Correctional systems in the US and any other country are established to help convicts in reforming before they are allowed back to the society. Over the years, the governments have funded the correctional facilities. Various changes in the nation have led to an escalation in the number of imprisonments. The prison facilities are overcrowded with limited facilities shared among hundreds or thousands of prisoners. Whereas, the regular prison environment may require survival technique for mentally stable prisoners, mentally ill prisoners are facing a myriad of challenges in regular prisons. The unwelcoming prison environment compounded with mental illness has been attributed to numerous suicidal cases that have been reported in the past. Research shows that approximately three hundred thousand inmates in US prisons are suffering from mental disorders. The intensity of mental disorders varies as some suffer from more severe cases including bipolar disorder, major depression, and schizophrenia. Rehabilitating mentally ill inmates requires a different environment with adequate resources. The society will face more problems by failing to cater to the needs of the mentally ill inmates.
Punitive and Rehabilitative Justice
The establishment of prisons in many states was predicated on the need to rehabilitate and punish individuals who had committed various crimes. As cases of mental disorders are steadily increasing in the society, the criminal justice system has assigned prisons a role that was never a primary intention. Most prisons systems were designed and created to cater for the requirements and needs of mentally stable inmates, however, in the current periods, mentally ill inmates represent a significant number of individuals who are serving prison sentences. Most of the offenses that are committed by the mentally ill prisoners range from minor to capital. The justice system seemingly is unfair to the mentally ill inmates considering their conditions. Due to their deviant behaviors, mentally ill prisoners have been treated as disciplinary problems in many regular prisons.
Delegate your assignment to our experts and they will do the rest.
As much as the mentally ill inmates contribute to a significant percentage of the total prison population, it is imperative to discuss the driving factors. Research shows that the number of mentally ill people in prison is three times higher than the number of mentally ill patients in community mental health facilities ( Gopnik, 2012 ). The shocking revelations introduce a new angle of view into this critical issue. The probable cause of a high number of incarcerations of mentally ill individuals is the gap between the available mental health services in the society and the need for treatment. Deinstitutionalization of mental disorder patients resulted in the closure of many psychiatric hospitals; the few hospitals that are operational are ill-equipped leading to poor services ( Wright & Herivel, 2013 ). As such, addressing the cause of the problem is critical if any long-lasting solution is to be formulated. The regular prisons are custodial implying that the prison environment is adversative to the therapeutic setting that is needed for inmates who are mentally ill.
The unsuitability of regular prison for mentally ill patients is premised on the social setting of the prison. Mental stability and recovery require a conducive social environment. On the contrary, the social background of regular prison is harsh and distressing; it needs an individual to be fit to survive. The fitness of an individual to survive in a prison setting has been a matter of concern for many studies ( Wright & Herivel, 2013 ). The doubts are fueled by many cases reported on people who develop mental disorders in the prison settings. Medical evaluation of the inmates shows no sign of past psychological disorder. As such, prison setting is an environment that can amplify or aggravate mental conditions in inmates. It is noted that the longer a prisoner stays in prison, the more likely they are to heighten their vulnerability and develop suicidal tendencies.
In most prisons, segregation has been used as a protective technique for mentally ill inmates. Solitary confinement or isolation is a condemnation of the social environment of mentally ill prisoners. First, the act of keeping mentally ill people out of contact with the general population promotes stigmatization ( Frost & Monteiro, 2016) ). Already, it is known that mental illness attracts stigma from various factions in the community. Families with members who are mentally ill fail to receive adequate support from friends and relatives. The feeling of isolation, which is attributed to stigmatization, hence intensifies the mental conditions of the patients. Mental disorder patients who are isolated develop anxiety, frustration, stress and the cumulative effect is self-harm and suicidal tendency.
