Showing posts with label Illness. Show all posts
Showing posts with label Illness. Show all posts

Mental Illness in the Prison System

University Hospitals - Mental Illness in the Prison System.
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Should the mentally ill be placed in the mainstream population of a prison?

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How is Mental Illness in the Prison System

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Chances are you've never given much - if any - thought to this question. A paranoid schizophrenic kills someone because the voices in his head tell him that person is an alien trying to steal his brain. Is that schizophrenic safe in a prison? Are the other prisoners safe with him (or her) there?

A person suffering with severe bipolar disorder shoplifts an armload of clothing during an attack of acute mania. He or she is sent to prison, to co-exist with gangbangers, rapists, and murderers. Or, perhaps worse, to live in a solitary cell with no human interaction, for 23 out of 24 hours each day. The acute mania shifts to severe depression. What are the chances he or she will survive the prison term?

According to the U.S. Justice Department's Bureau of Justice Statistics, in 1998 approximately 300,000 inmates had some form of mental illness. A decade later, that number rose to 1.25 million.

The National Alliance for the Mentally Ill (NAMI) states that 16 percent of the prison population can be classified as severely mentally ill. This means that they fit the psychiatric classification for illnesses such as schizophrenia, bipolar disorder, and major depression. However, the percentage skyrockets to as high as 50 percent when altered to include other mental illnesses, such as anti-social personality disorder, and borderline personality disorder.

Two major causes attribute to the rise of mentally ill inmates:

In the 1950s, the U.S. had 600,000 state run hospital beds for those suffering from any form of mental illness. Because of deinstitutionalization and the subsequent cutting of state and federal funding, the U.S. now has just 40,000 beds for the mentally ill. The inability to get proper treatment left this segment of our population vulnerable and, consequently, many of them now land in prisons.

Deinstitutionalization hasn't worked. All this has managed to do is to shift the mentally ill from hospitals to prisons - one institution to another. We have made it a crime to be mentally ill.

The largest psychiatric facility in the U.S. isn't a hospital; it's a prison. At any given time, Rikers Island in New York City houses an estimated 3,000 mentally ill prisoners. The average inmate population at Rikers Island is 14,000. One out of every 4 to 5 inmates at this prison suffer from mental illness.

Florida judge Steven Leifman, who chairs the Mental Health Committee for the Eleventh Judicial Circuit, states that, "The sad irony is we did not deinstitutionalize, we have reinstitutionalized-from horrible state mental hospitals to horrible state jails. We don't even provide treatment for the mentally ill in jail. We're just warehousing them."

What happens to the mentally ill in an overcrowded, violent prison system with little to no psychological counseling available?

In state prisons, the mentally ill serve an average of 15 months longer than the average inmate. The very nature of most mental illnesses makes it difficult to follow prison rules. These inmates are more likely to be involved in prison fights and they tend to accumulate more conduct violations.

Prison staff often punishes mentally ill inmates for being disruptive, refusing to comply with orders, and even for attempting suicide. In other words, these inmates are punished for exhibiting the symptoms of their illness.

Gaining parole is also more difficult for the mentally ill. Their disciplinary records are often spotty, they may have no family willing or able to help, and community services are usually inadequate.

In October 2003, Human Rights Watch released a report entitled Ill Equipped: U.S. Prisons and Offenders with Mental Illness. Following two years of in-depth research, this organization found that few prisons have adequate mental health care services. Furthermore, it found that the prison environment is dangerous and debilitating for the mentally ill.

An excerpt from Ill Equipped:

"Security staff typically view mentally ill prisoners as difficult and disruptive, and place them in barren high-security solitary confinement units. The lack of human interaction and the limited mental stimulus of twenty-four-hour-a-day life in small, sometimes windowless segregation cells, coupled with the absence of adequate mental health services, dramatically aggravates the suffering of the mentally ill. Some deteriorate so severely that they must be removed to hospitals for acute psychiatric care. But after being stabilized, they are then returned to the same segregation conditions where the cycle of decompensation begins again. The penal network is thus not only serving as a warehouse for the mentally ill, but, by relying on extremely restrictive housing for mentally ill prisoners, it is acting as an incubator for worse illness and psychiatric breakdowns."

According to Fred Osher, M.D., director of the Center for Behavioral Health, Justice and Public Policy at the University of Maryland, the majority of mentally ill inmates are arrested for misdemeanors and crimes of survival. He states, "That's a whole host of folks who land in the criminal justice system because of their behavioral disorders."

