Psychiatric Services in Jails and Prisons: A Task Force Report of the American Psychiatric Association, second edition

Why do we need a special book about psychiatric services in jails and prisons? Are psychiatric services any different for this population? Mental health workers in these institutions are often puzzled by the basic concepts that are taken for granted in the free world, such as confidentiality, boundaries, and how to conduct research. They struggle with a variety of problems, including ethical difficulties, in providing psychiatric care in segregation units and in interprofessional relationships that may facilitate the work or make it extremely difficult. Psychiatric Services in Jails and Prisons presents comprehensive guidance on providing adequate psychiatric services for this special population.

Redefinitions of the principles and guidelines for working with this population were clearly needed. The first edition of these guidelines was published in 1989. Since then jails and prisons in the United States have gone through various changes. It was timely to revise and refine these guidelines in accordance with experience in their use.

The book's introduction details the need for psychiatric services in jails and prisons. Here the task force points out that about 20 percent of all inmates have serious mental disorders and as many as 5 percent are actively psychotic. Seventy-five percent of these people have comorbid substance use disorders. These inmates are likely to stay incarcerated four to five times longer than similarly charged inmates who do not have mental disorders. What are our duties and responsibilities in the face of such overwhelming numbers? This book seeks to answer these questions.

The main body of the book is divided into three parts. The first part underscores the fact that provision of mental health care in jails and prisons is constitutionally guaranteed. It defines constitutionally adequate psychiatric care and provides succinct information about the basic principles of delivering psychiatric services in these institutions.

Part 2 specifies the actual services that should be provided in particular settings. It details the core components of psychiatric services, such as screening, evaluation, treatment, and discharge planning. Part 3 applies the principles and guidelines set forth in the first two parts to particular patient populations. It elaborates on services that should be provided to meet the needs of particular groups of inmates. These groups include inmates with substance use disorders, inmates with comorbid disorders, women inmates, youth in adult correctional facilities, the geriatric inmate population, the terminally ill inmate population, and inmates with mental retardation and developmental disabilities.

Psychiatric Services in Jails and Prisons is a must-read for everyone who provides psychiatric care in jails and prisons. It is concise, practical, and easy to read. Mental health professionals can also use it as a quick reference when providing psychiatric services to the incarcerated population.

Dr. Kayatekin is associate professor of psychiatry and director of the Women's Program Center for Psychopharmacological Research Treatment at UMass Memorial Health Care/University Campus in Worcester, Massachusetts.