Solitary Confinement and Mental Illness in U.S. Prisons - Assignment Example

A prison or a jail is a confinement in which law breakers are forcibly kept and denied several rights by the state as a punishment for the crimes committed. Prisons serve several purposes as part of criminal justice. They use prisons to confine people awaiting trial or people found guilty of their crimes and are serving their sentence. Inmates or prisoners, people found in prison, lack several civil privileges as a form of punishment. Prison run as a centre for punishment therefore, prisoners experience a lot of physical and mental trauma which affects their health. Mental health, specifically mental illness, is a major issue developing in many prisons around the world. According to surveys carried out, prisons and correction facilities are currently the largest mental health providers in the United States (Manderscheid, 195-198). However, prisons do not have the equipment to handle issues of mental health nor does its environment help in containing the issue of mental disorders. For this project, the main context includes history, causes, and solutions to the mental health issues affecting inmates in prisons and correction facilities. Research carried out in the past indicates that prisons hold the largest percentage of mentally ill patients. More than 300000 men and women, confined in correction facilities in the United States, suffer from mental illness. Some of the mental disorders found in inmates include, schizophrenia, major depression, and bipolar disorder (Manderscheid, 195-198) . The proportion of prisoners suffering from mental illness is on the rise. Statistics state that close to 15% of the total number of inmates found in state, federal, and local jails suffer from mental illness. The number of mentally ill persons in prison has tripled that of people found in mental health institutions. The growth rate of mental illness in correction facilities is twice that found in the general public. There exists little historical data, but experts believe that the population of mental illness in prisons is on the rise. Over the previous five years, a disproportionate number of mental illness cases developed in nineteen out of thirty states. Clinical researches indicate 8-19% of prison inmates have major functionality disabilities due to psychiatric disabilities. 20% require psychiatric intervention. Department of Justice Survey of Inmates declares that the rate of mental illness varies with the type of correction facility. The figure below gives the results of the survey: In a 12 month period survey, local jails recorded the highest percentage of 64.2. State prisons held the second position with a total percentage of 56.2%, and finally federal prison which recorded 44.8%. From the given results, local jails hold the largest percentage of mental illness cases while, federal prison record the lowest percentage. Bedford Hills Correction Facility, a correction facility located in Westchester County is New York’s only maximum security prison for women. Affiliates of the Correction Association’s Women in Prison Project Visiting Committee carried out a research in January 9, 2007 and filed a report indicating cases of mental illness in the facility. 63% of the women inmates served time for violent crimes and 21% served time due to drug abuse. A rough estimate of 74% reported cases of alcohol or substance abuse before serving time in prison. Bedford Hills is considered as a level one facility that provides women with most intensive mental health services (Segal, 45). An interview with the Executive Director of Central New York Psychiatric Centre assisted in gaining statistical information about mental illness in the facility. As of the 2007, the Office of Mental Health recorded 50% of the women population in the facility suffered from mental illness. This indicated a proliferation in the number of patients as compared to a 42% count in 2005. 30% of the women suffered from major disorders such as major depression, psychotic depression, and bipolar disorder. Official records showed 15% of the women suffered psychotic disorders including schizophrenia, and 72% of the women took psychotropic medication (Segal, 45). The American Psychiatric Association and the correction Service of Canada indicate that correction facilities in Canada establish a rise in cases of mental illness. Within the Canadian context, Brink, Doherty, and Boer conducted a research that had the following findings: 31.7% of inmates in federal penitentiaries in British Columbia, suffered from a mental disorder with 12% diagnosed with serious psychotic disorder (Metzner, 1). Fazel and Danesh found out that one in seven prisoners in the western countries suffer from major mental illness. If an individual is diagnosed with mental health illness and is treated, or it is their first time, every corrections facility aim is to provide care. The facility should treat the patient. Most prisoners have had cases of mental breakdown in the past even before going to prison. However, prison facilities enhance the development of mental illness rather than aim at reducing it. Several questions emerge in a bid to understand why prisons are for punishment rather than behaviour correction. Does the society have the right to deny any individual their rights? Does punishment solve the problem? What kinds of restrictions are humane and which ones are not? Putting a human being or any animal in a cage, metal bars, small space, alone is harmful to their health particularly their mental health. Several challenges faced in prison lead to the development of mental illness among inmates. Most prison facilities currently hold people suffering from mental illness, which is not appropriate. Prisons lack the necessary equipment and environment required to accommodate mentally ill patients. Several policies such as the rules found in prison make it difficult for physicians who work in U.S prisons to administer the necessary medical practices. Practitioners find it ethically difficult due to the substandard working environment, dual loyalties to patients and employers, and tension as a result of the rules stipulated. Long-term solitary confinement leads to serious brain damage and chronic psychological conditions. Prison officials embrace different forms of solitary confinement to contain potentially dangerous inmates or those who cause a lot of trouble. Despite the perception that it is a good