Mental Health Issues in the Incarcerated Population

Mental Health Issues in the Incarcerated Population
Introduction
From a world point of view, mental health problems account for about 13% of disability-adjusted life years, which is close to a third of a person’s life. (Lovett et al., 2019). Studies show that the number of people in prison who have mental health problems is rising. People who are incarcerated are those who are being held in prisons, jails, forensic in-patient units in hospitals, or youth institutions. Several systematic reviews show that the risk of suicide is six times higher in prisons than in other places, where mental health problems are more common. (Lovett et al., 2019). Lovett et al. (2019) say that there are more than 10 million people locked up in prisons and jails around the world. These people are more likely to have bad health effects, like suicide, self-harm, violence, being a victim, or dying.

Even on a world scale, the people who are in jail haven’t gotten much attention. United Nations (UN) and World Health Organization (WHO) data from the past 15 years on mental health and incarcerated populations show that mental health problems are not well covered in the media. (Lovett et al., 2019). This proof goes against the agreement in the international prison literature, which says that a lot of mental health services need to be offered. If this important part of the vulnerable population isn’t taken care of, it could cost the country a lot of money in terms of social welfare and a possibly productive population that could be saved with the right resources at the right time.

Because there aren’t many studies on mental health problems in the incarcerated population, the goal of this research article is to find and talk about the most important mental health problems in this group. This will help future studies, interventions, efforts, and policies lead to better health outcomes. Depression and anxiety are the most common mental health problems among inmates. About 11% of prisoners around the world have these problems. This talk focuses on depression as a big mental health problem among people who are in jail or prison.

What came before and why it matters

There are about 10 million people in jails around the world. Beyen et al. (2017) say that the number of people living in this area grows by about 1 million every 10 years. So, between 2001 and 2012, the number of people in prison in the U.S. grew by 16%. Mental health problems have always been more common among people in prison than in the general community.About 450 million people around the world have mental health problems. (Beyen et al., 2017). Gonzalez and Connell (2014) say that at least half of the male inmates and no more than three-quarters of the female inmates had signs of mental health problems in 2013. This was 9% more than the general community.

Beyen et al. (2017) say that several epidemiological studies show that there are a lot of mental illnesses among people who are in prison. When compared to the general population, the number of people in prison who had these problems was 5 to 10 times higher. (Beyen et al., 2017). Beyen et al. (2017) also show that about 25% of people had both depression and anxiety conditions. Even though some people go to jail with these problems, it is likely that the conditions of solitary confinement and violations of human rights in the areas of confinement make the problems worse.

In 2001, the World Health Organization said that by 2020, sadness will be the second biggest cause of illness around the world. A study was done in 24 countries to find out how many prisoners around the world are depressed. The results showed that 10% of male prisoners and 14% of female prisoners are depressed. (Beyen et al., 2017). Depression was also different from one country to the next. In a 2017 study by Rousan et al., sadness and major depressive disorders were found to be the most common types of mental illness. They affected 18% of all prisoners and 38% of all mentally ill prisoners. Beyen et al. (2017) say that overcrowding, increased violence, forced solitary confinement, lack of privacy and meaningful activities, isolation from the social world, uncertainty about the future, poor access to quality health services, especially mental health services, limited social support, frustration before and after serving the prison term, and older ages all have a big effect on mental health, especially depression. When all of these things came together, they led to more suicides, which is linked to depression.

Studies show that there are a lot of people who go back to jail after getting out, especially those with untreated mental health problems. Gonzalez and Connell (2014) agree with the results of a study that found that inmates with a professional diagnosis of any mental health disorder were 70% more likely to go back to jail than inmates without a mental health diagnosis. They also say that the rate of re-arrest for people who had been in prison before was 50–230% higher for people with mental health problems than for people without those problems, no matter what the diagnosis was.

When people with mental health problems don’t have access to the right treatments, there are more discipline problems, rule-breaking, and physical assaults. (Lovett et al., 2019). These situations are made worse by the fact that these people are locked up alone. Even though all inmates need healthcare, even those with long-term conditions like diabetes and high blood pressure have a hard time getting it. According to Mental Health America (2020), there is a strong positive association (r=0.69, p=000) between the number of people in jail and their lack of access to mental health care. The study also confirms that more people are in the criminal justice system in places where mental health care is hard to get.

Most of the people in jail are young, useful people who go back to their lives in the society after they finish their sentences. The government has put in place amazing plans to make sure that prisoners keep a creative mindset and can keep growing even after they finish their sentences. This is a great move because it will help the country have a good future. But it’s clear that mental health isn’t given much attention around the world, especially among people who are in jail.

Unlike physical health needs, mental health needs are easier to spot and need a trained mental health provider to carefully evaluate. We can’t say enough about how important mental health care is for people who are in jail, both from a legal and a human standpoint. Even though the U.S. Supreme Court has made rulings that support prisoners’ rights to health care, including mental health care, it is still very hard to find and treat mental health problems.

Table 1 shows how common mental health problems are in the United States and in New Jersey (Rousan et al., 2017).

Government numbers

Stats about the state of New Jersey

The number of inmates who have been diagnosed with a mental health problem.

