Families in Malakal turn to prisons amid mental health care crisis, says MSF

Families in Malakal, Upper Nile state are increasingly sending relatives with severe mental health conditions – not to hospitals, but to prison, according MSF’s mental health activity manager.

That’s according to Médecins Sans Frontières – or MSF – who say this desperate measure highlights a critical shortage of psychiatric care in the region.

Laura Ximena, MSF’s Mental Health Activity Manager, explains that for many families, detention centres have become the only option when loved ones show severe symptoms. In her words – “While far from ideal, it’s often the only place people can be kept safe or receive any care at all.”

MSF currently runs mental health programmes at Malakal Teaching Hospital and at the Central Prison. They report that patients with psychosis, bipolar disorder, and severe depression are being locked up… simply because there’s nowhere else to treat them.

Between January and August this year, MSF carried out over 1,100 mental health consultations – with more women than men seeking help. Twelve patients reported suicidal thoughts, and April saw the highest number of such cases.

One man, 33-year-old Samat Nyuk, shared his story of being sent to prison by his own family when traditional remedies failed.

He said – “I knew I was unwell, but not a criminal. What hurt most was that my own family chose prison instead of treatment.”

Samat was confined to a small, isolated cell in Malakal Central Prison in June, where MSF provided limited psychiatric support.

South Sudan’s mental health crisis is largely invisible – but widespread. Decades of conflict, displacement, poverty, and hunger have left deep psychological wounds. And instability continues to disrupt what few services exist.

Survivors of sexual and gender-based violence are especially vulnerable, often lacking access to both mental health and legal support.

MSF continues to offer follow-up care in prison and across the community, including counselling, medication, and awareness sessions for health workers and families.

Laura Ximena stresses that “With proper medication, counselling, and support, recovery is possible – but it’s fragile without food, safety, and a functioning health system.”

MSF is now calling on authorities to fully integrate mental health services into South Sudan’s primary healthcare system – ensuring trained professionals, essential medications, and community support are available at every level.