Psychiatry In Prisons

Psychiatry in Prisons provides a comprehensive overview of the history, problems and development of psychiatric health care in prisons. It tackles a broad range of issues, from familiar mental health issues such as substance misuse, self-injury and health screening to complex legal, moral and philosophical dilemmas.

This book examines how the prison environment, architecture and culture can affect mental health as well as determine both the type and delivery of mental health services. It also discusses how non-medical practices, such as peer support and prison education programs, offer the possibility of transformative practice and support. By drawing on international contributions, it furthermore demonstrates how mental health in prisons is affected by wider socio-economic and cultural factors, and how in recent years neo-liberalism has abandoned, criminalised and contained large numbers of the world’s most marginalised and vulnerable populations. Overall, this collection challenges the dominant narrative of individualism by focusing instead on the relationship between structural inequalities, suffering, survival and punishment. Chapter 2 of this book is available open access under a CC BY 4.0 license via link.springer.com.

“A haunting and harrowing indictment . . . [a] significant achievement.” —The New York Times Book Review L.A. Times Book Prize Finalist * New York Times Book Review Paperback Row * Time Best New Books July 2020 Waiting for an Echo is a riveting, rarely seen glimpse into American jails and prisons. It is also a damning account of policies that have criminalized mental illness, shifting large numbers of people who belong in therapeutic settings into punitive ones. Dr. Christine Montross has spent her career treating the most severely ill psychiatric patients. This expertise—the mind in crisis—has enabled her to reckon with the human stories behind mass incarceration. A father attempting to weigh the impossible calculus of a plea bargain. A bright young woman whose life is derailed by addiction. Boys in a juvenile detention facility who, desperate for human connection, invent a way to communicate with one another from cell to cell. Overextended doctors and correctional officers who strive to provide care and security in environments riddled with danger. Our methods of incarceration take away not only freedom but also selfhood and soundness of mind. In a nation where 95 percent of all inmates are released from prison and return to our communities, this is a practice that punishes us all.

Recent surveys demonstrate a high and possibly increasing prevalence of mental disorders in prisoners. They have an increased risk of suffering from a mental disorder that transcends countries and diagnoses. Ethical dilemmas in prison psychiatry arise from resource allocation and include issues of patient choice and autonomy in an inherently coercive environment. Ethical conflicts may arise from the dual role of forensic psychiatrists giving raise to tensions between patient care/protection of the public.This book describes models and ethical issues of psychiatric healthcare in prison in several countries. Relevant issues are: the professional medical role of a psychiatrist and/or psychotherapist working in prison, the involvement of psychiatrists in disciplinary or coercive measures; consent to treatment, the use of coercion in forcing a prisoner to undergo treatment, hunger strike, confidentiality. The book ends with consensus guidelines concerning good practice in Prison Psychiatry.

For the past decade, the first edition of this unique book has lighted the way for those seeking to navigate the perilous shoals of providing mental health services in jails and prisons. These guidelines have been used and cited extensively in many contexts: educational, planning, and legal. They also have been used by surveyors and monitors of correctional facilities. Since the publication of the first edition, American jails and prisons have seen many changes, including considerable litigation, the development of consumer groups, and the creation of some exemplary programs. However, there has also been a dramatic increase in the population of U.S. jails and prisons. In September 1989, when the first edition of these guidelines was published, our nation's jails and prisons held an estimated 1.2 million men and women. This number is now 1.8 million. Many studies have consistently demonstrated that about 20% of these inmates have serious mental illnesses, and as many as 5% are actively psychotic. With upward of 700,000 men and women entering the U.S criminal justice system each year with active symptoms of serious mental disorders, with 75% of these people having co-occurring substance abuse disorders, and with these persons likely to stay incarcerated four or five times longer than similarly charged people without mental disorders, what are our duties and responsibilities? How do we live up to our personal moral principles, our professional ethics, and our public service obligations in the face of these overwhelming numbers? This is the question to which this book is addressed. This book is intended both to prod to action and to provide comprehensive guidance on how to fulfill these responsibilities to ourselves, our profession, and these badly underserved patients. We have the technologies for treatment and the knowledge and the skills, yet limited resources and public and professional resistance often impede appropriate response. We believe that these guidelines can help overcome many of these sources of resistance through informed action. More active involvement of our profession, as described in these guidelines, is needed, is possible, and will make a difference.

A Disturbing and Shocking Expose-A Passionate Cry for Reform Prison Madness exposes the brutality and failure of today's correctional system-for all prisoners-but especially the incredible conditions Andured by those suffering from serious mental disorders. "A passionately argued and brilliantly written wake-up call to America about the myriad ways our penal systems brutalize our entire culture. Dr. Kupers not only diagnoses the problem, he also offers a set of solutions. I hope this book will be read by all concerned citizens and voters, for it conveys truths that are vitally important to all of us." —James Gilligan, Department of Psychiatry, Harvard Medical School, and author of Violence: Reflections on a National Epidemic

The 15 years since publication of the second edition of the American Psychiatric Association’s task force report on psychiatric services in correctional facilities have seen increasing rates of incarceration of mentally ill individuals, continuing criminalization of substance use disorders, and a lack of accessible and appropriate care in the community. The purpose of the new edition, Psychiatric Services in Correctional Facilities, and the aim of the work group that authored it over many years of research, dialogue, and development, is to provide leadership in addressing the needs of the often disenfranchised population of the incarcerated and to provide guidance to mental health clinicians working in correctional settings. Urging an expanded role in leadership and advocacy, the work group members present the foundational principles that apply to providing care in correctional facilities, outline the basic types of services that should be provided, and apply the principles and guidelines previously established to specific disorders, patient populations, treatment modalities, and special needs. Working with these patients and in these settings presents particular challenges that clinicians are unlikely to have encountered elsewhere in practice, such as the use of seclusion and restraint and administrative issues. Psychiatric Services in Correctional Facilities provides critical guidance and support for mental health professionals operating in this often frustrating environment, enabling them to provide both effective treatment and informed advocacy for their patients.

This collaborative text addresses the full range of issues faced by correctional psychologists and other mental health service providers who offer programs and services within correctional institutions--from critical program development and management issues to specific treatment options for special populations.