Kyla
03-18-2004, 05:42 PM
The prevalence of mental health illnesses within correctional institutions is high, with some estimates reaching 25%. This is in part due to the transinstitutionalization that occurred in the last century. Transinstitutionalization describes the movement of mentally ill from publicly funded mental health hospitals to nursing homes and correctional institutions. The increase in mental health illnesses in prisons not only burdens the prison health care system, but it further compromises the mental health status of prisoners with mental health diseases. Mental health care providers are also in short supply within correctional institutions, despite the fact that courts have mandated the treatment of mentally ill offenders. Additionally, correctional officers, who are in charge of security issues, often lack an understanding about appropriate management of mental health illnesses (e.g.: psychosis). As such, psychotic patients may be treated as violent patients (implying intent to harm), and managed in a manner that aggravates their psychiatric condition (e.g.: with restraints, solitary confinement, isolation, etc.).
The prison institution as it stands is not only a poor solution to managing individuals with acute and chronic mental health diseases, but also a potential contributor to the development of mental health diseases. This is best exemplified by examining prisoners placed in solitary confinement for weeks, months and years (sometimes up to 15 years!). Psychiatrists with an interest in prison mental health care note that individuals placed in solitary confinement over time may begin to have a cluster of symptoms, including psychosis, that together are known as the SHU syndrome (SHU stands for Security Housing Unit, see Voices of Thought below). While some psychiatrists believe that the mental health status of prisoners with the SHU syndrome can return to normal once released from solitary confinement, the reversibility may depend on the amount of time spent in isolation.
Other mental illnesses (both Axis I and Axis II diagnoses) are prevalent in correctional institutions. These include, but are not limited to, bipolar disease, major depression, schizophrenia, PTSD (post-traumatic stress disorder) and addiction disorders. Due in part to the high prevalence of mental health diseases in prisons and to the isolative and disempowering nature of imprisonment, death from suicide is common in prison (NB: rates of suicide in jails much exceed rates in prisons). Suicide ranks third, behind natural causes and AIDS, as the leading cause of death in prisons. Some have estimated the rates of suicide to be 50% greater in prisons than in the community at large. Furthermore, some studies have suggested that solitary confinement, overcrowding in prisons, longer prison sentences and lengthening death rows may put prisoners at higher risk of committing suicide.
The mental health of prisoners is also affected by the hostile prison environment. This is especially expected given than many prisoner have been subjected to a lifetime of physical, mental and sexual abuse. With the continuation of abuses in prison, including physical abuse and rape (see Voices of Thought below), prison can begin to destroy people psychologically.
Some prisons have begun to screen inmates for mental health diseases, but no standard systematic program exists to manage this health care problem. Additionally, many prisons have cut back on funding for rehabilitation programs for prisoners with additions, even though with tougher laws more people are imprisoned secondary to drug crimes (e.g.: possession, trafficing). Overall, mental health care in prisons is in drastic need of attention.
The prison institution as it stands is not only a poor solution to managing individuals with acute and chronic mental health diseases, but also a potential contributor to the development of mental health diseases. This is best exemplified by examining prisoners placed in solitary confinement for weeks, months and years (sometimes up to 15 years!). Psychiatrists with an interest in prison mental health care note that individuals placed in solitary confinement over time may begin to have a cluster of symptoms, including psychosis, that together are known as the SHU syndrome (SHU stands for Security Housing Unit, see Voices of Thought below). While some psychiatrists believe that the mental health status of prisoners with the SHU syndrome can return to normal once released from solitary confinement, the reversibility may depend on the amount of time spent in isolation.
Other mental illnesses (both Axis I and Axis II diagnoses) are prevalent in correctional institutions. These include, but are not limited to, bipolar disease, major depression, schizophrenia, PTSD (post-traumatic stress disorder) and addiction disorders. Due in part to the high prevalence of mental health diseases in prisons and to the isolative and disempowering nature of imprisonment, death from suicide is common in prison (NB: rates of suicide in jails much exceed rates in prisons). Suicide ranks third, behind natural causes and AIDS, as the leading cause of death in prisons. Some have estimated the rates of suicide to be 50% greater in prisons than in the community at large. Furthermore, some studies have suggested that solitary confinement, overcrowding in prisons, longer prison sentences and lengthening death rows may put prisoners at higher risk of committing suicide.
The mental health of prisoners is also affected by the hostile prison environment. This is especially expected given than many prisoner have been subjected to a lifetime of physical, mental and sexual abuse. With the continuation of abuses in prison, including physical abuse and rape (see Voices of Thought below), prison can begin to destroy people psychologically.
Some prisons have begun to screen inmates for mental health diseases, but no standard systematic program exists to manage this health care problem. Additionally, many prisons have cut back on funding for rehabilitation programs for prisoners with additions, even though with tougher laws more people are imprisoned secondary to drug crimes (e.g.: possession, trafficing). Overall, mental health care in prisons is in drastic need of attention.