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First aid for mental health: A new approach in Pennsylvania’s prisons

Pennsylvania prisons trained staff and inmates in Mental Health First Aid

Bellefonte, Pennsylvania (CNN) – The man was about to snap. He had just lost a child.

“I couldn’t really relate to that,” Peter Robinson said of his fellow inmate. “I know what loss feels like, though.”

Like the other prisoner, Robinson struggles with mental illness; he has bipolar disorder and depression. The men talked for a long time. They came to focus on the message of the Serenity Prayer: God grant me the serenity to accept the things I cannot change, the courage to change the things I can and the wisdom to know the difference.
“The things I can’t, you’ve just got to let it go,” Robinson recalled.

The two remain friends now at State Correctional Institution-Benner Township, a medium-security men’s prison with about 2,000 inmates. The concrete collection of buildings stands starkly against the rolling green farmlands of central Pennsylvania.

That moment, when Robinson talked his friend through a mental health crisis, “it’s something I’m proud of,” he said.

It’s part of Pennsylvania’s innovative new approach to mental health care in prisons. Inmates and staff alike train to reach a mutual understanding about how to deal with the myriad issues surrounding mental health.

It’s an approach born from necessity, after a scathing government investigation into the state’s prison practices.

‘A huge amount of scrutiny’

The investigation began after a lawsuit was filed by the Disability Rights Network against the Pennsylvania Department of Corrections. The Department of Justice launched it in May 2013 in one prison and then expanded it to the entire Pennsylvania prison system. It focused on the treatment of inmates with mental illness and the use of solitary confinement.

“It put our system under a huge amount of scrutiny,” Pennsylvania Department of Corrections Secretary John Wetzel said.

According to Wetzel, about a quarter of the inmates in the Pennsylvania corrections system struggle with some kind mental illness. Nationally, more than half of inmates suffer from some kind of mental illness, according to 2006 Bureau of Justice statistics (PDF), the most recent available.

Before the investigation, individuals with mental illness could be sent into solitary confinement. Over the course of a year, more than 1,000 mentally ill inmates were held in solitary confinement for more than 90 days, according to the Department of Justice’s initial letter to the Department of Corrections.

That practice resulted in “serious harm” to inmates. That year, 206 of 288 documented suicide attempts took place in the isolation units.

The investigation, which was closed in April, resulted in an overhaul of the department’s approach to mental health care.

“The improvements we have seen since our February 2014 findings, together with [the department of corrections’] commitment to sustainable reform, give us confidence that the same pattern of practice of violations we found early in our investigation does not exist today,” the final report read.

Inmates with mental illness are no longer held in solitary confinement. Additionally, all staff members — 15,000 to 16,000 people, according to Wetzel — are trained in Mental Health First Aid. The full staff was trained in just a year, according to Wetzel.


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