Can You Access Mental Healthcare And Counseling Services In Prison?
Mental illnesses are prevalent at alarmingly high rates in all nations. However, there is an overrepresentation of persons suffering from mental problems in correctional facilities. For instance, about two out of every five individuals in prison have mental issues. This represents 37 percent in state and federal prisons and 44 percent in local jails.
This high rate of mental illnesses in prison is due to several factors:
- The common myth is that everyone suffering from mental health issues is a threat to the community.
- Society’s intolerance to a disturbing character.
- Lack of proper treatment and rehabilitation services in prison.
- Limited or no access to mental services in many parts of the world.
Many of these illnesses may be present before entry to jail, and they may be aggravated even more by the stress of incarceration and confinement.
Inmates with mental illnesses often struggle to adjust to life during incarceration. They may face penalties for breaking facility regulations, such as solitary confinement or prohibition from engaging in programs due to behavioral issues. This emphasizes the need to receive proper mental health care while in prison. Inmates with mental illnesses need access to adequate mental health care, including screening, frequent and prompt access to professionals, and recovery-oriented activities.
Causes of Mental Health Issues in Prison
The following are some of the standard variables that may contribute to anxiety and depression during incarceration:
Memories of their Unlawful Acts
Offenders tend to replay the events that led up to their crime again and again during incarceration. This act may cause individuals to feel regretful and guilty. Having these kinds of thoughts regularly may lead to severe depression.
Prison Life
Prisoners often stay in confinement in a small space. They are also subject to the same routine over and over again, bringing about monotony. This sort of life may cause inmates to overthink about their lives, resulting in mental health issues.
Absence of Loved Ones
Inmates often experience loneliness due to separation from family members and friends. They remember the days they spent outside the jail walls reminiscing. These feelings of loneliness contribute to the development of mental problems.
Violence in Prison is Unavoidable and Traumatizing
It is impossible to avoid violence in prison. These correctional facilities have only a few places where prisoners may take refuge. However, even the safe havens that do exist offer only the most rudimentary degree of protection. Cells and areas under close monitoring are among the safe-havens, which help prisoners feel more secure. Nonetheless, prisoners are still vulnerable from observing violent acts around them, even in relatively secure environments.
Stabbings, beatings, and assaults with improvised weapons are among the acts of violence that prisoners see daily. Innocent inmates are sometimes made to directly and unwillingly assist in these acts by forcefully having to clean up the blood after an inmate’s attack.
As a result, the prisoner may experience the crippling mental and emotional responses that they evoke. Additionally, the inmates will have to face dreadful consequences.
Common Mental Issues and Depression Symptoms
Hopelessness
Depression is a kind of mental illness that impacts how you feel about yourself and your life in general. It is characterized by a dismal or negative perspective on life, which is the most frequent symptom.
Other emotions that may arise include feelings of worthlessness, self-hatred, and inappropriate guilt. Self-blame is the major example of the common, recurrent depressive idea that recurs.
Anxiety
Anxiety is another mental illness that coexists with depression. Its symptoms may include:
- Nervousness, restlessness, or a tight sensation in the chest.
- Fear feeling and panic.
- Fast heartbeat.
- Increased breathing.
- Sweating that is excessive.
- Trembling or twitching of the muscles.
- Difficulty concentrating or having clear thoughts on the issues bothering you.
Suicidal Thoughts
Most people with mental illnesses often have suicidal thoughts. Inmates who commit suicide typically exhibit signs and symptoms before they actually commit the act. It is common for individuals outside the prison to speak about suicide before succeeding in taking their own lives. However, the act by inmates is usually spontaneous.
Other symptoms include a loss of interest in engaging in any previously fun activity to the inmate and disassociation.
Current Mental Health Intervention Measures in Prison
Psychotherapy Sessions
There are various mental treatment options for inmates with mental issues. One of them is through cognitive behavioral therapy (CBT), which may contain or not include a criminal thinking curriculum. The other method is dialectical behavior therapy in correctional facilities or forensic hospitals.
Cognitive Behavioral Therapy
Cognitive-behavioral therapy is concerned with the relationship that occurs between one’s ideas, feelings, and behaviors. It also includes a focus on current problems and symptoms, as well as emerging patterns of behavior, attitudes, and emotions that are creating difficulties in one’s ability to operate.
The medical practitioners usually encourage their patients to reevaluate their thinking patterns to identify potentially detrimental thought patterns. Overgeneralizing outcomes, a lack of optimism in one’s life, and expecting terrible occurrences are just a few examples of detrimental inclinations.
Inmates can acquire more positive and productive thinking habits from this focus. As a result, these individuals can reconsider their knowledge of traumatic experiences as well as their awareness of themselves and their ability to deal with difficulties as a result of the occurrences.
Nonetheless, the exposure must be kept to a minimum with cooperation from both the therapist and the inmate. Hence, this treatment strategy helps in restoring inmates’ emotions of control and self-confidence. There is also a decrease in a person’s avoidance traits.
Medical practitioners have recently incorporated dialectical behavior therapy (DBT) into the prison sector to treat severe mental illnesses. Its previous application was in treating persistently suicidal women. DBT blends CBT techniques with mindfulness practices to provide a new approach to treating depression.
Treatments Using Psychopharmacology
It is a requirement that inmates with Severe Mental Illness have access to medication. Medications for mental issues include antipsychotics, antidepressants, and mood stabilizers. However, correctional institutions have unique challenges. Such challenges include the high prevalence of drug use disorders. As a result, there is a need to include restrictions on or exclusion of medicines with a high potential for misuse or abuse. There must be consultation between a correctional facility and a psychiatrist or other mental health experts in developing a formulary for cognitive drugs.