Extensive research has been conducted underscoring the growing number of mentally ill inmates ( Fazel et al., 2016 ). However, the focus on the fate of mentally ill inmates behind bars has attracted little attention from scholars. It must be understood that prisons are correctional facilities whose primary objective is to reform the characters of convicts. Whether reforms drive prison activities is a matter of conjecture based on the reports available to the public domain. Most of the activities that happen behind the prison walls are unknown to the public. Only inmates can narrate well from experience. However, taking into account the experience of former inmates, then prisons have changed from being rehabilitative to punitive. In theory, the correctional systems take one into prison to change their behaviors and actions. In reality, the prison has transformed to be war-ravaged setting with all manner of evils. As such, different stakeholders have questioned the efficacy of correctional facilities. Seemingly, the correctional centers have failed to achieve the original goals given the higher number of re-offenders.
Challenges in Prisons
Regular prison in the US or elsewhere is characterized by convicts from different races, ethnicity, religion and socioeconomic backgrounds. The crimes upon which the convicts have been convicted ranges from minor to major. The minor offenses constitute those crimes that attract few years of imprisonment. Conversely, capital offenses such as murder, drug trafficking, rape and robbery with violence draw long prison sentences. Some of the crimes that are committed attract life sentences. The volatility of prisons is attributed to the nature of the crime, and the years an inmate is assigned to be imprisoned. Studies show that prisoners who have a shorter prison sentence are likely to maintain good behavior leading to early release compared to those serving long sentences ( Harner & Riley, 2013 ). Understanding the behavior of prisoners serving long sentences is well explained through the psychological punishment. The inmates who have long prison sentence on their heads have the uncaring attitude. Such prisoners care less on their freedom as they are bound to spend their entire lives in prisons. The resultant effect of such an attitude is a manifestation of aggravated criminal behaviors inside the prisons.
Regular prisons, especially in the US have been an away playing ground for gang members. With the anticipation that incarcerating gang members reduces gang-related activities, the authorities have achieved less ( Winterdyk & Ruddell, 2010 ). Instead, the gang members have continued to engage in unlawful activities such as money laundering, extortion, kidnapping, and drug trafficking within the prison settings. With many gang members, incarcerated, specific gang operates an empire within the prison environment. The continued activities of gangs in the prison setting are attributed to inadequate policy planning and corrupt correctional officers ( Winterdyk & Ruddell, 2010 ). Whereas the correctional department can provide the essential resources required by the inmates during their stay in prison, the gangs have made life in most prisons inhabitable. The gang culture that has infiltrated the prison settings requires most of the inmates to be identified with a specific gang for their protection to be guaranteed. The conception that gang leadership has overtaken government-run prison facilities highlights the loopholes that exist in the correctional system ( Winterdyk & Ruddell, 2010 ).
The violent environment of regular prisons affects the lives of mentally ill inmates. Due to their vulnerability, most of the mentally ill inmates have been victims of gross abuse from both the correctional officers and fellow inmates. Apart from the physical torture that mentally ill inmates encounter in regular prison, the emotional torture has grave ramifications on the inmates ( Harzke et al., 2010 ). The general treatment of mentally ill inmates makes regular prisons unsuitable. First, despite the crimes committed and the mental status, all inmates should be treated with respect and dignity. The fundamental human rights sanctioned by international bodies such as the UN and the constitution of many countries commit to enhancing the rights and freedoms of all humans. Unfortunately, prisons in democratically advanced nations such as the US have been at the forefront in denying prisoners their fundamental human rights. The regular prison system has been rooted in neglect and mistreatment of the inmates. As such, when mentally ill inmates are mistreated and neglected, the resultant effect of such actions is amplified mental disorder.
Mental health is a mainstay of life just as physical health. As such, when it comes to treatment of inmates’ physical health condition, it is imperative to consider the state of their mental health. Incarceration, though necessary to lock those who exhibit deviant behavior should be rehabilitative rather than punitive ( Hassan et al., 2011 ). As such, neglecting mentally ill prisoners is a punitive act. Prisons are the hardest of all social places to live considering the tense and overcrowded facilities where inmates strive to maintain emotional equilibrium and self-respect despite the paucity of opportunities, work, meaningful education, limitation on community and family contact, extortion, violence, and exploitation.
