Finally, a very important dimension of religiosity is religious commitment , which reflects the influence that religious beliefs have on a person's decisions and lifestyle. Persons with this orientation are disposed to use religion for their own ends. Many find religion useful in a variety of ways — to provide security and solace, sociability and distraction, status and self-justification. The embraced creed is lightly held or else selectively shaped to fit more primary needs.
Persons with this orientation find their master motive in religion. Other needs, strong as they may be, are regarded as of less ultimate significance, and they are, so far as possible, brought in harmony with the religious beliefs and prescriptions. Having embraced a creed the individual endeavors to internalize it and follow it fully. Usually, the intrinsic orientation is associated with healthier personality and mental status, while the extrinsic orientation is associated with the opposite.
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It is exactly this behavior that has been most consistently associated with better mental-health. Gartner, Larson and Allen reviewed the literature and found numerous variables, which had positive correlations with religiousness. Of physical health, religiousness was related to decreased smoking and alcohol consumption, as well as positively effecting heart disease and blood pressure. A confound was that, at least in the elderly, physical health supported religious activities, more than the other way around.
Religious commitment and participation seemed to affect longevity, as well, especially in men. Suicide ideology was also lowered, as well as, more disapproving attitudes towards suicidal behavior. An interesting finding was that church attendance was a major predictor in suicide prevention, even more than employment.
In Hindu, religious beliefs if you take your life prematurely than you have to suffer in the next birth. Hence in this religion there is a strong believe in rebirths. There is a negative correlation between drug use and religiousness. The best defense against overuse of alcohol was modeling disciplined drinking habits by the religion.
This was found because different denominations had different rates of alcoholism Jews the lowest, Catholics the highest, and Protestants somewhere in-between , and that even in conservative Protestant homes, there were found some higher rates of alcoholism, so some concluded that the religious tradition had more impact than the home. Gartner's findings demonstrated mixed result in regard to anxiety. Some research showed greater anxiety with religiosity, while other research showed less anxiety. Some people were less anxious and showed less somatic symptoms with public religious activities, yet more so with private devotions.
Intrinsic religion was associated with lower anxiety, while higher levels were found with extrinsic religion. There was also mixed results on death anxiety and religiosity. Of the controversial findings on self-esteem, one study found that loving portrayals of God were positively correlated with higher self-esteem, and negatively correlated with God portrayed as vindictive and punitive. If a Hindu dies in Kashi Varanasi then it is believed that he goes directly to heaven. The mixed results may be from confusion between humans as sinful, as held by conservative Christians, which might result in a misdefinition of what self-esteem is.
The literature on sexual disorders showed that more male clients in sex therapy were from religious homes. A replication failed to find this. Some research has looked at denomination and sex, but little research has included the variable religion or religious commitment. Several studies have found a weak positive correlation with education, others found a negative correlation. Early findings found that there was more prejudice from religious people. More recent studies have suggested a curvilinear relationship between prejudice and church attendance; so that those who attended church often and those who never attended were less prejudiced than those who attended infrequently.
Intrinsic religiosity was negatively correlated with prejudice, as was religious commitment. Extrinsic religiosity has been found to have a positive correlation with prejudice. Although there are plethora of studies reporting relationships between religious involvement and mental health, they rarely investigated the potential mediators of this relationship. Several mechanisms have been proposed to explain the influence of religion on human health.
Several illnesses are related to behavior and lifestyle. The way we eat, drink, drive our automobile, have sex, smoke, use drugs, follow medical prescriptions, exam ourselves for prevention have important influences in our health. Most religions prescribe or prohibit behaviors that may impact health. The biblical teachings, years ago, about diet, ways to handle food, cleaning and purity, circumcision, sexual behavior were important for preventing disease. Today other illnesses are more relevant. Prescriptions about keeping a day of rest, the body as a sacred temple, monogamous sex, moderation on eating and drinking, peaceful relationships are doctrines that might be also helpful for contemporary health problems related to stress, competition, individualism, narcissism, anger, shame etc.
