how does prison impact on the mental health of prisoners?

With one of the lowest incarceration charges globally, Norway is recognised as having one of the world’s most progressive and humane approaches to prison with a spotlight on rehabilitation and reintegration (Berger, 2016). Nevertheless, like most prison populations, there’s a excessive stage of mental health and social care want amongst folks in Norwegian prisons. In a nationwide survey, there was proof of mental dysfunction in 92% of incarcerated people (Cramer, 2014).

The beliefs people maintain relating to the causes or causes for his or her mental health issues have an effect on how they assume and reply to them and affect their help-seeking behaviour. ‘Prisonization’ refers to psychological adjustments that happen as a consequence of prison life (Haney, 2001). Factors that affect these adjustments embrace a loss of autonomy and being separated from assist networks. The surroundings and regime of prison may have a damaging impact on mental health.

In order to have the ability to meet the mental health wants of incarcerated people, it is very important perceive how they conceptualise their mental health and how these conceptualisations affect their coping preferences. The matter of this weblog is a research by Solakken et al. (2023) who aimed to fulfill this want.

‘Prisonization’ can change how somebody thinks, feels, and behaves. There is restricted perception into how this would possibly affect their beliefs about mental health and methods of coping.

Methods

A qualitative design was used, and a relativist ontological stance was adopted, recognising subjective realities and co-construction of information between researchers and individuals. Fifteen in-depth interviews have been performed throughout three male prisons in Northern Norway. Participants have been predominantly Norwegian residents with a median age of 44 years. Their expertise of prison diversified, however all had skilled mental health issues in prison.

The semi-structured interviews lasted 60 to 90 minutes and aimed to discover mental health, prison tradition, and help-seeking. Analysis used parts of Grounded Theory, together with line by line coding and growing conceptual classes from the knowledge. A collaborative, reflexive course of guided interpretation.

Results

Three themes (with related subthemes) have been recognized: views on mental health, beliefs about the impact of imprisonment on mental health and beliefs about administration of mental health issues.

Participants described mental health as a multifaceted idea involving stability and well-being, figuring out coping methods akin to train and social contact. They felt that prison life had altered their views on mental health, highlighting the significance of social connections and significant actions. Self-isolation was thought of to be an apparent signal of mental health issues and signs of melancholy have been most regularly described. Participants emphasised the connection between mental health and social surroundings, noting the impact of stressors in prison on worsening mental health points. Mental health issues have been felt to be attributable to a range of components together with expertise of parental neglect, poverty, violence, and trauma.

Prison was inextricably linked to individuals’ definitions of mental health, with a transparent connection between the prisonization course of and deterioration of mental health. Anxiety associated issues have been generally mentioned. Many people shared tales of friends’ experiences and spoke about prison circumstances, the quantity of time spent alone, lack of autonomy and significant actions as being damaging to mental health.

In phrases of preferences for administration of mental health issues, friends have been seen as essential for assist and there was a choice for psychosocial methods over remedy. Although the efficacy of remedy was acknowledged, there have been considerations about unintended effects and dependency. However, ADHD was seen in a different way; this was thought of as a extra acceptable prognosis in prison and individuals have been extra accepting of remedy. ADHD was additionally mentioned by individuals as being a proof for his or her offending behaviour.

Participants perceived that prison circumstances akin to time spent alone and lack of autonomy had a marked impact on mental health.

Conclusions

The essential discovering of the research was that individuals’ beliefs about mental health, and how points are managed, could be very a lot built-in with the expertise of prison.

Participants diversified of their understanding of mental health however tended to attribute mental health issues to stressors in the prison surroundings reasonably than inner causes. Both importation principle (Irwin & Cressey, 1962) and deprivation principle (Sykes, 2007) provide views on how individuals’ beliefs about mental health are built-in with their prison expertise, and the advanced interaction of components: importation principle highlights the affect of pre-existing traits, whereas deprivation principle emphasises the impact of the prison surroundings itself. Social assist and significant actions have been highlighted as essential components for well-being and non-medical interventions have been most popular when it got here to administration of mental health issues.

Prisoners beliefs about mental health are strongly built-in with the expertise of prison itself.

Strengths and limitations

The adoption of a qualitative strategy is a power of Solakken et al.’s (2023) research. This enabled an in-depth exploration of individuals’ views on mental health inside the prison context. The research additionally included a pattern of individuals with numerous experiences of prison from three totally different prison institutions.