The harsh and unwelcoming prison environment is particularly challenging for prisoners who are mentally ill considering their mental condition affects their ability to cope, impairs their thinking, and emotional responses. As such, prisoners with mental illness will require special facilities, programs, and advanced health services. The prisoners who are mentally ill are susceptible to exploitation and victimization compared to other inmates. Mental disorders negatively affect the copying and adaptability techniques of prisoners ( Lee, Fang, & Luo, 2013 ). The rules of regimented life in prison are premised on obedience and punishment for violations of rules. Such implies that the impaired judgment of the mentally ill inmates places them on the wrong side of the law as the correctional officer, mental health notwithstanding, punishes any misconduct committed.
Research has shown that out of the many prisons in the US; few can cater to the need of the prisoners with mental illness ( Lee, Fang, & Luo, 2013 ). Prisoners with mental illnesses are often viewed as disruptive and difficult. As such, they find a place in solitary confinement where human interaction is limited. Additionally, the construction of isolation units aggravates the mental condition of the inmates, as some of them are windowless. Continued stay in solitary for most of the mentally ill prisoners intensifies their conditions to the extent of admission in the hospital for critical psychiatric care. However, after stabilization, the inmates are usually returned to the same solitary confinement where the series of decompensation is re-initiated again.
Human Rights Laws and Practices
International human rights laws and standards are categorical on the conditions of confinement, including how prisoners with mental illness should be treated. Practices in American penitentiaries will progress significantly if the authorities would strictly adhere to the dictates of International Covenant on Civil and Political Rights. Another statute that the US is party to is the United Nation’s Standard Minimum Rules for the Treatment of Prisoners. The human rights provisions contained in these documents unequivocally outlines the procedures and standards of treating prisoners which include the right of inmates not to be exposed to an inhuman, cruel and degrading environment of confinement and the right to receive mental health treatment that is similar to the community standards of mental health care. Therefore, it is evident that human right principles disapprove the practices of correction agencies in undertreating or ignoring prisoners with mental illness because they have been incarcerated. The eighth amendment of the US constitution also prohibits the mistreatment of prisoners. Such implies that a country like the US ascribes to the legal duties and obligations of ensuring that all inmates enjoy their fundamental human rights and freedoms.
Prisoners suffer from disenfranchisement; they have an insignificant impact when it comes to influencing the executive and the legislature. Additionally, due to less public constituency power, the authorities have often ignored their threat of litigation. The US has set some reservations concerning the international human right treaties the county has signed. As such, the prisoners are limited to the suit they can hold against the state for violation of such treaties. The interpretations of the US constitution by the federal courts have further scaled down any prospect of hope for the prisoners. The federal courts have ruled that violation of the constitution occurs only if the correction officials are deliberately indifferent to the known needs of a prisoner with a mental disorder ( Torrey et al., 2014 ). Neglect and malpractice are uncategorized as a violation of the constitution. The constitutional vagueness has led to continued neglect and mistreatment of inmates in regular prisons. Again, implementation of the Prison Litigation Reform Act in 1996 seemingly appears misguided. The Act has severely obstructed the ability of inmates to achieve timely and yielding results in the courts. The legal view of prisoners’ fates implies that inmates with mental illness are suffering immensely in the regular prisons.
Treatment of mental condition can help patients to recover from the illness, while for serious cases, the painful symptoms are alleviated ( Torrey et al., 2014 ). The treatment of mental disorder facilitates autonomous functioning and the effective improvement of internal controls. In the perspective of the prison system, mental health plays a significant role. Effective treatment of the mental health of the prisoners not only improves their coping skills but also promote order and safety in prison and the community. Again, when the prisoners receive adequate mental health services to the point of recovery, then the prospect of safety and order are enhanced because the offenders are usually released upon completion of their prison sentence.
