Bolivia's prisons were already overcrowded and understaffed prior to the Covid-19 pandemic. The prison population rate was high at 150 per 100,000 and occupancy was at 236% of capacity with most prisoners sharing cells. Mental health services and psychiatrists per capita were scarce. When the pandemic hit, Bolivia's weak healthcare system and political unrest exacerbated risks to prisoners' health and rights. Overcrowding made social distancing impossible and exposed prisoners to high risk of virus transmission. The pandemic highlighted the need for reforms like reducing overcrowding, improving prison data reporting, researching mental health in prisons, and strengthening legislation on prisoners' right to health.

1. Bolivia, its Prisons and Mental Health Services in the
Time of Covid-19
Dr Anne Aboaja, Consultant Forensic Psychiatrist
Tees, Esk and Wear Valleys NHS Foundation Trust, UK
&
Prof Guillermo Rivera-Arroyo, Professor of Psychiatry
Universidad Privada de Santa Cruz de la Sierra, Bolivia

2. Declarations
 None

3. NEWS FLASH!!!
Bolivia,
“the least prepared country in the world to
deal with Covid-19”?

4. Outline
1. Ecosystems model
2. Pre-Covid: Mental health and prisons
3. Pre-Covid: Political situation
4. Covid: Prisons, politics and mental health
5. Conclusions

5. Ecosystems and Prison
Health
Globalisation/culture
Policies/Law
Prison community/
organisations/
institution
Interpersonal
relationships
Prisoner

6. Pre-Covid-19: Mental Health and Prisons

7. Psychiatrists per
100 000 population

9. Prisoners = 17,833
Prison pop rate = 150 per 100,000
Pre-trial/remand = 64%
Female prisoners = 7%
Occupancy level = 236%

10. Number of prisoners sharing a cell
Guimarães, Alice Soares, MacLean Soruco, Enrique, & Eguivar, Mario A.. (2020). Cárcel, derechos humanos y
salud pública en el contexto de la pandemia COVID-19. Revista Latinoamericana de Desarrollo Económico,
(34), 35-66.

11. Overcrowding rates in the Bolivian prisons
Defensoría del Pueblo (2018a). Informe defensorial: volcar la mirada a las cárceles. La Paz:
Defensoría del Pueblo.

12. Prison data

13. Pre-Covid-19: Political situation

14. Pre-Covid-19: Political system
October 2019
1st wave of political unrest

15. Covid-19: Prison, politics and mental health

20. Conclusions

21. NEWS FLASH!!!
Bolivia,
“the least prepared country in the world to
deal with Covid-19”?

22. “Covid-19 pandemic exposed
and exacerbated these
weaknesses, putting the
incarcerated population…at
risk”

23. Future directions
 Efforts to reduce overcrowding
 Prison data reporting
 Prison mental health research
 Legislation to safeguard right to health

24. Contacts
guillermorivera@upsa.edu.bo
anne.aboaja@york.ac.uk
@AboajaAnne