Special Housing Units
This is the use of self-contained mental health facilities to treat prisoners with severe mental illness (SMI). These persons are unable to function in the general public. The specialized housing choices often differ from one institution to another. However, they often include inpatient treatment, short-term crisis beds, and long-term residences for inmates needing long-term care.
Special Housing’s Negative Effects on Mental Illness
It is common for the mental health of individuals suffering from mild mental illnesses to deteriorate as a consequence of the isolation in special housing units. Doctors advise against these practices as they put the patient at risk of overthinking and loneliness, which are triggers for worsening mental health.
The Integrated Dual Disorder Treatment (IDDT)
This paradigm helps individuals who have recurrent severe mental illness and drug use disorders. This model improves the patient’s life by integrating substance misuse treatments with mental health care. Addressing both problems simultaneously in the same service organization by the same team of care professionals is beneficial to these persons.
Individuals may accomplish significant improvements such as sobriety, symptom control, and an increase in independent living. This goal is achievable through a succession of modest, overlapping, continuous changes over time through IDDT. Hence, this therapy method is structured on the phases of change, and each treatment plan is tailored to the specific needs of the individual receiving treatment.
Telemedicine
The most popular telemedicine technologies in correctional institutions are store-and-forward doctor-patient communication and interactive videoconferencing. Doctors may perform a remote medical examination of inmates via videoconferencing, diagnose the illness, and recommend medication without physical interactions.
Medical practitioners may capture, save, and transmit imprisoned patients’ health data using store-and-forward (asynchronous) technology. Consequently, doctors evaluate the information gathered about a prisoner’s health and provide treatment recommendations via the internet, eliminating face-to-face contact.
This method has become very popular in the delivery of psychiatry services in prisons.
Mental Health Care for Inmates Transitioning Back to the Society
It is difficult for returning prisoners who have Severe Mental Illness to reintegrate successfully into society. The likelihood of experiencing homelessness and finding work is higher for them than for the rest of the inmates. It is even worse for inmates with SMI and drug use disorder. As such, prison facilities try to provide certain programs to help in the reintegration process:
Critical Time Intervention
It is a three-phase therapy approach that facilitates the transition from institutional settings to community environments. It involves stages such as transition, tryout, and transfer to care for successful therapy. The initial intention of CTI was to help in the reintegration of people coming from mental health facilities such as hospitals and shelters. As such, prison authorities have also adopted the method.
It intends to avoid homelessness and other negative consequences among individuals with mental illness during societal reintegration. Further, it incorporates a number of treatment approaches, including cognitive-behavioral therapy (CBT), disease management, and assisted housing.
Planning on Discharge or Release
It involves establishing a continuum of care related to mental health and drug addiction treatments upon a prisoner’s discharge to the community. The most fundamental aspect of release planning involves:
- An evaluation of the prisoner’s clinical and social requirements.
- A documented plan outlining the treatment and services that the convict will need.
- Identification and coordination with specific community providers.
Determining the degree of release planning will rely on the inmate’s requirements, the availability of resources to fulfill those requirements, and the kind of imprisonment. It is essential to note that access to health benefits is key in effectively connecting returning prisoners with mental health issues to the community.
Case Management in Strengths Basis
This measure helps work on an inmate’s strengths. The individual will get a feeling of personal empowerment by building on his or her previous accomplishments. It encourages the use of an informal supporting network, as it helps in aggressive community engagement. Moreover, it also emphasizes the importance of the connection between inmates and case managers.
Assertive Case Management
This kind of management focuses on tasks such as evaluation, planning, referral, and monitoring rather than on significant outreach, connection, or direct service interaction.
Assertive Community Treatment
ACT offers individuals extensive mental health services, including access to a psychiatrist, a nurse, and a drug addiction expert. The patient-to-staff ratio is ten patients to one member of staff. Medication is included, as is cognitive-behavioral therapy (CBT). ACT also involves:
- Organizing time and dealing daily tasks.
- Organized work opportunities.
- Assistance with rent for a while, transportation, and any other inmate’s requirement.
Benefits of Effective Response to Mental Health Issues in Prison
To Prisoners
Taking care of the mental health requirements of inmates with mental illnesses enhances the life quality of the general prison population at large. Addressing these issues reduces stigma and prejudice towards those suffering from mental diseases if others better understand their problems. As such, addressing these issues increases the inmates’ ability to adapt to community life upon release. In turn, there’s a decrease in the likelihood of recidivism after prison.
To Prison Staff
Prisons are notoriously tough and demanding workplaces for employees. The presence of inmates suffering from mental illnesses would complicate and adversely impact the prison environment. Additionally, such an unattended situation can put more pressure on the prison personnel. Having a jail that is attentive to and encourages inmates’ mental health can boost the staff’s morale. As a result, this should be one of the primary goals of an excellent prison administration.
To the Community
Effective address to prison health must be in conjunction with the health of the general population. There is a regular exchange of information between inmates and the community, whether through the guards, administration, or other personnel. As a result, prison health is an essential component of general health. Looking after inmates’ mental health help reduce the chances of recidivism hence reducing those who return to prison. Moreover, addressing the inmates’ mental issues assists in diverting will help the community positively view these persons. A reduction in recidivism means that there is more workforce in the community, improving the general economy.