A good clinical example trying to apply those teachings was the research of Thoresen et al. Certain religious practices are responsible for health hazards and risks. Visits to a holy shrine on specific times can enhance the risk of accidents. Prohibition of vaccines, medication or blood transfusion, endogamous marriages, violence against unbelievers, handling of poisonous snakes, the way dead bodies are handled are other examples of behaviors that can bring health problems. Belonging to a group brings psychosocial support that can promote health. Religion might provide social cohesion, the sense of belonging to a caring group, continuity in relationships with friends and family and other support groups.
Social support can influence health by facilitating adherence to health promotion programs, offering fellowship in times of stress, suffering and sorrow, diminishing the impact of anxiety and other emotions and anomie. Social support, although important, is not the only mechanism by which religion influences health. Religion still has beneficial effects even when social support is a controlled variable.
Beliefs and cognitive processes influence how people deal with stress, suffering and life problems. Religious beliefs can provide support through the following ways: Enhancing acceptance, endurance and resilience. They generate peace, self-confidence, purpose, forgiveness to the individuals own failures, self-giving and positive self-image. On the other hand, they can bring guilt, doubts, anxiety and depression through an enhanced self-criticism.
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Locus of control is an expression that arises from the social learning theory and tries to understand why people deal in different ways even when facing the same problem. Why some actively act and others stay in despondency.
An internal locus of control is usually associated with well-being, and an external one with depression and anxiety. A religious belief can favor an internal locus of control with impact on mental-health. Many patients use religion to cope with medical and non-medical problems. The study of religious coping, which can be positive or negative, has emerged as a promising research field. Positive religious coping has been associated with good health outcomes, and negative religious coping with the opposite.
Religious patients tend to use more positive than negative religious coping. Negative religious coping includes passive waiting for God to control the situation, redefining the stressor as a punishment from God or as an act of the devil and questioning God's love. Public and private religious practices can help to maintain mental health and prevent mental diseases.
They help to cope with anxiety, fears, frustration, anger, anomie, inferiority feelings, despondency and isolation. The most commonly studied religious practice is meditation. It has been reported that it can produce changes in personality, reduce tension and anxiety, diminish self-blame, stabilize emotional ups and downs, and improve self-knowledge. Improvement in panic attacks, generalized anxiety disorder, depression, insomnia, drug use, stress, chronic pain and other health problems have been reported.
Follow-up studies have documented the effectiveness of these techniques. Other religious practices such as personal prayer, confession, forgiveness, exorcism, liturgy, blessings and altered states of consciousness ; may also be effective, but more studies are necessary.
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In Muslim patients during days of fasting Roza they have to readjust the dose of medications so that it will prevent relapse. Spiritual direction is described as a special relationship between two human beings to help the development of the spiritual-self. Its aims are to develop a relationship with God, to find meaning in life, and to promote personal growth.
Several religious and psychological techniques may be used, and great similarities with psychotherapy can be found, as the same themes are discussed. The psychotherapy and its Indian adaptation are discussed in different article elsewhere. In times of stress and social disorganization certain religious rituals by means of techniques that elicit altered states of consciousness, can produce catharsis, dissociative states and a special milieu to express problems and suffering.
Religion is a multidimensional phenomenon and no single fact can explain its actions and consequences. The combination of beliefs, behaviors and environment promoted by the religious involvement probably act altogether to determine the religious effects on health. However, empirical studies have had limited success in accounting for the psychosocial mechanisms described above for the health-promoting effects of the religious involvement. The explanation of the mechanisms by which religion affects health has been an intellectually and methodologically challenging enterprise.
The importance of the relationship between religion and mental health is recognized exists. Patients do have spiritual needs that should be identified and addressed, but psychiatrists and other mental health professionals do not feel comfortable tackling these issues. Adequate training is necessary to integrate spirituality into clinical practice. In the presence of psychopathology, religion may be part of it, contributing to the symptoms obsessions or delusions for example. Sometimes, religion may become rigid and inflexible, and be associated with magical thinking and resistance.
It may hinder treatment if it forbids psychotherapy or the use of medication. It has been described the elements of a functional theology, present in all religions, which may promote good mental health. They are: Awareness of God, acceptance of the grace and love of God, repentance and social responsibility, faith and trust, involvement in organized religion, fellowship, ethic, and tolerance and openness to the experiences of others.
