Mental health in our prisons, Part 1
Understanding behavior is the key to effective management
Part 1 of a series
Mental health in our prisons, Part 2: Dispelling the myths of mental health
By Ruth D. Nirenberg, PsyD
Aggression is an outlet for many problems, both intrapersonal and interpersonal. Inmates and probationers who present as provocative often have no other means for communication. Though this clearly does not excuse or justify their behavior, understanding what is simmering under their anger can help us manage it more effectively.
The first step is to acknowledge that what is otherwise labeled as ineffective or destructive by the system and society may actually be very effective and productive for the individual. For example: when one inmate physically attacks another, resulting in either injury or isolation of the aggressor, one may question the motive behind the attack. In fact, the resulting separation from the general population may have been the desired outcome for any number of reasons, but the only known means of bringing about that result was through aggression. Until one looks closer at why the isolation was needed, the inmate will never have the opportunity to learn other means of modulating and expressing their needs more safely.
|(AP Photo/Troy Maben)|
Secondly, we need to understand that these styles of communication and interaction developed in settings and as results of life circumstances that required survival. Returning to the example of the fight, in any community, one learns their role and the skills needed to survive in it. As a means of preservation on the streets or in jail, someone may present aggressively. Until the individual roles in the community and the rules of survival are replaced with different ones, they will continue to be re-enacted.
What is simmering under the anger? Any of a number of psychological problems could be at the root: depression, trauma, anxiety, psychosis. Sometimes these difficulties are compounded by drug use, social stressors and possible cognitive or physical limitations. The fact is, while police and COs are not expected to diagnose and treat someone in the forensic world, they are eyes andthe front-line professionals observing and interacting with the problems.
So what can be done?
Revisiting the example: Suppose Inmate A attacks Inmate B, with full knowledge of their own smaller stature and likelihood of being hurt, restrained and isolated subsequent to the attack. Inmate A manages to sustain minor injuries before being restrained by CO and taken to the infirmary or a lockdown cell to recuperate.
Rather than reliving this scenario weekly with frustration on the part of the COs for Inmate A's lack of behavior change (and the inmate's own increasing vulnerability), consider the following: Inmate A was feeling overwhelmed psychologically and needed time away from the general population. Inmate A’s pre-jail experience, in his/her family and community of origin, discouraged verbal expression of emotion and otherwise labeled him/her as weak. The secondary gain to being involved in a fight and sustaining injury becomes two fold: (1) protecting against the stigma of weakness and (2) securing the safety and care originally desired due to feeling psychologically overwhelmed.
If front-line professionals witnessing the above scenario can consider and incorporate this underlying knowledge in their daily interactions with probationers or inmates, subsequent interventions can include more than routine procedures. Acknowledging thoughts, beliefs, and emotions which motivate behaviors can shift the purpose a given behavior serves.
If Inmate A has alternate venues through which to safely express his/her feeling of weakness or need for separation and if professionals in the inmate’s setting are able to redirect his/her behavior, the attack can be averted and the desired safety still secured.
This process is neither easy nor instant, but with police and COs providing immediate setting interventions and mental health professionals being involved for more long-term underlying support, collaborative services can benefit the population in question as well as the larger community in which we all live.
The Mental Health Series will address various topics and ways law enforcement officers can interact with individuals impacted by mental illness, identify basic underlying issues, and collaborate with other providers in the system to effectively improve inmate and probationer functioning, both in the jail and the larger community settings.
Readers are encouraged to send in questions or specific examples to be directly answered and addressed by mental health professionals.
About the author
Dr. Ruth Nirenberg is a New York State Licensed Psychologist, distinguished as a trainer on multiple topics related to mental health, professional development, and interdisciplinary work. As a New York State Municipal Police Training Council Certified Mental Health Instructor, Dr. Nirenberg has been an annual speaker at the Office of Child and Family Services (OCFS) Corrections and Youth Services Association (CAYSA) Region IV Conferences and works collaboratively with various police departments throughout Westchester County on training and community service initiatives.