The purpose of most prison sentences is to rehabilitate offenders and help them return to society as healthy, productive individuals. To accomplish this goal, prisons need to provide services that help these inmates improve as individuals and prepare for life outside of prison.
When thinking about successful rehabilitation for people in prison, most people consider the basic needs of the prisoners, such as food, water, exercise and rest. They may also consider services designed to improve the inmate's chances of a successful life after prison, such as access to education and employment opportunities. However, one of the common issues people often overlook is the mental health of prisoners. Unfortunately, many people who are currently incarcerated are struggling with mental health problems, and these problems often get worse while the person spends time behind bars.
According to the Bureau of Justice Statistics, more than half of all prisoners in state prison and 45 percent of those in federal prison struggle with mental health issues. This percentage climbs to 70 percent and 61 percent respectively when only female inmates are considered. For males, mental health issues affect 55 percent of inmates in state prison and 44 percent in federal prison.
The most common disorders affecting inmates involve symptoms of depression and/or mania, while other inmates with mental health problems often suffer symptoms of psychosis. Regardless of the specific symptoms an inmate suffers, having a mental health problem in prison complicates the situation considerably.
While some inmates are already dealing with mental health issues when they become incarcerated, others develop these problems because of the stresses of incarceration. Even those who had a history of mental health issues before they came to prison will likely deteriorate further because of their experiences behind bars.
As inmates spend more time separated from their loved ones and dealing with significant restrictions on their daily activities, mental health problems can worsen quickly. The problem is exacerbated when inmates are subjected to solitary confinement and other psychologically-damaging punishments, or when they are involved in fights with other prisoners.
Mental Health and Crime
It's no surprise that mental health issues are so prevalent in prison. Multiple studies have identified mental health disorders as a factor contributing to crime. Although most people with mental illness will never be involved in crime, having a history of mental illness can make committing a crime more likely, especially when the individual experiences symptoms of mania or rage. Mental illness can also lead to "self-medication" with illegal drugs, which can also raise the chances of future crime. For individuals who enter the prison system with existing mental illness, treating the mental illness is essential to a successful rehabilitation.
Direct Consequences of Mental Health Problems in Prison
Inmates with mental health problems rarely receive the help they need while they are incarcerated. Prison officers, nurses and other individuals responsible for the care of the inmates are not trained to deal with these issues. These inmates may engage in several unwanted behaviors, including self-harm, refusing food and more. When inmates can smuggle drugs into the prison, those with mental health issues are more likely to overdose. In addition, inmates who have struggled with untreated mental problems throughout their time in prison may be less likely to qualify for parole and are more likely to be incarcerated again in the future after they are released.
The people in charge may do what they can to help a disturbed inmate, but they don’t have the knowledge or skills to provide struggling inmates with the right type of care. Some inmates may be referred to a specialist, but, in many cases, inmates with symptoms of mental health disorders don't receive any professional help at all, either because the issue wasn't discovered or the prison didn't have the resources to provide quality mental health care.
In addition to harming themselves, inmates with mental health problems may also cause problems that affect living conditions for other inmates. For example, inmates with mental health problems are more likely to fight and lash out at the other inmates around them than those who don't struggle with their mental health. This can lead to unnecessary injuries and stress for all inmates in the prison, including those who aren't dealing with acute mental health issues. Ongoing turmoil within the facility also affects prison officers and other staff members, causing them to lose morale, treat inmates more harshly and even deal with mental health concerns of their own.
Bringing Mental Health into Prison Reform
When policymakers discuss prison reform, the focus is often on reducing recidivism rates and making the prison system more effective. Unfortunately, many of these conversations fail to address the pervasive issue of mental health problems within the prison population. Until this issue is included in every prison reform conversation, significant reductions in recidivism are unlikely. Whether an individual comes into the prison with a mental health problem or develops an issue while incarcerated, he or she is unlikely to receive quality treatment before being released. Releasing an inmate with a known mental health issue is unlikely to produce the desired result. Thus, prison reformers need to pay attention to this problem and find ways to provide prisoners with the help they need before they return to society.
Fortunately, the Federal Bureau of Prisons is already taking some steps to improve mental health services for inmates. In 2014, the BOP issued internal guidance to its prisons that encouraged the use of cognitive behavioral therapy and other effective treatment techniques for patients who have a history of violence and/or mental illness. As these techniques are adopted, mental health care in prison will improve. However, this type of prison reform is still in its earliest stages at the federal level and hasn't yet taken hold in many states.