MONOGRAPH SERIES NO. 8 Crime and Mental Health Issues among the Young Bhutanese People Crime and Mental Health Issues among the Young CRIME AND MENTAL HEALTH ISSUES AMONG THE YOUNG BHUTANESE PEOPLE Lham Dorji, Sonam Gyeltshen, Thomas Minten, Pema Namgay, Tashi Dorjee, Cheda Jamtsho and Tenzin Wangchuk National Statistics Bureau Thimphu 2015 MONOGRAPH SERIES NO. 8 Crime and Mental Health Issues among Young Bhutanese People Lham Dorji, Sonam Gyeltshen, Cheda Jamtsho, Thomas Minten, Tashi Dorjee, Pema Namgay and Tenzin Wangchuk National Statistics Bureau 2015 © National Statistics Bureau, 2015 ISBN: 978-99936-718-0-0 Publication: Monograph series 8. All rights reserved. United Nations Population Fund, Thimphu Bhutan financed the study and the printing. This publication is available in hard copy or PDF format from the National Statistics Bureau website at www.nsb.gov.bt. Publications Inquiries: National Statistics Bureau Thimphu Bhutan Post box: 338 Tel: 975 (02)333296 Fax: 975 (02)323069 Please post critical opinion/views directly to [email protected] ABOUT THE MONOGRAPH This monograph presents the findings from the analyses of the police crime data, National Health Survey data (NHS, 2012), mental health records (OPD) of Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), and qualitative data collected using the face-to-face interviews of 44 inmates of Chamgang Jail and Youth Development and Rehabilitation centre (YDRC). UNFPA, Bhutan provided the funding for the study. The monograph is a part of the thematic studies of the Socio-Economic Analysis and Research Division (SEARD), NSB. SEARD regularly conducts studies on the issues of policy importance and in areas where the research gap exist. The monographs covering various socioeconomic themes can be obtained from the National Statistics Bureau (NSB), Thimphu. The electronic versions are available at www.nsb.gov.bt under Research Reports. The summary of each monograph is published as the NSB Research Digest. DISCLAIMER UNFPA and NSB hope the study will be of value to the policy-makers, politicians, development partners, researchers, private sector, communities, and any other interested individuals. The views expressed in the present publication are those of the authors and do not imply the expression of any opinion on the part of the National Statistics Bureau (NSB) representing the Royal Government of Bhutan and the United Nations Population Fund (UNFPA). Both NSB and UNFPA take no responsibility for the accuracy or omission of facts, statements, opinions, recommendations, or any other errors in this publication. Table of Contents Director General’s Foreword ..............................................................................i Acknowledgements ............................................................................................iii Chapter I: Introduction .......................................................................................1 Chapter II: The analysis of reported crime among young people in Bhutan .................................................................................................................13 Chapter III: The analysis of interviews with young offenders in the police custody ................................................................................................................44 Chapter IV: An assessment of mental disorders among young people using hospital records .....................................................................................110 Chapter V: Descriptive analysis of mental health conditions among young Bhutanese people using NHS data ...............................................................124 Chapter VI: Local leaders’ views on issues faced by young Bhutanese people ................................................................................................................148 DIRECTOR GENERAL’S FOREWORD NSB’s Socio-Economic Analysis and Research Division (SEARD) conducts regular thematic studies of relevance to the country. The monograph titled ‘Crime and Mental Health Issues among Young Bhutanese People’ is the result of effort that our small research team has made to study and understand the various social and economic issues in the country related to the young populace. This is the second series of the thematic monographs covering the emerging challenges of our young people. The United Nations Population Fund (UNFPA), Bhutan Office funded the study and its publication. Young people in Bhutan are now exposed to many risks and vulnerabilities, those that may baulk their smooth transition to adulthood. Some of them gets trapped into various problems: crime, substance abuse, alcoholism, and mental disorders. Concerns are raised about the need to prevent young people from becoming unproductive citizens, and the worst: as criminals, substance abusers and alcoholics. There is so much to understand young people’s challenges, risks factors, problem trends, nature and extent of the problems, their dreams and aspirations, and possible solutions. For this, we need more researches, which at the moment is much wanting. This thematic research has been conducted to address such research gap, more so, to serve as the basis for more such studies. By reorganising and analysing the police crime records and the OPD mental health records of Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), our researchers have tried to shed some light on the nature and extent of crime and mental health issues among young Bhutanese people. The administrative data allowed only explorative analysis. The correlational, associative, and causality analyses could not be carried out. The qualitative study was conducted with young prisoners as the research subjects to supplement the analysis of the police crime records. Our research team had listen to a sampled young prisoners mainly to find out the reasons for their crimes, their sense of justice, dreams and aspirations, and their opinions about what ought to be done to prevent and reduce juvenile and youth crime in the country. They also had interviewed a couple of local leaders to understand from the local perspective the many issues facing our young people in the local communities. !i Second issue that the study covered was the mental health problems of our young people. The research team, with the support from the Psychiatric Department, JDWNRH, has created the outpatient mental health dataset. The analysis of the dataset constituted exploring the nature of mental disorders common among our young people (who have sought mental health services), their prevalence across sex and age groups, and the yearly trends. The dataset, unfortunately, has not allowed the assessment of associative and casual factors of different mental disorders. Further, they have used the National Health Survey (NHS, 2012) data to explore the mental disorders among young people to supplement the analysis of the clinical records. I believe this monograph would serve as an eye-opener to various challenges of our young people. It is expected to provide some understanding to the problems of growing crime and mental disorders among our young people. We know these problems exist, and we can to a certain extent, make out what causes them, but we lack researches to provide evidence in black and white. The criminality and mental health problems among young people seem to be caused by multiple factors, which shows us that devising strategies and solutions will involve much complex and integrated approaches. The findings of this thematic study raises many questions that can be answered by doing more researches. Despite many limitations, mainly caused by data constraints, we hope this study may be useful to inform the policymakers, social workers and others. I acknowledge the effort the NSB’s researchers have made, led by Lham Dorji, to produce this document. I sincerely appreciate UNFPA’s financial support, which has not only resulted in this monograph, but helped our research officers gain more experiences. Kuenga Tshering Director General !ii ACKNOWLEDGEMENTS We could not have achieved this study without the financial support from UNFPA. We thank Mr. Yeshi Dorji and UNFPA team, Bhutan office. We were motivated when they communicated to us that other than achieving the study results, they also aim at improving our capacity to conduct independent researches by providing us the opportunity to conduct research. The study could not have been possible without the access to the crime record of the Royal Bhutan Police (RBP) and Jigme Dorji Wangchuck Referral Hospital (JDWNRH). We wish to thank the Chief of Police and RBP as whole and the JDWNRH’s Medical Director, Superintendent and Psychiatrist Doctor Damber Kumar Nirola. We thank the Officer-in-Commands (OCs) of Chamgang Central Jail and Youth Development and Rehabilitation Centre (YDRC), Tsimasham. Without their support, we could not have been able to interview 44 young inmates. We thank young inmates who were highly responsive to our interview questions. We also thank our local leaders (Tshogpas and Mangiaps) who shared with us their views on youth issues prevalent in their local communities. We thank Professor John Matta of Western University, Oregon, USA for reviewing the analysis of the OPD data of the Psychiatric Department, JDWNRH to understand mental disorders among young people. Our heartfelt thanks goes to Yeshi Wangchuk and Chimi Tshering (research interns) for their assistance in conducting field works and transcribing interview data