Lived experience of psychosis within prison institutional settings

Epidemiological studies consistently commonly claim high prevalence rates of ‘mental disorder’, including experiences of psychosis, within prison environments. While the methodological limitations of these claims are open... [ view full abstract ]

Epidemiological studies consistently commonly claim high prevalence rates of ‘mental disorder’, including experiences of psychosis, within prison environments. While the methodological limitations of these claims are open to critique, what cannot be denied is that prisons represent sites for considerable psychic distress, including phenomena that could be termed as being psychotic in their nature. The experience of psychosis is informed by the psychological and social environment in which individuals find themselves; prisons therefore represent institutional environments where an understanding of individual psychic distress, and the manner in which it could be supported, is in great demand.

In the current paper I seek to explore in greater detail the lived experience of psychosis within a prison environment. I will propose that an act of ‘emotional labour’ is undertaken by individuals in such environments that requires a finely balanced negotiation of psychological and social understanding in relation to personal experience in the act of constructing of new narrative understandings regarding the sense of personal identity as ‘moral self’, as well as ideas in relation to a ‘hoped for future.’

Building on the above, I will reflect on my own practice to consider the role that ‘professionals’ working in forensic institutions may occupy in relation to the described process of ‘identity work’. The place occupied by various treatment modalities, as well as the institutional environment itself, in supporting this process will be commented upon.

In closing, I want to propose that adequately resourced and supported prison environments can, in some cases, provide a powerfully containing institutional setting that allows individuals to address elements of psychic distress and construct new narrative identities as they move on to an alternative future. The limitations of this argument will be highlighted before a call for further research and greater understanding is made.