The responsibilities of the state for the prevention and treatment of mental illness among prisoners.

There is mounting evidence that severe stress may produce profound psychophysiologic disturbances that can persist for many years. Imprisonment may be viewed as one such stress. The prison population has a high baseline incidence of mental illness, reflecting the societal groups from which most prisoners are drawn. The great stress of imprisonment may thus be a significant factor in the exacerbation of existing psychoses or in the precipitation of first psychotic episodes in certain prisoners. The responsibilities of the state in the prevention and treatment of mental illness among prisoners are not clear. United States Supreme Court rulings on sentencing procedures could be interpreted as requiring psychiatric evaluations of all prisoners. Furthermore, court rulings on the adequacy of medical care in prisons could be construed as requiring therapy for all prisoners suffering from major mental illnesses. Failure of the state to take reasonable steps to prevent and treat mental illness in the prison population may constitute cruel and unusual punishment under the Eighth Amendment of the Constitution.