Those on the fringe of society are primarily affected. These people are almost always impoverished and disabled by their illness. They have nowhere to turn, no one to help them, and so we toss them in prison. Even minor offenses keep them locked in prisons, since many cannot afford and/or do not know how to bond themselves out.

The recidivism rate among the mentally ill is higher than that among the general prison population. Prison has become a revolving door system for dealing with mental illness. By default, prisons have become the new mental hospitals. However, they lack the funding and the training to deal with these patient-inmates.

Ratan Bhavnani, executive director of the Ventura County chapter of the National Alliance on Mental Illness, states that, "In general, people with mental illness can recover when given the appropriate treatment rather than to be sent off to jail only to become more psychotic and come back and reoffend."

Michael Jung of Ventura, California suffers from bipolar and hears voices telling him that he is the devil. Over the past 10 years, Jung has been arrested a minimum of 15 times - all for relatively minor offenses. Earlier this year, Jung spent six weeks confined in G Quad, the unit where mentally ill inmates stay in their cells 23 out of the 24 hours in each day.

Cells such as those in G Quad are referred to as the "rubber rooms" because the walls are padded. There is no furniture in these rooms. The "toilet" is a grate in the floor. They are stripped naked and monitored via video camera. Inmates who are paranoid, delusional, or otherwise difficult to manage are often placed in this type of cell, whether for their own protection, the safety of the other inmates, or just plain convenience.

Susan Abril, a former inmate who suffers from bipolar disorder, was placed in this type of cell. During her confinement, Abril began hearing voices for the first time. "I didn't sleep," she said. "I mentally went insane being locked down 23 hours of 24."

We are essentially making the mentally ill inmates sicker, as well as ensuring their return to an already massively overcrowded prison system. Obviously our current system is not working. We cannot expect prison staff to function as psychiatrists. We also cannot expect the mentally ill to be "rehabilitated" in a mainstream prison system.

The Taxpayer Action Board for Governor Pat Quinn of Illinois cited annual savings in the tens of millions of dollars that could be gained by releasing thousands of non-violent offenders, closely monitoring them and providing substance abuse treatment, mental health counseling, education, job training, and employment opportunities.

For the most part, the mentally ill do not belong in prison. It would be cheaper (and smarter) for us as taxpayers to divert funding in order to provide adequate treatment programs to keep them out of prison.

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How former Chinese condition Beliefs and Chinese Culture work on condition and Illness?

Hospice Of - How former Chinese condition Beliefs and Chinese Culture work on condition and Illness?.
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Traditional Chinese health beliefs adopt a holistic view emphasizing the importance of environmental factors in increasing risk of disease. According to Quah (1985), these factors work on the balance of body's harmony, yin and yang. These are two opposite but complementary military and, together with qi (vital energy), they operate the universe and elucidate the connection between habitancy and their surroundings. Imbalance in these two forces, or in the qi, results in illness.

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How is How former Chinese condition Beliefs and Chinese Culture work on condition and Illness?

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In order to restore the balance, customary healthful practices may be needed. For example, excess `hot' energy can be counterbalanced by cooling herbal teas, and vice versa. These beliefs are deeply ingrained among the Chinese, and have been found to be unchanged following migration to Singapore.

Lee, et. Al. (2004), found that patients with exact continuing diseases, namely arthritis, musculoskeletal diseases and stroke, were more likely to use customary Chinese rehabilitation (Tcm). This was strongly determined by the 'chronic disease triad', perceived pleasure with care and cultural health beliefs.

Hence the use of Tcm is not linked with the quality of doctor-patient interaction. Astin (1998) also agreed that it was seen as being more compatible with the patients' values, spiritual and religious philosophy, or beliefs with regard to the nature and meaning of health and illness.

In customary Chinese culture, taking medication is belief to be aversive, hence medications tend to be taken only until symptoms are relieved and then discontinued; if symptoms are not obvious, medications will probably never be taken.

Apart from parental cultural beliefs, minor side effects of unavoidable antibiotics such as stomach upset may contribute to the poor adherence of medication. The use of "leftover", "shared" antibiotics and over-the-counter purchase of antibiotics by parents are coarse situations in the community.

They think that their children suffer from the same illnesses judging by the similar symptoms, so they would give the "leftover" or "shared" antibiotics to their children and only bring them to their doctors if there is no correction (Chang & Tang, 2006). This may cause their conditions to deteriorate and may necessitate aggressive treatments later which may have unnecessary side effects.

However, there are small groups of Chinese who also blamed ill-health or misfortunes on supernatural forces, or on divine retribution, or on the malevolence of a 'witch' or 'sorcerer' (Helman, 1994). Such groups will commonly seek cures from their religions.

