Physicians need to be advocates for prisoners' health

Providence, RI -- Physicians are an essential component of correctional institutions and have a responsibility to advocate for effective and humane treatment for inmates. This is the view expressed in a commentary published in the January 11 issue of the New England Journal of Medicine by Scott A. Allen, MD, and Josiah D. Rich, MD, MPH, physicians at the Center for Prisoner Health and Human Rights at The Miriam Hospital and Brown Medical School.

Citing the steady increase of incarcerated individuals in the United States that has resulted in record high inmate numbers, the authors point to the inadequate treatment of mental illness and addiction in the community as a source of the increase especially among women.

"The natural history of untreated addiction and mental illness often results in illegal activity, and persistently inadequate treatment perpetuates a cycle of crime and incarceration," says Rich. "The correctional system should view incarceration as an opportunity to link inmates with effective therapy such as mental health services, high-quality drug treatment, and support services for reentry into society upon release, if we ever expect to decrease recidivism rates."

The authors note that punishment is often favored over rehabilitation in many prisons, which may cause harm to a prisoner's physical and mental health. In addition, in situations where effective therapeutic services are available, they are often underused.

Statistics show that although 57 percent of inmates in state prisons reported using drugs during the month before committing their offense, only 20 percent participated in substance abuse programs while in prison. Federal prisons echo this trend with reports stating that of the 63 percent of inmates being held for drug offenses, only 15 percent participated in prison-based drug treatment programs.

The authors also support programs for non-violent offenders that would place them in res

Contact: Megan Martin

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