We have discussed in class about how neglected mental health
is globally. Often, because it is not physical, we do not think of mental
health as a huge issue. It remains ignored and stigmatized by society. We also
spoke about how few health services are available for patients with mental
illness. Because of this, the burden of treating patients with mental illness
has largely fallen on the prison system.
The prison system is the largest provider of mental health
services in the country. There simply is not enough space in mental health
institutions to provide care to all patients that require care. If patients who
needed care received treatment, they may not have committed the crimes that got
them in prison.
If a patient was having an episode in schizophrenia, for
example, they may not know what is real and what is not real. People with
schizophrenia hear voices and become very anxious and suspicious that something
is going to happen to them. Most patients with schizophrenia are not harmful to
others, even during an episode. In very rare cases, they may cause harm to
others.
Here is an extreme example of a man who murdered his in-laws
during an episode of schizophrenia:
What should happen to this man? His crime was awful, but it was
the result of his illness. We discussed human rights in depth earlier in the
semester. What rights does this man deserve? What about all the people in the
prison system because of their mental illness?
Personally, I believe that this man should not be executed.
Instead, he should be treated by mental health professionals. Had his illness
been better controlled, he may not have committed his crime in the first place.
People with mental illness should not be kept in the prison system. They should
be treated and helped to integrate back into the community. Part of the problem
with this solution is that the community fears people with mental illness. It
is so stigmatized that often people do not seek treatment. I learned in
pharmacy school that men often have lower rates of depression simply because
they are too ashamed to seek treatment. Society tells men to be strong and not
show emotion.
My professor, Dr. Carol Ott, mentioned that many countries
in Africa actually have higher rates of recovery and lower rates of episode recurrence
than the United States. Apparently, it has to do with the culture in African
countries. There, people are more willing to let their family with mental
illness come back to live with them. In the United States, patients with mental
illness have a hard time reintegrating with their community. This surprised me,
as Farmer (2013) mentions the low rates of mental health professionals in
proportion to the population (p. 218). Stigma is such a huge issue as it
affects health outcomes. Dr. Ott says that 1 in 4 people have a mental illness.
It is such a common issue, yet so overlooked by society and health care
professionals.
Farmer, P., Kim,
J. Y., Kleinman, A., & Basilico, M.
(2013). Reimagining global health an
introduction.
Berkeley: University of California Press.
I think you bring up some interesting points here. First, mental health is definitely stigmatized. I wonder how some of these stigmas began. Second, unfortunately, the rehabilitation system in the United States is not very good at rehabilitating people. In many cases, I actually think it has the opposite effect. I wonder if that environment had adverse effects on mental health and well-being.
ReplyDeleteAlso, you mentioned depression and how men may avoid seeking help. In I Don’t Want to Talk About: Overcoming the Secret Legacy of Male, this issue is referred to as “covert” depression. Real argues that covert (hidden or unexpressed) depression can lead to acting out. The book claims that this may be the reason why in the United States overwhelmingly more men are convicted for violent crimes. Perhaps, because of these social pressures, men display different symptoms of depression than women.
I think that the stigmas began because people did not understand what mental illness was or what caused it. The first "lunatic" wards were funded in part by the rich people who would pay to see the "lunatics" in their cells. It was sort of like a freak show.
ReplyDeleteYou are definitely right about the United States not having a very good rehabilitation system. That is part of the reason why it is sad that the prison system is the largest provider of care to people with mental illness. I would be willing to bet that being in prison does negatively impact mental health and well-being.
That book sounds very interesting! I haven't read much into the reason men behave the way they do, but I have some speculations. I always felt like men are more aggressive in the first place. Of course, this is all very stereotypical. Not all men are aggressive. It is just a trend I have noticed.
Your post became a surprise to me when you stated that the prison's in America is one of the largest providers of health care in America.
ReplyDeleteLast year, I did my psychiatric nursing rotations at a behavioral health unit in one of Indianapolis's hospitals. I had a patient that came in due, because he was taken off his schizophrenia medications suddenly after he was sent to prison. It was stated in his chart that the prison did not allow people to continue their medications once they come to the prison. Of course, when a person is suddenly taken off their medications, without tapering them (as they should), a schizophrenia episode occurs. This man, heard voices that led him to try to commit suicide in his cell. I wonder whether or not there was a break in the system that caused the discontinuation of his medications to occur.