Physical and mental health improvement program for prison inmates

Letter of Transmittal

To the Head,

Department of Jails

There are often heavy psychological pressures on inmates as they are dislocated from the society. The type of interactions that happen in a prison setting also create psychological pressures and the incarceration also results in acute psychological stress. Prison life of inmates is most often associated with reduced physical activity as they are often subjected to a solitary life style without much scope for physic activity. There are also reduced opportunities for mental activities due to lack of resources as is the norm in prisons. Physical problems such as diabetes mellitus, heart diseases and other chronic disabilities have been established to have greater chance of setting on individuals who are sedentary.

This study recommends the ways and means to reduce physical and mental ill health of inmates due to the above mentioned reasons and conditions as recommendations of a training program for the inmates that include both physical and mental training and suggests ways and means for the improvement of self-confidence and reduction of loneliness of inmates.

Contents

The Problem 4

Problem Assessment 4

The Method 6

Results of the Study 8

A viable solution 10

Recommended Actions 10

References 12

The Problem

By characteristics, the penal institutions are generally sick places where unhealthy behaviors such as smoking, inactive lifestyle, irregular diet and of inmates cramped in to overcrowded conditions often results in the inmates developing both chronic physiological and psychological diseases at high rates.

There are often heavy psychological pressures on the inmates as they are dislocated from the society. The type of interactions that occur in a prison setting can also create psychological pressures and thus the incarceration also result in acute psychological stress. Moreover, the social stigma associated with being imprisoned and the impact of the institution of prison itself can leave long-lasting psychological impacts on prisoners and inmates. These often manifest in acute mental illness and other psychological problems (CASHIN, POTTER & BUTLER, 2008).

Over the yearsmany studies and reports have shown that prison inmateshave poorer overall health levels with a consequential associated lower rate of healthcare utilization in comparison to the general population. Chronic debilitating conditions are also common such as a co-infection with the HIV, hepatitis C virus, and/or opioid dependencewhich can be included among the health risks beyond what mental disorder that inmates may face. These also result in increased medical personnel employment and pharmacological costs which ultimately increases public spending by the government due to thehealth and psychological diseases commonly present in a prison population (Battaglia et al., 2013).

Methodology

The study was conducted with two different methods. One of the ways was to study the results of research efforts and studies that were conducted on the issue in the past. The context and the place of the studies as well as the settings of the studies were kept in mind and were selected on the basis of similarity of condition and facilities at the prison in contention. The results of the studies on mental health and physical fitness of jail inmates was carefully studied and analyzed. The conditions of the inmates in the previous studies were evaluated and compared with the conditions of the inmate sin the jail concerned the mental health issue was given specific focus upon while selecting and analyzing the studies. The studies and researches were chosen that bore resemblance to the reported mental illness of the inmates in the jail for which the report is being prepared. This report was prepared after careful consideration of the earlier reports on the basis of the conditions of the jails and the habits and norms and regulations of the jails, along with the facilities for the inmates of for physical exercise and recreation. The report took into consideration the best practices in the U.S. prison and other prisons of the world as depicted in the studies and compared them with the prison for which the report is being prepared. The results and recommendations of the variousprevious studies were considered while preparing the recommendations for suggesting a health training regimen for the physical and mental well-being of the inmates of prison being considered.

Along with studying previous reports and researches of mental health in other prisons, the report also took into account a detailed survey among the prison inmates of the jail in question. The survey was conducted among the inmates who had been diagnosed with having mental illness problems from mild to severe to acute. The survey also inquired with the inmates about their views of the regular regimen and the regular exercise opportunities that they got in confinement and the recreational opportunities present in the prison under consideration. The study also included views of the jail doctor about the possible reason for the mental illness and the prison authorities about the extent to which the rules and regulations could be flexed in order to include and adopt a health training and fitness regimen along with a plan for better and effective recreation facilities within the prison premises.

The survey included a written questionnaire for the inmates that had 15 questions regarding their view of about the health care system in the prison and their suggestions for a better health care regimen. Those who refused to answer the questions in writing were aided in answering by verbally placing the question with them and taking the answer. The questions were closed questions with multiple options to tick on. Each of the options carried a value according to the Likert scale. The results of the survey, carried out on 550 inmates, were then analyzed using statistical methods and the most number of answers in favor of a question was considered to the answer from the majority of the inmates. The answers were analyzed using simple statistical tools. Lastly, the results of the survey were compared with the results from the study of previous research and studies and then they were combined together to form a final set of recommendations.

