Prisoners with Mental Disorder - Research Paper Example

Prisoners with mental disorder Victims Of Ignorance And Brutality September 18’ 2009 Introduction People suffering from mental disorders have been victim of ignorance and brutality since decades. In the ancient times, when there was no knowledge about psychological disorders, they were tortured and punished cruelly by others who thought that they were forms of evil. However, even in today’s modern age of technology and human advancement, the injustice towards the people who are mentally ill has not stopped. Mentally ill people are treated badly and their needs are ignored. Even in the social institutions like prisons, inmates with mental disorder are treated harshly and are not provided with the medical and mental care that they need badly. The purpose of the research is to find out if the mental care needs of the mentally ill prisoners are being met in United Kingdom and United States and if not, then what are the obstacles in the fulfillment of their needs. The treatment of the Prisoners with mental disorders in United Kingdom: In the United Kingdom, the lack of the accurate data and the knowledge has led to the ignorance of the issues of mentally ill prisoners. The faulty screening and carelessness about their needs has resulted in inadequacies of the mental care and has made the treatment of all the prisoners impossible. Research by Kunz and colleagues in the year 2004 showed that if criminals who are mentally ill, are treated with cognitive skills program, then their chances of repeating the crimes and hence getting arrested reduces ( Ashford et al p.458). However, it was found that the treatment given to the prisoners was below standards and lacked adequate mental health care ( British Medical Association P.64). There was much to be done to improve the mental care services in prison. Unfortunately, it is also evident from different studies that not much is known about the specific needs of the prisoners, their mental conditions and if the need for treatment of mental disorders is being met. It was found that the efforts taken to gather the facts about the mental disorders amongst the prisoners is very minimum. Most of the surveys done to diagnose the illnesses focus on knowing about the physical illness. The questions related to detection of the presence of mental disorder or mental illness are very few. Hence, the presence of the mental disorder remains undetected (Columbus p.159). The percentage of the population that was getting treated for different physical ailments was more than 75% while the population among the prisoners who were getting treated for the mental illness was only 18%. This is not because the remaining population was not suffering from mental disorder but because of the fact that there was no attempt to know if the prisoners were mentally ill. Also, the disorders and the illness related to mind were not documented. Not only that, but even after realizing that they are suffering from mental disorder, only 14% were getting anti-depressants and 5% were treated with psychotropic medication. This medication was not documented(Columbus p.159). This shows that the needs of the mentally ill prisoners is not being met. In fact, even an effort to study the number of population that needs psychiatric treatment is not made. Prisoners who are mentally ill needs and deserves equal attention and care as the prisoners who are physically ill. The law states that the treatment of medication should be avoided as long as the condition does not become life threatening and an emergency (Columbus p.161). It is important to understand that the case of mental illness is different. As it s not related to the body, the need of emergency does not occur. However, the right of a prisoner to lead a healthy life and to get treatment as other human beings do, has to be respected. Just because mental illness does not kill a person doesn’t mean that prisoners should not be treated. The evidence of the presence of mental illness has been ignored. The example of a Yorkshire Ripper case, in which in spite of getting the information of the psychotic condition of the criminal by various medical witnesses, the criminal was admitted to the normal prison system, shows how careless the system is. In one other case, a man who was stated as normal in his mental condition was admitted to mental institution as there was no way to convict him of any crime as his was a case of trespassing the grounds of Buckingham palace. This shows that the treatment of the criminals with mental illness is completely inadequate. The examples show how carelessly the issue of the treatment of mentally ill criminals is being handled (British Medical Association p.79). Because of lack of seriousness in the matter of putting a criminal in the right prison system, the staff at the prison is having a problem. The medical staff of the normal prison system is not capable of handling the criminals who have mental disorders. This makes them to maintain distance from them. This might be one of the main reasons for the increase of rates of suicide in the Brixton prison medical wing (British Medical Association p.79). The Committee for prevention of torture and inhuman or degrading treatment for punishment (CPT) on their visit to United Kingdom found that the Brixton prison, which was used to house the prisoners suffering from mental illness, was not well equipped to practice medically appropriate ways to handle the needs of mentally ill and violent prisoners(Morgan and Evans p.266). The United Kingdom government is taking initiative to improve the conditions of the prisoners who are mentally ill. The efforts have started to put the mentally ill patients in the right wing where they will get sufficient facilities and environment which is conducive to their treatment. However, the lack of infrastructure and lack of knowledge regarding their needs has caused the problem to persist (Landsberg and Smiley p.xx). At the same time, it has to be noted that the government of United Kingdom has woken to the fact that mental health care is an important issue and the improvement in the mental health services is a matter of priority. The treatment of the Prisoners with mental disorders in United States: Studies conducted by different researchers over a decade have found that although there is no association between mental illness and