Exploring the Relationship between Prison Experience and Prison Misconduct among Inmates with Mental Health Problems: Are They Bad, Mad, or Unfortunate?
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An increasing number of inmates with mental health problems have become a critical challenge to the criminal justice system, and critical concerns regarding these inmates’ adjustment problems in prison have been stressed in both research and practice. Existing studies, however, primarily considered mental health problems as one broad construct encompassing many different mental disorders or symptoms, and compared inmates with and without mental health problems in examining risks of prison misconduct. Consequently, little is known about how mental illnesses and associated problems shape the risk of disciplinary behavior among inmates with mental health problems. The purpose of the current study was to broadly investigate a heterogeneous prison population to uncover embedded mechanisms of the relationship between mental health problems and prison misconduct. Specifically, the current study examined whether inmates’ misconduct was a manifestation of mental disorders or related to other individual risk factors, including victimization, substance abuse, and/or suicide attempts. Furthermore, it examined how incarceration experiences shape the relationship between individual risk factors and institutional rule-breaking behavior. The current study used self-reported data obtained from Survey of Inmates in State and Federal Correctional Facilities, 2004. The sample included state inmates with a history of various mental health problems (i.e., diagnoses of depression, psychoses, post-traumatic stress disorder (PTSD), anxiety disorder, or personality disorder, medication use, and hospitalization for mental health problems) during their life time (n = 4,246). To answer four research questions pertaining to the effects of inmates’ mental health problems, other relevant risk factors, and prison experiences on violent and nonviolent misconduct, univariate, bivariate, and multivariate analyses, including logistic and negative binomial regressions were conducted. The results showed that 21% of the inmates with mental health problems were written-up for violent misconduct and 49% received a nonviolent infraction. Findings of the current study revealed meaningful variations among inmates with mental health problems. Personality disorder was positively associated with the likelihood and number of violent infractions, net of controls. Additionally, having a history of depression, psychoses and hospitalization increased the rate of violent infractions and PTSD decreased the risk of violent misconduct, net of controls. At the same time, none of the mental health indicators were significantly predictive of nonviolent misconduct. Rather, other individual-level risk factors, such as substance abuse and victimization, significantly predicted increased risks of nonviolent misconduct. Interestingly, mental health treatment and program participation were associated with the increased risk of both violent and nonviolent misconduct, while work assignment in prison and visitation only reduced the risk of violent misconduct. Limitations of the current study and policy implications are discussed.