During assessment, the psychiatrist should be able to determine whether the religion in the life of his patient is important, has a special meaning, is active or inactive, involves values in accordance to his main tradition, is useful or harmful, and promotes autonomy, personal growth, good self-image and interpersonal relationships. Koenig recommendations go beyond listening and respect, appropriate referral, and support of spiritual needs. A brief spiritual history is necessary to become familiar to the patients religious beliefs as they relate to decisions about medical care, understanding the role religion plays in coping with illness or causing stress, and identifying spiritual needs that may require assistance.
Four basic areas should be remembered when taking a spiritual history:[ 3 ]. Does the patient use religion or spirituality to help cope with illness or is it a source of stress, and how? Religious beliefs and practices are often contributory to the development of certain psychiatric disorders more so as regards to obsessions, anxiety and depression. Somehow, this aspect of psychopathology has not been given due consideration.
For instance, Freud observed remarkable similarity between obsessive behavior patterns and religious practices in view of their fixed, stereotyped and rigid character, their being meaningless and the anxiety that follows when specific action is not properly performed. Religion provides mechanisms for both intensifying guilt as well as alleviating it. Religion often creates guilt by setting high moral standards while, on the other hand, it also provides a number of methods of alleviating guilt such as confession, prayer, charity etc. In spite of the presence of almost all religions in India for centuries, Hinduism continues to be the predominant religion.
To an outsider Hinduism continues to present bewildering arrays of beliefs, customs, and code of conduct, which are often mutually contradictory. To understand Hinduism is to understand India because in Hinduism lies the history of this subcontinent for the last years. In early Aryan religion, there is mention of many natural deities like sun, fire and lightning and perhaps there were no idols and worship was in open. Rig Veda also gives some account of religious hymns. I've been in the S. In March of I had a mental breakdown because of being in S.
I was then discharged and sent to Wende Correctional Facility…. Upon my arrival at Wende I was put in an observation cell in the mental health unit where I was kept for 25 days in a strip cell. I was mistreated and denied everything. There was no heat in the place. I was put in a dirty, bloody cell. I was jumped and assaulted by correctional officers, and was left unattended to by the mental health staff. Instead the mental health staff took me off my mental health anti-depression medication and told me that they was not going to send me back to CNYPC no matter what I did or said.
In the course of the 25 days I spent in M. I attempted suicide 3 times. They said I'll just have to do that and they sent me back to S. Right now I don't know what more to do. I'm writing this letter in hopes that someone will do something about the way these people in the mental health department here treats people, after I'm gone because I simply cannot carry on no more like this I hope that my death will bring about some good, if not at least I'll finally find some peace. We have been practicing nuclear allimators stronger than the Russians.
If I'm killed it's going to burn stars and the world at the same time. If we don't watch it, people will burn and I will go into a different dimension. So I'd like to keep my single cell as long as possible. I write to Berlin, to Red China, they don't send me no package. The mentally ill in prison, as in the world outside prison, suffer from a wide array of mental disorders serious enough to require psychiatric treatment.
The symptoms of some prisoners with serious mental illness are subtle, discernable only by clinicians. This is particularly true for prisoners suffering serious depression, who may just appear withdrawn and unsociable to other prisoners and staff. While many of the mentally ill in prison do not suffer major impairments in their ability to function, some, like the above-quoted prisoner, are so sick they live in a world entirely constructed around their delusions.
Not only is the number of prisoners with mental illness growing, but more persons are being incarcerated whose illnesses fall at the most severe end of the mental illness spectrum. According to Dave Munson, lead psychologist at Washington State's McNeil Island Correctional Center, "the severity of the mental illness of those coming in is increasing. People are no longer going to state hospitals.
The prisoners often have no idea how they ended up here. I don't know how [some of these women] were sentenced to prison.
They have no understanding of why they are in prison. I don't know what purpose it serves. To some degree the services will be limited, because this is a prison, not a state hospital. We're having to adjust and make changes to accommodate mental health - and it's difficult. Mental disorders include a broad range of impairments of thought, mood, and behavior. The degree of impairment can vary dramatically from individual to individual.
