There are around 10 times as many people with serious mental illnesses in jails and state prisons than there are in state hospitals, according to estimates from the Treatment Advocacy Center. Yet a bioethicist from the University of Pennsylvania argues that colleagues in his field have not paid enough attention to the serious ethical questions that arise from this fact.
"Bioethicists have largely overlooked the area of correctional mental health care despite the fact that there are currently over 1 million individuals incarcerated who have a mental illness and a significant subpopulation who have a serious mental illness such as schizophrenia or bipolar disorder," writes Dominic Sisti, a professor of medical ethics and health policy.
That is why, as Newsworks reported, Sisti is leading a yearlong pilot program for Penn's Leonard Davis Institute of Health Economics to research the inner workings of the prison mental health care system
Sisti's team, which includes ethicists, therapists, and criminologists, will examine policies related both to treating mentally ill inmates and reducing the number of mentally ill people in jails and prisons to begin with. They plan to interview current and former inmates who have had experiences with the mental health care system while incarcerated, then publish "a research agenda for bioethicists to address overlooked issues."
Key ethical questions include: are therapists treating patients inside the prison system the same way they would treat a patient outside the system? Are prisoners getting medication to help them get better, or just to keep them docile? Do patients get follow-up care after they finish their sentence and return to normal life?
In Pennsylvania, where the state prison population has more than tripled since the 1980s, these are questions that researchers can't afford not to answer.
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