In Singapore, the Ministry of health has drawn up the Tcm Practitioners' Ethical Code and Ethical Guidelines to forestall any unscrupulous practitioners from preying on their patients and taking advantage of their beliefs, for example, molesting ignorant patients.

The degree of acculturation has been evidenced in the following case. An old man was brought into our hospital with a week-long history of malaise, nausea and vomiting, and sudden jaundice. He was diagnosed to have an obstructive mass in the liver.

A biopsy revealed hepatocellular carcinoma. The serological test recommend continuing active hepatitis B. When the news broke to his son that his father had cancer, he requested not to disclose that to his father.

When we discussed end of life issues such as hospice care and "do-not-resuscitate" (Dnr) orders, the son tried to divert the argument to other issues such as when his father could go home.

Cultural Issues that may be involved in this case are:

The Chinese tend to safe the elderly from bad news.

Believing in karma - the older folk believe that discussing illnesses or death/dying is bad luck. They think that talking about something bad will cause it to come true.

There is an increased incidence of liver cancer resulting from Hepatitis B due to delayed rehabilitation in the elderly, as it may take a long time for them to accept the initial diagnosis.

Reference:

Astin Ja. (1998). Why patients use alternative medicine. J Am Med Assoc 1998; 279: 1548-1553.

Chan, G. C. & Tang, S. F. (2006) Parental knowledge, attitudes and antibiotic use for acute upper respiratory tract infection in children attending a customary healthcare clinic in Malaysia. Singapore healing Journal, 47(4):266

Helman, C. G. (1990) Culture, health and Illness. Wright, London.

Quah, S. R. (1985) The health trust Model and preventive health behaviour in Singapore. Communal Science and Medicine, 21, 351-363.

Lee Gbw, Charn Tc, Chew Zh and Ng Tp. (2004). Complementary and alternative rehabilitation use in patients with continuing diseases in customary care is linked with perceived quality of care and cultural beliefs. House Practice, 21(6): 654-660.

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Mental Illness in the Prison System

University Hospitals - Mental Illness in the Prison System

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Do you know about - Mental Illness in the Prison System

University Hospitals! Again, for I know. Ready to share new things that are useful. You and your friends.

Should the mentally ill be placed in the mainstream population of a prison?

What I said. It is not in conclusion that the actual about University Hospitals. You check this out article for information on anyone want to know is University Hospitals.

About University Hospitals

We had a good read. For the benefit of yourself. Be sure to read to the end. I want you to get good knowledge from University Hospitals.

Chances are you've never given much - if any - thought to this question. A paranoid schizophrenic kills someone because the voices in his head tell him that person is an alien trying to steal his brain. Is that schizophrenic safe in a prison? Are the other prisoners safe with him (or her) there?

A person suffering with severe bipolar disorder shoplifts an armload of clothing during an attack of acute mania. He or she is sent to prison, to co-exist with gangbangers, rapists, and murderers. Or, perhaps worse, to live in a solitary cell with no human interaction, for 23 out of 24 hours each day. The acute mania shifts to severe depression. What are the chances he or she will survive the prison term?

According to the U.S. Justice Department's Bureau of Justice Statistics, in 1998 approximately 300,000 inmates had some form of mental illness. A decade later, that number rose to 1.25 million.

The National Alliance for the Mentally Ill (NAMI) states that 16 percent of the prison population can be classified as severely mentally ill. This means that they fit the psychiatric classification for illnesses such as schizophrenia, bipolar disorder, and major depression. However, the percentage skyrockets to as high as 50 percent when altered to include other mental illnesses, such as anti-social personality disorder, and borderline personality disorder.

Two major causes attribute to the rise of mentally ill inmates:

In the 1950s, the U.S. had 600,000 state run hospital beds for those suffering from any form of mental illness. Because of deinstitutionalization and the subsequent cutting of state and federal funding, the U.S. now has just 40,000 beds for the mentally ill. The inability to get proper treatment left this segment of our population vulnerable and, consequently, many of them now land in prisons.

Deinstitutionalization hasn't worked. All this has managed to do is to shift the mentally ill from hospitals to prisons - one institution to another. We have made it a crime to be mentally ill.

The largest psychiatric facility in the U.S. isn't a hospital; it's a prison. At any given time, Rikers Island in New York City houses an estimated 3,000 mentally ill prisoners. The average inmate population at Rikers Island is 14,000. One out of every 4 to 5 inmates at this prison suffer from mental illness.

