Carl won't call himself an abolitionist (yet), but like most sincere people engaged in trying to make this world a kinder place for all, I think he'd celebrate the day we can abolish our prison system with the same enthusiasm that I will. We need to tear down this machinery that's so deeply invested in perpetuating crime and exploiting punishment instead of directing our collective resources towards ending victimization and empowering communities to hold their transgressors more directly - and effectively - accountable.
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Prisons Versus State Hospitals
----------Are Correctional Officers Expected to Do the Job of Mental Health Providers?
By Carl ToersBijns
Reading several reports that illustrates the most recent trends in society related to incarceration and the closures of state hospitals back about a decade ago, it has become very evident this new tread of putting thousands of inmates in prisons in lieu of placing them in state hospitals has created a most critical mass for those who work and live inside prisons. The stress and anxiety of prisons can most certainly be identified as one of the highest reasons for morbidity for these individuals as they are exposed to more extreme or severe symptoms and disruptive behaviors among those they are housed with identified as being not mentally ill.
Many states have formulated teams that can offer reasonable treatment options to these mentally ill and many find it beneficial for correctional officers to participate in this process. In fact, such collaboration is encouraged by many mental health providers as it creates a seamless program and contents that can help every team member to recognize and observe specific behaviors that would have otherwise been missed or omitted in a report. It should be noted that when working in the New Mexico Mental Health Treatment Center, there were many occasions where these same methods of sharing and reporting behaviors contributed to the preservation of life and reduced psychosis for the inmate patients.
The need to share the information and improve the communication has never been more urgent than today. A report released by the Treatment Advocacy Center (TAC) revealed that many states are becoming substitutes for prisons as their mentally ill patients are no longer being accepted in state hospitals as there is no bed space. Instead, with a national ratio of 1 person in a hospital to 3 being incarcerated into prison. In Arizona and Nevada, these figures are 1 to 9.3. and 9.8 respectively demonstrating an extreme need to change cultures in prisons.[1]
Thus it becomes very clear where the urgency has shifted to as prisons are not the ideal places for such persons. A trend gathered by the U.S. Department of Justice reveals that in their own surveys relying on self-report methods to determine whether an inmate had a mental illness, most studies have found that 10 to 15 percent of state prisoners have serious mental disorders. It is speculated that these figures would be higher in Arizona and Nevada as their incarceration rate of the mentally ill are almost 10 times the national average.
This is supported by the report delivered by the TAC group. There is no doubt these prisoners are experiencing functional problems and difficulty with their coping skills within such an unsettled and often volatile environment. Impaired to a degree enough to create confusion and agitation, they are often misunderstood and treated as aggressive behavioral inmates rather than a person having a learning disorder.
Learning how to cope and function within a general population setting creates a difficult task for the mentally ill. It has been documented that persons "who have schizophrenia or mental retardation commit more rule infractions, spend more time in lockup, and are less likely to obtain parole. Acts of self-mutilation and attempted or completed suicides disrupt the operation of the prison and divert staff time and resources. Dysfunctional behavior by inmates who have mental disorders not only impairs the ability of officers and administrators to operate safe and orderly facilities but also results in stress for correctional employees at all levels. [2]
Today, correctional officers face constant stress while working the prison environment. This exponentiates stress as their responsibilities to provide sound custodial care increases and these added pressures to multitask and do more work with the economic and budget restraints are taking a toll in their ability to handle mentally ill inmates as well as their general population inmates as this stress level is with the different custody levels they work at. Variables beyond their control e.g. overtime, short staffing, lack of resources, low pay and furloughs impact their ability to perform and to manage their environment. It is fair to guess that the strain to deal and manage mentally ill inmates adds more stress to their jobs.
The conflicts inside prisons are obvious to those who work there or have worked there. There are two dominating cultures at "war" with each other since the day prisons were built. Inmates versus the cops exist with many complicated rules of engagement in place between the two factions. These two cultures are divided on many issues and are certainly not linked in any way to work with each other except by mandated rules and regulations.
Regarding the supervision of the mentally ill, a third culture comes into the picture and this is recognized to be unlike anything the other cultures possess. This third culture, the medical / mental health people hired to treat and medicate the mentally ill is often rejected by both cultures related to inmates and officers. The mistrust by the inmates compounds their workloads and their "soft" and "easy to manipulate" approach with inmates creates misunderstandings among officers. This gap is too wide to assume it doesn't exist and takes a complete shift in all cultures to be successful.
