An anxiety disorder is considered to be a serious disease of the psyche. It can be of organic or psychological origin. Nowadays, its prevalence is high within correctional settings. This fact encourages policy-makers and clinicians to find new treatment options for the population within the justice system. This paper aims to research anxiety disorders among offenders. The review involves identifying the symptoms and methods of treatment. In particular, incarcerated juveniles and adults are subjects of this research. The urgency of the issue is in violent, antisocial and aggressive behaviors that often lead to the incarceration of individuals that affects their mental health. The role of healthcare providers is to consider these problems and find adequate solutions. Since offenders with anxiety disorders are in a risk group, mental disabilities may aggravate their conditions and give rise to mental health problems or exacerbate the existing ones.
Over the past few decades, individuals with anxiety disorder have experienced significant behavioral and mental health problems that affect the justice system. A large proportion of offenders enter correctional facilities having this health condition accompanied by substance abuse disorder. These individuals create management challenges since they have trouble adjusting to the established rules and regulations. They violate discipline and accumulate serious consequences more often than others. As a rule, while incarcerated, these individuals receive punishment for verbal threats, disorderly conduct, self-harm, destruction of property, refusal to follow directions, and others. These reported violations are evidence of their behavioral, emotional, and cognitive difficulties. This paper aims to research an anxiety disorder in offenders and provide information about the treatment reality in a correctional setting.
Cognitive-behavioral approaches are often used for offenders who suffer from anxiety disorders. Dialectic behavioral therapy (DBT) has supported them within the justice system and has shown particular results. In combination with the core therapeutic methods, such as skill training, exposure, problem-solving, contingency management and behavior therapy, and others, this approach changes individuals behavior and reshapes their cognition (Shelton, Kesten, Zhang, & Trestman, 2011). Dialectic behavior therapy focuses on teaching how to prevent maladaptive behaviors by developing self-management skills, interpersonal regulations, and emotional self-control. It is encouraged, coached and reinforced by healthcare social professionals. This therapy attempts to engage offenders in the treatment process, motivates them for change, and creates the relationship between the client and the therapist (Shelton et al., 2011). In fact, DBT has become the first empirical treatment method for anxiety disorders.
Studies reveal that half of all prisoners have at least one mental disorder, and all incarcerated individuals with anxiety disorders reach 30 percent as compared to 4 percent in the community population (Shelton et al., 2011). For example, 18.5 percent of juvenile girls are reported to have this problem unlike 12.9 percent of boys (Shelton et al., 2011). In the United States, such ethnic minorities as African Americans and Hispanics have the highest rates of anxiety prevalence among other populations. Moreover, they have not received treatment before coming to the juvenile justice system. Many studies suggest that there is a gender disparity among males and females since the latter are more likely to have anxiety disorder symptoms within correctional settings (Byron, 2014). Admittedly, those who have an opportunity to receive timely treatment recover faster than untreated mentally ill offenders.
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Kinds of Anxiety Disorders
It is a common fact that the justice system is a critical place for people with mental disorders, in particular with anxiety problems. The findings reveal that out of two million persons arrested annually in the USA, about 70 percent have a mental health disorder (Grigorenko, 2012). Many of them suffer from severe impairments. An anxiety disorder is a definite mental state characterized by specific symptoms that arise because of various problems or danger. Among the most common types of this condition, professionals distinguish panic disorder, generalized disorder, social anxiety disorder, and phobias. The main feature of the first one is recurrent panic attacks when patients experience sudden fear and discomfort associated with such symptoms as the shortness of breath, sweating, chest pain, palpitations, dizziness, dyspnea, tremor, and the fear of dying or getting mad (Grigorenko, 2012). Typically, it lasts from five to twenty minutes. Patients often mistakenly believe that they have a heart attack.
Generalized anxiety disorder is characterized by severe anxiety caused by various life situations. This type has a persistent nature, which is not limited to any specific environmental circumstances and does not have an explicit pattern. Symptoms of generalized anxiety disorder involve undefined restlessness constant in time. It is expressed as a state of internal stress and a foreboding of a disaster and threats, which are often triggered by minor conflicts and frustrating situations (Grigorenko, 2012). As a rule, offenders feel extremely uncomfortable in a correctional setting since they experience increased aggressiveness and constant internal stress that lead to disruptions in the functioning of the autonomic-endocrine system that makes them ready for a fight, which in turn increases the state of internal tension.
Furthermore, social anxiety disorder is expressed in the form of an excessive fear to face humiliation or embarrassment in front of other people what is a common thing in correctional facilities. For example, such persons cannot use public toilets, eat in the presence of people, and avoid public speaking among others. These multiple fears often lead to agoraphobia and severe restrictions. Next, simple phobias are a permanent strong fear of a specific object or situation, such as snakes, elevators, blood, flying on a plane, and others. Fear is not caused by an object itself, but by the consequences of getting into a certain situation (Grigorenko, 2012).
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The Treatment Reality in Correctional Settings
The treatment reality of anxiety disorders in a correctional setting differs from the one in ordinary life. As a rule, staying in prison gives rise to mental health problems, exacerbating the existing ones. The studies have shown that women are more prone to do harm to themselves or attempt to commit a suicide than man (Byron, 2014). Anxiety disorders can be effectively treated by rational conviction, drugs or both. Supportive psychotherapy may help a person understand psychological factors that trigger his or her problem, as well as learn gradually how to cope with them. Manifestations of anxiety are sometimes reduced by relaxation, biofeedback, and meditation. There are several types of drugs, allowing some patients to get rid of these painful experiences, such as excessive fidgeting, muscle tension, or the inability to sleep.
However, in terms of medical service, correctional facilities are often poorly equipped, and the staff often works in the absence of communication with other sectors of public health service. The literature reveals that the justice system does very little to successfully treat patients with mental disorders, in particular, anxiety conditions (Grigorenko, 2012). Therefore, in the USA, healthcare providers working in correctional facilities face many problems providing appropriate healthcare to offenders. At the same time, the administration of detention centers often cannot deal with health problems of offenders, poorly responding to their complaints.
Treatment for psychological disorders is as prevalent as for addiction in correctional settings. However, in most prisons, these issues receive little support from the authorities. As a result, their number is rising tremendously. This problem requires future research and legal concerns. Recent studies suggest that, if available, treatment works. However, poor psychiatric care for inmates is determined by its high cost (Byron, 2014). In general, offenders with mental illnesses and substance abuse problems receive one and the same treatment. The absence of the latter pushes them to homelessness, drifting, and a further mental decline after release. A great number of inmates released every year return untreated to society, and it does not only create problems for them, but also for others. Therefore, this condition should be changed in order to protect society from dangerous influences.
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Anxiety disorders are prevalent among offenders along with other addictions. However, treatment for this disorder is not readily available. Moreover, the number of affected persons is constantly growing due to poor care provided in correctional facilities. Inmates do not have the same opportunities as those patients in ordinary communities. Moreover, their conditions are constantly worsening, and it indicates that the justice system does not work properly. Although it is a rather controversial issue, regardless of whether they are incarcerated or free, all people must have equal rights to medical treatment.