Societal Obligations for Mental Healthcare Provision in Correctional Facilities: An Ethical Approach
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Author
Holladay, Grace Anne
Subject
Washington and Lee University, Shepherd Poverty Program
Prisoners -- Mental health services
Capabilities approach (Social sciences)
Mentally ill -- Treatment
Discrimination in mental health services
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Capstone; [FULL-TEXT FREELY AVAILABLE ONLINE] Grace Ann Holladay is a member of the Class of 2021 of Washington and Lee University. The prison system has increasingly come under scrutiny due to poor conditions, racial inequalities, privatization, and overcrowding. Moreover, increasing numbers of incarcerated individuals are being released in response to the COVID-19 pandemic. We may be on the precipice of restructuring our prison system. Many prison systems have decreased their populations over the past year due to the pandemic through mild decarceration and fewer arrests and admissions (Macmadu et al.). An Arizona report found that their state prison system could save $1.4 billion over the next ten years by enacting an expanded release policy that could decrease prison populations by over 20% (Forslund). As such, investigating better ways to provide mental healthcare to incarcerated individuals could provide needed structure as changes to the criminal justice system begin to occur. With the pressing nature of future changes in mind, this essay investigates the essential question that must be answered when structuring a correctional healthcare system: What ethical and moral obligations does society hold to provide incarcerated individuals with healthcare access and resources, especially in the realm of mental healthcare? This essay conducts a systematic literature review to evaluate the existing state of mental healthcare in correctional facilities in terms of health outcomes, legal precedents, and current policy. Using theories of justice described by John Rawls and Martha Nussbaum, this essay analyzes the medical, legal, and economic dimensions of existing correctional medicine. Thereafter, these ethical frameworks are applied to investigate the merits of the principle of equivalence, the theory underpinning correctional healthcare in many European countries. Ultimately, this ethical analysis supports the conclusion that a system based on equivalence could serve as an alternative to current practices in correctional medicine that addresses some of the existing ethical shortcomings. [From Introduction]