Prison

Abstract

Prisons present a complex array of problems relating to mental health. Perhaps most notably, the prison environment is quintessentially iatrogenic—that is, the “treatment” for substance abuse and mental illness now comes commonly in the form of incarceration, and this treatment by incarceration is related to further sickness. In other words, the American prison environment is the antithesis of a therapeutic community. Argumentatively, this has resulted in part from a combination result of a recent “no-frills” movement (Finn, 1996) and a growing scarceness of resources. Regardless, prison is often awash in contraband (e.g., alcohol and drugs) and trauma-inducing situations (e.g., physical and sexual violence, administrative segregation and isolation, and missing the death of loved ones in the free world while incarcerated). The data provided in earlier sections of this text presented the daunting statistics behind these issues: just over half of state prisoners have a mental health problem; only one-third of state inmates with a mental illness receive treatment for their illness in prison; and a smaller proportion receives professional mental health therapy for their symptoms. It appears that change is occurring most slowly for prisons than any other segment of the criminal justice system, primarily due to persistent budgetary constraints dating back to at least 1998 (CASA, 1998).