Also, some individuals with mental illness have periods of relative stability during which symptoms are minimal, interspersed with incidents of psychiatric crisis. Other individuals are acutely ill and dramatically symptomatic for prolonged periods. In this report, we use the term serious mental illness to refer to diagnosable mental, behavioral, or emotional disorders of sufficient duration to meet diagnostic criteria specified in the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association, generally referred to as DSM-IV  and that result in substantial interference with or limitations on one or more major life activities.
In prisons, the category of serious mental illness is typically limited to such conditions as schizophrenia, serious depression, and bipolar disorder. Schizophrenia is a frightening, complex, difficult, and debilitating disease which may include disordered thinking or speech, delusions fixed, rigid beliefs that have no basis in reality , hallucinations hearing or seeing things that are not real , inappropriate emotions, confusion, withdrawal, and inattention to any personal grooming. Among the subtypes of schizophrenia is "paranoid schizophrenia" with characteristics of delusions of persecution and extreme suspiciousness.
Even if a person with schizophrenia is described as recovered or in remission, quite likely he or she is neither ill nor well, but will usually have a great deal of difficulty adjusting to life situations, and can be driven over the edge by overwhelming demands. Clinical depression, which is far more common among women than men, is a significant suicide risk factor. Bipolar disorder previously called manic-depressive disorder is characterized by frequently dramatic mood swings from depressions to mania.
During manic phases some people may be psychotic and may experience delusions or hallucinations. Wholly apart from ensuring adequate mental health treatment, the incarceration of thousands of persons with these illnesses poses extremely difficult management challenges for correctional staff trying to ensure prison safety and security.
For example, serious depression puts people at risk of suicide. Persons with schizophrenia may experience prison as a peculiarly frightening, threatening environment that can result in inappropriate behavior including self-harm or violence directed toward staff or other prisoners. Persons with bipolar disorder in a manic phase can be disruptive, quick to anger, provocative, and dangerous. According to correctional mental health expert and clinical professor of psychiatry at the University of Colorado's Health Sciences Center Dr.
Jeffrey Metzner, "A small percentage [of prisoners] don't understand the rules. They're the ones who are psychotic. More common is that prison rules don't mean much to someone hearing voices - that's the least of their problems. It is not uncommon for persons who end up in jail or prison to have Axis 2 personality disorders which result in serious problems in thinking, feeling, interpersonal relations, and impulse control. When these disorders are associated with significant functional impairments they constitute serious mental illnesses.
According to the DSM-IV, personality disorders are "an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment.
Perhaps the most prevalent personality disorders among jail and prison inmates are anti-social personality disorder ASPD and borderline personality disorder.
The essential feature of the former is "a pervasive pattern of disregard for, and violation of, the rights of others. Yet, according to psychiatrist Dr. Terry Kupers, who has examined mental health services in many prisons, correctional mental health staff have a tendency to over-diagnose the presence of ASPD, essentially using it as a default diagnosis for anyone who seems to have mental problems of some sort but does not have an obvious Axis I illness. According to the DSM-IV, borderline personality disorder is marked by "patterns of instability in interpersonal relationships, self-image and affects, and marked impulsivity that begins in early adulthood.
Many resort to self-mutilation at some point. Borderline personality disorder can also include episodes of psychotic decompensation. Research suggests that childhood trauma - particularly sexual and physical abuse - is one of the causal factors for the disorder. About 70 to 77 percent of people diagnosed with this disorder are women. Judith Herman, believe that many, if not most, women diagnosed as borderline are in fact suffering from what Herman calls, "complex posttraumatic stress disorder.
If the diagnosis, however, is of borderline personality disorder, the complex posttraumatic stress disorder is ignored and, all too often, the women are considered just plain difficult and not amenable to or in need of treatment. Although people with personality disorders may appear "normal" - just obnoxious or difficult - these mental disorders are very real and drive those who have them to behave the way they do. Unlike Axis 1 mental illnesses, personality disorders are not believed to be caused by abnormality of brain chemistry or other organic problems, but are rooted in life histories, such as childhood traumas and neglect, and perhaps genetics.
