Implications of long-term incarceration for persons with mental illness
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Currently in the United Stated, 1.6 million offenders are incarcerated within state and federal prison systems (Guerino, Harrison, & Sabol, 2011). Most recent estimates purport approximately 24 percent of the prison population presents with serious mental health problems (James & Glaze, 2006); however, there is a paucity of research examining the impact of long-term incarceration among persons with mental illness (PMI). Although research with non-disordered offenders has failed to demonstrate deleterious psychological consequences due to long-term incarceration (Bonta & Gendreau, 1990; Bukstel & Kilmann, 1980), recent investigations with PMI have suggested otherwise (Morgan et al. 2007; Yang et al., 2009). For example, Morgan et al. (2007) suggested that increased time served in prison was associated with increased psychiatric symptoms, criminal thinking, and poorer institutional behavior for female PMI incarcerated in a general population prison facility, but not necessarily with concomitant complications for male PMI incarcerated in a psychiatric inpatient prison facility. Thus, the purpose of this study was to examine the relationship between time served in prison and the mental health functioning and criminal and behavioral presentations of male PMI incarcerated in general population correctional facilities. Participants (n = 134) were sampled from three separate general population correctional facilities within a Midwestern state correctional system. The majority of participants were diagnosed with Major Depressive Disorder, sentenced to an average of 20 years in prison, and served an average of 10 years on their current sentences. Results of a repeated measures regression using multilevel modeling indicated increased time served in prison was related to increased psychiatric symptoms associated with Major Depression, as well as with other depressive syndromes and personality traits. Increases in aggressive, antisocial, and negativistic personality traits were also evidenced as a function of time. Results of a series of negative binomial regression analyses suggested time served in prison was not associated with other measures of mental health functioning (i.e., days on crisis watch, mental health sick call visits, mental health referrals and follow-ups), nor were significant associations found between time served in prison and the number of disciplinary infractions received. Further, multivariate regression analyses revealed no significant relationship between time served in prison and criminal thinking and attitudes. There was a significant underrepresentation of participants with severe mental illness, such as Schizophrenia and Bipolar Disorder. This resulted in the sample being less severely mentally ill than initially intended and perhaps limited the results. In light of this limitation, implications of findings are discussed in terms of practice and future directions for research.