Psychological Interventions in Forensic Settings

Abstract

Studies have shown that 25% or more of the current prison population have been diagnosed with a mental illness. In addition, at least 50% have had difficulties in regulating their use of alcohol and illegal substance. Many are on psychotropic medications while in prison. If you add the number of inmates who have been traumatized, usually from child abuse, rape, or domestic violence, it raises the numbers to over 80% or higher. Some say the prisons have become the new mental health hospitals, and outpatient clinics are providing court-ordered treatment to mentally ill and disabled, alcohol and other drug addicted and traumatic victims. In jails and prisons, medication is often the first line of intervention in most jails and prisons today. We discuss training of first responders using critical incident stress management to try to keep the mentally ill out of jail and prison and then present a model for mental health professionals work in the specialty courts, jails, and prisons as needed. Issues such as suicide prevention, anger management, and restoring calm when inmates become agitated are often programs conducted by the psychologists in the facility. Special units may work with sex offenders and other behaviorally disordered people. Special programs for women are presented including an evidence-based model of the Survivor Therapy Empowerment Program (STEP). While some jails and prisons work on a crisis model, newer models suggest effective psychoeducation and psychotherapy is possible to help people work toward recovery, responsibility for their own health, and stay out of prison.