When a person is incarcerated and removed from society, their mental illness follows them. The Bureau of Justice Statistics reports that over half of all inmates experience mental health episodes while in jail. The statistics are similar for both State and Federal prison systems.

This shouldn’t be too surprising, right? A person’s mental illness can sometimes lead to criminal behavior. Sometimes, though, a person can develop a mental illness after being incarcerated.

Substance abuse accounts for many disorders among prison inmates. Research connects substance abuse to mental illness, finding evidence that addiction is a disorder of the brain. Believe it or not, some prisoners are able to find ways to continue abusing substances while in prison.

With over 700,000 Americans incarcerated today, the types of mental illness in prisons vary widely.

Types of Mental Illness in Prisons

Mental illness in prisons comes in many forms. Prisoners have episodes of depression, anxiety, panic attacks, and even schizophrenia. One of the most common disorders found in prisons are bipolar disorder. Post-traumatic stress disorder (PTSD) is also among the top mental health disorders among prisoners.

Many prisoners have co-occurring disorders. Meaning, they have more than one mental illness. For example, some prisoners have substance abuse issues while also dealing with severe depression. Or, some have both severe depression and anxiety.

Female prisoners have a significantly higher number of mental health episodes than male prisoners. Depression is among the top mental illness with both populations.

Counseling in Prison

The treatment therapies provided for mental illness in prisons will vary among all institutions. Most of them offer a minimum of individual and group counseling. Others offer those treatments, along with several more, including therapeutic communities, group counseling and education.

Therapeutic community programs are offered in a separate housing facility to create a culture of healing. It runs as a long-term, structured program to guide prisoners to gaining the life skills (coping, decision making, addiction, recovery, and more). Therapeutic communities allow peer support and evaluation to help foster positive behaviors of all participants.

Group counseling programs are available in correctional facilities and are led by trained mental health professionals. Some groups are formed to simply help prisoners cope with being incarcerated. Others are formed for varied reasons.

If the group focuses on substance abuse, a substance abuse counselor will lead the group. If the group focuses on sex offenders, a sex offender specialist will run the group. All groups allow peer to peer support and feedback.

Vocational Counseling and Education are provided to prisoners who wish to learn more about career paths and obtaining higher levels of education. While these are not technically considered therapies, they do provide an increase in self-esteem which leads to a boost in a person’s mental health.

Psychotropic Medicines for Prisoners

One noticeable problem when a person enters prison is management of any medications they may need. Some prisoners need medication but have not been taking them consistently. Others have been consistently taking the wrong medicines before entering prison. And then there are many more who have been taking illegal medicines or abusing their prescriptions when they enter prison.

While psychotropic medications have proven to be a huge benefit to those with mental illness in prisons, establishing medicinal care can be difficult.

Also, if a prisoner is released back into society, their prescription doesn’t always follow them. They usually must start over with a psychiatrist that is not associated with the prison. This lapse in service can become a barrier for those in mental health recovery.

Medicines used for mental health disorders are the same medicines prescribed to regular members of society. Some have even shown to greatly reduce aggression among prisoners.

A correctional psychiatrist makes a routine visit to the prison to diagnose and prescribe the necessary medicines. Among the commonly prescribed medicines are anti-depressants and anti-psychotics.

No medicines that offer a “high” feeling are prescribed. These might include benzodiazepines or suboxone for substance withdrawal.

Mental Health Courts

A movement to provide mental health treatment to criminals is on the rise. Mental health courts are recommending sentencing to include mental health therapy rather than strictly incarceration. A judge can order an offender into a treatment program instead of sending them straight to a jail cell.

Being ordered to a mental health treatment program includes several requirements, including:

• a mental health assessment
• individualized treatment plans
• consistent communication with the judicial system

The long-term treatment facility must keep in contact with probation officers and the courts to update them on the offender’s progress or lack of progress.

An offender can expect to spend a minimum of six months up to two years in a mental health program. They are basically serving part of their sentence in a recovery program that can better help them succeed in society upon their release.

Transitioning Back into Society

When a person is released from prison, their immediate thoughts are not on continuing their mental health treatment. Instead, they are focused on finding a place to live, finding a job, reuniting with family and friends and meeting with parole or probation. This becomes a problem over time because their mental health issues begin to interfere with their personal and professional goals.

There are parole and probation systems that require a parolee to be evaluated by mental health professionals to continue or begin treatment care. However, this is still not made a priority by prisoners upon reentry.

The ideal program for criminal offenders being released back into society would include a case manager who could coordinate the appropriate continuing care programs needed. The case manager could assess the needs of the prisoner and set up initial appointments for them before they are released. In addition, a case manager could follow up to make sure they are attending appointments and assess additional care needs such as family counseling, career guidance or medication needs.

Correctional facilities all over the United States are making great advances in treating the mental health of prisoners. They are training correctional officers and prison staff to notice and react to those with mental illness in a distinct way.

They are also providing a variety of types of counseling treatments to assist prisoners suffering with a mental health problem. Prisoners can get a diagnosis while incarcerated and begin or continue their treatment plan goals.

It is important for society to recognize that mental illness in prisons exist and need to be properly treated. Society should also make attempts to aid in the continuance of an offender’s positive mental health upon their release.

They can do this by offering them second chances in professional and personal areas. This will enable the offender to keep a positive mental health environment that supports their recovery.