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Some Inmates Cannot Be Helped

A prison psychiatrist names John who recently moved to California with his wife planned to set up a private practice upon his arrival. Private practices however gratification one can get it can be all-consuming. In the need for cash flow, he got a job at a men’s prison which he found to be much easier. At a prison there are guard towers everywhere and several armed guards, the prison’s compound is fenced by a 20-foot chain-link fences with a coiled razor on top. There is an electric wire between the two fences to ensure that nobody gets out.

Before he gets to work he gets ‘em “pads” which is a garage-door-opener that is specific to his office. This is for safety precautions in the event that an inmate makes at attempt to assault me, hitting the pads alerts officials of the danger and about 15 custody officers will be there to assist in moments. He confirms that he is probably only used in twice in 20 years. Due to the sensitivity, he has occasionally hit it without intending to do so which results in having to buy the officers doughnuts.

In a day he can see about 8 to 12 inmates who come to his office every 30 to 45 minutes; a custody official will make an announcement on the PA for each inmate to come to my office. The inmate is then patted down to make sure they have no weapons on their person. He then meets them at the door and most of them the time the consultations are friendly 80% of the time. Some of the inmates will try to feign mental illness in order to avoid being transferred to a prison out of state to Arizona, Mississippi, etc. The inmates could also be gang members and they would like to do free time and easy time and would like to avoid dangerous situations. Some inmates are so determined to stay within the confides of the mental-health program, they will go so far as to scratch their wrists, claim to have chronic pain; depression and or claim to be having hallucinations.

Inmates have a tendency to lean on typical accusatory terms like “You’re just as bad as the cops” all in an attempt to get the medication that they want, which could either be inappropriate and or addictive, whilst some of the other inmates are antisocial, a young man he met with the other day who had little guilt or remorse and was proud of his toughness and how people were afraid of him. The psychiatrist is of the opinion that these guys are in actual fact struggling with dealing with the consequences of their impulsive behavior. They only have to deal with their emotions because they were caught.

He is very hesitant to write off anybody, he believes that he would rather be swept up in a lie in order to not make sure nothing is missed. To avoid making mistakes it is better to act cautiously. Usually he will ask a cell-custody officer on their observations of an inmate’s behavior which can then give him an insight on how depressed the inmate could be. As prison psychiatrists they spend a lot of their time assisting inmates deal with their feeling and teaching them the right ways to deal with their anger. Usually inmates can fly into a rage, whilst yelling profanity or they hit a guard or an inmate. They have a task of teaching inmates the basics like impulse control, learning how to delay gratification, basically things they would have learned as a kid like how not hit someone when they are angry.

The clients he is most able to help are those that are struggling with depression, anxiety, or psychiatric disorders like bipolar disorder or schizophrenia. Most inmates who suffer such levels of depression are those who are struggling with dealing with disappointing their families. In most cases these inmates have previously had drug or alcohol problems and once the drugs and alcohol are out of their system they feel remorse. In most cases these are the inmates they can make the most difference with, particularly with the use of medical and brief psychotherapy and counseling.

Prison only makes difficulties that an inmate felt before prison worse particularly because they will be having trouble with coping and dealing with the rules in prison. Being away from their families only adds to the difficulties and further to that not having anybody to open up to. There has been an inmate who successfully committed suicide, he had been convicted of killing his wife who had been cheating on him. It took him twenty years for him to come realization that he was wrong and had no right to kill her. His failure to forgive himself lead to him killing himself. As a psychiatrist you must be prepared to lose a life just like a doctor is bound to lose a patient.

Long term inmates who had been in prison for a long time have taught him four things on what they do to survive:
  • They have to exercise regularly;
  • They have to read;
  • They learn a new language(inmates have found it helpful to develop a spiritual program); and
  • Having friends (most prisons have cliques like blacks hang with blacks and whites hang with whites, etc).


These four survival tips could be extended to the prison staff as the environment is naturally negative and oppressive. The psychiatrist, John tries to be realistic and helps each person as much as he can by not alienating them even if they can’t be helped. One of the questions he likes to ask his patients is if they feel like they have anyone who loves them in their lives. In most circumstances the inmates look at him like he is crazy for thinking that love exists. He also believes that one in five inmates had a good family that loves him, people who care and they feel terrible about letting them down so they are motivated to change their life.

For more information about mental illness