| Abstract | This three-paper dissertation examined mental health treatment within correctional facilities in the US with the goal of exploring the reality of mental health treatment in this space and advocating for equitable mental health treatment. After the Community Mental Health Act (CMHA) of 1963 pushed for deinstitutionalization, many individuals living with mental illnesses were re-institutionalized within correctional facilities. Although correctional facilities were not created to become primary mental health facilities, the need for services has increased. In this dissertation, correctional facilities include both short- and long-term facilities.
The first paper, chapter two of this dissertation, is a systematic review of therapeutic interventions being used to improve mental health of males and females incarcerated in U.S. jails and prisons. This review highlighted several interventions and programs that are being effectively implemented in correctional facilities and can be replicated in others to increase access to mental healthcare for the incarcerated individuals.
The second paper, chapter three of this dissertation, is a qualitative study that focuses on the perceptions of mental health service-providers working in a correctional facility regarding inmate mental health, provider experiences working in corrections, and provider education and training background. The major finding of this study was mental health is not a priority in the jail. Three sub-themes also emerged: staff are concerned for inmate’s health, there is a legal and systems focus, and staff are limited.
The third paper, chapter four of this dissertation, is a qualitative study that focuses on incarcerated individuals living with mental illnesses and their perceptions of current mental health services offered within the correctional facility, and explored what types of therapeutic mental health interventions incarcerated individuals would like to see and find beneficial within the jail. Participants share what services are offered, their perception of these services, and what they would like to see being offered. Overall, participants express dissatisfaction with mental health services and report limited mental health services are offered; report largely brief and negative interactions with facility staff and service-providers; and share both group and individual therapeutic interventions they would like to see added for the benefit of their mental health.
Together, these three papers highlight the gap in mental health care that exists within many correctional facilities, and possible treatment options that could be implemented to close that gap. Chapter five discusses the dissertation’s findings, similarities and differences between manuscripts, and implications for practice, correctional facilities, and policy makers. Though correctional facilities were not created to be mental health providers, they must adjust to the needs of their population and adhere to national standards for mental health services within correctional facilities. Additionally, addressing the policing of mental illness and adequate funding for community programming could potentially decrease the rates of individuals with mental illnesses who are incarcerated. |
