Treatment for incarcerated patient with paranoid schizophrenia

Victimization is also known to be high in the prisons, therefore making the problem worse. Treatment for the mental illness is however critical and should be taken seriously. Untreated the psychiatric illness often gets worse and they leave prison worse than they got there. Individuals in jail deserve to receive good medical care and this pertains to mental illness too. Treatment can also be challenging especially if the patient is suffering from a serious mental illness such as schizophrenia. According to DSN-5 criterion A, the patient with schizophrenia the patient must have delusions, hallucinations, disorganized speech, catatonic behavior and negative symptoms such as diminished emotional expression. At least two of these five symptoms must be present for at least one month if untreated.

Criterion B states that the disorder must cause social dysfunction and the level of functioning is low as compared to before the illness. Criterion C sets the duration at extra pyramidal. It discusses the six months that distinguishes schizophrenia from schizophreniform disorder including the one month symptomatic period set in criterion A. Pharmacological therapy however remains the mainstay treatment regime for paranoid schizophrenia. Non-pharmacological therapy also known as psychotherapy is highly recommended and used in treating paranoid schizophrenia. Psychotherapy has three main categories namely individual, cognitive and group. Individual therapy works on helping the patient learn how to cope with stress, focus on improving communication and social interaction and improve the ability to work on daily activities. It also helps in vocational rehabilitation.

However, if a patient does not respond to the second generation antipsychotics, the recommended treatment involves the use of another second-generation antipsychotic or a first line antipsychotic. It is worth noting that the first generations antipsychotic are discouraged due to their ability to exacerbate extra pyramidal symptoms. The failure of the second phase calls for initiation of the third stage of treatment, which includes the use of clozapine with a strict caution to monitor white blood cells. The failure of the third phases calls for a combination of clozapine with a first line antipsychotic, a second line antipsychotic, or electroconvulsive therapy (ECT). The final phase of treatment, which should be commenced after all the above phases have failed, involves a comprehensive combination of a first line antipsychotic, a second line antipsychotic and ECT.

The failure of the prisoners to receive proper mental treatment and to utilize recommended treatment strategies is attributed by certain factors. These factors include, expanding prison population without a corresponding increase in prison staff, cost cutting and inconsistence on screening procedures. Personal application point of view Based on research and the above findings, mental health should be given more attention in prisons. Prison administrators should prioritize screening procedures for identifying and treating mental illness in inmates. Non-pharmacological therapies should also be embraced to go hand in hand with pharmacological therapies so as to help inmates with paranoid schizophrenia. S. Prisons: A Challenge for Medical Ethics. The Journal of the American Academy of Psychiatry and the Law, 38(1): 104-108. Retrieved from: http://www.