Mental Health of Prisoners: Identifying Barriers to Mental Health Treatment and Medication Continuity

Abstract

Objectives. We assessed mental health screening and medication continuity in a nationally representative sample of US prisoners. Methods. We obtained data from 18 185 prisoners interviewed in the 2004 Survey of Inmates in State and Federal Correctional Facilities. We conducted survey logistic regressions with Stata version 13. Results. About 26% of the inmates were diagnosed with a mental health condition at some point during their lifetime, and a very small proportion (18%) were taking medication for their condition(s) on admission to prison. In prison, more than 50% of those who were medicated for mental health conditions at admission did not receive pharmacotherapy in prison. Inmates with schizophrenia were most likely to receive pharmacotherapy compared with those presenting with less overt conditions (e.g., depression). This lack of treatment continuity is partially attributable to screening procedures that do not result in treatment by a medical professional in prison. Conclusions. A substantial portion of the prison population is not receiving treatment for mental health conditions. This treatment discontinuity has the potential to affect both recidivism and health care costs on release from prison.

Reproductive Justice, Health Disparities And Incarcerated Women in the United States

“…HIV affects 2.4% of women in prison, compared with 0.18% of nonincarcerated women and 1.8% of incarcerated men . In addition, 50% of women in prison and 80% of women in jail report a history of physical or sexual abuse, and nearly three‐quarters of incarcerated women demonstrate symptoms of a psychiatric illness . This reality results from deeply entrenched structural inequalities—poverty, unstable housing, limited access to health care, undereducation, racial discrimination and unemployment—that manifest themselves in unequal rates of disease …”

Schizophrenia and violence: realities and recommendations

“…Moreover, most mental health service providers do not assess for or manage risk of violence, or provide treatments for violence reduction (Hodgins et al, 2009), leading to suboptimal treatment and persistence of unnecessarily elevated violence risk. Compounding the problem, many patients are placed in forensic psychiatric settings, jails, or prisons, where there are significant barriers to obtaining adequate mental health care (Reingle Gonzalez & Connell, 2014). In the United States, approximately 15% of state prisoners and 24% of jail inmates meet the criteria for a psychotic disorder, and there are three times as many men and women with mental illness in prisons as in mental health hospitals (James & Glaze, 2006;Torrey, Kennard, Eslinger, Lamb, and Pavle 2010).…”

Depression and experience of incarceration in North Central Nigeria: a situation analysis at Makurdi medium security prison

“…It could also be that in an environment with limited access to mental health care, there is no motivation to identify prison inmates as having depression, which will likely go untreated anyway. However, studies from high-income countries also report that psychotic disorders are more easily identified by correctional facility authorities than mood disorders and recommend routine screening to improve detection rates [ 30 , 31 ].…”

“…This is similar to findings from high-income countries regarding treatment of prison inmates with mental disorders. For example, a 2014 analysis of data from over 18,000 American prison inmates found that treatment was disrupted upon admission for the majority of prison inmates with a history of mental disorders [ 31 ]. Only a small proportion of prison inmates with a lifetime diagnosis of a mental disorder continue with their treatment upon admission in prison [ 31 ].…”