Prison Mental Heath: Fostering the Role of Correctional Line Staff as Therapeutic Agents

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Article Reviewed:

Dvoskin, J.A., Spiers, E., M. (2004). On the role of correctional officers in prison mental health. Psychiatric Quarterly, 75, 41-59.

According to Dvoskin and Spiers (2004), the primary charge of the correctional system is to serve the punitive and protective functions of society and, more specifically, maintain the order, safety, and security of incarcerated offenders. In addition, the authors suggest that the prison system is legally mandated and ethically bound to play a rehabilitative role, one that involves provision of appropriate and adequate care to inmates, including meeting their medical and psychiatric needs. It has been argued, however, that the ability to provide adequate and effective psychiatric treatment to offenders has been hampered by the increased number of persons incarcerated in the United States (Bureau of Justice Statistics, 1999). This trend is also apparent within the context of Canadian Corrections (Goff, 2001). According to recent statistics, the most dramatic increases occurred between 1988-89 and 1992-93, when the total correctional population in Canada increased from 109,000 to 152,000 (+39%) (Juristat, Vol.17, No.4, p.2). Further, according to the statistics published in Corrections Population Growth--First Report on Progress (1997), the prison population in Canada is expected to grow by 50% over the next decade.

In conjunction with this general growth, the number of inmates in need of some form of mental health care is also on the rise; however, the overcrowding within the correctional system deflects valuable resources from treatment and programmes for inmates who might gain from them, as well as crippling the capability of the correctional system to deliver treatment and programmes through timely and suitable means. It may be argued that the additional environmental stressors found within this context (e.g., excessive noise, temperature, fear, and anger) often prove to be overwhelming to those with pre-existing mental conditions and/or limited coping mechanisms, and ultimately increase the potential for disruption in an inmate's ability to function, particularly in the absence of adequate treatment. To keep pace with the escalating demand for mental health care in the prison system, and to continue to improve the quality and effectiveness of services in treatment of prison inmates with serious mental illness, Dvoskin and Spiers advocate the need to acknowledge and foster the role that correctional staff plays as a therapeutic agents, a label often reserved exclusively for mental health professionals. There has not, however, been very much systematic research conducted in Canada, nor elsewhere, on the role of frontline correctional personnel in the provision of mental health services within the prison system.

Recognising the need for research on front-line personnel and mental health, Dvoskin and Spiers discuss the integral role of correctional line staff in this domain, and propose several means by which to increase the optimal climate for successful treatment. According to these authors, employing conventional or strictly defined treatment approaches within a correctional context tends to be unsuccessful; rather, they propose that both formal and informal intervention strategies need to be implemented. While not disputing the necessity of formal clinical mental health training and credentials, Dvoskin and Spiers suggest that, quite often, any interested staff member can accomplish intervention strategies in corrections, as well as assist with the traditional goals of ongoing psychotherapy, responsibilities that often fall on the shoulders of correctional line staff. This proposition is supported by previous research on functional professionals (i.e., individuals who lack formal credentials, but nevertheless provide functions typically reserved for credentialed mental health professionals). The authors suggest that clinicians need not maintain a sense of superiority, nor engage in "turf wars" around treatment provision, as the primary goals of custody and treatment staffs are surprisingly similar (i. …