Development of Mental Health in Prisons

There are about 10 million convicts across the globe, and incidence of all studied mental illnesses is higher in the prison population compared to the general population (Reingle Gonzalez and Connell, 2014). Though the level to which prison escalates the occurrence of mental conditions remains uncertain, there are substantial facts of low rates of detection and treatment of mental disorders. Convicts are also at the elevated peril of all-cause violence, mortality, victimization, self-harm, and suicide, and research has noted some adjustable risk aspects. Superior treatment tests for mental disorders in convicts have been inadequate. Also, it is demonstrated in tests that opiate substitution treatments trim down drug abuse relapse and probable reoffending. The psychiatric health requirements of older adults and women in detention are different, and national regulations should be formulated to fill the gaps. Research, clinical and policy recommendations to advance jail mental healthcare are highlighted, and findings suggest that national efforts to attain these recommendations ought to be surveyed annually.

Introduction

Reingle Gonzalez and Connell (2014) report that the number of prisoners across the globe exceeds 10 million people and the research findings reveal that convicts have high rates of mental disorders. In some nations, the number of prisoners with severe mental disorders surpasses those in psychiatric hospitals. In spite of the high extent of need, these illnesses are usually under-diagnosed and inadequately treated. This literature review offers an extensive synopsis of the epidemiology of mental disorders in jail, brief on rates of violence victimization, suicide and risk aspects for these results.

The study summarizes evidence-based involvements for mental health. Following the results, there are various proposals of a chain of research, policy and clinical recommendations. The objective is to offer a more extensive synthesis of the critical aspect linked to the psychiatric health of women and adult convicts, and indicate gaps in practice and evidence. The literature review discusses two special groups; older adults and women. Adolescent prisoners have different psychological needs, and its synopsis falls outside the scale of this literature review.

A structured search for systematic reviews on convict’s mental health from 2003 to 2015 was conducted. The search was supplemented by recognizing fundamental studies on personal mental disorders, risk aspects and rates for severe outcomes, as well as interventions for psychiatric health issues.

Studies by Fazel, Hayes, Bartellas, Clerici, and Trestman (2016) have reported a high occurrence of most mental disorders in convicts, though the data should be carefully interpreted. Convicts evaluated by amateur interviewers have been linked to higher incidents than those diagnostic interviews undertaken by clinically trained psychologists and psychiatrists. The heterogeneity of occurrence projections can indicate the actual discrepancy related to differences in community rates for personal disorders across the globe, how courts and police handle mental sickness, levels of distinct crimes, and provision of healthcare in prison (Fazel et al., 2016).

There are various reasons which account for issues emerging form prevalence in studies of mental disorders among prisoners as explained by Melnikov, Elyan-Antar, Schor, Kigli-Shemes, and Kagan (2016). First is the inclusion of antisocial personality disorder that is a common ailment among prisoners. Secondly, various diagnostic tools presently utilized have not passed prison validation, and encompass aspects that might not be explicit. However, despite these issues, significant numbers of occurrence findings are constant, and the facts for key psychotic illness and depression are the strongest. The primary concern when addressing prevalence is to establish whether the high rates are resulting from the incarceration of if they are imported to jail (Melnikov et al., 2016). Result findings hint that stress from prison entry and criminal conviction are not the only basis for the high prevalence of psychiatric disorder.

Self-harm and suicides are the most prevalent outcomes resulting from mental health issues in jails. The occurrences are higher among prison population than among community-based individuals outside prison of similar gender and age. It is challenging to account for suicide incidents due to aspects like natural, unknown deaths, accidents and reluctance to record self-inflicted deaths in jail as suicide. Self-harm is a significant cause of morbidity though less researched as compared to suicide (Reingle Gonzalez & Connell, 2014). Regarding intervention for self-harm and suicide in jail, various recommendations are suggested including screening during the reception, timely treatment, suitable custody of at-risk convicts, and improvement of the existing security systems in prisons as well as social support systems and physical setting.

Chang, Larsson, Lichtenstein, and Fazel (2015) explain that additional severe results that can arise due to mental disorders include victimization and violence in prison. Though violent behavior is rampant in various custody facilities, limited studies prevail on its occurrence. Clinical aspects like impulsiveness, aggressiveness, psychopathy, and antisocial features are reliable predictors of institutional differences. Convicts with psychological disorders are significantly involved in jail conflicts and violent instances and are more prone to be charged with prison policies violation compared to other prisoners. Consequently, there is a range of environmental aspects that should be taken into consideration like policies, staffing, overcrowding, level/nature of daily operations, and considered alongside personal-level aspects (Chang et al., 2015).

Mental health and psychological disorders are overlooked in convicts. Studies reviewed here demonstrate that about 1 in 7 convicts are diagnosed with clinical or psychosis depression. Broader research is recommended to establish the causes of the high prevalence of mental disorders in prisons. Prisoners with mental disorders are at high risk of violence, self-harm, victimization, and suicide. Consequently, the departments of justice should work together with researchers and other stakeholders in prison management since tackling the scantiness of treatment research will require concerted action by funding agencies, government, and researchers.