Introduction
Most prisoners undergo a painful and stressful experience when they are held in solitary confinement. This is because they are cut off from any form of human contact, except with fellow inmates and the prison guards. In addition, prisoners only make very few movements, all of which are closely observed and tightly controlled (Nurse, Woocock & Ormsby, 2003). The prison environment is also another source of stress for prisoners. For example, they are usually confined to very small cells with very little ventilation. Sometimes, many prisoners can be confined to a small room to the point of almost being deprived of air (World Health Organization, 2007). Such extreme conditions interfere with the mental and physical health of inmates. Behavioral and mental disorders have been noted to be very prevalent among prisoners. The current research paper is an attempt to explore how being incarcerated affects the mental health of inmates. In addition, the paper shall also attempt to examine how inmates who are incarcerated with mental illness deteriorate in condition due to the poor environment in prison.
Factors affecting the high rate of mental disorders among prisoners
The high rates of mental disorders among prisoners could be linked to a number of factors including the widely held misconception that all individuals with mental disorders pose a threat to members of the public, with most of them ending up in prison. In addition, many societies do not tolerate difficult or disturbing behavior (Metzner & Esq, 2010). There is also a lack of promotion for care, treatment and rehabilitation for patients with mental disorders. Other people lack access to proper metal health services and as such, they could end up in prison without the condition having been diagnosed. Once they have been incarcerated, the condition deteriorates even further owing to the numerous stressors in prison (Nurse et al, 2003). On the other hand, the prevailing conditions in prison could also trigger mental disorders among inmates. Such conditions include the issue of human rights violations and torture.
Prison life exacerbates mental health due to the a number of factors including different types of violence, overcrowding, lack of privacy, isolation from social networks, enforced solitude ,inadequate health services, and insecurity about such future prospects as relationships and work (Nurse et al, 2003). The cumulative effects of the aforementioned factors are usually manifested by such unfortunate incidents as the increased cases of suicide in prison. The increased cases of suicide are mainly as a result of depression owing to stressors in the prison environment.
Effects of solitary confinement on the mental health of prisoners
Evidence show that solitary confinement impacts negatively on the health and well-being of inmates, especially for the inmates who have a pre-existing mental disorders (World Health Organization, 2007). It is important to note that the extent of such psychological damage differs and can be affected by such individual factors as pre-existing health problems and personal background. In addition, the nature and extent of the psychological damage can also be affected by the regime (for example, degree of human contact, time out of cell) environmental factors (for example, provisions and physical conditions), the duration, and the context of isolation (for example, own protection, punishment, criminal/physical, nonvoluntary/voluntary) (Shalev, 2008).
Recent studies on the effects of prison environment on the mental health of prisoners have demonstrated that solitary confinement negatively affects individuals who have been subjected to it (Shalev, 2008). In particular, these studies have shown that solitary confinement alone may lead to decline in mental functioning, emotional damage, and such forms of psychopathology as hallucinations, delusions, and depersonalization (Shalev, 2008). This is the case even when solitary confinement is not accompanied by unhygienic conditions and physical brutality.
Why the high suicide rates in prison?
Statistics indicate that the suicide rates in prisons are 6 times higher than those reported among members of the general public (Shalev, 2008). As such, the mental health of inmates’ is an issue of particular concern and it needs to be handled with the seriousness that it deserves. Although environmental and social factors are believed to impact on the mental health of inmates, not much is known about the effect of prison environment on the mental health of inmates (Nurse et al, 2003). In the last two decades, there has been a proliferation of supermax prisons where inmates live under extensive security control and surveillance. Inmates are not allowed to socially interact, and the cells are characterized by abnormal environmental stimuli. Usually, prisoners only get no more than 5 hours of recreation a day and if they do, this is often in caged enclosures. In addition, they are denied access to any vocational and educational programs (World Health Organization, 2007). They do not leave cells without first being handcuffed. Being isolated in the prison environment affects prisoners psychologically, with the severity and nature of the ensuing impact depending on the duration of incarceration, the individual, as well as specific conditions in the cell (for example, natural light, radio, or books) (Metzner & Esq, 2010). Some of the psychological effects often manifested by inmates include depression, anxiety, cognitive disturbances, anger, obsessive thoughts, perceptual distortions, and psychosis.
