Nav: Home

How to treat depression in prison -- and why it matters

February 21, 2019

Of the 4 million prisoners released each year, 23 percent have suffered from major depressive disorder. Due to resource shortages, many go without adequate treatment while in prison. Oftentimes they rejoin society in worse mental shape than before their incarceration - which could be prevented with the right care. A team led by Michigan State University has found a cost-effective way to improve mental health in prisons.

The research, published in Journal of Consulting and Clinical Psychology, tested the effectiveness of interpersonal psychotherapy for inmates battling major depressive disorder, or MDD, as a strategy to bring affordable treatment into a prison setting. It 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."

About 2.3 million people are incarcerated every day, and if they too suffer from depression, addiction or other disorders, they often do not get the help they need. Prison funding for mental health care is determined by state legislatures, which often leaves them understaffed and under-resourced, Johnson explained. Voters may be unsympathetic, which creates a deficit for mental health treatment in the prison system - which houses many people with untreated mental illnesses.

To address the issues of care and cost, Johnson and colleagues trained a team to treat 181 inmates through interpersonal psychotherapy, or IPT. 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.

Johnson explained that IPT is one of the most-effective forms of therapy because it addresses difficult life events, which consistently burden prison populations. She explained 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 reduced the cost of treatment. Inmates were individually assessed at the beginning of the trial, after the trial ended and then three months later to see if the therapy had a lasting impact.

"As compared to the usual treatment prisons offer, IPT reduced depressive symptoms, hopelessness and PTSD symptoms and was better at ending cases of major depression," Johnson said.

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, she said.

"This is the first large randomized study for major depression ever conducted for an incarcerated population, one that found an effective and cost-effective solution," Johnson said. "This method could drastically improve the mental well-being of people while in prison - and when they re-enter the world."

Moving forward, Johnson will continue researching ways to treat inmates by conducting the first large randomized suicide prevention trial for people leaving the criminal justice system.
-end-
(Editor's note: Please include a link to the original paper in online coverage: https://psycnet.apa.org/record/2019-05660-001?doi=1)

Michigan State University

Related Depression Articles:

Tackling depression by changing the way you think
A thought is a thought. It does not reflect reality.
How depression can muddle thinking
Depression is associated with sadness, fatigue and a lack of motivation.
Neuroimaging categorizes 4 depression subtypes
Patients with depression can be categorized into four unique subtypes defined by distinct patterns of abnormal connectivity in the brain, according to new research from Weill Cornell Medicine.
Studies suggest inflammatory cytokines are associated with depression and psychosis, and that anti-cytokine treatment can reduce depression symptoms
Studies presented at this year's International Early Psychosis Association meeting in Milan, Italy, (Oct.
Is depression in parents, grandparents linked to grandchildren's depression?
Having both parents and grandparents with major depressive disorder was associated with higher risk of MDD for grandchildren, which could help identify those who may benefit from early intervention, according to a study published online by JAMA Psychiatry.
Postpartum depression least severe form of depression in mothers
Postpartum depression -- a household term since actress Brooke Shields went public in 2005 about her struggle with it -- is indeed serious.
Tropical Depression 1E dissipates
Tropical Depression 1E or TD1E didn't get far from the time it was born to the time it weakened to a remnant low pressure area along the southwestern coast of Mexico.
Diagnosing depression before it starts
MIT researchers have found that brain scans may identify children who are vulnerable to depression, before symptoms appear.
Men actually recommend getting help for depression
Participants in a national survey read a scenario describing someone who had depressed symptoms.
Depression too often reduced to a checklist of symptoms
How can you tell if someone is depressed? The Diagnostic and Statistical Manual of Mental Disorders (DSM) -- the 'bible' of psychiatry -- diagnoses depression when patients tick off a certain number of symptoms on the DSM checklist.

Related Depression Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Digital Manipulation
Technology has reshaped our lives in amazing ways. But at what cost? This hour, TED speakers reveal how what we see, read, believe — even how we vote — can be manipulated by the technology we use. Guests include journalist Carole Cadwalladr, consumer advocate Finn Myrstad, writer and marketing professor Scott Galloway, behavioral designer Nir Eyal, and computer graphics researcher Doug Roble.
Now Playing: Science for the People

#530 Why Aren't We Dead Yet?
We only notice our immune systems when they aren't working properly, or when they're under attack. How does our immune system understand what bits of us are us, and what bits are invading germs and viruses? How different are human immune systems from the immune systems of other creatures? And is the immune system so often the target of sketchy medical advice? Those questions and more, this week in our conversation with author Idan Ben-Barak about his book "Why Aren't We Dead Yet?: The Survivor’s Guide to the Immune System".