Mental Illness – An Overview

Mental illness can be defined as a disease of the brain that causes disruptions in one’s behavior and/or thought and therefore results in difficulty or inability to manage the general demands and routines of one’s life.

Mental illness falls on a continuum of severity that can range from mild up to severe. More than 60 million Americans have a mental illness in any given year, affecting one in four adults and one in five children at some point in their lives. As a result of the stigma typically associated with mental illness, a small percentage of people actually seek treatment.

There are more than 200 classified forms of mental illness, but many fall into the following five major categories: anxiety disorders; mood disorders; schizophrenia/psychotic disorders; dementias; and eating disorders. General symptoms can include changes in mood, personality, personal habits and/or social withdrawal.

Statistics: Mental Illness in Prisons

According to a report submitted by the University of Pennsylvania in February, 2011: “Incarceration has a robust relationship with subsequent mood disorders, related to feeling ‘down,’ including major depressive disorder, bipolar disorder, and dysthymia.”

The risks of having serious psychiatric disorders are significantly higher in the prison population compared to the general population. Studies show that at any one time in the United States, about 56% of State prisoners, 45% of Federal prisoners and 64% of jail inmates have some sort of mental health problem.

Further studies have shown that about one in seven prisoners in western countries have some form of psychotic illness or depression. Additionally, about 50% of male prisoners and 20% of female prisoners are found to have antisocial personality disorders. In comparison to the general American or British population of similar age, prisoners have about two- to four-fold excesses of psychotic illnesses and major depression, and about a ten-fold excess of antisocial personality disorder. It is not clear whether these excesses are causes, consequences, or both, of imprisonment.

Common Risk Factors

The most common risk factors for mental illness among prisoners are many of the risk factors that lead to the offenses that land them in prison in the first place. These include:

• Homelessness
• Unemployment
• Physical or sexual abuse
• Substance dependence or abuse
• Family background of incarceration

The interconnected nature of these risk factors makes it difficult to identify any one in particular.

The path to incarceration often starts early in life during childhoods marked by poverty and trauma. Research shows that there are three main factors which are highly protective against the development of mental problems, especially depression: having sufficient autonomy to exercise some level of control in response to severe events; access to material resources that allow for making choices in the face of severe events; psychological support from family, friends, or health providers is powerfully protective. When signs start to present themselves in young kids, they often go untreated by a lack of these required resources and the conditions therefore go unmanaged.

Inmates with mental health disorders are much more likely to have witnessed or experienced traumatic events during their youth, such as abuse, violence, and incarcerated family members. It is easy for a child to become victimized under these circumstances; feelings of self-worth are put into question. Mental health problems like depression, anxiety, and posttraumatic stress disorder are made worse by victimization.

As these adolescents grow up, their conditions often worsen and drug and alcohol use becomes a common escape mechanism. These habits can turn quickly to addiction and in order to maintain them, these individuals often turn to crime and potentially violent offenses.

The Affects of Prison on Mental Illness

Unfortunately, prisoners who suffer from mental illness typically find their condition is actually exacerbated and amplified by their incarceration. The hostile and restrictive environment is the true opposite of what person suffering from mentally illness needs.

Undiagnosed individuals with serious mental disorders like schizophrenia or bipolar disorders are often sent into prisons without proper diagnosis or any plan for treatment or medications. Their condition tends to worsen as a result. Overall, many people who enter prison with a mental illness leave with a worsened condition. Therefore, recidivism rates among the mentally ill are climbing. As one writer wrote in the Huffington Post, “Any hopes of rehabilitation based on any criminal activity are outweighed by the intense and long-lasting affects of incarceration on mentally ill individuals.”

Treatment in Prison

There are those who are treated, at least minimally. A U.S. Department of Justice report showed that State prisoners who had a mental health problem (34%) had the highest rate of mental health treatment since admission, followed by Federal prisoners (24%) and local jail inmates (17%). All Federal prisons and most State prisons and jail jurisdictions, as a matter of policy, provide mental health services to inmates, including screening inmates at intake for mental health problems, providing therapy or counseling by trained mental health professionals, and distributing psychotropic medication.

Taking a prescribed medication for a mental health problem was the most common type of treatment inmates who had a mental health problem had received since admission to prison or jail. About 27% of State prisoners, 19% of Federal prisoners, and 15% of jail inmates who had a mental problem had used prescribed medication for a mental problem since admission.

However, this tends not to be enough. For many of these inmates, prison is not the right place for them. They have long histories of trauma and minimal support, eventually leading them to turn to crime as a means of survival. The minimal services available to them within the prison system are not achieving the rehabilitation they aim to and instead are generating a revolving door. Incarcerated populations suffering from mental illness require concerted, specialized care and a nurturing environment, which is not provided to them behind bars.