Individuals with serious mental illnesses are affected the most by the adverse effects of solitary confinement. They include individuals who have been diagnosed with bipolar disorders, schizophrenia, and major depressive disorder (World Health Organization, 2007). The segregated units in prisons are characterized by a disproportionately high number of suicides compared with the other sections of a prison. On many occasions, mentally ill inmates end up de-compensating in isolation, and they cannot get the psychiatric hospitalization or crisis care that they so much need (World Health Organization, 2007). Majority of the mentally ill inmates do not improve at all so long as they remain in isolation.
Why are mental health professionals finding it hard to assist with mental disorders?
It is becoming increasingly harder for mental health professionals to offer their help to inmates with mental disorders. The only mental health service that inmates who have been secluded to segregation units get is psychotropic medication. This entails mental rounds whereby a health care clinician goes round the cells asking inmates how they are doing (Metzner & Esq, 2003). Once in a while, inmates meet with a clinician in private. Inmates lack individual/group therapy, life-skill enhancing, structured educational and recreational activities, as well as other therapeutic intervention programs. This is because there are limited resources to provide the services. In addition, these intervention programs cannot be accomplished in isolation, and inmates are required by prison rules to stay in their cells.
The increase in the proportion and number of inmates with mental disorders has resulted in the use of segregation as a strategy for confining inmates diagnosed with mental illnesses. Although prisons have been built and are managed as places of punishment, nonetheless, they are increasingly being turned into de facto psychiatric facilities in spite of not being able to provide the necessary mental health services (World Health Report, 2001). According to the findings of clinical studies on how prisons impact on the mental health of inmates, 8 to 19 % of the prisoners have been diagnosed with one form of psychiatric disorder or another. In addition, a further 15 to 20 percent of the inmates are in need of psychiatric help during the time when they are serving prison term. In a study carried out by Hill (2004), 60 percent of the state correctional facilities that had participated in the survey responded that more than 15 percent of their inmates had already been diagnosed with a mental illness.
Conclusion
There is compelling evidence to show that being incarcerated in prison can affect the mental health of inmates negatively. This is because the social and environmental conditions in prison acts as stressors to the inmates, and this may trigger the development of mental health conditions. Some inmates are incarcerated when they have already developed a mental disorder but because they do not get adequate mental health services in prison, the conditions is likely to get worse. Overcrowding, lack of adequate ventilation, infringement on human rights and torture are some of the factors that can worsen the mental health of inmates. The fact that the reported cases of suicide among inmates held in isolation are 6 times higher in comparison with those reported among the general public is an indication that prison conditions exacerbate the worsening of the mental health of the inmates. Inmates with mental disorders hardly get any adequate mental health services, save for the occasional round by a health care worker asking if they are doing okay. The fact that prisons lack adequate facilities to provide these mental health services means that inmates have to contend with the poor services available to them.
Reference List
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Metzner, J. L., & Esq, J. F. (2010). Solitary Confinement and Mental Illness in U. S. Prisons: A Challenge for Medical Ethics. The Journal of the American Academy of Psychiatry and the Law, 38(1),
Nurse, J., Woocock, P., & Ormsby, J. (2003). Influence of environmental factors on mental health within prisons: focus group study. BMJ, 327(7413): 480.
Shalev, S. (2008). A Sourcebook on Solitary Confinement. London: Mannheim Centre for Criminology, London School of Economics.
World Health Report. (2001). Mental Health: New Understanding, New Hope. Geneva: World Health Organization.
World Health Organization. (2007). Mental health in prisons. Web.