The balance to bring these three cultures together is a most difficult task. The prison system has to be careful not to compromise the role of the correctional officer in this balance. Traditionally, the correctional officers are the prison's police force. They observe and report, intervene, detain inmates and hold them accountable for their actions. The mere fact that these actions are ongoing all the time, 24/7; this could give mental health a powerful insight of the behaviors of inmates under their treatment. The officers could in fact contribute to mental health's role to monitor, diagnose and treat prisoners.
Because of the heavy influx of mentally ill prisoners into the prison systems, it has been proposed and resisted that correctional officers conduct certain responsibilities and duties that would enhance treatment of those deemed to be more severe than others. This could never take place at an optimum level if the cultures don't agree on some basic rules and stick to them to preserve trust and confidentiality of both the inmate and the officer. In the past, these unilateral conversations have resulted in many successful interventions and never compromised the officer's role with the inmate treated.
The bottom line is the ultimate role of the officer, to enforce institutional rules and regulations must never be compromised. They must be able to apply their authority related to disciplinary matters and apply sanctions that are important to control inmate behaviors. Here is where there is a fine line to consider. Sanctions of behavioral inmates versus mentally ill inmates should be considered to allow the disparity of levels of "understanding the rules" to apply. Untrained officers will not understand such a concept and resist any variances in their disciplinary procedures unless directed to do so by their respective administrators.
Basically, it all falls back on sound training and reasonable accommodations provided by the administration and training specialists to identify the rationale behind these actions. In such training, there will be no additional incentives by the officers to change their approach with the mentally ill unless they understand the concept and the role of the mental health providers so they can communicate and speak with one message. In order to breach the cultures, they must mix and mingle to understand the dynamics involved in each and every task performed so they mutually understand and respect each other's role in treatment.
Risking creating levels of trust in a most untrusting environment is s major challenge and it often fails to develop unless given the time and dedication to evolve. The administration must embrace such an approach, foster growth and trust and then support these newly developed cultures to work together and treat the inmate population accordingly.
Regardless of what roles the correctional officer plays, they are not the therapists. They are not the treatment providers and they are not there to hug or care about feelings or emotions. They are there to control the environment, to communicate the needs, to observe behaviors and report accordingly and to support the mental health providers to gain access to the inmates so they can be treated and medicated accordingly. Assignments of correctional officers on such teams e.g. a multidisciplinary team, is beneficial but must be presented from a non-clinical point of view and consistent with their training and purpose for being on that team.
Sources: [1] www.treatmentadvocacycenter.org
[2] http://psychservices.psychiatryonline.org/cgi/content/full/52/10/1343
Many states have formulated teams that can offer reasonable treatment options to these mentally ill and many find it beneficial for correctional officers to participate in this process. In fact, such collaboration is encouraged by many mental health providers as it creates a seamless program and contents that can help every team member to recognize and observe specific behaviors that would have otherwise been missed or omitted in a report. It should be noted that when working in the New Mexico Mental Health Treatment Center, there were many occasions where these same methods of sharing and reporting behaviors contributed to the preservation of life and reduced psychosis for the inmate patients.
The need to share the information and improve the communication has never been more urgent than today. A report released by the Treatment Advocacy Center (TAC) revealed that many states are becoming substitutes for prisons as their mentally ill patients are no longer being accepted in state hospitals as there is no bed space. Instead, with a national ratio of 1 person in a hospital to 3 being incarcerated into prison. In Arizona and Nevada, these figures are 1 to 9.3. and 9.8 respectively demonstrating an extreme need to change cultures in prisons.[1]
Thus it becomes very clear where the urgency has shifted to as prisons are not the ideal places for such persons. A trend gathered by the U.S. Department of Justice reveals that in their own surveys relying on self-report methods to determine whether an inmate had a mental illness, most studies have found that 10 to 15 percent of state prisoners have serious mental disorders. It is speculated that these figures would be higher in Arizona and Nevada as their incarceration rate of the mentally ill are almost 10 times the national average.
This is supported by the report delivered by the TAC group. There is no doubt these prisoners are experiencing functional problems and difficulty with their coping skills within such an unsettled and often volatile environment. Impaired to a degree enough to create confusion and agitation, they are often misunderstood and treated as aggressive behavioral inmates rather than a person having a learning disorder.
