Free Research Paper On PTSD Among Incarcerated Felons
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PTSD in incarcerated felons
Close to one fifth of the adult population of the United States of America suffers from some form of mental illness including emotional, mental or behavioral disorders. These figures are quite significant considering that America is one of the most developed nations in the world and is likely to have better mental health care facilities and infrastructure than the rest of the world. But these figures reach alarming proportions when the population in prisons is considered. According to surveys and studies conducted in the previous decade approximately two-thirds of the inmates suffer from some form of diagnosable mental illness. Over half of these inmates never get treatment for their mental conditions and only a third are treated after their arrival at the correctional facility. Post-Traumatic Stress Disorder is one particular ailment that affects a significant segment of the prison population especially because of disturbed childhoods but institutional support and interest seems to be lacking. Considering the horrible nature and effects of PTSD it is long due that people suffering from it in the prison system are attended to and measures are put in place that help with rehabilitation and medication and overall betterment of the incarcerated individuals.
Post-Traumatic Stress Disorder is when a traumatic incident adversely affects an individual and its effects persist even after the incident and become debilitating and the normal functioning of the individual is impaired. PTSD is when the individual’s flight-or-fight response is thrown off balance and the person feels threatened even with no apparent danger present. These perceived dangers evoke a full blown psychological and behavioral response and in everyday circumstances such response is unhealthy and leads to a diagnosis of PTSD. Specific symptoms of PTSD are grouped into three categories; re-experiencing, hyper-arousal and avoidance. A person suffering from PTSD re-experiences the traumatic events in the form of flash-backs, bad dreams or frightening thoughts. PTSD patients can be easily startled, feel tense and exhibit fits of aggression. Additionally PTSD patients can also feel emotionally numb, have a hard time connecting with people and finding interest in activities, avoid people, places and objects and also feel strong feelings of guilt or worry. These symptoms can have a sudden or a delayed onset and they have to last more than a month to be considered PTSD. PTSD patients also show particular irregular patterns in their brain activity. Their brains show greater activity as compared to healthy subjects in the regions linked with negative emotions like fear, guilt and sadness. There is also heightened activity in the regions that govern experience and regulation of emotions. PTSD can also be accompanied by other anxiety disorders like Social Anxiety Disorder, Agoraphobia or Claustrophobia. The severity of the symptoms and their ease of getting triggered make the normal functioning of the human especially difficult and the individual can become a source of danger for himself and for others around him.
In the beginning PTSD was most commonly associated with war veterans as they witness the most horrendous of acts and incidents. Even after returning from war they relive the experiences and perceive similar danger in their ordinary neighborhood. Their military training and experience with handling weapons also inclines them towards violent aggression and this is why PTSD started getting greater attention. Over time PTSD has come to be linked with various sorts of traumatic incidents including mugging, rape, accidents and natural disasters. Traumatic incidences in the childhood make one especially susceptible to develop PTSD later on in life. For children who already have little experience and cognitive skills, perception of danger is more easily distorted and if this problem goes untreated it can advance in to full blown pathology and also incline them towards violence, crime and drug abuse.
Considering the causes of PTSD it can be hypothesized that the instances of PTSD in prison population will be higher. Generally there is a higher rate of mental illnesses in prisons and this can be both either a cause or an effect of the crime committed. PTSD can also be higher because frequency of traumatic experiences among prisoners is greater than in normal population. The socio-economic strata most criminals belong to and the neighborhoods that have the highest crime expose individuals to events and incidents that can lead to PTSD later on. Research has found that there is a higher rate of physical abuse and childhood neglect among prisoners. Childhood sexual abuse is also more common in prison populations and it is a strong causal factor for the development of PTSD. Goff et al went over extensive research to ascertain the prevalence of PTSD in prison population. Their findings revealed that PTSD can range anywhere between 4 to 21%. The rate of PTSD among women is significantly higher than in men and this difference becomes more pronounced when the prison population is under consideration. It has been estimated that the percentage of women suffering from PTSD is ten times more among women in prisons than in the general population.
