Mental health disorders and recidivism among incarcerated adult offenders in a correctional facility in South Africa: A cluster analysis

PLOS ONE RESEARCH ARTICLE Mental health disorders and recidivism among incarcerated adult offenders in a correctional facility in South Africa: A cluster analysis Kwanele Shishane ID1*, Johannes John-Langba2, Eyitayo Onifade3 a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 OPEN ACCESS Citation: Shishane K, John-Langba J, Onifade E (2023) Mental health disorders and recidivism among incarcerated adult offenders in a correctional facility in South Africa: A cluster analysis. PLoS ONE 18(1): e0278194. https://doi. org/10.1371/journal.pone.0278194 Editor: Andrea Knittel, University of North Carolina at Chapel Hill, UNITED STATES Received: June 28, 2021 Accepted: November 11, 2022 Published: January 19, 2023 Copyright: © 2023 Shishane et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: Data cannot be shared publicly because of the sensitivity of the data and ethics. The data underlying the results presented in the study are available from Dr Kwanele Shishane. Email: Kwanele. or the doctoral study supervisor Prof. Johannes John-Langba Email: or Department of Correctional Services Research Ethics committee Email: . 1 School of Society, Community and Health, University of Bedfordshire, Luton, England, United Kingdom, 2 School of Applied Human Sciences, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa, 3 Whitney M. Young Jr. School of Social Work, Clark Atlanta University, Atlanta, Georgia, United States of America * Abstract The contribution of mental illness, substance use, and appetitive aggression to recidivism has significant policy and practice implications. Offenders with untreated mental illness have a higher recidivism rate and a greater number of criminogenic risk factors than those without mental illness. Previous research has demonstrated that the likelihood of appetitive aggression increases in violent contexts where individuals perpetrate aggressive acts. Using the Ecological Systems Theory, this study investigated the association between mental health disorders and recidivism among incarcerated adult offenders in South Africa, and the intervening role of appetitive aggression and substance use. Using a cross-sectional quantitative research design, a sample of 280 incarcerated male and female adult offenders aged 18–35 with no known psychiatric disorders were sampled at a correctional facility in South Africa. The re-incarceration rate, mental health disorders, substance use, and appetitive aggression symptomology were assessed using the Hopkins symptoms checklist, the CRAFFT measure of substance use, and the appetitive aggression scale. Findings indicate a 32.4% recidivism rate (n = 82). Cluster analysis indicated that the combination of anxiety, depression, substance use, and appetitive aggression increased the likelihood of recidivism. Appetitive aggression median differences between clusters 2 and 3 played a key role in distinguishing recidivism risk among recidivist and non-recidivist participants. Chi-square analysis highlighted group differences in education levels among the established clusters [x2 (3, n = 217) = 12.832, p = .005, which is < .05] as well as group differences in the type of criminal offence [x2 (3, n = 187) = 24.362, p = .000, which is < .05] and cluster membership. Combined factors that increase the likelihood of recidivism provide a typology for classifying offenders based on particular recidivism risk determinants, which offers insights for developing tailored interventions that address a combination of factors. PLOS ONE | https://doi.org/10.1371/journal.pone.0278194 January 19, 2023 1 / 18 PLOS ONE Funding: The authors have no financial obligations to disclose. This study was conducted as part of author KS’s doctoral studies, whose tuition was funded by doctoral scholarship awards from the National Institute for the Humanities and Social Sciences and the Harry Crossley Research Foundation. There was no financial obligation attached to these scholarships. Competing interests: The authors have declared that no competing interests exist. Mental health and recidivism among incarcerated adult offenders in South Africa: A cluster analysis Introduction Historically, if a community deemed particular behavior anomalous, unacceptable, or immoral, it was addressed through traditional courts as there were no prisons [1]. Traditional courts were managed by community chiefs and their assisters. For example, in the ‘Lekhotla’ [2,3], a community conflict resolution gathering generally practiced by the Sotho people, the chief would convene a hearing meeting including the offender, the victim, the offender, victim’s family, and community members. Traditional courts fostered peace, restoration, and reconciliation [2]. This approach to restorative justice was founded on the premise that when a community member violates another, the whole fabric of the community is affected [2]. Prisons, now referred to as correctional facilities in South Africa, did not originate from Africa; they were a Western system utilized to make people law-abiding citizens [1]. In those times, the convention of the law was unfair and unjust, and the courts’ judgments of offenders were often based on innate traits such as race [4]. This study recognizes the importance of person-first, non-stigmatizing language and therefore used the terms “offenders” and “correctional facilities” as required by the Department of Correctional Services in South Africa. In South Africa’s post-Apartheid era, social conditions promote violence and crime as normative while simultaneously using punitive measures to correct the behavior. Thus, the issue of incarceration and recidivism weakens structures that hold communities together and reduces employment opportunities, ultimately leading to poor social and economic development [5]. Recidivism indicates that there are challenges within the system where members of our society are trapped in the cycle of crime, and state strategies to address it are not as successful as intended. Consequently, recidivism remains a challenge [6]. The incarceration rate has expanded over the years, where correctional facilities are filled beyond capacity with startling overcrowding, leading to unfavorable living conditions for inmates [7]. Padayachee stated that recidivism ranges between 80%-94%, and many offenders recidivate in less than six months to a year [8]. Schoeman [9] posited that recidivism rates in South Africa range between 55%-95%. Similarly, Khwela [1] stated that general recidivism rates range between 50%-70% for offenders who recidivate within three years. The impact of educational programs on recidivism reduce the rate by at least 29% [1]. Karrim [10] estimated that 90% of South African offenders are r (...truncated)