Kaufman E
Am J Psychiatry. 1980 May;137(5):566-70. doi: 10.1176/ajp.137.5.566.
The author evaluated psychiatric care in three U.S. prison systems. Major problems included limitations imposed by prison architecture, inadequate staff, medication prescription and distribution by unlicensed, untrained personnel, and a punitive rather than therapeutic attitude. Following the standards of care recommended by American Correctional Association would correct most of these problems. Psychiatrists should guard against prescribing unnecessary medications, particularly minor tranquilizers and sedatives, and should be concerned with prison conditions conductive to mental illness, particularly overcrowding, abuses of solitary confinement, and inadequate programs for inmates who are mentally disturbed but not overtly psychotic. The author recommends minimum staffing standards and suggests considering the transfer of mentally ill inmates to appropriate psychiatric hospitals outside the prison system.
作者评估了美国三个监狱系统中的精神科护理情况。主要问题包括监狱建筑造成的限制、人员不足、由无执照、未受过培训的人员进行药物处方和分发，以及惩罚性而非治疗性的态度。遵循美国惩教协会推荐的护理标准将纠正这些问题中的大部分。精神科医生应避免开具不必要的药物，尤其是小剂量镇静剂和安眠药，并应关注导致精神疾病的监狱条件，特别是过度拥挤、单独监禁的滥用，以及针对精神错乱但未明显精神病的囚犯的项目不足。作者建议了最低人员配备标准，并建议考虑将精神病囚犯转移到监狱系统外合适的精神病医院。
