Mental Health in Prison: Integrating the Perspectives of Prison Staff.

Ines Testoni,Cristina Selmi,Erika Iacona,Francesca Vianello,Adriano Zamperini,Francesca Marrella,Alfonso Nava,Irene Nencioni,Maibrit Arbien,Michael Alexander Wieser,Vittoria Gorzegno

doi:10.3390/ijerph182111254

Abstract

(1) Background: The Italian Constitutional Court’s decision n. 99/2019 abolished the distinction between physical and psychological health care in the Italian prison system. However, this and other changes to the penitentiary system present challenges to prison staff, which may vary based on their roles and backgrounds; (2) Purpose: To create a process of dialogue and collaboration that include different points of view, needs, and proposals regarding mental health in prisons, this study collects and integrates the perspectives of 91 prison staff who work in various capacities in eight prisons in northeast Italy. (3) Methods: Each participant was involved in either a focus group or a semi-structured interview, and thematic analysis was used to process the resulting transcripts; (3) Results: Through this process, 10 themes were derived that highlight the difficulties of working with prisoners with psychiatric disorders or psychological distress, including lack of human and economic resources, lack of positive communication between prisoners and society and a sense of professional incompetency; (4) Conclusions: Based on these themes, the need for increased points of view, dialogue, and collaboration between prison professionals and between prison and society is discussed, and the current feasibility of treating psychiatric disorders in prison is considered.

Highlights

IntroductionIn 2019, the Italian Constitutional Court [1] decided to abolish the distinction between caring for prisoners’ mental and physical health
In light of the far-reaching reorganisation of the mental health system in Italy’s penitentiary system, the concerning incidence of poor mental health amongst both prisoners and prison staff, and the reported obstacles to cooperation between different kinds of professionals within prisons, the present study aims to explore patterns of meaning in different prison staff’s perspectives on the topic of mental health and increase the understanding of potential risk factors and strategies for improving prisoners’ and prison staff’s mental health
‘frontline’ roles: physicians (n = 11), nurses (n = 19), juridical-educational professionals (JEPs) (n = 12), psychologists (n = 2), volunteer (n = 1). They know the rules, the system, they are trained people, so we considered them part of the staff.) and Penitentiary police officers (PPOs) (n = 28)

Summary

Introduction

In 2019, the Italian Constitutional Court [1] decided to abolish the distinction between caring for prisoners’ mental and physical health. The notion of health in the Italian penitentiary system includes both physical and mental health, as encapsulated in the World Health Organisation’s (WHO) definition—‘a state of complete physical, mental and social well-being’ [3]. Starting from these considerations on mental health, intended as a broad concept involving several aspects of life, the following paragraphs will provide an overview of the conditions of the Italian prison system and its population (prisoners and staff) and the effects on their mental health

Methods

Results

Discussion

Conclusion