Trauma within the jail and prison environment: The effects of incarceration on men's mental health

Background: The prevalence of mental health problems is disproportionately high among jail and prison inmates. Over half of inmates have a recent history or symptoms of mental health problems, but less than one-third receive treatment while incarcerated. Research suggests that mental health problems may worsen during incarceration; however, there is a lack of understanding of the effect of the correctional environment on mental health and inmates' perceptions of trauma. Methods: Qualitative interviews were conducted as part of a mixed-methods evaluation of a trauma-specific intervention for homeless men with substance abuse and a history of trauma. Participants were receiving residential or outpatient substance abuse treatment at Palladia. Interviews focused on participant background, drug use, and history and perceptions of incarceration. Interview notes were coded and analyzed using pre-identified themes and themes emerging from the data. Results: Participants (N=21) described experiencing acute and chronic trauma during incarceration. Acute trauma included interpersonal violence inflicted by inmates or correctional officers (“Violence became normal procedure”), and inadequate medical treatment. Chronic trauma included feelings of loneliness or fear, separation from family, and the effects of solitary confinement (“You walk around in circles like a caged animal”). A small subset of participants reported being unaffected or desensitized by their prison experience. However, most described experiencing multiple traumas with prolonged effects on their mental wellbeing (“You're damaging what you're gonna let back into society”). Conclusions: Findings suggest that the jail and prison environment is associated with significant traumas and may negatively impact on the mental health of inmates.