Monday, September 23, 2013

Bipolar in Prison

Research into a connection between bipolar disorder and crime is inconclusive. There is no solid evidence that bipolar people are any more inclined toward criminal behavior than those who are not bipolar. But if bipolar people do become violent from time to time, psychiatric care should address the problem. 

Yet according to the National Institute of Mental Health (NIMH), "… People with serious mental illness are frequently arrested for minor offenses, many times as a result of homelessness, and then they are incarcerated in jails where their mental health needs are not met. There are also significant numbers of persons with serious mental illness who come in contact with the police but are not arrested."

Bipolar people are most likely to attract police attention if they are in an extreme manic state, behaving in disruptive or illegal ways. If they do break the law while manic and are arrested, they may be funneled to a psychiatric facility rather than to prison.

Suspects who are manic and irrational despite being on medication are in a more precarious position than those who are off their meds and will cease irrational behavior when they resume medication. Agreeing to take their meds as prescribed may gain them a degree of leniency if they are arrested.

Unfortunately, bipolar prisoners may be misdiagnosed and prescribed meds for a mental disorder they do not have while being denied the meds they need. Prison authorities may continue to deny correct medications and provide the wrong ones even after the prisoner's family and own doctor try to interfere.

Bipolar prisoners who are not appropriately medicated are at risk for becoming violent and irrational even if they were not manic when arrested. On the other hand, if they have been abusing alcohol and drugs, a stay in prison will force them into cold-turkey withdrawal. When they are later released, they may not return to those addictions.

As our society tries to cope with people who have mental disorders and break the law, some police receive training in how to deal nonviolently with irrational suspects. There are even prisons, although not enough of them, that provide therapists for prisoners who need them.

Bipolar prisoners' problems are not necessarily diminished when the prison term ends. Back in the general population, a bipolar ex-prisoner needs a safe, healthy place to stay. Some will go home to people who love them. But others may return to halfway houses or to the streets. Ideally, prisons would provide counseling for recently released prisoners, but let's not hold our breath waiting for that to happen.

Meanwhile, people with bipolar friends and relatives should encourage them to seek and maintain a relationship with a doctor skilled in working with bipolar patients.