Integration of prisoners in the community is essential. Therefore, prisoners should only be released upon evaluation of their mental status. Failure to offer effective mental health services to the inmates with mental disorder implies that they are likely to commit crimes again and get reconvicted and imprisoned ( Simon, 2011 ). Provision of mental health services has benefits to both the individual inmate and the community at large. The cost of maintaining an individual incarcerated is higher compared to the same person receiving treatment in community based mental health facilities. Arguably, the deplorable state of regular prisons is attributed to budget cuts ( Torrey et al., 2014 ). Both the state and federal governments have slashed funds appropriated for the prison systems. Such implies that the resources required by the prisons are limited. With the inclusion of mentally ill prisoners in the regular prison, their situation has exacerbated.
Comprehensive Prison Mental Health Treatment Policy and its Challenges
The components that constitute quality and comprehensive health care in correctional facilities are well known. The components include systematic, procedural screening and assessment for mental illness, techniques of providing prisoners with prompt access to mental health care and service; mental health treatment plans ( Tripodi & Pettus, 2013 ). In summary, the mental treatment plans are detailed and practical with positive success when implemented fully. Despite the comprehensiveness of the mental health care in prisons, the policies have been sound on paper without any tangible results ( Tripodi & Pettus, 2013 ). Most of the correctional facilities are still lagging behind when it comes to implementing the policies. Various concerned parties and stakeholders have pushed some prisons to expedite the implementation process by filing lawsuits against individual prison. Across the country, mental illness in prisons is a pandemic that requires affirmative action. The number of mentally ill prisoners engaging in self-mutilation and suicidal tendency are on the rise. The prisons are understaffed and lack adequate resources to cater for the needs of mentally ill inmates.
Whereas inadequate resources have been blamed for frustration in the delivery of mental health services to prisoners, realities of prison life are also contributing significantly to the frustrations. Prison mental health care personnel are forced to work in environments run by security staff according to regulations that were never established or envisioned to accommodate inmates with mental disorders ( Murray, Farrington, & Sekol, 2012 ). For instance, prisoners with mental disorders have been relegated to isolation units even though the harsh and segregated detention units can invoke psychiatric cessation. Furthermore, the guidelines created by the security staff for inmates in unsocial confinement restricts the mental health specialists from providing more than just treatment to the prisoners, the professionals cannot provide structured activities, group therapies, and private counseling, all of which accelerates the recovery process ( Metzner, & Fellner, 2010 ). The untrained correction officials, who are called to make decisions in the absence of medical staff, often misjudge manifestation of psychotic or bizarre behavior. Many experts have also noted that mental health officers working in a prison setting are compromised over time. Such implies that their ability to make professional discernment is compromised. The resultant effect is demotivation of the health worker, which affects their performance.
Recommendations
From empirical studies, it logical to conclude that not a single prison system, particularly in the US intentionally and without regret harms inmates with mental disorder through a well-structured plan of providing substandard care. However, it is important to note that deprived mental health treatment for prisoners with mental illness is a countrywide pandemic. Both the federal and the state government are tasked with the duty of protecting fundamental human rights, and especially for those individuals whose state makes them vulnerable. To mitigate the problems prisoners with mental disorder faces requires a concerted effort from both the public officials and the public. As discussed, it is evident that prisoners with mental disorder should not be placed in regular prisons; preferably, they should be placed in correctional facilities with specialized care and an environment conducive for the amelioration and recovery of their condition. Considering the measures taken earlier to deinstitutionalize mental healthcare facilities, it would be unfeasible to suggest that new institutions be established. Establishment of new mental health institution may be a long-term solution, one that depends on the political goodwill and convincible public support. However, short-term solutions are necessary to mitigate the prevailing challenges.
The first recommendation that is necessary for this scenario is for the legislative bodies such as the US Congress and Senate to formulate laws that will enhance treatment of mentally ill inmates and reduce the rate of crime. The act should contain provisions on diversion programs such as mental health courts and jail diversion. The Department of Justice in collaboration with the Department of Health and Human Services should create a framework of managing programs that benefits prisoners in correction and the community upon release. Secondly, the Congress should solve the serious funding problems that are hampering effective functionality of federal programs that exclusively deals with the provision of mental health services. By rapidly restoring the medical benefits of released offenders with mental illness, the ex-convicts can manage their condition in the community and avoid committing other crimes. The third recommendation for the Congress is to retract or amend the Prison Litigation Reform Act. The Act as it stands currently inhibits prisoners from receiving justice from the courts on the deplorable conditions that characterize most of the correctional facilities.
