Is There Mental Health Help If You’re in Prison?

Medically Reviewed by Sabrina Felson, MD on May 06, 2022
5 min read

Tim Deal of Dorchester, Massachusetts, was 17 years old when he got in a fight that would change the trajectory of his life. When an altercation broke out at his house, he grabbed a knife and ended up killing the other man. He was charged with second degree murder and given 15 years to life in prison. Deal would go on to serve nearly 2 decades, much of it in a maximum-security facility.

But once in prison, he began to turn his life around. He completed his high school equivalency. He became a math tutor for other prisoners at the Department of Corrections. He helped found the Youthful Offender Coalition at Massachusetts Correctional Institution at Norfolk and was a board member of the African American Coalition Committee. He recalls when the mother of the man whom he killed even advocated for his release.

According to Deal, he did everything he could to be a rehabilitated inmate. But 15 years into his sentence, he didn’t make parole. “I was distraught, crying,” he says, “and then a few months later my father passed away and I wasn’t allowed to attend his funeral.”

When Deal sought mental health care, he says he was told by the prison that he needed to be having a “dramatic event” in order to see a counselor. He says that prisoners like himself often suffered mentally and didn’t get the care they needed.

“[Prison] can be a really dangerous environment watching people get stabbed, watching people overdose,” Deal says. “None of that is normal, and it takes a toll on mental health.”

Shannon Scully is a senior advisor for justice and crisis response policy at The National Alliance on Mental Illness. She says that this isn’t uncommon, considering that 3 in 5 people with a mental illness do not receive treatment while they’re incarcerated in a state or federal prison.

“The No. 1 complaint we hear from those who have been imprisoned and their family members is that care isn’t widely available,” Scully says.

Still, some states are better than others at providing mental health care for prisoners. And it really depends on where you’re in prison.

Arizona, Alabama, and Mississippi, for example, have pending lawsuits against them for mistreatment of prisoners, and one of the top complaints is that there’s little available treatment for mental health issues. “We often see inmates with mental health problems placed in solitary confinement,” says Scully, “which perpetuates the condition.”

She says that all states face their challenges, but in certain parts of the country, care is improving. According to a recent survey from the watchdog group Disability Rights Oregon, mental health conditions in that state are vastly better than they were just a few years ago. The survey found that inmates at Oregon State Penitentiary were able to access more effective and confidential mental health care.

According to Scully, inmates facing mental health issues should be able to put in a request with their corrections officer for care. Although it’s up to those officials whether or not they receive it. If there’s an ongoing criminal case, they may also be able to seek help getting mental health care from their attorney or public defender.

 

Family members who are concerned about a loved one in prison can also contact the medical staff at the facility to request care. But Scully says that again, it’s up to that facility and the family member whether or not they get help. In some cases, the facility may cite The Health Insurance Portability and Accountability Act, widely known as HIPAA, as a reason to keep the inmates’ medical care private.

“The facility also individually screens inmates so even if you had a mental illness on the outside, it doesn’t mean they will receive the same care on the inside,” Scully says.

Vincent Atchity is the president and CEO of Mental Health Colorado and founder of the nonprofit Care Not Cuffs. He says that this lack of coordination between the inside and outside creates a crucial breakdown in care for inmates that sometimes desperately need it.

“In some cases that means once imprisoned, inmates are forced off of the medications that may have been sustaining their well-being,” Atchity says. “They may be screened again once imprisoned, and the facility may prescribe a medication, but it might not be the same one that the individual is used to taking.”

Atchity says that family members concerned that their loved ones aren’t getting good care shouldn’t be afraid to advocate for help. Each state has an organization that’s designated by law to be an oversight for jails and prisons. Run by The National Disability Rights Network, these groups may have more access to the facility and, in some cases, they can use their watchdog role to advocate for prisoners.

They may also seek to improve conditions, as in the case of Oregon State Penitentiary. In another case in 2015, Disability Rights Network of Pennsylvania sued The Pennsylvania Department of Corrections regarding mental health care. In a settlement, the PDC agreed that patients with serious mental health problems would “receive enhanced mental health care” instead of being placed in solitary confinement.

Still, in many cases, experts contend that mental health care for incarcerated people is inconsistent and in some cases, inadequate.

That was the case for Deal. He’s still adjusting to life on the outside since his release in July 2021. Today, he’s taken a paid fellowship with the Transformational Prison Project, a group led by four former inmates that meet with prisoners at Massachusetts Correctional Institution at Norfolk, Massachusetts, where Deal once served time. To support healing, the group allows inmates to discuss their personal trauma with fellow inmates in the group. It’s a way for those on the inside to provide mental health care for one another.

And for Deal, it’s a chance to help those whom he thinks need it most.