THE PREVALENCE OF POST TRAUMATIC STRESS DISORDER IN AMERICAS INMATES AND WHAT CAN BE DONE

By Sean R. Francis, MS

President

Justice Solutions of America, Inc. 

It has been estimated that one in seven inmates in Western countries suffers from some form of mental illness ( Goff, et al, 2007). There is also significant evidence that many if not most prison inmates have suffered some form of abuse or neglect as children. Therefore, the prevalence of Post-Traumatic Stress Disorder in the inmate population is likely much higher than in the general population.

Furthermore, older inmates  expeirance significantly higher rates of mental health conditions such as depression, mania and PTSD ( Flatt, et al, 2017). Older adults in the criminal justice system may be at an even greater risk for PTSD due to the high prevalence of early-life trauma and the impact of lifelong stress on this population. According to the cumulative advantage/ disadvantage theory, the cumulative effects of experiencing trauma and stressful events over the life course may heighten the risk for poor physical and mental health in later life. It may also increase the risk for subsequent and reoccurring health problems and social disadvantages (poor health, disability, poverty, home- lessness, discrimination, and violent trauma) over the life course. Criminal justice-involved older adults may be more likely to have experienced several traumatic and stressful life events ( Flatt, et al, 2017). 

However, people facing difficulties from post-traumatic stress do have options to help them deal with these issues. One treatment option that is showing promise is group therapy. While this method is not recognized as a “first line” treatment option by the professional community it is becoming increasingly relied upon in settings, like in the Veterans Administration, where the rate of PTSD among patients is very high (Sloan, et al, 2012). 

Group therapy has been found to help patients interact with others who have gone through a similar expeirance. This allows the group to support each other and allows the patient to begin to trust others and not socially isolate (Sloan, et al, 2012). Generally, there are three types of group therapy treatment models, psychodynamic, interpersonal and cognitive behavioral therapy (Sloan, et al, 2012). 

Another treatment model that has been successful with PTSD patients is the prolonged exposure method. Specifically, this has been highly effective for victims of assault related PTSD (Zoellner, et al, 2003). Prolonged exposure therapy involves the patient confronting their traumatic memory or memories (Zoellner, et al, 2003). The client exposes themselves to situations that they are avoiding due to trauma. This can include in vivo exposure and imaginal exposure (Zoellner, et al, 2003). 

Medication is also used as a treatment method quite frequently. Often patients suffering from PTSD also suffer from depression and anxiety disorders (Tetyana, 2017). Serotonin reuptake inhibitors (SSRI) medication has proven useful in treating these issues and helping those suffering from PTSD overall. Additionally, antipsychotic and benzodiazepines medication has been found to be useful in treating patients suffering from PTSD. Whether medication is appropriate or not depends on the patient’s motivation, preference and severity of symptoms (Tetyana, 2017). 

Medication is often used in conjunction with a treatment method like eye movement desensitization and reprocessing ( EMDR). This treatment method is often used for combat veterans. EMDR attempts to reprocess the traumatic event or events that cause negative thoughts and feelings. The patient will focus on the traumatic event while moving their eyes back and forth. The goal of EMDR is to reduce the stress and trauma. Over time the traumatic memories should start to fade (Tetyana, 2017). 

Cognitive therapy is a huge treatment model used for multiple psychological issues including PTSD. The goal of this treatment model is to identify thinking errors and correct them (Tetyana, 2017). CT therapy is used for managing traumatic memories and the persons perception of the world around them (Tetyana, 2017). This treatment model is viewed as time sensitive. Often clients are recommended to attend treatment weekly while engaged in this process (Tetyana, 2017). 

In conclusion, post-traumatic stress disorder is a prevalent mental illness in our society and in our prisons. However, multiple treatment methods exist that can help control the symptoms and offer people relief.

References
Sloan, D. M., Bovin, M. J., & Schnurr, P. P. (2012). Review of group treatment for ptsd. Journal of Rehabilitation Research and Development, 49(5), 689–701.
(2013). Living with PTSD [Video file]. Healthily. Retrieved October 25, 2020, from Kanopy.
Zoellner, L. A., Feeny, N. C., Cochran, B., & Pruitt, L. (2003). Treatment choice for
ptsd. Behaviour Research and Therapy, 41(8), 879–886. https://doi.org/10.1016/S0005- 7967(02)00100-6
Tetyana, S. (2017). Effectiveness of ptsd treatments for military service members and veterans. Psihosomatična Medicina Ta Zagalʹna Praktika, 2. https://doi.org/10.26766/pmgp.v2i4.73
Goff, A., Rose, E., Rose, S., & Purves, D. (2007). Does ptsd occur in sentenced prison populations? a systematic literature review. Criminal Behaviour and Mental Health, 17(3), 152–162. https://doi.org/10.1002/cbm.653
Flatt, J. D., Williams, B. A., Barnes, D., Goldenson, J., & Ahalt, C. (2017). Post-traumatic stress disorder symptoms and associated health and social vulnerabilities in older jail inmates. Aging & Mental Health, 21(10), 1106–1112. https://doi.org/10.1080/13607863.2016.1201042

Oct 30th, 2020