Mental health services in restricted housing: Do we know what's going on behind the steel doors?

Abstract

The use of administrative segregation (AS) in North American prisons remains a common but contentious practice that is currently at the forefront of human rights and legal discussions. While extant research is mixed regarding the direct links between segregation and psychological functioning, it is clear these individuals are worse off in many ways. Mental and behavioral health interventions appear especially limited for people incarcerated in secure units, yet little is known about the extent of services offered or existing barriers to service provision. Using a standardized survey, we attempted to obtain a nationally representative sampling of mental health practices for people incarcerated in segregation and frontline provider perspectives across 24 state prisons. Survey results suggest that, while most facilities offer some form of mental health services to clients in restrictive units, most do not provide structured, manualized interventions. An even smaller number provide interventions specifically tailored to this unique population. Perceptions of service delivery barriers fell into four categories: (a) the nature of the restrictive environment, (b) lack of available programs, (c) staff-related concerns, and (d) client/inmate-related concerns. We conclude with recommendations to improve program accessibility and delivery on segregated units. Focused intervention efforts may reduce the number and duration of restricted placements. (PsycInfo Database Record (c) 2021 APA, all rights reserved).