Learning how to cope and function within a general population setting creates a difficult task for the mentally ill. It has been documented that persons "who have schizophrenia or mental retardation commit more rule infractions, spend more time in lockup, and are less likely to obtain parole. Acts of self-mutilation and attempted or completed suicides disrupt the operation of the prison and divert staff time and resources. Dysfunctional behavior by inmates who have mental disorders not only impairs the ability of officers and administrators to operate safe and orderly facilities but also results in stress for correctional employees at all levels. [2]
Today, correctional officers face constant stress while working the prison environment. This exponentiates stress as their responsibilities to provide sound custodial care increases and these added pressures to multitask and do more work with the economic and budget restraints are taking a toll in their ability to handle mentally ill inmates as well as their general population inmates as this stress level is with the different custody levels they work at. Variables beyond their control e.g. overtime, short staffing, lack of resources, low pay and furloughs impact their ability to perform and to manage their environment. It is fair to guess that the strain to deal and manage mentally ill inmates adds more stress to their jobs.
The conflicts inside prisons are obvious to those who work there or have worked there. There are two dominating cultures at "war" with each other since the day prisons were built. Inmates versus the cops exist with many complicated rules of engagement in place between the two factions. These two cultures are divided on many issues and are certainly not linked in any way to work with each other except by mandated rules and regulations.
Regarding the supervision of the mentally ill, a third culture comes into the picture and this is recognized to be unlike anything the other cultures possess. This third culture, the medical / mental health people hired to treat and medicate the mentally ill is often rejected by both cultures related to inmates and officers. The mistrust by the inmates compounds their workloads and their "soft" and "easy to manipulate" approach with inmates creates misunderstandings among officers. This gap is too wide to assume it doesn't exist and takes a complete shift in all cultures to be successful.
The balance to bring these three cultures together is a most difficult task. The prison system has to be careful not to compromise the role of the correctional officer in this balance. Traditionally, the correctional officers are the prison's police force. They observe and report, intervene, detain inmates and hold them accountable for their actions. The mere fact that these actions are ongoing all the time, 24/7; this could give mental health a powerful insight of the behaviors of inmates under their treatment. The officers could in fact contribute to mental health's role to monitor, diagnose and treat prisoners.
Because of the heavy influx of mentally ill prisoners into the prison systems, it has been proposed and resisted that correctional officers conduct certain responsibilities and duties that would enhance treatment of those deemed to be more severe than others. This could never take place at an optimum level if the cultures don't agree on some basic rules and stick to them to preserve trust and confidentiality of both the inmate and the officer. In the past, these unilateral conversations have resulted in many successful interventions and never compromised the officer's role with the inmate treated.
The bottom line is the ultimate role of the officer, to enforce institutional rules and regulations must never be compromised. They must be able to apply their authority related to disciplinary matters and apply sanctions that are important to control inmate behaviors. Here is where there is a fine line to consider. Sanctions of behavioral inmates versus mentally ill inmates should be considered to allow the disparity of levels of "understanding the rules" to apply. Untrained officers will not understand such a concept and resist any variances in their disciplinary procedures unless directed to do so by their respective administrators.
Basically, it all falls back on sound training and reasonable accommodations provided by the administration and training specialists to identify the rationale behind these actions. In such training, there will be no additional incentives by the officers to change their approach with the mentally ill unless they understand the concept and the role of the mental health providers so they can communicate and speak with one message. In order to breach the cultures, they must mix and mingle to understand the dynamics involved in each and every task performed so they mutually understand and respect each other's role in treatment.
Risking creating levels of trust in a most untrusting environment is s major challenge and it often fails to develop unless given the time and dedication to evolve. The administration must embrace such an approach, foster growth and trust and then support these newly developed cultures to work together and treat the inmate population accordingly.
Regardless of what roles the correctional officer plays, they are not the therapists. They are not the treatment providers and they are not there to hug or care about feelings or emotions. They are there to control the environment, to communicate the needs, to observe behaviors and report accordingly and to support the mental health providers to gain access to the inmates so they can be treated and medicated accordingly. Assignments of correctional officers on such teams e.g. a multidisciplinary team, is beneficial but must be presented from a non-clinical point of view and consistent with their training and purpose for being on that team.
Sources: [1] www.treatmentadvocacycenter.org
[2] http://psychservices.psychiatryonline.org/cgi/content/full/52/10/1343
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