For that reason, they do not generally respond to medications and are thus harder to treat and contain. Personality disorders can and often do co-exist with Axis-1 mental illnesses, further complicating the diagnosis and treatment of both. It is a convention in correctional psychiatry to identify as serious mental illnesses only certain serious Axis I disorders such as bipolar disorder, major depression, and schizophrenia, and to limit mental health treatment to prisoners with those disorders. It is a convention in part created by the shortage of mental health staff: absent sufficient numbers to treat everyone, the determination of who warrants treatment is restricted to the most deeply troubled individuals and also those who are more likely to respond to the primary treatment modality offered in prison - medication.
Correctional mental health staff are particularly reluctant to expend treatment time on prisoners with personality disorders. The judgment of correctional mental health staff about the seriousness of a non-psychotic mental condition may also be colored by their concerns that prisoners may be malingering or seeking secondary gains. It is also a convention that survives under constitutional jurisprudence that has failed to clarify the boundaries of the "serious mental illness" for which mental health services are required.
Nevertheless, individuals who suffer from other illnesses not on the short list of Axis I disorders can be equally distressed and disabled. Some personality disorders can include episodes of psychotic decompensation and several of the personality disorders can result in severe disability. For example, an individual suffering from a severe generalized anxiety disorder with panic attacks might spend all of her time terrified, incapable of acting productively, and cringing in her cell.
Someone with severe obsessive-compulsive disorder might spend all his time cleaning his cell or counting cracks in the wall and be completely incapable of undertaking other activities. A person with a dysthymic disorder a less severe form of depression than a major depressive disorder might successfully commit suicide. Failure to diagnose and properly attend to prisoners' personality disorders can lead to inappropriate responses by correctional staff that aggravate the prisoners' conduct and heighten the incidence of self-mutilation and suicide attempts. The clinical diagnosis of personality disorders should be followed with useful therapeutic interventions, such as individual and group talk therapy and cognitive skills and anger management training.
Medication cannot address the fundamentals of personality disorders but can alleviate frequently concomitant symptoms, such as depression and anxiety. Mental health interventions can not only make life in prison more tolerable both for the prisoners and the staff who have to deal with them; they also can provide the prisoners with life-skills - such as personal hygiene, education, anger management, and an ability to recognize the signs of an approaching mental health crisis - that will serve them well when they are released from prison. To provide a sense of the nature and degree of serious mental illness from which some prisoners suffer, we note below some descriptions, many of which were made by mental health experts and courts who had access to complete mental health records:.
He has a history of serious mental illness beginning at age According to a  entry in his clinical file…he was diagnosed with Paranoid Schizophrenia. Prisoner 1 experiences command hallucinations, which are voices that tell him to do bad things. Prisoner 1's charts list medication orders dating back to that include the antipsychotic medications Thorazine, Haldol, Quetiapine, Seroquel, Loxitane, Risperdal and Olanzopoine. Major Depression with Psychotic Features. Kupers [plaintiffs' expert] that he hears voices constantly that command him to kill himself or hurt others….
Prisoner 1 told Kupers that he cannot sleep because he "sees things," including "demons moving around the floor and climbing on my bed" all night. Prisoner 1 told Kupers that he has paranoid thoughts that the guards are out to get him. He paces in his cell. Prisoner 1 continues to experience auditory hallucinations and massive anxiety despite his strong psychotropic medications… .
In a number of instances, there were people who had smeared themselves with feces. In other instances, there were people who had urinated in their cells, and the urine was on the floor…. There were many people who were incoherent when I attempted to talk to them, babbling, sometimes shrieking, other people who appeared to be full of fury and anger and rage and were, in some instances, banging their hands on the side of the wall and yelling and screaming, other people who appeared to be simply disheveled, withdrawn and out of contact with the circumstances or surroundings.
Some of them would be huddled in the back corner of the cell and appeared incommunicative when I attempted to speak with them. Again, these were not subtle diagnostic issues. These were people who appeared to be in profound states of distress and pain. His thinking was grossly disorganized and his speech was irrelevant. He appeared confused, agitated, and paranoid.
