Thomas Fagan

Thomas Fagan

Farquhar College of Arts and Sciences
Exploring Mental Health Treatment

A new book examining both the shortfalls and best practices of mental-health treatment for inmates in U.S. prisons has been co-edited by Thomas Fagan, Ph.D., associate professor and director of the Division of Social and Behavioral Sciences at the Farquhar College of Arts and Sciences.

Correctional Mental Health: From Theory to Best Practice was co-edited by Fagan and Robert Ax, Ph.D., a retired clinical psychologist formerly employed by the U.S. Federal Bureau of Prisons. It includes chapters on specific prison populations, such as juveniles and sex offenders, and examines the unique challenge of treating prisoners who are mentally ill.

The book discusses how the decades-old trend of de-institutionalizing the mentally ill and a lack of treatment for these patients once they are released into the community have resulted in homelessness, crime, and a growing prison population.

"During the past 30 years, the population of seriously mentally-ill people has moved from state hospitals to prisons. They end up in prison because we don’t have adequate treatment facilities for them in the community," Fagan said. 

While the number of beds at psychiatric hospitals has dramatically decreased during the past three decades, the percentage of prison inmates with serious mental illnesses has grown from about two percent to about 20 percent.

"The growing population of prisoners who have separate mental health needs wasn’t on anyone’s radar within the prison system 20 to 30 years ago," Fagan said. "Prison administrators were slow to recognize and address the needs of this population. Once in prison, many of these offenders were unable to follow institutional rules because of their mental illness and were punished for misbehavior with progressively longer periods of confinement in segregated housing, which frequently worsened their mental illness."

Other problems include inadequate training for mental-health professionals treating prisoners and a lack of cohesiveness and collaboration among what Fagan calls the "three silos" - the criminal justice, mental health, and correctional/prison systems.

"An overall theme of this book," Fagan explained, "is that academic institutions need to start preparing professionals to treat these prisoners. And, correctional administrators need to open their doors to academic professionals who can provide research expertise. We are trying to paint a realistic picture by presenting the problems, presenting what we know from research literature, and identifying the places where the best practices are working."

Contributors to the book include academic researchers, practitioners, and prison administrators. In addition, one chapter is co-authored by alumna Dyona Augustin, a 2009-2010 Outstanding Student who earned a Bachelor of Science degree in Psychology at the NSU.