Mental Health Disorders and Prison Recidivism: Causes and Solutions
Introduction
The topic of mental health has progressed immensely throughout the years. Before 2000, it was a topic that, at one point, didn’t exist. My parents would tell me that mental health was not a concern or even a thought when they grew up.
People didn’t understand mental health until it became more well-known in the late 1900s. So many people around the world are affected by mental health. In the United States, for instance, the issues of psychiatric disorders in the justice department, specifically in prison, represent a national public health crisis. “Epidemiologic studies show that 15%–24% of U.S. inmates have a severe mental illness (Baillargeon et al., 2009).” As people continue to be incarcerated, the number of inmates suffering from mental health issues will increase.
As the discussion around mental health continues, I feel many people don’t think about the mental health of prisoners. This group sticks out to me because I have struggled with mental health issues my whole life, and both my parents are criminal defense attorneys who deal with inmates in prison who suffer from mental health disorders. I have grown up hearing them talk about their clients and how some have mental health disorders.
When I listen to them talk about some instances or clients, I often wonder how they are treated for these disorders while incarcerated and what it is like for them once they are released. I believe that if inmates who suffer from mental health disorders are not appropriately treated inside of prison and after they are released, the recidivism rates will increase. Prinsloo and Hesselink (2015) state that people suffering from mental health issues are most likely to engage in offending behavior and recidivism. Therefore, exploring the connection between recidivism and untreated mental health issues in prison inmates will hopefully bring more attention to the topic. Offenders with mental health issues have a higher recidivism rate and a greater number of criminogenic risks than their counterparts who are not suffering from mental health disorders.
Cause of High Recidivism Rates
High recidivism rates in prison are mainly attributed to insufficient mental health services for prisoners. In prison, mental health issues and services are often disregarded. The mental health services in prison are underfunded and minimally appear in the guidelines that focus on the development of mental health systems globally (Jack et al., 2018).
According to Fazel and Baillargeon (2010), many prisoners with mental health disorders do not receive mental health support and treatment while serving terms in prison. Throughout their stay in prison, their mental health issue often gets worse. According to Birmingham (2004), in England and Wales, prisoners suffer from a high rate of psychotic illnesses and major depression.
This is similar to the case of the United States of America. As of May 2017, the government had assessed nearly 188,000 prisoners in the country through the Federal Bureau of Prisons. Through the assessment, 8,000 were considered seriously ill as they were diagnosed with mental diseases like schizophrenia or bipolar disorder (GAO, 2018). A good amount of research indicates that when prison inmates’ mental health issues go untreated, the recidivism rates increase.
As the number of people incarcerated worldwide increases, so does the number of inmates with mental health disorders. Putkonen et al. (2003) investigated recidivism rates in homicide and non-homicide inmates among women in Finland. The study mainly focused on women sent for mental health evaluation before incarceration between 1982 and 1992. Putkonen et al. (2003) concluded that young women diagnosed with personality and substance abuse disorders and having a history of violence are more likely to return to jail or prison. The authors of the study also concluded that all of the women in this study who were homicide recidivists had personality disorders and that the rate of recidivism was very similar to that of the other non-homicidal female criminals.
This is supported by research conducted by Zgoba et al. (2020), which found that approximately 68 percent of prisoners released from prison in the United States would be rearrested within the first three years. Most of these people who are likely to return to prison are inmates with serious mental health illnesses (GAO, 2018). The recidivists are prisoners with more than one health issue, and approximately 4 in 10 men and 6 in 10 women were diagnosed with mental health and substance abuse issues (Mallik-Kane & Visher, 2008). Inmates with substance abuse disorder are more likely to return to prison upon release (Zgoba et al., 2020). They have a high recidivism rate because of the challenges they face once they are released from prison, which may include finding a house, a job, and mental health treatment
Potential Risk of Recidivism to Society and the Individual
The United States is highly affected by the issue of mental health illnesses. In addition to the mental health issue, nearly 1 percent of the population, about 2.2 million people, were incarcerated or in prison at the end of 2016 (Zgoba et al., 2020). It is estimated that nearly 97 percent of these people will return to prison upon their release (Zgoba et al., 2020). This negatively affects society, as the financial and societal costs of recidivism are substantial.
Thus, the country’s criminal justice system has prioritized measures to reduce recidivism, particularly for the Department of Corrections. Because if the government fails to address the issues, the burden of recidivism will be incurred by the taxpayers, and the crime rate will continue to increase in society. Apart from society, recidivism also has some potential risks to individuals. The recidivists have a high potential for violence and risk committing serious crimes (Zgoba, 2020). Thus, better engagement in treatment for the mental health of recidivists directly impacts reducing crime.
Values and Ethics of Social Work
One of the values of social work involved in addressing the issue of increased recidivism rates is the importance of upholding the dignity and worth of every person. Through dignity and respect, social workers can promote their clients’ capacity to address their own needs, thereby improving their situations. Most social workers in prison departments neglect this significant value while serving their clients.
