7.6 Summary
- People with mental and substance use disorders are disproportionately represented in jails and prisons.
- Screenings, assessments, and evaluations are used to identify needs of those housed in prisons and jails, but these are often inadequate to ensure needs are met.
- Housing is an important tool in management of people with mental disorders in prisons and jails. Overly restrictive settings must be used with caution.
- Victimization is an important risk for those with mental disorders in jails and prisons. Laws like PREA attempt to reduce this risk, along with attention to and reduction of various risk factors.
- Research has shown that the high prevalence of mental disorders in jails and prisons consistently produces poor outcomes for both affected people and correctional agencies. In 2002, evidence-based practices were put into practice to utilize effective strategies to improve behavioral health outcomes. These efforts promote personal recovery and reduce criminogenic risk for people transitioning out of the community from a controlled environment (Osher, Steadman, & Barr, 2002).
- While many correctional settings have begun implementing evidence-based practices for this population, there is still work that needs to be done to provide adequate treatment to incarcerated people diagnosed with mental disorders.
- Effective transition planning needs improvement to better support people transitioning out of a controlled environment and reentering the community. Without supportive ‘warm hand offs’ to treatment providers in the community, the likelihood of recidivism greatly increases.
7.6.1 Key Terms
- Alternative Incarceration Programs: Intensive treatment programs in prisons, intended to address criminal risk factors (such as substance use).
- Assessment instrument: A tool completed by a behavioral health professional that provides a more in-depth examination of reported presenting problems while also working to develop a treatment plan.
- Cognitive behavioral therapy (CBT): A broad set of therapeutic techniques that are aimed at adjusting someone’s mental processes (e.g. thinking or perceiving) to promote behavior change.
- Dialectical behavior therapy (DBT): A type of CBT technique that works to address maladaptive behaviors and the negative thinking that comes with these behaviors and works to incorporate healthy behaviors that are less detrimental to the person.
- Medication supported treatment: use of medication along with other therapies to treat substance use disorders. There are several medications that target alcohol use, as well as medications that treat opioid use disorder (SAMHSA, 2023).
- Milieu: a controlled social environment within a prison or jail, such as a therapeutic community, which provides structure, responsibility, and lifeskills to emulate and develop skills necessary once the person is released from a controlled environment.
- Power differential: An unavoidable dynamic between a person with authority (such as a psychologist or correctional officer) and a person who may be greatly impacted by the power-holder’s decisions.
- Screening: A standardized instrument that is designed to flag incarcerated individuals who are at risk for a targeted problem, such as a mental or substance use disorder. These tools do not provide diagnostic information nor do they provide guidance on the severity of any disorder.
7.6.2 Discussion Questions
- Reflect on the potential benefits of providing education and vocational training inside correctional facilities to better prepare people for community reentry.
- How can communities work together to reduce the stigma and negative perceptions associated with people who have been incarcerated?
- What job training and education programs do you think would be helpful to see in both men and women’s prison to provide long-term success for formally incarcerated people?
7.6.3 Summary Licenses and Attributions
Some information summarized or copied verbatim from public domain: