Running Head: POLICY ANALYSIS ON PREVALENCE OF MENTAL ILLNESS AMONG THE INMATES 1

POLICY ANALYSIS ON PREVALENCE OF MENTAL ILLNESS AMONG THE INMATES 9

Policy Analysis on Prevalence of Mental Illness among the Inmates

Nikita Warren

Southern New Hampshire University

Policy Analysis on Prevalence of Mental Illness among the Inmates

Statement of the Problem

In several nations, imprisonment and detention are a critical measure or sanction used against crime suspects who have contravened the law’s requirements or convicted for wrongdoing. Due to the overuse of the correctional system, it leads to universal reinforcing issues in response to the inmates’ social inclusivity. The primary concern is the prevalence of the mentally ill inmates depicting a definition of poor health services in prison, and policymakers must address the issue before it overflows. In various prison settings, health services are substandard and under-resourced financially, leading to a shortage of essential medication and understaffing. Mostly, the healthcare facilities in prisons work under total isolation from the other general healthcare setting, hindering the quality of services and progressive care upon these inmates’ release. Specifically, mental illness care is a critical aspect that is underserviced in the prisons, which leads to the reduced social integration of the prisoners and exposes them to more threatening situations. It is essential to address this element of mentally ill inmates’ prevalence to enable the prisoners to handle psychosocial, emotional stress, and related aspects.

Addressing this issue is essential to the corrective system to minimize cases of inmate suicide attempts and correctional facility staff burnout that results from overworking and subjection to stressful working conditions. Mental illness among the inmates or prisoners is possible to evaluate by observing and examining early warning signs such as pulling away from people (self-isolation), reduced energy, and irrational behavior among the inmates, stress, and related elements, among other factors.

Thesis of the Policy

It is essential to address mental health issues since there are dominant-negative factors in prison that render it unsafe for mentally challenged persons. These factors include overcrowding, violence, lack of privacy, isolation, and enforced solitude. It is crucial to address the mental illness problem to improve the prisoners’ mental health needs and attain quality life for the mentally ill inmates. Addressing the issue also promotes an extensive understanding of the stigma and discrimination that sick mentally prisoners encounter, and the need to mitigate. The policy alternatives need to address the mental illness problem in prisons to create a less complex and positive environment for prison employees, and increase morale and empower central prison management. Thus, this article ascertains that policy alternatives can mitigate the mental illness problem in the prisons through the diversion of mentally ill persons towards the health systems instead of prisons, providing appropriate access to mental health care among the prisoners, providing acute care for the prisoners relating to mental disorders in the general hospitals. Besides, availing training to the staff on mental health programs, providing information and education to the prisoners on mental issues, encouraging inter-sectoral collaboration, and promoting high standard prison management skills would enable a robust way of addressing mental health problems in the prisons.

Literature and Evaluative Review on Prevalence of Mental Illness among the Inmates

More than 10 million persons are in prison, and at least 30 million circulate annually. In prisons, inmates are prone more to mental disorders. In most nations, the mentally ill inmates number supersede that of the general public’s mental health facilities (Fazel, Hayes, Bartellas, Clerici, & Trestman, 2016). Most of these disorders go undiagnosed. In other cases, they are poorly treated, depicting a more significant justification of the overall and escalating percentage of mental disorder cases in the prisons.

John Podmore establishes that a significant number of mentally ill persons are swept into the prisons, and failure to mitigate the prevalent mental illness cases in the juvenile system is an enormous burden on the future public health and social well-being to the criminal justice system stakeholders (Spasova, 2017). Although there is an increasing demand for the change, many inmates have mental illness due to poor care and lack of diagnosis among the prisons. Overcrowding, insufficient skilled health personnel, and unsatisfactory prison conditions are the critical leading risk factors for the increased mental illness case among the inmates.

The prevalent mental disorders among prisoners include bipolar disorder, psychopathy, depression, anxiety, psychosis, personality disorders, and schizophrenia. Further studies justify that incarceration is positively correlated with negative emotional responses such as anxiety. Increased imprisonment or conviction indicates an escalated level of mentally ill inmates in the juvenile system.

