Psychological Interventions in Forensic Settings

Abstract

In previous chapters, we have discussed the various mental health issues that can arise after a defendant is charged with a criminal offense (e.g., is he or she competent to proceed to trial, was he or she lacking criminal responsibility due to a mental disease or defect). In this chapter we will discuss some of the ways the criminal justice system intervenes in these prisoners’ lives. The above vignette about Tom unfortunately is a common response by prison staff, many of whom do not appreciate the desperation of a mentally ill inmate. Some question the ability of prison officials to ever adequately understand or provide for the needs of the mentally ill, stating that the goals of the prison system are to punish the offender and protect society rather than rehabilitate and reform. Yet, look at the statistics of who ends up in prison; certainly those from the underbelly of society, lending support to the classical thinkers who believe that crime is based on ‘weak’ genes or other failures of strong will to avoid temptation as juxtaposed to the reformers who want to treat them more kindly given their backgrounds filled with abuse and despair. Prisons have the largest population of adult illiterates suggesting that both education and psychological treatment might reduce recidivism and produce better citizens when offenders return to society.

Tom is an inmate in the state prison system. He has been diagnosed as suffering from PTSD. One day, he refused to come out of his cell for recreation. Officers sprayed him with mace and forcibly dragged him out. When he returned to his cell, he slashed his wrists seriously enough that it required 10 sutures to close the wound. Tom requested a transfer to the mental health unit. The request was denied because the prison staff regarded his behavior as manipulative and not genuinely suicidal.

If you were the staff psychologist in the prison, what would you do? What if your only choices were to refer him to the mental health unit or place him on lockdown? Is his behavior a product of his mental illness or a desire to manipulate the system? These are some of the dilemmas faced on a daily basis by psychologists who work in correctional settings.