However, as with all analysis, there are some limitations price noting. The authors acknowledge that the self-selecting nature of the pattern is a limitation of their work; that the views of those that volunteer to participate could also be totally different to those that don’t volunteer. Indeed, the authors do warning that the outcomes solely apply to the people who took half in the research, they usually make no broader claims about the generalisability of the work to prisons in Norway or farther afield. Nonetheless, though some context about the prison system in Norway is offered, it might have been useful to grasp how consultant the prisons included have been of the wider system. Likewise, the authors, rightly, don’t present an in depth description of participant demographics to make sure that anonymity is preserved, however some remark on whether or not individuals have been broadly consultant of the prison inhabitants would have been helpful to raised contextualise the outcomes.

There is an in depth description of the evaluation course of which supplies a great stage of transparency, however the lack of a positionality assertion is a limitation. Although the epistemological stance of the researchers is made specific, understanding how the researchers’ backgrounds and views influenced evaluation would have offered a extra nuanced understanding of their interpretation of the knowledge.

The qualitative nature of the research permits an in-depth exploration of mental health in the prison context, although this might have been higher contextualised in phrases of the Norway prison system.

Implications for observe

Despite some limitations, these findings have implications for the improvement and implementation of mental health interventions and insurance policies inside prison settings. In Norway particularly, the authors spotlight that enhancing companies for folks in prison varieties half of the Norwegian governments’ ten- yr mental health plan.

The discovering that individuals in prison perceived their mental health as interconnected to the prison surroundings emphasises the want for holistic approaches that take into account the broader social, environmental, and cultural components that affect mental well-being, in addition to scientific signs. The authors counsel it can be crucial that clinicians discover and acknowledge sufferers’ beliefs relating to their mental health to allow efficient communication between the health skilled and repair consumer, making certain therapy is adjusted in accordance with want. In addition, recognising the challenges of the prison setting in relation to sufferers’ mental health, is required to boost engagement with therapy.

In phrases of coverage, the findings stress the significance of mental health promotion in prison suggesting that offering folks in prison alternatives to interact in significant exercise, work and training is essential to advertise wellbeing. This is in line with the wholesome prison take a look at adopted by HM Inspectorate of Prisons in England and Wales; purposeful exercise is one of the 4 standards judged to find out whether or not a prison is ‘healthy’. Purposeful exercise is outlined as folks in prison having the ability, and anticipated, to interact in exercise that’s prone to profit them. Policy makers ought to take into account methods to boost the alternatives for this in the restrictive surroundings of prison.

Similarly, social isolation is recognised as a danger issue for poor mental health outcomes (Grav et al., 2012) and this research provides to the proof base advocating the significance of social connectedness. The research recognises friends as an important part of social assist to advertise well-being in prison. Although prison does present alternatives to keep up contact with family and friends in the neighborhood, that is restricted in a number of methods. Consequently, the significance of peer relationships as a kind of accessible assist is elevated. Peer relationships in prison will not be with out challenges and subsequently analysis exploring and evaluating peer interventions, akin to The Samaritans Listener scheme, to facilitate social assist is required. Improving health outcomes (and beliefs about optimistic health outcomes) of folks in prison is probably going to enhance the probabilities of profitable reintegration on launch. Further analysis could also be helpful to grasp how beliefs about mental health impact folks’s motivation for rehabilitation post-release.

These findings counsel that prisons ought to undertake a holistic strategy in enhancing mental wellbeing, bearing in mind the broader social, environmental, and cultural components that affect mental well-being, in addition to scientific signs.

Statement of pursuits

None.

Links

Primary paper

Solbakken, L. E., Bergvik, S., & Wynn, R. (2023). Beliefs about mental health in incarcerated males: a qualitative interview research. Frontiers in Psychiatry, 14, 1242756.

Other references

Berger, R. (2016). Kriminalomsorgen: A Look at the World’s Most Humane Prison System in Norway. Available at: https://ssrn.com/abstract=2883512

Cramer, V. (2014). The prevalence of mental issues amongst convicted inmates in Norwegian prisons. Oslo University Hospital. Available at: Hel_oppdatert_Victoria_Cramer_rapport_engelsk.pdf (sifer.no)

Grav, S., Hellzèn, O., Romild, U. & Stordal, E. (2012). Association between social assist and melancholy in the normal inhabitants: the HUNT research, a cross-sectional survey. Journal of Clinical Nursing, 21,111-120.

Haney, C. (2001). The psychological impact of incarceration: Implications for post-prison adjustment. University of California. Available at: The Psychological Impact of Incarceration: Implications for Post-Prison Adjustment | ASPE (hhs.gov)

Irwin, J., & Cressey, D. R. (1962). Thieves, convicts and the inmate tradition. Soc. Probs., 10, 142.

Sykes, G. M. (2007). The society of captives: A research of a most safety prison. Princeton University Press.

Photo credit