The Problem of Mental Health in Prison Populations

By Gater, Laura | Corrections Forum, March/April 2004 | Go to article overview

The Problem of Mental Health in Prison Populations


Gater, Laura, Corrections Forum


The criminal justice system was not meant to handle the needs of inmates with mental illness, but many children and adults in the system have mental health disorders. The U.S. justice Department estimates that 16 percent of individuals currently incarcerated in U.S. prisons and jails suffer from a severe psychiatric condition, such as schizophrenia, bipolar disorder, or major depression. Among the indirect costs of mental illness to society, the 1999 Surgeon General's Report estimates that $4 billion annually in lost productivity for incarcerated mentally ill Americans (see note 1 below).

Utilizing the criminal justice system to deal with the behavior of people with untreated psychiatric problems is not only unfortunate, it is also expensive. For most offenders with mental disorders, ' things only get worse once they are incarcerated. U.S. justice Department surveys find that 60 percent of persons with severe mental illness in jail and 40 percent of those in state prisons receive no treatment.

Inmates with schizophrenia fared significantly worse than their fellow prisoners in every way studied: ability to work while in prison, number of lock-ups, length of stay in lock-up, and ability to obtain release, according to an article by Jeffrey Swanson titled "Correctional Mental Health in N.C: An Expensive Non-solution" (see note 2 below). he cited a 1993 study of offenders' adaptation to life in prison which found that, when released, many "mentally ill offenders may turn again to substance abuse, drift into dangerous environments where violence and crime are commonplace, and may be victimized themselves. Arrest ' begets future arrest. Half of mentally ill persons in prison for violent crimes are repeat offenders."

BJS Statistics

The 2000 Census of State and Federal Adult Correctional Facilities, an enumeration of all 84 federal facilities, 1,320 state facilities, and 264 private facilities in operation on june 30, 2000, found that nearly all state adult facilities screen inmates for mental health problems or provide treatment.

Nearly 70 percent of facilities housing state prison inmates reported that, as a matter of policy, they screen inmates at intake; 65 percent conduct psychiatric assessments; 51 percent provide 24-hour mental health care; 71 percent provide therapy/counseling by trained mental health professionals; 73 percent distribute psychotropic medications to their inmates; and 66 percent help released inmates ' obtain community mental health services (see note 3 below).

Inmate Mental Health Issues

"Inmates are, first of all, people like the rest of us and so are subject to the same illnesses as the general population, including mental illnesses. However, the symptoms of some of the serious mental illnesses-schizophrenias, bi-polar disorder, for examplemay bring the mentally ill person more often to the attention of the police, especially if the individual may not be taking psychotropic medications that could control the symptoms," explains judith A. Stanley, MS, CCHP-A, director of accreditation, National Commission on Correctional Health Care (NCCHC), Chicago, 111. "The changes in the availability of return to psychiatric centers for 'brief respite/ and lack of adequate community-based resources for the chronically mentally ill has created problems.

"In addition, the pressures of incarceration may exacerbate the degree of illness. Depression, for example, is often a problem for inmates who may be fairly stable in the community, or may lead to suicidal ideation or behavior in those who were coping marginally in the community. If it is possible to generalize about the incarcerated population as a whole, a significant number have dual problems relating to varying degrees of mental illness, personality disorders and substance abuse problems."

Rachel Parks, RN, MS, and Carole seegert, Ph.D., MHM Services, Inc., Vienna, Va., agree that in corrections, the mental health population has a significantly higher percentage of Axis II disorders, either as the primary focus of treatment or underlying diagnosis. …

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