idea to lock someone in a dark room and alone as a form of punishment, it is difficult to withstand the conditions. Isolation is clinically comparable to psychological torture (Metzner, 1). According to prison rules, prisoners spend 23 to 24 hours of their time locked in cells. They live their lives under the watch of guards and lack ordinary social interaction. They also lack enough time for recreational activities with little time for any purposeful activity. This lowers body stimuli which are bad for human health. Isolation can be harmful to an individual depending on the severity, duration, and nature of confinement. It leads to severe psychological effects such as anger, cognitive disturbances, anxiety, paranoia, and psychosis. Above all solitary confinement, mental health professionals are unable to mitigate for this disaster. Adverse effects are quite essential when it comes to people with serious mental conditions, commonly known as schizophrenia and bipolar disorder (Metzner, 1). Stress, meaningless social contact, and unstructured days lead to illness and provoke recurrence of mental illness. The nation’s aggressive war on drugs leads to increase in the integral number of mentally ill people in prison. This approach has led to increase in number of mentally ill inmates in the United States by four times. Most drug abusers develop mental disorders; however with the new law instead of rehabilitation, the state finds it appropriate to imprison offenders. Mental health of the individual deteriorates, due to the physical and psychological stress they go through in prison. The predominant goal of correction facilities is to ensure the security of staff and inmates. To meet facility goals, management imposes heavy rules, policies, and regulations. However, no rules accommodate the mentally ill which makes it harder for mentally ill inmates to follow the rules. Consequentially most inmates break the rules followed by greater punishment. Therefore, the problem grows from bad to worse each day. Prison policies state that mentally ill prisoners should be separated from other inmates which are inappropriate. Many get worse as a result of isolation from the rest. Prison policies deny patients the right to proper medication such as individual therapy, group therapy, recreational activities or education. Most mentally ill patients result to life threatening behaviour such as committing suicide (Metzner, 1). Patients hallucinate, lack coordination skills and inflict pain to their bodies. Stakeholders in a correction facility include, Warden, subordinates, the government, guards, staff, and inmates. Each of the listed members plays a major role in the correction facility. Top officials including the state justice system; make the necessary rules and policies to be followed in the facility. Policies made by the prison official impact the health of inmates in a negative way. Rules made prohibit a suitable humane environment for prisoners to survive in. Health care professionals try to defend the rights of the inmates but what are practitioners’ ethics if prison officials impose rules that enhance solitary confinement. When mentally ill prisoners break the laws governing the facility, officials treat them just as other normal inmates. If lesser sanctions do not work on the individual, policy demands that the prisoner should be isolated from the rest. Prison official are afraid to embrace the fact that mental illness is a sensitive issue. Wardens are afraid that prisoners will provide it as an excuse to cause chaos. Despite the negative impact on the prisoner’s mental health, continued misbehaviour, leads to indefinite solitary confinement. Despite efforts by federal courts to prohibit solitary confinement, mentally ill prisoners continue leaving for solitary. However, the Federal courts issue rulings that prohibit solitary confinement of mentally ill inmates (Phillips, 10). Many cases challenge the segregation of mentally ill inmates defining it to be unconstitutional, and a very cruel act to a human being. Civil rights bodies such as U.N. Committee against Torture, Special Rapporteur on Torture, and Human Rights Committee define solitary confinement of mentally ill as a cruel act. The degrading act is in violation of International Convent on Civil and Political Rights. Mental health care professions struggle with the limited available resources and the large number of patients in prison. As part of the stakeholder group, physicians should do all they can, and use what they can get to treat patients. It is proper to conclude that doctors in prison have a positive impact on the mentally ill prisoners despite the minimal resources. However, currently no medical organization has acknowledged that prolonged solitary confinement of mentally ill patients is a cruel act. However, medical practitioners have their shortcomings; if a doctor do their rounds but do or say nothing about the treatment prisoners are getting, they are not helping the situation. In the world of technology, present modern prisons are implementing the use of technology to make them more secure. Prisoner’s confinement occurs in highly sophisticated facilities to prevent them from escaping. With implantation of information technology, prisoners’ freedom narrows down even more. Information technology supports the research for better ways of confining mentally ill inmates, for example, chemical confinement. However, some correction facilities embrace positive technology that aids in reducing the problem. Some correction facilities implement Tele-psychiatry which is an easy and cheap way to allow inmates to easily access mental treatment from doctors (Perm, 80-87). Through a research carried out, Tele-psychiatry improved access to mental health services by inmates. This decreased the level of mental illness found in some correction facilities due to the quality care it provides to inmates. Many correction facilities can now save up to $1 million while using this form of telemedicine. Through information technology communication eases up. This allows people to advocate for better ways of treating prisoners and create awareness about the issues on mental illness in correction facilities. Critics are able to fight for the rights of mentally ill people. This is an indirect approach of trying to deal with the crisis. A viable solution is required after analysing the problem. Tele-psychiatry is a viable solution to the problem in prisons. Reducing