violence, the likelihood that they will indulge in violence is more in them than in people without mental illness (Silver, Felson and Vaneseltine p.405). This increases the chances of people who are mentally ill to get involved in crime. The main question is of the diagnosis of the mental illness. In the United States, the situation of the prison regarding the prisoners with mental illness is similar to that of the United Kingdom. The illness of the prisoners goes undetected and hence the condition becomes worse. Study conducted by Roger and Regier (19901) found that even though a large amount of prison population with mental health problem receive a treatment for mental disorder, many others who are suffering from mental illness do not get the treatment (Silver, Felson and Vaneseltine p.405). The prisoners who are mentally ill are treated to shockingly inhuman treatment by the prison staff. The incidences of cruel treatment of the prisoners who are mentally ill at the ‘supermax’ confinement shows that the efforts to understand the helplessness and the inability of the prisoners who are mentally ill are zero. The conditions of the prison are so harsh and inhuman that even those prisoners who do not suffer mental illness get psychologically and emotionally disturbed and hence are likely to develop mental disorders due to the inhuman treatment they get at the prison. According to the Human Rights Watch (2000), the confinement is unduly severe and has no logical explanation for the suffering and the humiliation of the prisoners. They observed that the staff of the prison treats the prisoners as if they are not a part of human society (Haney p.957). In one incidence which shows the brutality towards the prisoner who is mentally ill, the guards dragged a prisoner who was mentally ill in nude and forced him to remain in hot water for such a long time that the skin of his lower torso peeled off. The guards did not even bother to call the medical staff to treat his mental illness or to treat his wounds (Haney p.959). In the study conducted by Ruiz V.Johnson (1999), it was found that the prisoners suffering from psychosis were locked round the clock by the staff, without giving them any medical care or treatment. Their treatment was nothing less than barbaric. The visitors from outside found them screaming and banging on the wall calling for help. The sad thing was that even when the guards knew that they were mentally ill, they did not make any attempt to get them treated. Due to indefinite lock up, the prisoners were found living in the cells which were smeared by their excrement (Haney p.957). According to a study by Gomez (1995), these incidences of torture and maltreatment towards the prisoners who are mentally ill were not isolated ones but a regular and ongoing practice in the prison. Several studies have found that 29% of the supermax prison population is suffering from serious mental disorder. Lovell and his colleagues (2008) found that 45% of the supermax population suffered from the overall psychosocial impairments and were going without treatment (Haney p.957). The lack of the health care procedures for the treatment of the prisoners who are mentally ill has made it difficult for the correctional officers to understand the nature of their problem. The correctional officers are not trained to deal with prisoners who are mentally ill and hence, lack the skill set to recognize or to treat their psychological problem (Haney p.965). Because of the lack of understanding of their psychological problems, the behavior of the mentally ill prisoners make the staff to label them as ‘mad’ and ‘dangerous’. Due to this, they are in fact treated to more severe and harsh conditions than the prisoners who are not mentally ill. This worsens their psychological and behavioral conditions (Haney 972). According to Correctional Association of New York (2004), 20% of the prisoners in New York, who were mentally ill were treated to punishments where they were kept on a loaf diet for months and their movements were severely restricted. This kind of brutal treatment at the hands of the staff has made the relationship between the prisoners and the staff extremely hostile. This in turn, makes the treatment of the mentally disturbed prisoners very difficult. Under these circumstances, the attempt of the therapist to treat the prisoner gets hampered. The interview of the prisoner happens with the guards looming around, which makes the transparency impossible for the prisoner. The prisoners are locked in cages that are arranged in a circle while the treatment for group therapy is conducted. This shows that the treatment of mental health is distorted, is not taken seriously and is done just for the sake of doing it (Haney 973). If this continues, then the chances of getting justice for the prisoners who are mentally ill is very bleak. The society as a whole is responsible to see to it that the mentally ill prisoners are treated with respect and as human beings. The conditions in prison does not facilitate a development of relationship between the mentally ill prisoners and the medical staff. The intention of the treatment remains unachieved. The physical condition of the prison discourages the staff and hence the treatment does not take place (Haney p.973). According to a study by Schaefer and Stefancic (2003), only 40% to 60% of the total prisoners who are mentally ill attend the quality therapy program. This is discouraging knowing the fact that 12% to 16% of the prisoners all over United State are mentally ill. The lack of quality treatment increases the chances of repetition of the crime. Psychotherapy has been used in a very positive way by helping the prisoners with mental disorder to understand the self-concept, understand the impact of their behavior and to form a healthy and positive emotional response to life and society (Klaus and Kluttig p.13). Group therapy in the prison encouraged the establishment of the behavior pattern that is equal to the social setting outside the prison. The group was initially fearful and anxious to disclose their feelings and thoughts. However, after some sessions, they realized that accepting who they are is difficult but talking about it makes them light and open. Later, the talking and sharing of emotions built trust amongst the group members and slowly, they tried to find a new identity (Klaus and Kluttig p.18). They also