Measures needed for mental distress behind bars

In the recurring debate on the conditions in which the prison population is condemned to survive there is always a stone guest: mental distress. The psychiatric emergency in penal institutions - which affects inmates but also reflects on directors, officers, legal and educational officials, medical staff and volunteers - is a looming but invisible presence, which everyone knows but few mention. For many analysts, experts and politicians, the subject is taboo because, 11 years after the closure of the judicial psychiatric hospitals and faced with the agony of the residences for the execution of security measures - which have taken their place -, no one or almost no one knows what to do.

Yet, in its 2009 Handbook on Prisoners with Special Needs, the United Nations Office on Drug Control and Crime Prevention identified eight groups of special needs prisoners worldwide who are motivated by a situation of particular vulnerability: in first place are those with (plural) psychiatric care needs.

Little or nothing has changed in recent years. Not least because - in the removal of the problem, which is not emergency but structural - much is affected by the fact that statistics for inmates with psychiatric care needs are not systematically collected. And so no one actually knows how many inmates with mental and psychiatric distress there are and their rate of severity. Antigone's latest report on prison conditions states that mental distress is greater among women than among men. Female inmates with serious psychiatric diagnoses accounted for 12.4 per cent of the admissions in the institutions visited by the Association, compared to 9.2 per cent in the overall survey. Women who regularly used psychotropic drugs accounted for 63.8% of the admissions, against 41.6% overall.

Can, therefore, that overall figure - 9.2 serious psychiatric diagnoses for every 100 prisoners - be reliable? Absolutely not, because if it were - on a population that today fluctuates around 61,000 against a maximum capacity of 51,234 - there would be little or nothing to worry about. Instead - as Antigone recalls - "it is becoming a prison of madmen".

The social-health agencies - which are supposed to manage the health area in the institutes - rarely hire or contract full-time psychiatrists and thousands of cases escape diagnosis. The aleatoriness of some statistics, in the face of the naked reality, is also testified by what magistrate Roberta Palmisano - former director of the Study Office of the Department of Penitentiary Administration - writes in no. 3 of 2015 of 'Rassegna penitenziaria e criminologica'. Palmisano recalls that a study involving six regions on the health needs of 16,000 inmates (1/3 of the prison population at the time) revealed that the problem of mental health afflicted more than 40 per cent of inmates.