Corrections Quandary: Mental Illness and Prison Rules

The number of incarcerated men and women with severe mental illness has grown so tremendously in the last few decades that prisons may now be the largest mental health providers in the United States. Yet U.S. prisons are not designed or equipped for mentally ill prisoners. Prison conditions are hard on mental health in general, because of overcrowding, violence, lack of privacy, lack of meaningful activities, isolation from family and friends, uncertainty about life after prison, and inadequate health ser- vices.1 The impact of these problems is worse for prisoners whose thinking and emotional responses are impaired by schizophrenia, bipolar disease, major depression, and other serious mental illnesses. The mentally ill in prison also face inadequate mental health services that leave them under-treated or mistreated. In addition, poor mental health services leave many prisoners receiving, as Thomas C. O’Bryant points out, inappropriate kinds or amounts of psychotropic medication that further impairs their ability to function.

There is an inherent tension between the security mission of prisons and mental health considerations. The formal and informal rules and codes of conduct in prison reflect staff concerns about security, safety, power, and control. Coordinating the needs of the mentally ill with those rules and goals is nearly impossible.

Read the full essay at ttp://www.law.harvard.edu/students/orgs/crcl/vol41_2/fellner.pdf