The medical record indicated that his antipsychotic medication had been discontinued…due to refusals. There could be no question that his decompensation was long and tortured…. A 28 year old man with schizoaffective disorder and mental retardation…he appeared floridly psychotic and deteriorating. His left arm was severely mutilated from multiple self-inflicted lacerations. Inmate [V. His mental status deteriorated and regressed considerably while in the infirmary, including alternatively claiming to be Jesus and denying he was Jesus.
His affect was often intense, agitated and paranoid threatening. Thought process was disorganized, grandiose, and delusional, with auditory hallucinations at times reported but at other times denied. Decompensation continued until Inmate [V. He believes that he is 'attached to an alien affiliation' and that he has been forced to commit treason against the Untied States. He also claims that he is a woman, but 'they haven't found his vagina yet. He also reported that he believes that there is a radio in his nerves that is broadcasting. He often picks at his ear to see if the receiver is in there but can't find it.
He still believes it is there. He also gets messages through 'federal codes' in his cell. He describes visual hallucinations of seeing ghosts, animals, people and things move. Auditory hallucinations are outside of his head, they are sometimes about Jesus, they take up to different forms and talk to each other. They sometimes command him to kill himself although he has not made any previous suicide attempts. He is obviously severely mentally retarded and appeared to be blithely indifferent to his conditions.
BF is a forty year old black man who has been incarcerated since July On each occasion that he was transferred to CNYPC, he presented with symptoms of a highly agitated, confusional psychosis with some suicidal features. His clinical presentation has also included a great deal of agitated, bizarre and inappropriate behavior, including sexual preoccupations, grandiose ideation of being a rock star, and a fixation with princess Diana of Britain. At times he experienced visual and auditory hallucinations, and sometimes carried on loud conversations with the voices he heard.
He was observed to be hearing voices and seeing strange people who were not there, and became preoccupied with spacecraft, aliens, voodoo, and the singer Mariah Carey. At times, he was observed to be overtly confused and disoriented, mumbling incoherently. His behavior was often grossly bizarre and inappropriate…[H]e was observed to have inserted a lighter, cigarettes, and pictures into his anus. On at least one occasion, he inflicted multiple lacerations on both sides of his face…. He smeared feces on his cell wall - even using his excrement as a paint to write words on the walls.
At times he was suicidal. No visual, olfactory, gustatory or tactile hallucinations. Sometimes it is intended to be lethal. He was convicted of a triple-murder carried out when he was eighteen years old. Although he underwent a psychiatric evaluation conducted by a state expert, he was never given a mental health competency hearing, despite his lawyers believing him to be incompetent to stand trial.
At other times, he declares that he is God and that the Bible was written about him. He believes that when he is executed he will immediately return to earth, bringing with him all his dead relatives. When he acts out, bangs on the walls, or floods his cell, guards have, at least twice, placed him into four point restraints; because he is so ill, he cannot write to his attorney.
She only finds out about these events when other prisoners on death row contact her and tell her what has been happening to her client. For example, we interviewed a prisoner, V. He told Human Rights Watch that he'd been playing a game called "no murder. She talks about game playing. No Murder. She says she's sorry she fooled around…..
I think about game 'no murder. During that period of time, I have seen the number of mentally ill women entering the prison system rise precipitously. Where once mental institutions kept patients for long periods in back wards, today the burden of providing for mentally ill people who have committed crimes has shifted to the correctional system.
It is clear that prisons must adapt by creating more appropriate environments for these inmates — as long as society believes that is where mentally ill inmates should be maintained. While serious mental illness is epidemic amongst both male and female prisoner populations, the statistics for female prisoners are particularly stark.
A national study in by the Bureau of Justice Statistics based on a survey of prisoners, found that "[t]wenty nine percent of white females, 20 percent of black females and 22 percent of Hispanic females in State prison were identified as mentally ill. Nearly four in ten white female inmates aged twenty-four or younger were mentally ill. Striking as they are, the Bureau of Justice Statistics BJS figures may not fully represent the extent of mental illness among incarcerated women. In New York, for example, 26 percent of incarcerated women are on the active mental health caseload compared to 11 percent of men.