Research has been conducted to find out what particular events are most cited as the possible cause of PTSD among inmates. It was found out that for men the foremost experience is that of seeing someone getting severely injured or dying. The second most common cause is being sexually abused and the third is being physically assaulted. The highest concentration of these events tends to be in adolescence and the experience of community violence is also higher for men during adolescence. The occurrence of these events in adolescence is also linked with delinquency and criminal behavior in young adulthood. For men the possibility of recurrence of such events is also likely while in prison so by extension one can assume that most of the weaker or susceptible prisoners are at risk of developing PTSD by being in prison. The situation is worse in case of women as research has found them more likely than men to develop PTSD after experiencing traumatic incident. This explains why a greater number of women suffer from PTSD than men. Women in general are more likely than men to have interpersonal sexual assault as the foremost traumatic experience. Women also tend to experience sexual violation throughout their lifespan starting from childhood. This early experience of trauma exposes women to PTSD causes earlier and childhood makes them more vulnerable and likely to develop PTSD.
As for the treatment of PTSD usually psychotherapy or medication or both are used. The treatment depends on the person being treated and it can take some trial and error to arrive at a specific treatment plan for a specific individual. Psychotherapy mainly involves communicating with a mental health professional. In psychotherapy various objectives can be at work like educating the patient about PTSD, making them confront their fears, equipping them with coping strategies etc. one important type of therapy is the Cognitive Behavioral Therapy (CBT) where the mental health professional attempts to address the problematic schemas and thought patterns of the patient and by modifying these the behavior of the patient can be modified. Once the patient has control over his or her behavior it becomes easier to manage the symptoms and the individual can function with more ease in the society. Cognitive Behavioral Therapy can also assume various types like the exposure therapy where the patient is made to face his or her fears and the trauma under supervision and in a controlled environment. This reduces the effect of the trauma and it becomes less harmful and over time its effect can be diminished with repeated exposures. Cognitive restructuring is also a way CBT is used in psychotherapy. Using this methodology, the patient is made to see the traumatic experience in a more realistic way. It helps the patient get over any misplaced feelings of guilt or responsibility they might feel and the incident is made free of any exaggerated meanings the patient might have attached with and that causes the unmanageable fear and other symptoms of PTSD. Stress inoculation training is where the patient is directly taught to manage the symptoms of PTSD. The patient is informed of the nature of the symptoms and their physiological manifestations and told how to bear them in a healthier way. Patients are told deliberate thoughts and actions they must perform while they are having an anxiety attack and this will help them distract themselves and remain in control while the spell lasts. Sometimes when the PTSD is more severe doctors may also prescribe medication but these medications are mostly anti-depressants like sertraline and paroxetine which only help with the negative affects and have no effect upon the causes and the schemas associated with the PTSD.
It can be seen that there are various treatment options available to the normal population but the situation is not so in prisons. The treatment of a problem begins with a diagnosis but no systematic attempt has been made to ascertain what percentage of people in prisons has PTSD and what can be done to help them out. Researchers have done studies that show that the instances of PTSD are greater in the prison population than in the normal population but these only provide estimates and not the actual number of people thus affected. The high percentage of untreated mental patients in prisons also contributes to the hostile environment in prisons and the prisoners who serve their sentence and come back in to the normal society are bound to feel alienated. The environment these people face in the prisons can itself be a cause of PTSD and if they are unfortunate enough to develop this problem they are also more likely to end up back in prison. This shows the adverse condition of prisons in a country that has the highest number of incarcerated people in the world. The number of felons serving time in the USA is more than 2 million and this sizeable portion of the society is more prone to mental illnesses and also the recipient of little mental health care.
In a nutshell it can be stated that mental health is as important, if not more, than physical health and the prevention and treatment of mental illnesses will have a deep impact on criminality and incarceration. The instances of mental illnesses are greater in prisons than in the normal population and this highlights both the causes and effects of mental illnesses. One could argue that if underprivileged or crime prone localities are targeted and provided mental health care facilities a decrease in crime would result because of better mental health. On the other front as well, if the population in prisons is diagnosed and treated better their rehabilitation and correction will become more manageable and once they step back in to the society their transition into normal life will be less problematic. Through both these means crime could be controlled and the huge expenses being incurred on the correction system could be used elsewhere. With regards to mental health in prison, Post Traumatic Stress Disorder is of considerable importance as its causes and effects both include violence. The higher the rate of PTSD the greater the violence in a society is. Treating PTSD thus becomes a multi-dimensional task where on one hand the levels of violence and crime in a society have to be reduced and proper care has to be provided to patients so that they pose lesser danger to themselves and to others. On a more advanced level greatest importance has to be attached to curtailing sexual offenses against women as the primary cause of PTSD and to help men out physical assaults and community violence have to be addressed on a societal and national level.
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