Florida judge Steven Leifman, who chairs the Mental Health Committee for the Eleventh Judicial Circuit, states that, "The sad irony is we did not deinstitutionalize, we have reinstitutionalized-from horrible state mental hospitals to horrible state jails. We don't even provide treatment for the mentally ill in jail. We're just warehousing them."

What happens to the mentally ill in an overcrowded, violent prison system with little to no psychological counseling available?

In state prisons, the mentally ill serve an average of 15 months longer than the average inmate. The very nature of most mental illnesses makes it difficult to follow prison rules. These inmates are more likely to be involved in prison fights and they tend to accumulate more conduct violations.

Prison staff often punishes mentally ill inmates for being disruptive, refusing to comply with orders, and even for attempting suicide. In other words, these inmates are punished for exhibiting the symptoms of their illness.

Gaining parole is also more difficult for the mentally ill. Their disciplinary records are often spotty, they may have no family willing or able to help, and community services are usually inadequate.

In October 2003, Human Rights Watch released a report entitled Ill Equipped: U.S. Prisons and Offenders with Mental Illness. Following two years of in-depth research, this organization found that few prisons have adequate mental health care services. Furthermore, it found that the prison environment is dangerous and debilitating for the mentally ill.

An excerpt from Ill Equipped:

"Security staff typically view mentally ill prisoners as difficult and disruptive, and place them in barren high-security solitary confinement units. The lack of human interaction and the limited mental stimulus of twenty-four-hour-a-day life in small, sometimes windowless segregation cells, coupled with the absence of adequate mental health services, dramatically aggravates the suffering of the mentally ill. Some deteriorate so severely that they must be removed to hospitals for acute psychiatric care. But after being stabilized, they are then returned to the same segregation conditions where the cycle of decompensation begins again. The penal network is thus not only serving as a warehouse for the mentally ill, but, by relying on extremely restrictive housing for mentally ill prisoners, it is acting as an incubator for worse illness and psychiatric breakdowns."

According to Fred Osher, M.D., director of the Center for Behavioral Health, Justice and Public Policy at the University of Maryland, the majority of mentally ill inmates are arrested for misdemeanors and crimes of survival. He states, "That's a whole host of folks who land in the criminal justice system because of their behavioral disorders."

Those on the fringe of society are primarily affected. These people are almost always impoverished and disabled by their illness. They have nowhere to turn, no one to help them, and so we toss them in prison. Even minor offenses keep them locked in prisons, since many cannot afford and/or do not know how to bond themselves out.

The recidivism rate among the mentally ill is higher than that among the general prison population. Prison has become a revolving door system for dealing with mental illness. By default, prisons have become the new mental hospitals. However, they lack the funding and the training to deal with these patient-inmates.

Ratan Bhavnani, executive director of the Ventura County chapter of the National Alliance on Mental Illness, states that, "In general, people with mental illness can recover when given the appropriate treatment rather than to be sent off to jail only to become more psychotic and come back and reoffend."

Michael Jung of Ventura, California suffers from bipolar and hears voices telling him that he is the devil. Over the past 10 years, Jung has been arrested a minimum of 15 times - all for relatively minor offenses. Earlier this year, Jung spent six weeks confined in G Quad, the unit where mentally ill inmates stay in their cells 23 out of the 24 hours in each day.

Cells such as those in G Quad are referred to as the "rubber rooms" because the walls are padded. There is no furniture in these rooms. The "toilet" is a grate in the floor. They are stripped naked and monitored via video camera. Inmates who are paranoid, delusional, or otherwise difficult to manage are often placed in this type of cell, whether for their own protection, the safety of the other inmates, or just plain convenience.

Susan Abril, a former inmate who suffers from bipolar disorder, was placed in this type of cell. During her confinement, Abril began hearing voices for the first time. "I didn't sleep," she said. "I mentally went insane being locked down 23 hours of 24."

We are essentially making the mentally ill inmates sicker, as well as ensuring their return to an already massively overcrowded prison system. Obviously our current system is not working. We cannot expect prison staff to function as psychiatrists. We also cannot expect the mentally ill to be "rehabilitated" in a mainstream prison system.

The Taxpayer Action Board for Governor Pat Quinn of Illinois cited annual savings in the tens of millions of dollars that could be gained by releasing thousands of non-violent offenders, closely monitoring them and providing substance abuse treatment, mental health counseling, education, job training, and employment opportunities.

For the most part, the mentally ill do not belong in prison. It would be cheaper (and smarter) for us as taxpayers to divert funding in order to provide adequate treatment programs to keep them out of prison.

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