Author Archives: Casey Marson

Access to Mental Health Care in Prisons

Mental illness continues to be stigmatized in the United States, making it difficult for people to discuss and to pursue help. Like mental health, incarceration is a branding topic that often carries with it negative connotations and judgments. Both of these matters are significant and deserve research, awareness, and reform alone; however, the issue of mental health in prisons is one that encompasses both of these issues and must be addressed. The lack of access to services for incarcerated individuals is devastating.

One of the main objectives of incarceration is isolation and separation from the outside world. Because of this, the institutions must provide their inmates with everything essential like food, water, bedding, etc. At what point does the law draw the line between what is essential and what is not? What does this mean for mental health?

The U.S. has the highest rate of adult incarceration among the developed countries, with 2.2 million currently in jails and prisons. Those with mental disorders have been increasingly imprisoned over the last thirty years, most likely due to the deinstitutionalization of the state mental health system. Correctional institutions have become de facto state hospitals, with more seriously and persistently mentally ill inmates in prisons than in all state hospitals in the United States. In cases like Ruiz v. Estelle, U.S. courts have clearly established that prisoners have a right to receive medical and mental health care.

In order to meet this need, it is important to examine options and solutions inside the prisons. Often, state correctional departments have agreements with state departments of mental health to have professionals come into the prisons and provide acute care. Having these mental health professionals come to prison helps address many issues including the lack of ability to transport inmates to outside facilities, understaffed and under trained prison personnel, and lack of resources in general.

Suicide is the third leading cause of death in U.S. state and federal prisons. Suicide-prevention programs in prisons are of increasing importance to mental health professionals, correctional administrators, health care providers, legislators, attorneys, and others as they seek to rehabilitate offenders and avoid the multi-million dollar lawsuits that result from inmate suicides. Suicide prevention efforts must extend beyond the mental health staff of prison facilities, and begin to include guards, administrators, and custodial staffs.

Another important measure is a change of perspective on punishment as a whole. There has been an increase in the use of diversion programs such as mental health and drug courts across the country. These courts work with mental health and substance abuse treatment providers to assist those who struggle with these problems. In order to participate in this treatment alternative, a person must first plead guilty to a crime and be subject to incarceration. Although these alternative routes have many advantages and a great focus, evaluations of mental health and drug courts have shown questionable success and significant challenges.

Another alternative is the use of pre-booking diversion. A pre-booking diversion plan is is one that identifies low-level offenders and redirects them from jail and prosecution by providing linkages to community-based treatment and support services. This alternative requires the efforts of both a law enforcement and social services. When possible, individuals who do come in contact with police should be diverted to other options like treatment before they are ever faced with arrests, charges, and sent to the police station for booking.

Overall, the need for prison-based mental health treatment is profound. It is important we focus our efforts inside the prisons with the staff, health care providers, and inmates in order to create a safer environment. It is also important we move away from the system of punishment, and instead consider alternatives to incarceration in order to rehabilitate and prepare these individuals for life in the community.

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New Year’s Resolution: Drug Abuse Prevention

The start of a New Year is often a time to reflect on the past and make resolutions to improve in the future. An ever going epidemic in the United States is drug abuse. Drug overdoses are currently the leading cause of death among Americans under the age of fifty. Research in 2017 has indicated that trends in drug abuse and overdose death rates are at an all-time high. With more than 64,000 drug overdose deaths estimated in 2016, the sharpest increase occurred among deaths related to synthetic opioids with over 20,000 overdose deaths.

Although there are delays in toxicology reports and inconsistencies in reported data, it is nevertheless clear that drug abuse and overdose are problems of exceptional and imminent importance.

The question, now, is what does this mean for 2018? Goals moving forward involve prevention, rehabilitation, and education for people across the county. These encompass both health and legal objectives, as they are very much intertwined, and addressing the drug epidemic will keep people safer, healthier, and also out of the criminal justice system.

Health objectives include medical advancements as well as treatment. There have been many medical advances in the war against opioid overdose, including the FDA approval of Naloxone, designed to rapidly reverse opioid overdose. While paramedics and specially trained responders typically administer Naloxone via injection, there are also nasal sprays and other forms of medicine that are more accessible to the general population. While the problem of drug abuse needs to be tackled starting with prevention, advances such as these are extremely important for rehabilitation purposes for people that struggle with substance abuse and addiction. It also can immediately save lives in grave situations.

Along with scientific medical advancements like Naloxone, research has shown that drug abuse treatment can help people with the many aspects and consequences of drug abuse. Drug abuse is very much tied to both legal and health problems. Treatment targeted towards individuals in the criminal justice system can help alter their outlooks and actions toward drug use, avoid relapse, and positively disconnect themselves from a life of substance use and crime. Treatment can be effective, whether voluntary or ordered by the court.

There are many places and organizations dedicated to drug abuse rehabilitation and prevention. Programs like Narconon International are devoted to education to prevent drug abuse and addiction, specifically targeting youth. They point to the fact that in today’s society, we are inundated with media and celebrities and influences constantly. Educating youths who are vulnerable to these messages and influences is vital to prevention. Reaching out to young people can help to combat the perpetual abuse cycles that we see in both the health world and the criminal justice world.

The 2018 National Rx Drug Abuse and Heroin Summit will take place this year in Atlanta, Georgia in April. The National Rx Drug Abuse and Heroin Summit is a congregation of experts from local, state, and federal agencies, businesses, academia, treatment providers, and allied communities impacted by prescription drug abuse and heroin use. This annual gathering offers an opportunity to discover what is effective in deterrence and healing.

It is very clear that drug abuse prevention is a top priority for our country as we ring in this New Year. For more resources and information about drugs, drug abuse, and prevention, please visit and share the 2017 version of the DEA Resource Guide, Easy-to-Read DrugFacts, and The Science of Drug Use – Discussion Points.

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