37%

44%

The number of people who have been told they have “serious psychological distress,” which can include sadness.

40%

61.7%

Keeping watch and reporting

Psychologists are always looking for new ways to keep prisoners in line and help them avoid doing things that could get them sent back to jail after they get out. One way to keep an eye on people is to watch for patterns of antisocial thoughts and behavior in people with mental health disorders. This method is different from the old way of thinking, which was that better mental health care was enough to stop criminal behavior trends on its own. So, this method deals with both care for people with mental health problems and help for criminal behavior. This includes learning how to stop having bad thoughts and how to improve your interactions with others.

The mental health conditions of people who are in jail are reported by the health care centers that they can use. Several groups are in charge of keeping track of the annual data on the mental health of prisoners. For example, the Bureau of Justice Statistics found that 60% of jail inmates and 40% of federal prisoners had at least one mental health problem. (Rousan et al., 2017).

Analysis of how diseases spread

The DSM-5 says that depression is a mental illness that causes a person to lose interest in things they used to enjoy, feel hopeless, and feel tired all the time. This makes it hard to go about daily life. At the moment, more than 264 million people around the world are harmed. (WHO, 2020). It is believed that 800,000 people die by suicide each year because of depression. (WHO, 2020). This is seen as the second top cause of death for people between the ages of 15 and 29. (WHO, 2020). Most of the time, these deaths are blamed on the lack of effective solutions, especially in low- and middle-income countries where the problem is made worse by a lack of resources. At the moment, the cost of major depressive illnesses in the U.S. is thought to be $210,5 billion per year. Major depressive disorder has a big effect on how people interact with each other. Depressive disorders can lead to problems like suicide and major problems in relationships.

Checking and setting rules

The DSM-5 diagnostic manual is the most accurate and widely used tool for diagnosing sadness. It has a number of factors that are used to make a depression diagnosis. The manual says that a person must have had at least five minor symptoms and at least two big symptoms in the past two weeks for depression to be diagnosed. The most important signs are a sad mood and a quick loss of interest or pleasure in things that used to be fun. Some of the smaller signs are eating problems that start all of a sudden, being tired all the time, and feeling like you’re not worth anything.

Plan

To deal with depression, nurse practitioners should first stress the importance of keeping in touch with their patients after they have been diagnosed. They can do this through phone calls and in-person meetings. Keeping in close touch with the patient is a way for the nurse to be held accountable and improve the healing relationship with the patient. (Gonzalez & Connell, 2014). Basically, the nurse should make sure that the touch is not only regular but also proactive and well-written. To figure out how well this plan is working, there will be a monthly survey and surveys will be given to patients to find out how much they are getting out of the program.

Second, nurse practitioners should do regular follow-up assessments with people from different fields to look at the most important parts of care. This includes the signs and symptoms of sadness, how well the treatment plan is followed, and whether or not treatments need to be changed. (Gonzalez & Connell, 2014). The joint care will help the patients get the results that are wanted. To figure out how well this plan works, detailed notes on each patient will be made and looked at to see how well they work.

Third, the nurse should be an active part of helping the patient set goals for their treatment. By helping the patient figure out and get past the things that are stopping them from getting better, the nurses will give the patient more power and freedom. Behavioral activation helps a lot to ease the symptoms of sadness. (Mental Health America, 2020). To judge this plan, the patient’s behavior after treatment will be looked at to see if it has changed.

Summary

Depression is becoming more and more of a problem for people with illnesses in the 21st century. Statistics show that the young people who are most affected are the ones who are most active and busy. It is becoming more common among people who are in jail, which has serious financial and social effects. It is also very expensive, as the government has to spend a lot of money on these people’s medications and programs to help them get better. People also have lost and unhappy personal lives and relationships because of the social effects. If this problem is taken as seriously as it should be, it could save the country a lot of money and help the next generation be more effective.

References

Al-Rousan, T., Rubenstein, L., Sieleni, B., Deol, H., & Wallace, R. B. (2017). Inside the nation’s largest mental health institution: a prevalence study in a state prison system. BMC Public Health, 17(1), 342.

Beyen, T. K., Dadi, A. F., Dachew, B. A., Muluneh, N. Y., & Bisetegn, T. A. (2017). More than eight in every nineteen inmates were living with depression at prisons of Northwest Amhara Regional State, Ethiopia, a cross sectional study design. BMC psychiatry, 17(1), 31.

Lovett, A., Kwon, H. R., Kidia, K., Machando, D., Crooks, M., Fricchione, G., … & Jack, H. E. (2019). Mental health of people detained within the justice system in Africa: systematic review and meta-analysis. International journal of mental health systems, 13(1), 31.

Mental Health America. (2020). Access to Mental Health Care and Incarceration. Retrieved from https://www.mhanational.org/issues/access-mental-health-care-and-incarceration

Reingle Gonzalez, J. M., & Connell, N. M. (2014). Mental health of prisoners: Identifying barriers to mental health treatment and medication continuity. American journal of public health, 104(12), 2328-2333.

World Health Organization, (WHO). (2020). Depression. Retrieved from https://www.who.int/news-room/fact-sheets/detail/depression

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