A study on Spanish prisons indicates an increased incarcerated population for the past twenty-five years. This rising population is parallel to increasing mental disorders among the prisoners compared to the general public statistics. A research conducted in twenty-four countries shows the most common mental illnesses are the psychotic and significant depression disorders observable in one out of seven inmates. A co-morbidity of psychotic disorders with substance abuse has been established among the male inmates compared to the public (Zabala-Baños, Segura, Maestre-Miquel, Martínez-Lorca, Rodríguez-Martín, Romero, & Rodríguez, 2016). The results indicate the commonality of mental disorders among the inmates depicting a strong correlation of incarceration and the escalating rate of mental illness in the juvenile system through epidemiological research. The prevalence of mental disorders in Spanish prisons is adequately related to changing demographic profiles. The researchers suggest a vitality in studying the reality to translate the outcomes into the prisoners’ preventive action and therapeutic processes to minimize social inequalities regarding public health situations.

According to the 2017 report of the United States Department of Justice, approximately 37 percent of the prisoners have suffered an earlier mental disorder. The number of mentally ill inmates keeps rising. A significant population of the psychologists aims to remain purposeful to keep the mentally challenged person out of the prisons, and instead direct them to mental healthcare systems.

Alternatives and Recommendation

There are concerns relating to disruptive mentally ill individuals in the prisons; instead of releasing them to the public, and adopting restrictive housing units with the bureau of prisons (BOP) to mitigate their risky operations constitutes a critical element for the alternative policy. Some of the inmates present unique concerns relating to management and security due to their aggressive behavior in correctional institutions. Restrictive housing units would be regrouped into special housing units isolated from the general inmate population residence for their protection and that of others. The special housing unit program for isolating the mentally ill and dangerous individuals is useful to secure the public in the juvenile system. Reports of 2016 indicate that the prisons’ bureau accommodated at least 5 percent of the convicted inmates to special housing units for early monitoring before joining the other members of the system (U.S. Department of Justice, 2017). As part of the restrictive housing relating to the juvenile system members, select management units make an effective means of managing the interaction of the mentally ill individuals to foster the safety of other prisoners and orderliness in prison. Through the special management units program, the mentally challenged persons must complete a timed program where they are observed to infer whether they can coexist or interact appropriately with the staff and other inmates.

Designing the bureau of prisons mental health care in levels is a resourceful approach for mitigating the effects of prevalent mental illness among the inmates. The level one care involves observing the inmates with no significant impairment level that would need an immediate address from a practitioner. At this phase, the mental intervention is not regular, and the practitioners or the officials tend to execute functions that would minimize the risk of symptoms reemergence. The second level involves regular outpatient care based on the occurrence of a crisis. The element of this phase includes placing suicide watch and observing behaviors to comprehend an inmate’s intervention needs. The third level requires a weekly mental health intervention or house based approach that addresses mental problems among the inmates. The prisoners examined for the mental disorder are classified for exceptional care and scheduled for a regular check-in. At the fourth level, the inmate might need immediate inpatient and acute care if they cannot function effectively with the general population. These four levels represent an introduction of a national mental health care initiative where the correctional facility prioritizes constant care among all the sick and the healthy prisoners.

Diverting people with mental illness to the mental health care system rather than the juvenile system is critical to avoid directing sick individuals to the wrong place. Ensuring that offenders get the best and appropriate medication or mental health care before they are presented to the prison targets reduces the mentally ill people’s prison population. It promotes behavioral correction through a productive and evidence-based approach. Notably, a significant number of prisons lack the necessary medical facility to offer mental healthcare services. Thus, arraigning the mentally challenged individuals at the general population’s medical center would be effective advocacy for the imprisonment of the mentally fit individuals who can withstand the pressure in the juvenile systems or criminal justice systems.

Therefore, a recommendable policy for addressing the prevalence of mental illness among the inmates ensures constant medical procedures among all the prisoners and prioritizing regular examination of the inmates to evaluate their mental fitness over a specific period. Legislators stand an opportunity to advocate for the instruction of a law that allows the trial of a mentally challenged person while undergoing medications before they are presented to prison. The lawmakers should be present a petition that will enable the transfer of inmates from the prison or cells to general hospital psychiatric centers as the stages of criminal proceeding (arrest, prosecution, trial, imprisonment) continue. Diverting them to the public hospital psychiatric care before they are presented into the prison will help them acquire the appropriate treatment, and the prison population is optimally reduced. Using the general hospital psychiatric facilities as an alternative to jail for the mentally ill inmates is advisable to overcome skilled caregivers’ insufficiency and mental health service in the prison-stationed medical facilities.