the development of mental illness in correction facilities, fighting for the rights of mentally ill inmates is the prime of objective of this solution. Several guidelines provide a suitable path to follow while implementing Tele-psychiatry. Correction facilities should provide mentally ill prisoners with mental health services non-discriminatively. Facilities should provide comprehensive, holistic, and gender appropriate mental health services. Mechanisms are implemented to monitor the consistency of evaluation and delivery of services to mentally ill prisoners. Appropriate use of time by inmates, including recreational programs for the mentally ill which will assist in building a healthy stress free life. Despite the presence of Tele-psychiatric services in some correction facilities, it is still not fully implemented in a large percentage of the correction facilities. With the many rules and policies that prisons impose, it is difficult to avoid cases of mental illness. However, facilities can use Tele-psychiatry to mitigate the problem. It facilitates the diagnosis, monitoring, and intervention at a low cost. This method involves the use of information technology. It described as the use of telecommunication software and hardware, to provide mental health care (Wotton, 1). It facilitates patient access to medical healthcare services and can be used efficiently in correction facilities. Inmates receive substandard mental health care, but with the implementation of Tele-psychiatry they can now get treated. With this strategy, correction facilities are able to save on prison funds. Tele-psychiatry holds great advantages; it reduces the cost of transporting inmates from correction facilities for treatment. It also reduces public security risks while transporting inmates. Finally, it helps reduce hourly cost incurred by facilities due to treatment. Moreover, physicians refuse to over private services due to security issues; through Tele-psychiatry elimination of the barrier occurs. Below is a study done to measure the effectiveness of Tele-psychiatry on inmate access to mental health and cost of implementation: An observation of the literature review complemented with an open interview with a Tele-psychiatry practitioner. Five electronic databases provided information necessary to show the effectiveness of Tele-psychiatry; American Psychiatric Association Web Sites and National Bureau of Justice were searched. The observation included studying the effectiveness of Tele-psychiatry implemented in correction facilities in Arizona, California, Kansas, Ohio, and Texas. The information concentrated on the accessibility of mental health services by prisoners and the cost incurred by correction facilities. The interview with a Tele-psychiatric practitioner constituted the following questions: How have you implemented Tele-psychiatry in correction facilities? What method do you use in implantation, that is, software, hardware, or internet connection? What services does Tele-psychiatry provide? How has Tele-psychiatry benefited the facility? How has Tele-psychiatry benefited you as a practitioner? Are there any significant merits or demerits of using Tele-psychiatry? Results From both research methods, Tele-psychiatry presented inmates with easy access to mental health services. Through the interview results indicate that use of Tele-psychiatry is cheap, secure and very effective with inmates. The interview supported the use of Tele-psychiatry to increase access and diminish the cost of providing mental health services. A proper conclusion can be drawn judging from the results of the study. Mental illness in correction facilities can be mitigated through Tele-psychiatry. Facilities, the state, and providers can be assured of increased savings. Through online information, utilization of Tele-psychiatry assists in overcoming transportation and security barriers. Online information also indicates that Tele-psychiatry allows consistent treatment. It represents many employees including psychiatrists, psychologists, nurses, and therapists hence minimizing cost and maximizing savings (Perm, 80-87). They regard cases of mistreatment of mentally ill inmates as a serious violation of human rights according to the federal constitution. However, due to the deficiency in awareness many people ignore this fact. The most effective way to motivate people is by elucidation the importance of taking care of mentally ill prisoners. Regardless of the offenses and rules broken, prisoners are human beings. Through creating more awareness about Tele-psychiatry to correction facilities, explaining the advantages of using it to the policy makers may assist in making them understand. Critics and human rights supporters should involve the State’s Justice System in fighting for human civil rights. All stakeholders should understand the importance of human rights and the significance of offering mental health services to mentally ill inmates. Through creating awareness, it is possible for all stakeholders to understand causes of mental illness in correction facilities and how Tele-psychiatry can solve the problem. Use of effective ways of information technology can assist in disseminating the information hence attracting more and more supporters. Mental health issues have affected many correction facilities, and with continued ignorance the situation gets worse every year. However, with Tele-psychiatry and support from stakeholders the situation can be brought under control to an accommodating level for both mentally ill inmates and correction facilities. Work cited: Manderscheid, Ronald W.. "Mental Health Service Delivery Systems In The United States." Kybernetes 13.3 (1984): 195-198. Print. Metzner,, Jeffrey L. , and Jamie Fellner. "Solitary Confinement and Mental Illness in U.S. Prisons: A Challenge for Medical Ethics." The Journal of the American Academy of Psychiatry and the Law 38.1 (2010): 1. Print. Perm, J. "Telepsychiatry in Correctional Facilities: Using Technology to Improve Access and Decrease Costs of Mental Health Care in Underserved Populations."The Parmanente Journal 17.3 (2013): 80-87. Print. Phillips, Daniel W.. Mental health issues in the criminal justice system. New York: Haworth Press, 2007. Print. Segal, Ruth L.. The prison nursery Bedford Hills Correction Facility. New York (N.Y.)?: s.n., 1982. Print. Wootton, R.. Telepsychiatry and e-mental health. London: Royal Society of Medicine Press, 2003. Print. Read More