The second recommendation affects the community leaders, public officials, and the public. Measures should be formulated to reduce the number of mentally ill people who are imprisoned. Such implies that during prosecutions, mentally ill offenders should undergo special proceeding that will direct them to community mental health care centers instead of prisons. The reduction will also imply that few inmates who are actual threats to the public safety receive adequate treatment in the prisons ( White & Cones III, 2013 ). The quality of mental health services should be improved at all cost. Such can be done by setting standards for all correctional facilities.
Conclusion
Mental illness is as critical as physical illness. In the prison setting, mentally ill inmates are undergoing a myriad of challenges that are aggravating their conditions. The prison system is harsh and difficult to survive. In fact, the system can make a normal person mad or make a mad person to be madder. Such implies that regular prisons that were never designed to accommodate mentally ill inmates should not be used to house such inmates. Inmates with mental disorder should be transferred to specialized facilities where their conditions can be treated effectively. The measures may take time due to the legal and financial restrictions that may impede the transitions. However, the support of the Congress through contextual legislations and public support will significantly change the current situation that is facing prisons.
References
Fazel, S., Hayes, A. J., Bartellas, K., Clerici, M., & Trestman, R. (2016). Mental health of prisoners: prevalence, adverse outcomes, and interventions. The Lancet Psychiatry , 3 (9), 871-881.
Frost, N., & Monteiro, C. (2016). Administrative segregation in US prisons . Washington, DC: US Department of Justice, Office of Justice Programs, National Institute of Justice.
Gopnik, A. (2012). The caging of America. The New Yorker , 30 , 72-77.
Harner, H. M., & Riley, S. (2013). The impact of incarceration on women’s mental health: Responses from women in a maximum-security prison. Qualitative health research , 23 (1), 26-42.
Harzke, A. J., Baillargeon, J. G., Pruitt, S. L., Pulvino, J. S., Paar, D. P., & Kelley, M. F. (2010). Prevalence of chronic medical conditions among inmates in the Texas prison system. Journal of Urban Health , 87 (3), 486-503.
Hassan, L., Birmingham, L., Harty, M. A., Jarrett, M., Jones, P., King, C., ... & Thornicroft, G. (2011). Prospective cohort study of mental health during imprisonment. The British Journal of Psychiatry , 198 (1), 37-42.
Lee, R. D., Fang, X., & Luo, F. (2013). The impact of parental incarceration on the physical and mental health of young adults. Pediatrics , peds-2012.
Metzner, J. L., & Fellner, J. (2010). Solitary confinement and mental illness in US prisons: A challenge for medical ethics.
Murray, J., Farrington, D. P., & Sekol, I. (2012). Children's antisocial behavior, mental health, drug use, and educational performance after parental incarceration: a systematic review and meta-analysis. Psychological bulletin , 138 (2), 175.
Simon, J. (2011). Mass incarceration on trial.
Torrey, E. F., Zdanowicz, M. T., Kennard, A. D., Lamb, H. R., Eslinger, D. F., Biasotti, M. C., & Fuller, D. A. (2014). The treatment of persons with mental illness in prisons and jails: A state survey. Treatment Advocacy Center .
Tripodi, S. J., & Pettus-Davis, C. (2013). Histories of childhood victimization and subsequent mental health problems, substance use, and sexual victimization for a sample of incarcerated women in the US. International journal of law and psychiatry , 36 (1), 30-40.
White, J. L., & Cones III, J. H. (2013). Black man emerging: Facing the past and seizing a future in America . Routledge.
Winterdyk, J., & Ruddell, R. (2010). Managing prison gangs: Results from a survey of US prison systems. Journal of Criminal Justice , 38 (4), 730-736.
Wright, P., & Herivel, T. (2013). Prison nation: The warehousing of America's poor . Routledge.
