Mental Health First Aid Training in Prisons, Police Departments, and the Presidential Election

By Wendy S. Salkin

It has been widely reported and acknowledged that many incarcerated Americans live with mental illness. In 2014, the Treatment Advocacy Center and the National Sheriffs’ Association published The Treatment of Persons with Mental Illness in Prisons and Jails: A State Survey, a joint report that included the following findings:

  • In 2012, there were estimated to be 356,268 inmates with severe mental illness in prisons and jails. There were also approximately 35,000 patients with severe mental illness in state psychiatric hospitals. Thus, the number of mentally ill persons in prisons and jails was 10 times the number remaining in state hospitals.
  • In 44 of the 50 states and the District of Columbia, a prison or jail in that state holds more individuals with serious mental illness than the largest remaining state psychiatric hospital. For example, in Ohio, 10 state prisons and two county jails each hold more mentally ill inmates than does the largest remaining state hospital.

Similarly widely reported and acknowledged is that prisons often either cannot or simply do not serve the mental health treatment needs of those housed within their walls. As Ana Swanson of The Washington Post observed:

Unsurprisingly, many prisons are poorly equipped to properly deal with mental illness. Inmates with mental illnesses are more likely than other to be held in solitary confinement, and many are raped, commit suicide, or hurt themselves.

Solitary confinement is often used as a means of separating inmates living with mental illness from the rest of a prison population. As Jeffrey L. Metzner and Jamie Fellner reported in their March 2010 article, “Solitary Confinement and Mental Illness in U.S. Prisons: A Challenge for Medical Ethics”: Read More

When Law and Medical Ethics Conflict: The Case of Mohammad Allan

By Maayan Sudai

Mohammad Allan was an administrative detainee in Israel, a Palestinian who had been hunger striking since June 16 to protest his indefinite incarceration. Allan’s health has been deteriorating gradually, and the latest examinations raised concerns that he suffered irreversible brain damage. The crisis in Allan’s health created a tangle for the Israeli government, since releasing Allan was feared to serve as a precedent that would encourage more hunger strikes and symbolize submission to this type of protest, whereas force-feeding him might be considered unethical-illegal torture. This dilemma has brought a head-on clash between Israeli government officials and the Israeli National Medical Association, and led to an internal split between medical professionals regarding their positions on the ethics of the controversial practice of force-feeding.

In the midst of Allan’s health deterioration, the Israeli parliament passed a new law called “Hunger Strike Damage Prevention Act” also known as the “force-feeding law”. The law allows doctors to force-feed prisoners in immediate and imminent danger of irreversible severe damage or death, with a court order. The court could allow such force-feeding after hearing the prisoner (if possible) and an ethics committee recommendation. Moreover, the forced feeding should be carried out in a dignified manner, avoiding pain and suffering for the prisoner. It was declared that physicians will not be forced to comply with force-feeding under this law if they refuse.

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