spanish inmates are older, have higher rates of bipolar disorder and personality disorders, and receive more psychotropic prescriptions. They also present with more cardiovascular risk factors and physical comorbidities. Discussion and conclusions: Foreign incarcerated person are overrepresented in psychiatric admissions and are particularly vulnerable to suicidal behavior. Social precarity likely accounts for some of the differences observed compared to the native population.