This article, by Deborah H. Drake and David Scott of The Open University, states that for those living in extreme environments, such as prison, it becomes difficult to draw a line between mental well-being and diagnosable mental illnesses.
When accounting for mental health in prisons, the three key populations to consider are:
- Those with pre-existing conditions upon committal;
- Those with a latent mental illness that could possibly be triggered by the prison environment;
- Those who have no history of mental health problems, but suffer from extreme deterioration of their psychological well-being during their sentence.
Aside from the loss of liberty, the aspects of the daily prison regime which are damaging are to mental health are: separation from family and friends; loss of autonomy; limited mental and physical stimulation; exploitation; inadequate ventilation, nutrition and care.
It is important that psychologists and other professionals working with vulnerable prisoners avoid deploying the label of ‘mental ill-health’ as a way to manage the individuals labelled as such, rather than actually managing their needs. Due to the large number of prisoners with mental health issues, prisoners who have minor symptoms are often dealt with alongside prisoners with severe symptoms. Not only can this be traumatic for prisoners, it can result in those with complex needs receiving inadequate support. Prisoners themselves have called for prison staff to undergo more training to sufficiently understand their problems.
The modern prison should not only be expected to offer a level of care similar to that available on the outside, it should offer significantly greater care to balance out the negative effects of the environment. To work towards positive change, there needs to be a radical reduction in the prison population coupled with an improved provision for people in the community, and public education campaigns which promote supporting those with mental health problems. Prisoners, and all people, with mental health problems, require detailed information about treatment options and help in developing skills, rather than simply being given a label or a diagnosis.
As stated in the available literature, state confinement exacerbates or triggers mental health problems. Therefore, what is needed are alternative solutions that look beyond the prison walls.
The full piece by Deborah H. Drake and David Scott is available here.