The prevalence of mental health illnesses within correctional institutions is high, with some estimates reaching 25%. This is in part due to the transinstitutionalization that occurred in the last century. Transinstitutionalization describes the movement of mentally ill from publicly funded mental health hospitals to nursing homes and correctional institutions. The increase in mental health illnesses in prisons not only burdens the prison health care system, but it further compromises the mental health status of prisoners with mental health diseases. Mental health care providers are also in short supply within correctional institutions, despite the fact that courts have mandated the treatment of mentally ill offenders. Additionally, correctional officers, who are in charge of security issues, often lack an understanding about appropriate management of mental health illnesses (e.g.: psychosis). As such, psychotic patients may be treated as violent patients (implying intent to harm), and managed in a manner that aggravates their psychiatric condition (e.g.:
with restraints, solitary confinement, isolation, etc.).
The prison institution as it stands is not only a poor solution to managing individuals with acute and chronic mental health diseases, but also a potential contributor to the development of mental health diseases. This is best exemplified by examining prisoners placed in solitary confinement for weeks, months and years (sometimes up to 15 years!). Psychiatrists with an interest in prison mental health care note that individuals placed in solitary confinement over time may begin to have a cluster of symptoms, including psychosis, that together are known as the SHU syndrome (SHU stands for Security Housing Unit, see Voices of Thought below). While some psychiatrists believe that the mental health status of prisoners with the SHU syndrome can return to normal once released from solitary confinement, the reversibility may depend on the amount of time spent in isolation.
Other mental illnesses...