Editorial: Mental health in a prison setting: Implementation and practice (mhPIP)

Editorial on the Research Topic
Mental health in a prison setting: Implementation and practice (mhPIP)

The practice and delivery of mental health services in the prison setting present unique challenges. While the goal of correctional institutions is to transform and rehabilitate offenders into law-abiding members of society, the goal of psychiatry is to restore the positive mental health of mentally ill offenders. The nature and magnitude of crimes are as varied as the offenders. Moreover, the nature of interactions between therapists and prison inmates may be overlooked, and not systematically used in treatment of these individuals (1, 2). Therefore, it may be easy to inadequately prepare prison inmates with multiple needs (3, 4) for their return to their environments (5).

The chapter from northern Russia highlights the importance of correctional workers and mental health professionals being aware of the potential risk of suicide and non-suicidal self-destructive behavior among young prison inmates (Koposov et al.). Suicidal behavior is (a) always present among care seekers and inmates of correctional institutions and (b) suicidal urges and acts can be predicted and identified long before they occur in most cases. A chapter from the Female Prison in Hunan Province, China, revealed that 9.47% of women incarcerated met the criterion for post-traumatic stress disorder (PTSD) on admission to the prison (Zhong et al.). This finding should remind us that, amongst individuals admitted to prison, a number of them enter the prison system with one or more pre-existing mental disorders. It therefore makes sense to screen first-time detainees in a correctional institution for post-traumatic stress disorder. Another study on women incarcerated for the first time in Geneva Hospital in Switzerland revealed a significantly higher prevalence rate of mental disorders; 16.9% compared with 1.3% among those detained on a repeat occasion (D'Orta et al.). A study in Geneva, Switzerland, revealed an extremely high prevalence (82.6%) of two or more psychiatric disorders in incarcerated youths compared with those not incarcerated. These results showed that incarcerated youths do suffer from one or more unrecognized mental disorders (Heller et al.). However, a longitudinal study on correctional officer recruits in Canada reported an extremely low prevalence rate of 4.9% for one or more psychiatric disorders in this group, a finding that clearly deviates from the previously published rate of 54.6% (Easterbrook et al.). The study is a useful pointer to the need for correctional officers to undergo training and meticulous screening, not only for their suitability for employment, but also to detect the presence of poor mental health.

The implications of these studies are: (1) a proportion of offenders who are detained to a correctional center for the first time may present with unrecognized mental disorder, (2) a proportion of these offenders have multiple psychiatric disorders along with a variety of social needs, (3) screening of the mental status of recruits may yield benefits for both future correctional officers and offenders, (4) women present a special vulnerable group for mental disorders and other problems associated with incarceration, (5) the prison system may provide a conducive environment for suicide and non-suicidal self-harm among youths detained for criminal behavior, (6) those who enter the correctional institution are just as human as those outside prison, and (7) more longitudinal studies are recommended in order to improve the quality of correctional care and mental health care provision in the prison setting. Elaborated efforts, covering social needs, mental health problems, and correctional system, are needed.

Author contributions

EO drafted this editorial. DA reviewed and approved the manuscript for publication. EO and DA accept responsibility for the contents of the manuscript. All authors contributed to the article and approved the submitted version.

Acknowledgments

The authors are grateful to the team at Frontiers in Psychiatry, section Forensic Psychiatry for their support and guidance.

Conflict of interest

EO was employed at Bomvitae Agro Industries Limited (BAIL).

The remaining author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher's note

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References

1. Bacha K, Hanley T, Winter LA. Like a human being, I was an equal, I wasn't just a patient': service users' perspectives on their experiences of relationships with staff in mental health services. Psychol Psychother Theory Res Pract. (2019) 93:367–86. doi: 10.1111/papt.12218

PubMed Abstract | CrossRef Full Text | Google Scholar

2. Watson R, Daffern M, Thomas S. The impact of interpersonal style and interpersonal complementarity on the therapeutic alliance between therapists and offenders in sex offender treatment. Sex Abuse J Res Treat. (2017) 29:107–27. doi: 10.1177/1079063215580969

PubMed Abstract | CrossRef Full Text | Google Scholar

3. Vaughn MG, Wallace JM Jr, Davis LE, Fernandes GT, Howard MO. Variations in mental health problems, substance use, and delinquency between African American and Caucasian juvenile offenders implications for reentry services. Int J Offen Ther Comp Criminol. (2008) 52:311–29. doi: 10.1177/0306624X07304095

PubMed Abstract | CrossRef Full Text | Google Scholar

4. McSweeney T, Hough M. Supporting offenders with multiple needs: lessons for the ‘mixed economy' model of service provision. Criminol Crim Just. (2006) 6:107–25. doi: 10.1177/1748895806060669

CrossRef Full Text | Google Scholar

5. Denton M, Foster M, Bland R. How the prison-to-community transition risk environment influences the experience of men with co-occurring mental health and substance use disorder. Austral N Zeal J Criminol. (2017) 50:39–55. doi: 10.1177/0004865815620703

CrossRef Full Text | Google Scholar