The correctional psychiatrists who serve as editors and authors of this text have built upon the excellent work done by many of the same authors a decade ago in the sentinel book, Handbook of Correctional Mental Health.1 The Oxford Textbook of Correctional Psychiatry examines current thinking in correctional mental health care and mental health administration and covers new ground. It is thorough in the breadth of topics that it covers and will serve as a useful resource for forensic mental health professionals and trainees, as well as administrators and attorneys involved in correctional mental health care. The book addresses how correctional psychiatry intersects with community health care and public policy and will be a useful resource for individuals in those fields, as well.
The comprehensive Textbook has 13 sections and 71 chapters, and most have a common theme. The authors call upon correctional psychiatrists and administrators to be aware of the unique challenges inherent in this setting, while continually being mindful of medical ethics. The editors have ensured that the chapters do not duplicate information except when it is essential to understanding the material.
The first two sections review the context and organization of correctional institutions. Jamie Fellner's chapter on human rights makes for an especially interesting read when combined with the thoughtful discourse on multidirectional, robust professionalism by Philip Candilis and Eric Huttenbach. Robert Trestman notes the lack of studies comparing the various funding models of correctional health care and closes with a well-articulated suggestion of the potential benefits that this work could provide.
Section III covers patient management from screening to community re-entry with an important discussion on restricted housing. The effects, or possible lack thereof, that segregation has on the mentally ill are reviewed. The authors rightly point out that societal concerns with long-term segregation have to do with the potential violation of evolving standards of decency.
Sections IV, V, and VI address common management topics, emergencies, and general psychopharmacologic concerns in corrections institutions. Bernice Elger's chapter on sleep complaints elegantly examines the ethics of insomnia management in corrections. Reena Kapoor's review of crises management details how psychiatrists' roles may differ in a correctional setting but returns to the importance of applying one's medical ethics in these settings in the same manner that one does in community settings. The authors examine the need for and benefits of hospitalization, but remind the reader to give consideration to the stigma of hospitalization.
Section VII reviews various mental disorders and describes how their treatment differs in correctional institutions. Even the seasoned correctional psychiatrist should benefit from the discussion regarding attention deficit hyperactivity disorder and complex posttraumatic stress disorder (PTSD), as the authors point out that these are often unrecognized, underdiagnosed, and untreated, with resulting behavioral management challenges for the system. The chapters that address psychotherapy review evidence-based treatment modalities, including individual and group therapies and the recovery model. There is also a review of treatment of substance use disorders.
The discussions of suicide prevention, suicide risk assessment, management of aggression, self-injury and misconduct include the latest evidence-based research. James Degroot gives an informative review of the success of the Georgia Department of Corrections (GDC) in treating PTSD.
As with any textbook, there are some updates in diagnosis and treatment that are not included in the book. Specifically, our readers may find it useful to know that the frequently encountered complaint of middle-of-the-night insomnia has an evidenced-based U.S. Food and Drug Administration–approved treatment that is nonaddictive: low- to ultra-low-dose doxepin has a unique mechanism at the lower doses. This treatment is also recommended by the American Academy of Sleep Medicine.2 Also, the literature is evolving regarding the effect of the change in PTSD diagnostic criteria on its incidence in correctional institutions.
It is an understatement to say that this book is comprehensive. Its thoroughness is surpassed by the level of expertise of the authors and editors. The cohesive organization of the large number of essential topics, by so many experts, makes this a book that will be referred to constantly for both the evidence-based standards, but also, for ethics guidance while working in corrections, community health care, and public policy.
Disclosures of financial or other potential conflicts of interest: None.
- © 2016 American Academy of Psychiatry and the Law