Did you know that one of the most difficult task for a mental health counselor is to work with inmates that are in solitude confinement? I am a licensed mental health counselor and I have been in the field of mental health for over twelve years. During my career I have worked for different populations such as a dual diagnosis program, individual therapy, group therapy, and family therapy. But one of the most interesting and challenging populations that I have worked with as a mental health counselor is at a correctional institution with male inmates that were housed in confinement.
Inmates who are housed in confinement have been placed there because they have broken prison rules. I usually tend to say that inmates that are sent to confinement are going to a jail within a prison itself because they have lost their institution privileges, their personal properties have been stripped from them, and their family visits are taken away. Plus, they are being confined to a small cell for more than thirty, ninety, or even more days. This makes it very stressful for them and in such cases some inmates become suicidal.
Self-harm is a prevalent and dangerous occurrence within correctional settings specially when inmates are sent to confinement. Usually inmates who are sent to confinement often have a history of self-harm. Most inmates that I have attended in confinement attempted to harm themselves by cutting, hanging, overdosing, and in many other ways. There are many reasons why inmates try to harm themselves. Some of these suicidal attempts can be influenced by environmental stressors within correctional settings or pre-existing mental illness. Also, sometimes inmates malinger feeling suicidal or fake a mental illness to avoid certain situations or any type of punishment. So the motivation of the inmate can be complex and difficult to discern for a mental health counselor.
The effects of confinement are significant with inmates that have severe mental illness such as major depressive disorder, bipolar disorder, schizophrenia, etc. The lack of social contact and being in solitude with unstructured days can exacerbate symptoms of illness. They tend to display bizarre behaviors and even become dangerous to others or themselves. In my opinion many of these inmates with mental illness should not be placed in confinement because their mental condition will not improve but rather deteriorate. I will always refer them to an in-patient unit were they will be provided with the proper treatment.
Furthermore, in the correctional institution that I worked, an average of three to six inmates was sent to confinement on a daily basis and these inmates needed to be seen as soon as possible no later than five days to avoid any suicidal attempts and to insure their emotional and mental state. Between the daily evaluation and the crisis intervention, they tended to consume the workday and this can be challenging for any mental health counselor.
By Alfredo J. Picanol