Persons with Severe Mental Illness in Jails and Prisons: A Review

Keck School of Medicine, University of Southern California, Los Angeles, USA.
New Directions for Mental Health Services 02/2001; 5(90):29-49. DOI: 10.1016/S1353-1131(98)90016-5
Source: PubMed


Objective: The presence of severely mentally ill persons in jails and prisons is an urgent problem. This review examines this problem and makes recommendations for preventing and alleviating it. Methods: MEDLINE, Psychological Abstracts, and the Index to Legal Periodicals ana Boob were searched from 1970, and all pertinent references were obtained. Results and Conclusions: Clinical studies suggest that 6 to 15 percent of persons in city and county jails and 10 to 15 percent of persons in state prisons have severe mental illness. Offenders with severe mental illness generally have acute and chronic mental illness and poor functioning. A large proportion are homeless. It appears that a greater proportion of mentally ill persons are arrested compared with the general population, Factors cited as causes of mentally ill persons being placed in the criminal justice system are deinstitutionalization, more rigid criteria for civil commitment, lack of adequate community support for persons with mental illness, mentally ill offenders' difficulty gaining access to community treatment, and the attitudes of police officers and society. Recommendations include mental health consultation to police in the field; formal training of police officers; careful screening of incoming jail detainees; diversion to the mental health system of mentally ill persons who have committed minor offenses; assertive case management and various social control interventions, such as outpatient commitment, court-ordered treatment, psychiatric conservatorship, and 24-hour structured care; involvement of and support for families; and provision of appropriate mental health treatment.

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Available from: Harry Richard Lamb, Mar 24, 2015
    • "Another factor that can determine the nature of an interaction is the subject's behaviour at the time of police encounter (Teplin and Pruett, 1992). Independent of the severity of the underlying mental illness, when the seriousness of the alleged offence increases, with a lack of alternative diversion options, PMI are more likely to be detained in police custody to ensure public safety and security (Lamb and Weinberger, 1998). Despite the underlying factors that both PMI and the police bring to an interaction, the significance of the environment is often not considered. "
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    ABSTRACT: A subset of persons with mental illness is at risk for becoming involved with the police, and an even smaller subset of emotionally disturbed persons (EDP) has multiple contacts over time. Not much is known, however, about the nature of these contacts and how the patterns of everyday life can lead to the initial contact with, and type of police response to, EDP. To address this issue, a spatial point pattern test is used to compare the spatial distributions of calls-for-service involving EDP (n = 2,847) to all other police contacts (n = 137,901) in an urban Canadian setting. Findings indicate that there are significant variations among these two calls-for-service, with EDP calls clustering on very few street segments. To better understand this clustering, a series of place attractors that may affect EDP are analyzed. It is suggested that a link may exist between the density of place attractors and that of EDP calls-for-service.
    No preview · Article · Dec 2015 · Policing
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    • "Devís- Devís, & Sparkes, 2010), as well as programmes carried out prior to the present study (Ríos, 2004; 2009). More specifically, publications on mental health indicate that prison inmates with a mental disorder (or suffering the effects of a mental disorder) have to recover an awareness of their own body and accept it, discover their possibilities for movement, overcome motor problems, progressively recover coordination, and assimilate attitudes, values and habits to improve their health and quality of life (Faulkner & Taylor, 2005; Lamb & Weinberger, 1998). The effects of physical education on social and interpersonal relations are indisputable: motor behaviour encourages individual growth and contributes to the process of rehabilitation and reintegration into society (Ríos, 2009). "
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    ABSTRACT: In the Psychiatric Unit of the Modelo Prison, Barcelona, a physical education programme is carried out annually with the participation of University of Barcelona (UB) students. In this context, we carried out a study based on service-learning parameters. The aim of the study was twofold: to determine the impact on inmates of the physical education programme that was undertaken with university students; and to assess what university students’ learnt in the prison-based socio-educational intervention programme. This paper describes the context of the research and the methodological basis of service learning. The qualitative tools to gather the information were: two focus group; a semi-structured interview with a representative of the unit’s guards; and the students’ field dairy. We present results that demonstrate the impact of the physical, sports activity on the socialisation of inmates, in terms of aspects such as communication and personal skills. The results also show the effect of the programme on the university students’ learning processes, particularly with regard to the contextualisation of learning.
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    • "The research on mentally ill in prisons has been largely epidemiologic in nature to demonstrate the prevalence of mental illness among prison populations (Ditton 1999; Teplin 1990; Lamb and Weinberger 1998). It has been demonstrated that adjustment to prison and subsequent institutional functioning for mentally ill inmates has been poor, with higher rates of disciplinary infractions documented for this population (Abramsky 2003; Adams 1992: 306; Toch and Adams 1986). "
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    ABSTRACT: Of the two million individuals incarcerated in U.S. jails and prisons, approximately 15% of this population have a serious mental illness. Little is known of this psychiatric population's institutional life and how they cope and function in these environments. Based on 9 months of ethnographic fieldwork in a men's state prison, this paper investigates how institutional social and cultural processes mediate the course and outcome of severe psychiatric disorder for inmates with mental illness. Specifically, this paper identifies how social and cultural processes contribute to illness recovery within a maximum security penitentiary. This ethnographic research reconstitutes the prison as a unique social and cultural context with local ethnopsychiatric constructions of mental disorder that generate particular social responses to inmates with psychiatric illness. These responses are contingent on an institutional cultural ethos based on trust and respect that provides opportunities for establishment of social relationships among staff and inmates. These social relationships are discussed as crucial processes which contribute to positive course and outcome for inmates with mental illness. Prison staffs' culturally mediated response to the local construction of mental disorder is characterized as flexible, providing opportunities for social support and responsiveness to inmates with psychiatric illness. This local institutional construction of mental illness counters the biological reductionism prevalent in many professional ethnopsychiatries, as contextual factors and processes are identified by staff and inmates to be as critical as pharmacological interventions for illness recovery. These findings contribute to social theory, medical anthropology's approach to psychiatric disorder, and corrections policy.
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