Around 4 million prisoners are released each year, and 23 percent of these have suffered from major depressive disorder (MDD). Due to a general lack of funding for mental health treatment in prison, these individuals often rejoin society in worse mental condition than before their incarceration.
But a new study led by Michigan State University shows that this scenario can be prevented with a cost-effective treatment approach designed specifically to improve mental health in prison.
The research, published in the Journal of Consulting and Clinical Psychology, tested the effectiveness of interpersonal psychotherapy (IPT) for inmates battling MDD as a strategy to bring affordable treatment into a prison setting. The study is the first large randomized trial of any treatment for MDD, including therapy or medications, in any incarcerated population.
“About 15 million people touch the criminal justice system each year in the United States,” said Jennifer Johnson, lead author and professor of public health in MSU’s College of Human Medicine. “Most of us have friends, family or neighbors who have been through this system. The fact we’ve waited until 2019 to conduct a trial like this means we’ve understudied and underserved a huge population.”
Prison funding for mental health care is determined by state legislatures, which often leaves them understaffed and under-resourced, Johnson says. In addition, voters may be unsympathetic, which creates a deficit for mental health treatment in the prison system — which houses many people with untreated mental illnesses.
For the study, Johnson and colleagues trained a team to treat 181 inmates through interpersonal psychotherapy. The team included master’s level health therapists working in the prisons and bachelor’s level re-entry counselors. This allowed the researchers to keep costs down by extending the reach of counselors and care without having to hire new mental health professionals.
IPT is one of the most-effective forms of therapy because it addresses difficult life events, which consistently burden prison populations, says Johnson. She explains that traumatic and challenging experiences — such as assault, abuse, poverty, death of loved ones and loss of family members, children and friends — are overwhelmingly present with those incarcerated.
“When practicing IPT, you go back to when someone’s depressed mood began and talk about what was going on in their life at that time,” Johnson said.
“IPT deals with relationships, feelings, conflicts with others, life changes and grief. Using this therapy, you’re helping people feel and express emotions, and problem-solve with them in ways to improve communications or improve relationships that address the original problem.”
Counselors worked in a group-setting with inmates twice a week for 10 weeks, which lowered treatment costs. Inmates were individually assessed at the beginning of the trial, after the trial ended and then again three months later to see if the therapy had a lasting impact.
Using IPT proved a low-cost intervention as well. Once counselors are trained and supervision is no longer needed, the cost per patient would be $575 — significantly less than treatment options outside of prison, Johnson says.
Source: Michigan State University