Imprisonment may be even harder for women than for men.
One crucial difference is that women prisoners are more likely to have dependent children who were living with them prior to incarceration. In addition to the grief, emptiness, anger, bitterness, guilt, and fear of loss or rejection that women prisoners who are mothers may experience, all women prisoners must cope with the stresses that are inherent in incarceration.
Indeed, those stresses may be greater because facilities for women often lack the diversity and extent of educational, vocational, and other programs that are available albeit typically in insufficient quantity and quality in facilities for men. Like men, women with mental illness can find themselves unable to adapt to and cope with prison life, with the result that they end up accumulating histories of disciplinary infractions.
An analysis of data from the Bureau of Justice Statistics' Survey of Inmates at State Correctional Facilities showed that women who currently or in the past had utilized mental health services had significantly greater disciplinary problems in prison; female prisoners currently on psychotropic medications had annual infraction rates that were twice that of other women prisoners - and, indeed, had higher infraction rates on average than male prisoners who were also on medication.
Although women prisoners are typically less violent than men - and mentally ill women less violent than mentally ill men - they can and do cause injuries to themselves and others. Superintendent Lord observes:. Obviously, one of the dangers of having seriously mentally ill women in prison is that they are a source of violent acts within the inmate community that are very difficult to prevent because they are tied to mental illness; they simply make no sense.
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Just as the public has difficulty comprehending why a mentally ill person pushes someone off a train platform, so, too, prisoners and correction staff have difficulty comprehending seemingly random acts of violence perpetrated within a prison. Although the rate at which women are incarcerated has soared in the past decade, in great part because of the war on drugs, they still represent a small segment of the prison population. Prison medical care for women is particularly deficient, including mental health care.
In New York State, women who are seriously mentally ill must be confined at Bedford Hills Correctional Facility, a maximum-security prison, even if their security level is minimum or medium, because it is the only prison for women in the state with intensive mental health services. Over half of the population at Bedford Hills is on the active mental health caseload; and half of those cases fall within the two highest need categories for mental health services.
Twenty-two percent of the prisoners on the mental health caseload were diagnosed with schizophrenia, 21 percent with depressive disorders, and an additional 13 percent were diagnosed as psychotic, not otherwise specified. In , researchers from Northwestern University's Psycho-Legal Studies Program investigating jail conditions found that "because there are relatively few female inmates, the per capita cost is too high to provide them with comparable services" to the specialized mental health treatment available in an increasing number of male institutions.
In Vermont, the Chittendon Community Correctional Center is the intake jail in Burlington that deals with 40 percent of all intakes in the state. In the fall of , between eighty and ninety women were there on any given day out of a total population of prisoners. Even in states which make an effort to provide adequate mental health services for their prisoners, women are often short-changed.
For example,U. I was devastated. I hated it there. I saw the psychiatrist every three months and a counselor once in a while. There was nobody to talk to. They told me to go to church - that that would help me…. I remember trying so hard to remain in contact with reality before they put me back on Haldol.
It took a week to see the psychiatrist and get put back on Haldol. They said "you'll just have to wait till he gets around to you. I still had to wait four or five days to see the psychiatrist if I needed anything. I was doing good the first four years. Then I became incoherent again. They had me in a padded cell about a week. Then I improved. They put me on more medicine. I've been doing good since. Wisconsin Coalition for Advocacy attorney Todd Winstrom, who has represented mentally ill clients at Taycheedah women's prison, told Human Rights Watch that there are lower mental health staffing levels at Taycheedah than in men's prisons in the state and there is less access to drug and alcohol programming.
Although men's prisons have had specialized mental health units for several years, Taycheedah only opened its mental health unit in Payne , challenging the quality of medical,dental and mental health services at the facility. Under a consent decree, prison administrators agreed to develop a comprehensive plan to significantly upgrade delivery of medical, dental, and mental health care services to meet minimal constitutional standards. In , hearings were held to determine whether federal court jurisdiction over mental health services at WCCW should continue. While the court concluded it had concerns about the staffing and state of mental health services, it was persuaded that substantial efforts had been made to improve the delivery of mental health care at WCCW and that overall care did not fall below constitutional standards.
