Psychiatrists and others working with inmates in correctional settings can
anticipate inmates' concerns about mental health treatment and help them to be
more receptive to treatment by addressing those concerns.
This is the suggestion from one clinician based on a study in the September
"Educating inmates about how we can help them through treatment and
demystifying some aspects of mental health treatment may help them to be less
skeptical about treatment," first author Robert Morgan, Ph.D., told
Psychiatric News. Morgan is an associate professor of psychology at
Texas Tech University in Lubbock.
He pointed out that untreated mental health problems are common among
people in the correctional system, and as many as 45 percent of those with
serious mental health problems do not receive services while in prison or
To investigate some of the barriers that hinder inmates' willingness to
receive mental health treatment while behind bars, Morgan surveyed 418 male
inmates from the Kansas Department of Corrections who volunteered to be part
of the study. A total of 147 of the inmates were being housed in a reception
and diagnostic unit, 148 were in a maximum-security correctional facility, and
123 were in a minimum-security correctional facility.
Each completed a survey that included questions about past mental health
treatment in and out of the correctional setting and whether the treatment was
voluntary or mandated.
Morgan found that inmates who had had mental health treatment in the
community—whether in a group setting or on an individual
basis—were more likely to participate voluntarily in mental health
services to manage problems related to feelings of stress, anxiety, or
depression (p<.01) and interpersonal problems (p<.05) than were inmates
who had not had treatment in the community.
In addition, inmates who reported being ordered to undergo mental health
treatment previously expressed more concerns related to self-preservation
(p<.05) than those who had not been mandated to treatment in the past.
Inmates categorized as having self-preservation concerns endorsed survey items
indicating that they believe that if they receive services, they will be seen
as "weak" or as a "snitch" by other inmates. They may
also be afraid that the information they reveal in therapy could be used
against them, for instance.
Morgan, who has conducted previous research on the effectiveness of mental
health treatment for inmates, found that therapy was as effective for those
who were mandated to treatment by correctional personnel as for those who
sought treatment voluntarily.
"It didn't matter whether treatment was mandated or voluntary,"
he noted. "It was equally effective."
Morgan offered some interventional strategies for clinicians working with
inmates who may feel as if participating in mental health treatment makes them
seem weak or like "snitches."
"We need to help inmates view treatment a bit more
realistically," he noted. "We can explain that it doesn't make
them weak, and their personal information won't be used against
Many inmates attend an orientation session at their correctional facility,
during which they are informed about prison routine and how to receive health
services, including mental health services. Morgan said this would be the
ideal time to learn about how mental health treatment works in the
correctional setting and to correct any misperceptions in inmates' minds.
"For many of these inmates, mental health treatment is crucial to
their success once they've been released," he said.
An abstract of "Needs for and Barriers to Correctional Mental
Health Services: Inmate Perceptions" is posted at<psychservices.psychiatryonline.org/cgi/content/abstract/58/9/1181>.▪