Psychology in Prison

Prison Range

Jean Folsom, Ph.D., Past Chair, Criminal Justice Section, CPA

In 2006, more than one-out-of-ten male offenders had a psychiatric diagnosis on admission to the federal prison system. This represented an increase of 71% over the previous nine years.

During the same nine-year period, the number of women offenders diagnosed with a psychiatric disorder rose by 61% to one-out-of-five women.

Typical diagnoses include the major psychotic disorders, anxiety, depression, antisocial personality and alcohol and drug abuse. These rates are much higher than that of a comparable community sample (ex. 0.5 % of men in the community are diagnosed with a major mental illness versus 8% in federal prison and 7% versus 22% for depression, respectively).

Deinstitutionalization and homelessness have likely played a role in this phenomenon. It should not come as a surprise, then, that the federal penitentiary service is the largest employer of psychologists in Canada.

What are psychologists doing in prison?

Psychologists have been working within the federal prison system since 1955. Although working in a correctional environment, at first glance, may appear daunting, it provides very interesting and rewarding work for psychologists. There are opportunities to develop programs and strategies related to criminogenic needs, to carry out specialized assessments, and to provide clinical treatment.

Psychologists are also conducting research to evaluate treatment and programming efficacy as well as exploring new areas such as the psychology of terrorism, thereby adding to the knowledge base of forensic, correctional and clinical psychology. The field itself is among the most quickly evolving due to extensive research over the past few decades on the prediction of criminal behaviour and on evidence-based treatments.

For example, whereas it used to be held that you could not effectively treat sexual offending, research has shown that sexual recidivism can be reduced by about 40% with Cognitive Behaviour Therapy. A similar dismal view was held about treating people with personality disorders yet Dialectical Behaviour Therapy is proving effective for women offenders with Borderline Personality Disorder.

The majority of correctional psychologists have traditionally been involved in the determination of risk to re-offend or in carrying out individual or group treatments related to offending behaviour. In recent years, however, there has been an increased focus on the mental health of offenders in federal prisons and a growing need for psychologists to provide basic mental health care.

The realization of the increasing numbers of offenders with mental illnesses in the federal correctional system has led to the development of a Mental Health Strategy and to an increase in the demand for psychologists in order to tackle the problem. The hallmark of the Strategy is its plan to provide a continuum of mental health care from admission to release into the community and up to the end of an offender's sentence.

The Strategy provides that all offenders are screened for mental health problems on admission and receive an in-depth assessment, if warranted. Much as people with mental illnesses in the community are generally managed by community based services and providers, most offenders with mental health problems are placed in regular institutions where they can access psychological as well as other mental health services. For those offenders with acute or demanding mental health needs, there are in patient settings at Regional Treatment Centres — psychiatric hospitals whose catchment’s area happens to be the other prisons in the region.

In contrast to the current situation in many community hospitals in which the role of psychologists is diminishing, psychologists within the correctional system play a major leadership role and are involved at every step of the Strategy. Many of the regional and national coordinators of the components of the Strategy are psychologists. A psychologist oversees the mental health assessments that are completed on newly admitted offenders.

Psychologists also complete the in-depth assessments that are required on some of these offenders. Thus, there has been a significant shift in the role of the psychologist within the correctional system, with the provision of mental health care becoming an increasingly important component. Psychologists are frequently called upon to provide crisis intervention for offenders. Offenders are at increased risk for depression and suicide. A large percentage of offenders at Treatment Centres are diagnosed with schizophrenia.

In terms of treatment approaches, Cognitive Behaviour Therapy is the most frequently employed due to the extensive literature on its effectiveness in dealing with criminal behaviour (for example, see the work of Don Andrews, Jim Bonta and Paul Gendreau). It has also been shown to be an evidence-based treatment for depression and schizophrenia and is thus frequently used by correctional psychologists in dealing with mental health problems.

However, as is the case in most settings, psychologists may choose from a variety of intervention techniques and can use their professional judgement in selecting the most appropriate therapeutic approach to address an individual offender's mental health needs.

The single biggest challenge facing the correctional system in the next few years is the increase in the numbers of offenders that will result from proposed legislative changes such as expanding the list of crimes that carry mandatory minimum sentences to include drug offences and to the end of Statutory Release. As the population of offenders swells in the system, more offenders with mental health problems will enter the system and have more difficulty earning early release. This will place an additional burden on the correctional system and an increasing role for psychologists.