Mental Health in Prison: Integrating the Perspectives of Prison Staff

Abstract

(1) Background: The Italian Constitutional Court’s decision n. 99/2019 abolished the distinction between physical and psychological health care in the Italian prison system. However, this and other changes to the penitentiary system present challenges to prison staff, which may vary based on their roles and backgrounds; (2) Purpose: To create a process of dialogue and collaboration that include different points of view, needs, and proposals regarding mental health in prisons, this study collects and integrates the perspectives of 91 prison staff who work in various capacities in eight prisons in northeast Italy. (3) Methods: Each participant was involved in either a focus group or a semi-structured interview, and thematic analysis was used to process the resulting transcripts; (3) Results: Through this process, 10 themes were derived that highlight the difficulties of working with prisoners with psychiatric disorders or psychological distress, including lack of human and economic resources, lack of positive communication between prisoners and society and a sense of professional incompetency; (4) Conclusions: Based on these themes, the need for increased points of view, dialogue, and collaboration between prison professionals and between prison and society is discussed, and the current feasibility of treating psychiatric disorders in prison is considered.

Psychological screening service for men newly admitted to an Italian prison: Preliminary clinical outcome analysis after 1 year of clinical activity

“…Across the 1-year follow-up period, of those accepting treatment, only those 11 prisoners who left the prison (3 due to transfer to another prison and 8 to release) discontinued it at least in this prison; 140 (93%) continued to the conclusion of the study and completed the final assessments. This substantially confirms the high rate of acceptance of therapeutic proposals in Italian prisoners (Testoni et al, 2021). In our cohort, approximately 65% (n = 197) of newly admitted prisoners were affected by a current mental disorder (55% substance use disorder and 10% other psychiatric disorder).…”

Prisoners on prisons: Experiences of peer-delivered suicide prevention work

“…Our reflections became critical of the way some prison peer support schemes are operationalised, leading to anxiety that our findings could damage schemes – or result in reduced provision – and prisoners would suffer. Peer supporters face extremely high levels of distress and self-harm and, particularly given the chronic lack of other services such as healthcare (Testoni et al, 2021), their work is essential:Those girls that I used to go out to, they used to slash their faces all the time, it really upset me, I used to say to them ‘ you’ve got your whole life ahead of you, don’t slash your beautiful face’ … the thought of removing this one thing (Listening), this one person that they have, to talk to, and that they feel safe with … I don’t know ….…”

“…Our reflections became critical of the way some prison peer support schemes are operationalised, leading to anxiety that our findings could damage schemesor result in reduced provisionand prisoners would suffer. Peer supporters face extremely high levels of distress and self-harm and, particularly given the chronic lack of other services such as healthcare (Testoni et al, 2021), their work is essential:…”

Suicide Risk Screening and Assessment before and after the COVID-19 Pandemic in New Inmates

“…Overall, the findings of this study contribute to a more nuanced understanding of the pre-existing psychosocial vulnerabilities that inmates ‘import’ into prison and that, when compounded by stressful circumstances (such as COVID-19), may increase the likelihood of suicide attempts [ 20 , 21 , 22 , 23 ]. Interestingly, correctional physicians highlighted the tendency amongst prison staff to ‘psychiatrize’ behavioral difficulties, overestimating the presence of psychiatric disorders [ 73 ]. It is essential to distinguish between psychiatric illnesses, which tend to be enduring, and psychological distress, which is typically context-dependent and transient.…”