discussed their fear of facing challenges of life after they are released. This unburdened their mind and created a space for improvement in their mental disorder of which, fear and anxiety were major part. This is a positive picture of treatment going in the right direction. However, the application of the plans and the needs is yet to take place. Study by Beck and Maruschak (2001) found that despite the growing severity and the population of the mentally ill prisoners in United States, only 51% of them get 24-hour mental care (Kennet and Ferrandino p.914). Moreover, the lack of proper screening is resulting in confusion regarding the treatment. The terms, ‘psychopathy’ and anti-social personality disorder are overlapping. This makes the treatment difficult as the general understanding is that there is no valid treatment for ‘psychopathy’ and anti-social personality disorder and even if the efforts are made, they are not worth the time and money (Kennet and Ferrandino p.914). The mental conditions like depression, hallucination, paranoia etc. makes it difficult for the prisoners to follow the strict rules of the prison and this produces a harsher treatment from the guards. This creates hostility in them. The hostility between the prisoners and the guars makes it difficult for the medical staff to find a comfortable environment while treatment (Kennet and Ferrandino p.914). In the prisons where the environment is conducive for treatment, the therapeutic programs are run successfully. The McNeil Program which was designed with therapies like “careful monitoring and counseling concerning medications by psychiatrist and nurses; pdychoeducational classes and low stress milieu,” was found to be successful. The study of the results of the program revealed that the incidences of psychiatric symptoms reduced and the prisoners felt free from stress and restrictions (Kennet and Ferrandino p.920). This shows that the counseling and therapy does work successfully, if the programs are implemented without any disturbances and threats from the prison staff. The lack of understanding of the needs of the mentally ill prisoners, the brutal conduct and humiliating treatment from the prison staff is increasing the chances of suicides among mentally ill prisoners. A study by Correctional Association of New York found that one in four prisoners of New York State Prison are mentally ill. However, instead of giving them a mental care, they are being isolated. The isolation is making them indulge in thoughts of suicide and is worsening their mental condition (Kennet and Ferrandino p.921). The research proposal : The questions that come to mind after reviewing the literature is, who is responsible to help the mentally ill prisoners in United States and the United Kingdom? The research that needs to be done further is on the measures taken by United Kingdom to improve the service of mental care in the prison. The literature review about the different treatments tried in United States prisons revealed that more than medication and strict laws, what helps to improve the condition of the prisoners is counseling, group therapy and exposure to recreation and healthy physical activities. Looking at the inhuman and barbaric treatment of the mentally ill prisoners, it also becomes important to know the role of Human Rights Organizations regarding protecting the prisoners from further humiliations. So , along with an attempt to understand the situation of mental care, the further research also has to focus on the role of the society and the governing bodies regarding the improvement in the conditions of the mentally ill prisoners. The further research is intended to getting the answers to the following questions: 1. Has prisons in United Kingdom tried the therapies like counseling, group therapy and game activities to see how it helps the prisoners? 2. What are the other treatments practiced in UK prisons apart from medication? 3. What measures are the human rights organization in UK and USA taking to see to it that the mentally ill prisoners get treated as humans at the hands of the prison authority? 4. After knowing the success of counseling and psychotherapy, are efforts made by the researchers and practitioners in the field of psychology to design similar programs to help the prisoners improve their mental condition and help them to become responsible human being? To get the answers to the above questions, the literature related to the topics will be read and reviewed. The treatment of the prisoners who are mentally ill has become so cruel that they need help not only from the medical staff but also from the human rights activists. The prisoners are put in prison to give justice to their victims. Now, it is time to give the prisoners the justice by eradicating the humiliating and cruel conditions they live in. Works Cited Adams, Kennet and Ferrandino, Joseph. “Managing Mentally Ill Inmates in Prisons.” Criminal Justice and Behavior 35.8 (2008): 913-927 Ashford, Jose, B., Wong, Kai, W. and Sternbach, Katherine. “Generic Correctional Programming for Mentally Ill Offenders: A Pilot Study.” Criminal Justice and Behavior 35.4 (2008): 457-473 British Medical Association. Medicine Betrayed: The participation of doctors in human rights abuses. London : Zed Books Ltd., 1998 Clements, Carl., Althouse, Richard., Ax, Robert., Magaletta, Phillip., Fagan , Thomas and Wormith, Stephen. “Systematic Issues and Correctional Outcomes: Expanding the Scope of Correctional Psychology. Criminal Justice and Behavior 34.7 (2007) :919-932 Columbus, Alexander (Ed.). Advances In Psychology research, Volume 55. New York : Nova Science Publishers, Inc., 2008. Haney, Craig. “A Culture Of Harm : Taming the Dynamics of Cruelty in Supermax Prison.” Criminal Justice and Behavior 35.8 (2008): 956-984 Hoffmann, Klaus and Kluttig, Tilman. “Special Section: Psychoanalytic and Group- Analytic Perspective in Forensic Psychotherapy. Group Analysis 39.1 (2006): 9-23 Landsberg, Gerald, and Smiley, Amy. Forensic Mental Health: Working with offenders with mental illness New Jersey: Civic Research Institute, Inc., 2001. Morgan, Rod, And Evans, Malcolm (Eds). Protecting Prisoners. New York: Oxford Press, 1999. Silver, Eric., Felson, Ricard and Vaneseltine, Matthew. “The Relationship Between mental Health Problems and Violence Among Criminal Offenders.” Criminal Justice and Behavior 35.4 (2008) : 405-436 Read More