Results of the Study

Using the above mentioned two methods the study found out the following:

1) The prison has a significantly high number of mentally ill patients that include inmates who were suffering from depression. The survey and the doctor's views pointed that at least 35% of the inmates were suffering from one form of mental illness or another and the cases of mental illness was a rising trend.

2) The study found that while earlier there were limited number of inmates who complained of hypertension and limited number of brawls and fights amongthemselves -- as reported by the jail authorities, the trend has increased and in the last year there has been an increase of 55% more brawls and fights among the inmates where the jail authorities had to intervene (Ciuhodaru, Iorga & Romedea, 2013).

3) The study showed that psychological tests and counseling classes among the inmates involved in the fights, undertaken by the jail doctor in a limited way, indicated that 95% of the brawls had no apparent reason which led the doctors to conclude the that the almost all the inmates who had got engaged in the brawls were hypersensitive and were probably suffering from hypertension and mentally not in a perfect condition.

4) The survey showed that 85% of the inmates complained that the prison rules and timings did not given the sufficient opportunities for physical exercise during the day.

5) The survey also showed that 90% of the inmates were of the opinion that the prison rules and the facilities were very inadequate to get their regular dose of entertainment and recreation. The inmates noted that through there was a play ground in the prison it was often crowded and there were minimum facilities for outdoor games. The case of indoor games was far worse as almost no indoor games for recreation were available (LAWSON, SEGRIN & WARD, 1996).

6) A majority of the inmates (82%) also demanded that they be allowed more time to watch television and be wanted to watch movies specially screened at the prison central hall where all the inmates could gather sound at least once a week.

7) The inmates were also of the view -- 65% of them, that common room facilities and time period should be increased so that they could interact with one another more often and to greater lengths of time. This they said would reduce the boredom and loneliness that they face in the prison.

8) A large section ( 67%) of the inmates wanted to exercise regularly as they use dto do when they were not jailed.

9) 80% of the inmates were of the view that the confinement in the prison had affected them mentally and they felt psychological pressures from of not being able to meet their friends and family on a regular basis.

10) 75% of the prison inmates were of the view that the solitary and sedated life where they did not have much of activity to do was affecting them mentally and they were feeling alienated from the society more often than not.

A viable solution

The proposed program is the solution to the lack of cell physical activity of mental health patient housed in the acute care unit. If the current system cannot provide recreation time to the acute care inmates, then my proposed plan can bring the recreation to their cells through a potentially fun and healthy exercise program.

Recommended Actions

The outcomeof the study is shown below in the form of a tabulated trianing program and recreaitonal regimen for the inmates of the prison. The program has been desinged to provide enhanced psychological well-being, improved cardiopulmonary function, optimized skeletal strength, adequate stress management, enhancement of self-esteem, lowering of infractions, reduction of boredom and lonliness, managing weight and the over all improvement of custody staff relations with inmates.

1. Selection of fitness instructors from amongst the jail inmates who are well versed with physical training regimens as well as with the jail/prison cell conditioning

2. If required, the two inmates thus selected for fitness training should be givne a small crash course in professional fitness programs so that the best fitness regimen can be formulated for the inmates.

3. The inmates should treat this as a full time job and they should be compensated accordingly.

4. A fitness expert should be consulted to form a fitness program for the inmates which can last for 30 minutes twice a day.

5. Arrangements should be made for the fitness instructor to acute tier 3 days a week.

6. Exercise classes are coordinated to occur prior to and on scheduled shower days for personal hygiene considerations.

7. The two inmates serving as fitness trainers should instruct and impart fitness programs simultaneously so that the maximum number of inmates can be included in the regimen.

8. Fitness instructors will be compensated through the inmate work compensation program.

This would reduce the need for government spending separately on the fitness program as the inmates working as fitness trainers and the fitness expert are compensated from within the inmate work program funds.

9. Recreational facilities need to be improved. Indoor game facilities such as chess etc. can be included in the common room for the inmates.

10. Subject to government rules and regulations, the common room time for the inmates should be increased to the maximum extent possible

11. The demand for weekly film screenings can be looked into provided that such activities do not endanger the security of the prison and the inmates.

12. It is also advised that a specialist psychology expert be contacted and appointed to provide counseling sessions to the inmates who are diagnosed with mental illness.

13. The expert / counselor can visit the prison twice a month and more if felt necessary

14. The remuneration for the psychologists should be fixed and accorded to from the regular expenses of the prison. The remuneration is not expected to be high as the expert would visit just twice a month.

I am of the view that the above mentioned recommendaiotns would help the inmates of the prison to have a physically and mentally healhty life and improve the over all uality of life of the inmates lodged in the prison.