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Incidence of all-cause mortality in prisons: research protocol for a global registry study and systematic literature review with meta-regression analyses
(BMJ, 2025-12)
Adrian P Mundt
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Enzo Rozas-Serri
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Benjamín Ignacio Asencio Rojas
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Antonio Morales-Rojas
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Pablo A Cifuentes-Gramajo
<jats:sec> <jats:title>Introduction</jats:title> <jats:p>People in prison experience disproportionate health burdens compared with community-based populations, including elevated rates of infectious and non-communicable diseases, mental illness and substance use disorders. Previous studies have consistently shown increased rates of mortality following release from incarceration, particularly from external (unnatural) causes such as suicide and violence. However, evidence on mortality incidence during imprisonment is scarce, and many deaths may be preventable through targeted health and prevention interventions. This study aims to synthesise worldwide evidence on all-cause mortality incidence in prisons.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods and analysis</jats:title> <jats:p>We will conduct a worldwide registry study combined with a systematic literature review and meta-regression analysis. Eligible sources will report deaths among incarcerated people between 2005 and 2025 at the national or, where more appropriate, the subnational jurisdictional level. Mortality data will be retrieved from official reports of prison administrations and direct contact with prison authorities. Also, data from international databases and the scientific literature will be reviewed. Incidence rates of all-cause mortality per 100 000 person-years will be calculated and reported for each jurisdiction, alongside standardised mortality ratios comparing imprisoned populations with general population estimates.</jats:p> </jats:sec> <jats:sec> <jats:title>Ethics and dissemination</jats:title> <jats:p>Since the study relies on anonymised routine data registries available from different sources, an exemption certificate was granted by the Ethics Committee of Diego Portales University (UDP) in Santiago, Chile. Findings will be submitted for publication in a peer-reviewed academic journal.</jats:p> </jats:sec> <jats:sec> <jats:title>Trial registration number</jats:title> <jats:p> <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://osf.io/vkzae">https://osf.io/vkzae</jats:ext-link> . </jats:p> </jats:sec>
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Impact of burnout on turnover, medical errors, medical leave and a cross-sectional study of contributing factors among Chilean physicians
(BMJ, 2025-05)
Francisco Villalón López
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Adrian P Mundt
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Alejandro Hirmas
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Rita M Rivera
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Rodrigo Guiloff
Abstract Background During the COVID-19 pandemic, many physicians experienced burnout, underscoring the need to identify factors associated with this condition to develop effective prevention and treatment strategies. Objective To examine the relationship between physician burnout and individual factors, medical errors, medical leave and the work environment. Design A cross-sectional online survey conducted from November 2020 to December 2020. Participants Physicians registered with the Medical College of Chile. Setting Registered physicians working in Chile across primary, secondary and tertiary levels of healthcare. Primary outcomes Burnout was assessed using the Maslach Burnout Inventory for Human Services. Secondary outcomes Self-reported medical errors, medical leave and turnover. Independent variables Sociodemographic characteristics, personality factors, psychological well-being, mindfulness factors, self-compassion and work environment factors. Descriptive statistics, linear and logistic regressions and regression analyses with cross-validation using least absolute shrinkage and selection operator (LASSO) tests were applied. Results Of the 23 481 registered physicians, 795 (3.4%) completed the survey. The sample included 64.1% women, with a mean age of 37.7 years (SD=11.3). The prevalence of burnout syndrome was 20.4% based on strict criteria and 68.9% based on lax criteria. Burnout scores predicted days of medical leave (ß=0.086, p<0.01), turnover (ß=0.012, p<0.05) and perceived medical errors (ß=0.009, p<0.001). In contrast, burnout was inversely correlated with age (ß=−0.125, p<0.001), agreeableness as a personality trait (ß=−0.107, p<0.001), psychological well-being (ß=−0.248, p<0.001) and the mindfulness factor awareness (ß=−0.145, p<0.001). In the work environment, time pressure (ß=0.167, p<0.001) was positively associated with burnout among others. Conclusion Younger physicians may be prioritised for individual-level interventions, while addressing time pressure at the organisational level could help prevent burnout. However, longitudinal studies are needed to clarify the directionality of relationships with psychological factors.
1
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Need estimates of psychiatric beds: a systematic review and meta-analysis
(2024)
Adrian P Mundt
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Enzo Rozas-Serri
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Francesco D. Fritz
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Sabine Delhey
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Mathias Siebenförcher
<jats:title>Abstract</jats:title> <jats:p>This study aimed to review and synthesize the need estimates for psychiatric beds, explore how they changed over time and compare them against the prevalence of actually existing beds. We searched PubMed, Embase classic and Embase, PsycINFO and PsycIndex, Open Grey, Google Scholar, Global Health EBSCO and Proquest Dissertations, from inception to September 13, 2022. Publications providing estimates for the required number of psychiatric inpatient beds were included. Need estimates, length of stay, and year of the estimate were extracted. Need estimates were synthesized using medians and interquartile ranges (IQRs). We also computed prevalence ratios of the need estimates and the existing bed capacities at the same time and place. Sixty-five publications with 98 estimates were identified. Estimates for bed needs were trending lower until 2000, after which they stabilized. The twenty-six most recent estimates after 2000 were submitted to data synthesis (<jats:italic>n</jats:italic> = 15 for beds with unspecified length of stay, <jats:italic>n</jats:italic> = 7 for short-stay, and <jats:italic>n</jats:italic> = 4 for long-stay beds). Median estimates per 100 000 population were 47 (IQR: 39 to 50) beds with unspecified length of stay, 28 (IQR: 23 to 31) beds for short-stay, and 10 (IQR: 8 to 11) for long-stay beds. The median prevalence ratio of need estimates and the actual bed prevalence was 1.8 (IQR: 1.3 to 2.3) from 2000 onwards. Historically, the need estimates for psychiatric beds have decreased until about 2000. In the past two decades, they were stable over time and consistently higher than the actual bed numbers provided.</jats:p>
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Types of Psychiatric Beds and Mental Health Services in 16 Latin American Countries, 1990–2020
(2024)
Adrian P Mundt
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Sabine Delhey
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Pablo Martínez
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Matías Irarrázaval
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Luciano Grasso
1Scopus© Citations 4
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Changes in national rates of psychiatric beds and incarceration in Central Eastern Europe and Central Asia from 1990-2019: A retrospective database analysis
(2021)
Adrian P Mundt
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Enzo Rozas Serri
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Mathias Siebenförcher
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Valbona Alikaj
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Fuad Ismayilov
Scopus© Citations 16 1
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Changes in rates of psychiatric beds and prison populations in sub-Saharan Africa from 1990 to 2020
(2022)
Adrian P Mundt
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Sabine Delhey Langerfeldt
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J Maphisa Maphisa
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Oumar Sourabié
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Blaise Nguendo Yongsi
Scopus© Citations 6 1
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Minimum and optimal numbers of psychiatric beds: expert consensus using a Delphi process
(2022)
Adrian P Mundt
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Enzo Rozas Serri
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Matías Irarrázaval
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Richard O’Reilly
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Stephen Allison
1Scopus© Citations 32
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The prevalence of comorbid serious mental illnesses and substance use disorders in prison populations: a systematic review and meta-analysis
(2022)
Gergő Baranyi
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Seena Fazel
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Sabine Delhey Langerfeldt
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Adrian P Mundt
25Scopus© Citations 104

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