Managing Mentally Ill Inmates in Prisons

Mentally ill inmates now comprise a substantial portion of the prison population and pose administrative and therapeutic challenges to prison administrators and mental health professionals. Some evidence suggests that both the size of the population and the seriousness of their illnesses are increasing. Given this context, several issues are highlighted and discussed in terms of contemporary efforts to deal with mentally ill inmates. Specifically, discussion centers on the use of actuarial devices for prediction and classification, the conflict between treatment and control and the relation between treatment and management, the distinction between risks and stakes and use of the environment as therapy, use of medication and isolation, and the role of correction officers in mental health treatment. The authors make an argument for more sophisticated approaches in dealing with mentally ill inmates that rely on expanded therapeutic options, broader role definitions for prison staff, and an evidence-based approach for individualizing treatment.