Prioritizing medication and mental health care for the mentally ill inmates presents an opportunity to provide access to appropriate care and foster the integration of the general health services into the corrective system. Medication prioritization policy ensures that inmates are presented in the public hospital with adequate security levels to promote psychosocial support. As part of the mental care prioritization policy, providing sufficient training for the prison staff regarding mental health care fosters the staff’s understanding of the mental disorders and raises awareness of human rights (Mulvey & Schubert, 2017). Training the staff prepares them as advocates for encouraging mental health promotion and challenging stigmatization attitudes. The prioritization of staff training should be an essential element for encouraging mentally ill inmates to mitigate suicide cases that result from depressive disorders and other mental illnesses. Prioritizing medication of the mentally ill inmates should be achieved through inter-sectoral collaboration. The criminal justice system works with the health sector to provide appropriate and sufficient care for the severely mentally challenged prisoners (Kim, 2016). It is achievable by passing laws that merge the juvenile system’s services and those of the health sector to ensure maximum exploitation of medical services and sustainability.

Therefore, adopting a medication prioritization policy for the inmates and prosecuted persons through the diversion of the mentally ill person to the general hospital psychiatric facility rather than directing them to the prison and encouraging collaboration among sectors, and providing staff training are crucial elements to address the prevalence of mentally ill inmates’ problem.

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.

Kim, D. Y. (2016). Psychiatric deinstitutionalization and prison population growth: A critical literature review and its implications. Criminal Justice Policy Review, 27(1), 3-21.

Mulvey, E. P., & Schubert, C. A. (2017). Mentally ill individuals in jails and prisons. Crime and justice, 46(1), 231-277.

Spasova, K. (2017). The impact of incarceration on mental health and its prevalence [Master’s thesis]. DOI: 10.13140/RG.2.2.13995.95528

U.S. Department of Justice. (2017). Review of the Federal Bureau of Prisons’ Use of Restrictive Housing for Inmates with Mental Illness. Prison policy. Retrieved September 20, 2020, from https://oig.justice.gov/reports/2017/e1705.pdf

Zabala-Baños, M. C., Segura, A., Maestre-Miquel, C., Martínez-Lorca, M., Rodríguez-Martín, B., Romero, D., & Rodríguez, M. (2016). Mental disorder prevalence and associated risk factors in three prisons of Spain. Revista espanola de sanidad penitenciaria, 18(1), 13-23.

Use APA format—please see my post in the announcements

Title page

No abstract needed for this assignment.

You must use five (5) political science peer-reviewed academic research-based sources. If you are unsure of your sources, email me for assistance.

A. Introduction

1. Introduce the topic—briefly state why the issue is important (four to six sentences).

2. End the introduction with the research question (one sentence).

This is the question you have, your “ah ha” moment, after having read all the sources and written the literature review. The research question reflects a gap in the information/research, a question about how to move forward, or a question on the application of the information to policy making. In this case, as the next milestone is a policy paper, the research question should reflect a question you have about how to apply the research to a clear policy goal.

B. Content: review each source (This should be one to two paragraphs for each source):

1. The general research paradigm/theory (one sentence).

a. The reason for the research

b. The theoretical foundation

2. The methodology of the research (two to four sentences).

a. The hypothesis

b. The type of research—qualitative, quantitative, statistical, case study, etc.

c. The way the research was conducted—surveys, interviews, content analysis, ethnography, etc.

3. The research outcomes (five to eight sentences).

a. The hypothesis was supported or not supported

b. The interpretation of the research findings

c. Any additional information provided by the research

d. The “ah ha” of the researchers

C. Conclusion

1. Summarize the general overall line of reasoning that comes out of the research reviewed (five to six sentences).

2. State the “ah ha” moment you had after having read all the sources and written the paper (one to two sentences).

3. Form this into a research question and place it at the end of the introduction at the beginning of the paper (one sentence).