As stated by Baillargeon et al. (2009), the social workers involved in the screening process neglect their responsibility to enable their clients to identify their needs as mental health patients due to improper assessment. Thus, they are incarcerated without being assessed for their conditions. Society can have a stereotyped view of those who are incarcerated. This makes it difficult for them to integrate well into society, as they may face numerous challenges in finding employment and housing.
The potential source of the value conflict may arise from the clash between the individual values and beliefs and those of the Prison Department. The values of the criminal justice system contradict those of the general public health system and individual beliefs. The criminal justice system prioritizes security, whereas the public health system prioritizes individual and societal well-being (Fazel & Baillargeon, 2010). This contradiction results in mismanagement and misdiagnosis of mental health issues among prisoners, resulting in a high recidivism rate.
Ways of Reducing Recidivism
The main challenge that faces the criminal justice system when it comes to treating prisoners’ mental health disorders is getting the proper services needed for all inmates who suffer from mental health disorders. The World Health Organization recommends that national and regional governments oversee prisons to address this issue (Zgoba et al., 2020). In the United States, for instance, the prison staff in correctional facilities control which healthcare services are offered to inmates through the National Commission on Correctional Health Care (Baillargeon et al., 2009).
If the U.S. government adopts the WHO’s recommendation that prisoners’ health be overseen by national and regional health services, rather than prison staff, inmates could receive the proper care and services they need. Baillargeon et al. (2009) supported this by arguing that prisons and jails are not a substitute for psychiatric care and treatment. Knowing that people with mental health issues will stay in prison, it is necessary that these people get the proper care and treatment they need in person, and once they are released.
Providing inmates with the proper services, both inside and outside the prison, is necessary. When prison inmates receive adequate treatment, they are more likely to reintegrate into society successfully. Zgoba et al. (2020) note that inmates who are more involved in the treatment provided in prison are less likely to reoffend when released. Many reviewed sources suggest ways for prison inmates being released from prison to receive the proper care and services (Baillargeon et al., 2009). When inmates enter the prison system, not all of them are adequately screened for mental health disorders, and some go undetected.
According to Baillargeon et al. (2009), despite standardized procedures for screening inmates, there is a high possibility of misclassification at entry, misdiagnosis, and incorrect data entry in prisons. When this occurs, the inmates are thrown into cells with inmates who may not suffer from mental health disorders. The mental health issues or disorders these inmates suffer from continue progressing and worsening as time passes, and they are not adequately treated(Birmingham, 2004). When these inmates are released back into society and do not have access to mental health services, they often return to the prison system. If these inmates can continue with treatment outside of prison for a duration of time, that will help manage their mental health problems, which can ultimately help reduce the risk of them returning to prison.
Conclusion
It is shown through the literature that almost all prison inmates suffer from some mental health disorder. The studies indicate that inmates with major depressive disorder, bipolar disorder, schizophrenia, substance abuse disorder, and non-schizophrenic disorders had multiple incarcerations. Thus, recidivism is more likely in inmates who are released with a psychiatric disorder.
Inmates who have a mental illness deserve the same access to health care services as the public. As inmates continue to suffer from improper treatment, they will not successfully reenter society. They will want to return to what they know, where other inmates understand them. Creating programs and treating inmates with mental health problems correctly is necessary to decrease recidivism rates.
References
Baillargeon, J., Binswanger, I. A., Penn, J. V., Williams, B. A., & Murray, O. J. (2009). Psychiatric disorders and repeat incarcerations: The revolving prison door. American Journal of Psychiatry, 166(1), 103–109.
Birmingham, L. (2004). Mental disorder and prisons. Psychiatric Bulletin, 28(11), 393-397.
Fazel, S., & Baillargeon, J. (2011). The health of prisoners. The Lancet, 377(9769), 956–965.
GAO. (2018). Information on Inmates with Serious Mental Illness and Strategies to Reduce Recidivism Report to Congressional Committees United States Government Accountability Office.
Jack, H. E., Fricchione, G., Chibanda, D., Thornicroft, G., Machando, D., & Kidia, K. (2018). Mental health of incarcerated people: a global call to action. The Lancet Psychiatry, 5(5), 391–392.
Mallik-Kane, K., & Visher, C. (2008). Health and prisoner reentry: How physical, mental, and substance abuse conditions shape the process of reintegration. Urban Institute Justice Policy Center.
Prinsloo, J., & Hesselink, A. (2015). Mental health disorders and crime: an international comparison. African Journal of Criminology & Victimology, 28(1), 1-11.
Putkonen, H., Komulainen, E. J., Virkkunen, M., Eronen, M., & Lönnqvist, J. (2003). Risk of repeat offending among violent female offenders with psychotic and personality Disorders. American Journal of Psychiatry, 160(5), 947–951.
Zgoba, K. M., Reeves, R., Tamburello, A., & Debilio, L. (2020). Criminal recidivism in inmates with mental illness and substance use disorders. Journal of the American Academy of Psychiatry and the Law Online, 49(3).