It therefore ruled that the prospective-relief provisions of the Prison Litigation Reform Act barred it from granting plaintiffs' motion to extend the court's jurisdiction. In its decision, it pointed out that most of "the medical experts and staff expressed the opinion that WCCW was 'coping' with its mental health issues, but that its resources for delivering care were operating at full capacity, with little or no margin for planning, innovation , or increasing care for individual inmates.
It had also hired arisk management specialist. I'd like to see the ability to do better transitioning. When inmates leave here, all our great work goes to hell if they go out and there's no support for them. I'd also like better training for staff. What we have now is decent, but we need to do more - or else we can become part of the problem. Because Vermont's prison system is so small, the state has not built a specialized mental health unit for its women prisoners. Prisoners and outside observers acknowledge that the mental health services provided at the Dale Women's Facility are excellent.
But if women become unmanageable at Dale which is an open-plan prison in which prisoners are free to wander the facility and intermingle during the day they are transferred to the administrative segregation unit at the Chittendon Community Correctional Center in Burlington, Vermont, which is also operated by the state Department of Corrections. Chittendon's mental health staff, however, is limited to a part-time psychiatrist and two counselors.
Prisoners with mental health needs have no access to group therapy, infrequent access to counselors, and many report they are routinely provided ample opportunity to self-mutilate. Thus, when a prisoner gets to the point where they need non-stop observation, they have to be placed in the grimy holding cells that are usually reserved for those brought into the jail for the night to sleep off drinking binges. Inside the facility, R.
Her arms are criss-crossed with raw, red cuts. One of her legs, on the day Human Rights Watch met her, had a big, bloody, open wound. She also smashes her head against the walls of her cell when she gets agitated. Ill with serious diabetes, R. I can. I swallowed a pencil the other day. That was fun. I shove things in my legs all the time and they don't care.
It's ok. If they don't take me, I'm going to kill myself. Although the mental health staff do not think that R. Over the period of her involvement with mental health services at Chittendon, she has been listed as being agitated, angry, irritable, depressed, and as needing anti-depressant medication, mood stabilizers, and antipsychotics. The staff at Chittendon, and, indeed, the mental health teams throughout the state's prison system, devote weekly meetings to R. But the Vermont prison system lacks the resources to provide adequate services to seriously mentally ill individuals, particularly those like R.
Faced with the behavioral outbursts of R. In a period of under a year, R. The mental health team at Chittendon informed Human Rights Watch that despite repeated requests to the state mental hospital to take R. The team suspects the hospital's reluctance to admit R. When interviewed, R. Because the hospital was taking so long to develop a plan for her, it is likely that her sentence would be up before she was ever removed into a hospital setting. A typical memo written by mental health staff following one of the weekly team meetings reads as follows:.
There is vagueness in what exactly needs to be put in place to receive R. She believes they do not want her. It is, as the staff freely admit, a far from happy situation. The Vermont prison system's chief psychiatrist, Dr. Michael Upton, told Human Rights Watch that "this is not therapy. This is management. It's trying to keep the symptoms few. Human Rights Watch also interviewed mentally ill women at the Dale prison who had also spent time at Chittendon.
One prisoner, J. Describing conditions at the jail she said "I'd put a slip in on Sunday night for suicidal thoughts. They'd get it Monday and it'd be three weeks before they see you. The doctor only comes in once a week. Sometimes they put you on the wrong medications. I never knew when I was going to see my mental health counselor. It appeared, therefore, unlikely that these women were simply malcontents. Some of our problems…are, but not limited to: physical abuse by staff and custody, verbal abuse, by staff and custody. We are denied adequate clothing for the weather.
We have not been issued winter coats, or thermo underwear. You are commenting using your Facebook account. Notify me of new comments via email. Notify me of new posts via email. Preeti, in a conversational way, discusses everything from karma to palm reading. I received a free digital copy of this book from the author. And, thank you, for reading! Share this Librarian's Blog: Twitter Facebook. Like this: Like Loading Tagged Book Review book summary i'll put 3 chips on God just in case there is one Non-Fiction open mind preeti gupta read reading reviewed by request spirituality Ms.