The Mental Health Effects of Being in Prison

Unfortunately, thousands of individuals with mental health issues become incarcerated every day. And some individuals who were considered mentally healthy prior to their arrest develop mental health symptoms once they are in prison. 

Being in prison can take a serious toll on an individual’s psychological well-being. New conditions often develop and pre-existing conditions may worsen. Sadly, many inmates are released back into the community without ever receiving any type of treatment.

Mental Illness Among Inmates

According to the American Psychological Association, 64% of jail inmates, 54% of incarcerated individuals in state prison, and 45% of incarcerated individuals in federal prison report mental health concerns. Substance abuse is rampant among incarcerated individuals as well and quite often, mental health issues and substance abuse issues occur alongside one another.

Increased incarceration rates in the United States have disproportionately affected minority populations. Almost 40% of inmates are Black and 20% are Hispanic.

The American Psychological Association estimates that between 10 and 25% of inmates have a serious mental illness, such as schizophrenia. In the general population, it’s estimated that about 5% of individuals have a serious mental illness. 

Many other inmates may experience depressive disorders, anxiety disorders, or adjustment disorders. For some, these illnesses may be pre-existing conditions. For others, the issues may have started after their incarcerations.

Quite often, disorders go unrecognized by inmates and prison staff. The response of inmates with mental health issues to the prison system may simply seem like a “normal” reaction to an institutionalized setting; this prevents any type of acknowledgement of the problem, letting those with mental health issues suffer in silence.

Black individuals are more likely to be incarcerated before trial, to fare worse in plea agreements that might have otherwise kept them out of prison, to receive the death penalty, and to be arrested and charged with drug crimes.

While some people feel that increasing the number of people behind bars keeps communities safer, the statistics don’t necessarily show a decrease in crime. For example, there are 10 times as many people in prison for drugs today than there were 30 or 40 years ago, but the number of drug-related crimes hasn’t decreased.

The Toll Prison Takes on Psychological Well-Being

 Incarceration takes a serious toll on mental health for several reasons:

Inmates Are No Longer Productive Members of Society

Inmates experience a loss of purpose when they’re locked up. They're no longer able to contribute to society with a regular job and they can contribute to their family's financial or emotional needs. A lack of purpose in life can take a serious toll on anyone's psychological well-being.

Their Identities Get Stripped

When you’re incarcerated, inmates are no longer known for their profession, such as being a musician or a delivery driver, and they aren’t known for their skills, talents, or knowledge. They’re often known as an inmate number. The loss of sense of self can be quite disorienting, confusing, and troublesome.

They’re Separated From Loved Ones

They can no longer be with their friends and families. Missing their loved ones and not being part of their daily lives increases feelings of isolation and loneliness. Additionally, they can't be there for their loved ones so they may worry about those they can't support, such as an elderly family member. They may also experience a lot of grief over missing out on a child's activities or not being able to be there for a partner.

Physical Environment Adds to Stress

Concrete walls, little natural night, and a lack of overall stimulation can take a serious toll on mental health. Inmates have few ways to relieve stress. And there sterile environment is likely to fuel boredom, which can be quite stressful in itself.

Research shows the environment even takes a toll on the prison staff. Frequent staff shortages can mean inmates don't get out of their cells as often, which can add even more stress to their daily lives. This creates a cycle of stress that is tough to break.

Exposure to Violence

Inmates are often exposed to violence while behind bars. They may witness fights breaking out at meal times or during recreation times. They may also witness acts of violence between guards and inmates or they may become victims of aggression.

Research shows that exposure to violence while in prison creates emotional distress. But, perhaps even more troubling, is that exposure to violence has a direct impact on how well inmates adjust to life outside of prison after they're released. Those who are exposed to greater acts of violence are more likely to have trouble settling back into the community.

Solitary Confinement

Whether inmates are placed in solitary confinement due to disciplinary issues, or they're segregated because of a safety issue, being locked up alone for 23 hours a day, can take a serious toll on an inmate's well-being.

Researchers have found that the vast majority of individuals who are placed in solitary confinement have mental illness. Some of them likely had mental health issues prior to being placed there (which may be why they exhibited behavioral issues in the first place).

But others, are likely to develop mental health issues as a result of the extreme isolation. Studies show solitary confinement increases the risk of panic, insomnia, paranoia, aggression, and depression.

Lack of Treatment

Even when mental health disorders are known, disorders often go untreated. Most prisons lack the funds to offer adequate mental health treatment. Those who do offer services of some kind may be limited in the types of treatments they provide.

Additionally, services in prison may not be all that effective. It’s tough for inmates to open up to someone when they lack physical and psychological safety.

Many inmates may not be given proper medication either, even if they were taking medication to help with a condition at the time they were admitted to prison.

A 2014 study published in the Journal of American Health found that 26% of inmates were diagnosed with a mental health condition at some point during their lives. Only about 18% of them were taking medication for their condition when they became incarcerated. Of those who were taking medication, less than 50% were prescribed medication during their admission.

Inmates with schizophrenia were more likely to receive medication as compared to those with other mental health conditions, like depression.

Although courts mandate adequate treatment for healthcare, treatment is usually reserved for those that are considered the most serious mental illnesses. Medications are often expensive and quite often, in an effort to save costs, prescriptions are not made readily available.

Specialized treatment is rarely available in prisons. And generic groups or services may not be able to assist with specific conditions. Additionally, most prisons lack adequate treatment providers.

So inmates' conditions often go unrecognized. Quite often, inmates are given simple screening questionnaires to complete at intake. They aren’t assessed by a mental health professional at all and likely never come into contact with one throughout their time in prison.

Consequences of Inadequate Treatment

The consequences of inadequate mental health care contribute greatly to the suffering of the affected individuals and their families. Untreated mental illness among the prison population even takes a toll on society financially, in the form of taxpayers' money.

Untreated mental health conditions may prevent individuals from qualifying for special programs that could assist them upon being released from prison.

Additionally, untreated mental illness may increase the risk of recidivism. Inmates with a mental illness are 70% more likely to return to prison at least once.

Among those with previous incarcerations, the rates of recidivism are between 50 and 230% higher for persons with mental health conditions than for those without any mental health disorders, regardless of the diagnosis.

State Hospital Closures

Since the 1970s, there has been a big push toward the deinstitutionalization of individuals with mental illness. On the surface, closing “asylums” and institutions that housed people with severe mental health issues seemed like a good idea. Many of the institutions were understaffed and unable to give patients the individual treatments they needed.

Closing the doors to psychiatric hospitals and other long-term institutions, however, has had serious consequences—including a major increase in incarcerations.

So rather than reside in a state-run institution, many individuals with mental illness now spend much of their time in jail.

According to research conducted by The Treatment Advocacy Center, the number of individuals with severe mental illness is now 10 times higher in jails than in psychiatric hospitals.

A Word From Verywell

Anyone who is facing incarceration should consider revealing any pre-existing mental health conditions. Disclosing those issues may increase the likelihood of accessing treatment.

But bigger changes are needed at the systemic and legal levels. Better access to mental health services may reduce crime. Treating inmates during incarceration and providing access to ongoing treatment after they’re released may reduce recidivism rates.

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