Mental Disorder and Prisons
2004
by Luke Birmingham
Psychiatric Bulletin of The Royal College of Psychiatrists

EXTRACT:

There can be no doubt that imprisonment can have a detrimental effect on mental health. Prison life is dominated by the need to maintain security. In some prisons large amounts of time are devoted to trying to find space for prisoners, rather doing anything constructive with, and for them (Her Majesty’s Inspectorate of Prisons, 2000). A recently published study that examined the influence of environmental factors on the mental health of people in prison found that participants reported lengthy periods of isolation with little mental stimulation, contributing to poor mental health and feelings of anger, frustration and anxiety (Nurse et al, 2003). Prisoners spend on average around 8-9 h unlocked, but it is not uncommon to find in higher-security prisons that some prisoners spend 19-20 h and sometimes up to 23 h a day locked in their cells. According to Singleton et al (1998), those who are male, on remand and psychotic are likely to be locked up longer than other inmates. Further analysis of the ONS prison survey data found that prisoners with severe mental illness were no more likely than other prisoners to report being placed in disciplinary segregation (Coid et al, 2003a). However, those who reported being placed in solitary confinement in prison were more likely to have an extensive history of previous psychiatric treatment and a diagnosis of schizophrenia or depression (Coid et al, 2003b). The level of confinement and isolation experienced by some prisoners is detrimental to mental health in its own right, but the situation is made worse by the fact that some prisoners turn to the use of illicit substances to help them deal with long periods of isolation. It is not hard to imagine how under such conditions people with a pre-existing psychiatric disorder deteriorate, and others who are vulnerable to mental disorder can become mentally unwell.