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Theoretical Difficulties in the Treatment of Mentally Ill Prisoners

NCJ Number
141746
Journal
Journal of Forensic Sciences Volume: 38 Issue: 2 Dated: (March 1993) Pages: 426-431
Author(s)
R A Schultz-Ross
Date Published
1993
Length
6 pages
Annotation
Psychiatric work within the correctional setting involves the interface of psychiatry, law, and corrections. The difficulties inherent in this type of work directly affect the performance of clinical and evaluative functions.
Abstract
The primary theoretical gap for the forensic psychiatrist is the difference between law and psychiatry, marked by the law's system of absolute judgment, structured procedure, and adversarial confrontation. In contrast, psychiatry is rooted in medicine and is based on the premise that the patient can be restored to a good, stable condition. While much of the correctional system is based on a tradition of punishment, psychiatry promotes the concept of treatment. At least one study has found that prison conditions contribute to mental illness and that psychiatric care in correctional facilities is plagued by conflicts of interest. This dichotomy also affects the rehabilitation versus treatment debate. Because the legal system does not consider an antisocial personality disorder to be a mental illness, and an inmate's other symptoms of mental illness may not involve criminality, the forensic psychiatrist may find himself in the position of deciding whether to treat the patient's mental illness or criminality. To meet realistic goals, the forensic psychiatrist must employ triage principles, thereby treating the most treatable prisoners. However, he may find that countertransference issues will arise in many situations. 29 references