As a psychiatrist I have long consulted to various kinds of correctional facilities including local county jails, state prisons both low or “minimum” security facilities and “maximum” or “high management” units, a federal correctional evaluation center of some past fame and notoriety because of its infamous inmate-patient referrals especially in the turbulent 1980’s, juvenile correction detention centers in regional settings in the Southwest and one of the country’s largest adolescent detention center in a very large urban city. I also served as a forensic examiner at a state level maximum security state hospital based forensic correctional inpatient unit.
I have long been acutely aware that 1) a substantial percentage, at least one third in the old days, to now a growing majority these days with the last ten years of shifting of the chronically mentally ill from public psychiatric hospital beds to the jails at all levels in this country, have been mentally ill, and that, 2) the mental health treatment services in all correctional settings have always been and still are, woefully inadequate, and that 3) there is inadequate training for correctional personnel, that 4) management of the mentally ill offender has become consequently, and understandably necessarily more and more reliant on coercive, physical control measures in settings at all levels. This has been a disaster long in the making and obvious to any student and practitioner of correctional facility mental health services delivery who has had a long enough career to see it worsening in the last 10-15 years.
Pen and Psychiatrist 