Lewis C F
Department of Psychiatry, University of Connecticut Health Center, Farmington 06030-6410, USA.
Psychiatr Q. 2000 Winter;71(4):331-43. doi: 10.1023/a:1004684223522.
The population of prison inmates in the United States is rapidly growing; in 1994 it was estimated that 1.7 million Americans were incarcerated. Changes in the complexion of the prison population highlight the need for successful mental health interventions for special populations. Specifically, increasing numbers of women, middle aged inmates, physically ill inmates, and inmates with severe mental illness have challenged an already taxed system. Many inmates have complex pathology in which substance abuse, psychosis, affective disorders, personality disorders and medical illnesses play overlapping roles. One of the most challenging aspects of care involves management of inmates who are aggressive to themselves or others. This article discusses the approach to managing inmates with aggressive behavior and complex mental health issues. Specific diagnoses are discussed as are the general approaches best used to assess new onset violent behavior in a mentally ill prison inmate.
美国监狱囚犯的数量正在迅速增长；据估计，1994年有170万美国人被监禁。监狱人口构成的变化凸显了针对特殊人群成功开展心理健康干预措施的必要性。具体而言，女性、中年囚犯、身体患病的囚犯以及患有严重精神疾病的囚犯数量不断增加，这对本已不堪重负的系统构成了挑战。许多囚犯存在复杂的病理状况，其中药物滥用、精神病、情感障碍、人格障碍和疾病相互交织。护理工作最具挑战性的方面之一涉及对有自伤或伤人行为的囚犯的管理。本文讨论了管理有攻击行为和复杂心理健康问题的囚犯的方法。文中讨论了具体诊断以及评估患有精神疾病的监狱新发病例暴力行为的最佳通用方法。
