The Role of Psychiatric Epidemiology in Correctional Medicine

Abstract

Epidemiology is the basic science of public health. Since WWII, epidemiology has changed its focus from infectious diseases to an understanding of organic and functional problems, including psychiatric illness, within various social and organizational contexts. More recently, epidemiologists have studied special populations. However, the authors argue that correctional populations have, as yet, been neglected. For example, the purpose of psychiatric epidemiological investigations is to discover etiological associations between biological, social, psychological, and environmental risk factors to disease. While many authors have described the effects of prisonization on mental health, socioenvironmental factors present in correctional settings have not been systematically studied as risk factors for mental illness. Current knowledge of the epidemiology of mental disorders must be extended beyond that gathered in mental hospital and normal populations to correctional settings. In order to accomplish this, there is a need to resolve several basic issues so that comparable data can be identified across different populations. First, there must be agreement on what constitutes a case. Second, standardized case finding methods that are appropriate to the range of pathology in correctional settings must be developed. Third, in addition to studying prevalence and incidence, we must begin to compare differences in the duration, disability, and outcome of illness across different populations. Finally, there is a need to evaluate the effects of policy decisions on the flow of mental patients to justice and correctional settings.