There has been a great deal of empirical and methodological debateabout the causes and the treatment of multiple personality. Manysupport the hypothesis that it is linked with childhood abuse, and thatdissociating may be a way of coping with a traumatic experience whileit is happening or after it is over. Skeptical claims about multiplepersonality disorder come in different strengths, although they areoften mixed together. The most skeptical view is that multiplepersonality does not exist at all, and is a hoax by patients andtherapists seeking attention, money, or to use it as an excuse forcriminal behavior A more moderate claim is that multiple personality isnot really a separate phenomenon, but rather an unusual form of morefamiliar mental disorders such as manic depression, schizophrenia, orborderline personality disorder. This raises a taxonomic issue of whena condition should be classified as an atypical form of a known mentaldisorder rather than as an instance of a separate, independent mentaldisorder.) Milder still is the view that multiplepersonality, while a separate disorder, is caused not by traumaticchildhood experiences but is iatrogenic, caused by overenthusiastic andirresponsible therapists who, encouraging their patients to believethat they have been abused as children, and often hypnotizing them, endup encouraging forms of psychic dissociation. (Piper, 1996; Spanos,1998) These empirical debates are on-going, and considerablecontroversy still surrounds the diagnosis of Dissociative IdentityDisorder, yet it remains as a category in the American PsychiatricAssociation's DSM-IV-TR .
There are several possible explanations for these inconclusive and sometimes anomalous findings. First, because younger individuals often have trouble avoiding getting disciplinary reports in prison, it is possible that changes in the age structure of the prison or the practice of housing older and younger prisoners in separate facilities could influence the results of overcrowding research. Second, most of these studies overlook the positive or ameliorative effects that may reduce the negative impact of prison overcrowding. When researchers examine the effect of educational, occupational, and psychological programming on prison-based aggression, they frequently find that these positive pursuits can have a calming effect. Both these factors, age and positive influences, suggest that a systems approach should guide research on prison overcrowding.
In addition to the legislative response of politicians and policymakers to a punitive public, there are several other factors that may contribute to prison overcrowding. Drug use is instrumental in a quarter to a third of all new jail and prison admissions and is the leading cause of parole and conditional release violation. As such, drugs are both directly and indirectly (harsher sentences for drug offenses) linked to prison overcrowding. Demographic changes contribute to prison overcrowding, as exemplified by the crime explosion of the mid-1960s when the baby boomers were in the age range most conducive to crime (late teens to mid-20s). Over time, prisons age and become less efficient; some may even be closed. This places an increased burden on existing facilities and adds to the growing overcrowding problem. With advances in technology, law enforcement may become more efficient, which could potentially increase the jail and prison populations and contribute to prison overcrowding.
When viewing , we might wonder who these families are. Predominantly, they are families of poor minorities. If current incarceration trends continue, one in every three black men born today will go to prison at some point in their lives, compared with one in every six Latino males, and one in every 17 white males. Black women are four times more likely to be incarcerated than white women. Over half the female prison population is comprised of women of color, and yet women of color account for only about a quarter of the female population generally. Of the 1.5 million children with incarcerated parents, half are African-American children. That’s one in fourteen black children in the U.S.
It was the incongruous colors that first drew in artist . Finding a Polaroid of her 5-year-old self with her incarcerated brother, she noticed behind them a tropical beach scene. Prisons have a rich but scarcely studied history of mural painting, and in recent decades murals in prison visiting rooms have been used more frequently as backdrops for portraits. An appointed prisoner most often paints the murals. Usually, the visiting room photographer is a prisoner. At one time Polaroid cameras were the norm for this practice, but digital cameras have since replaced them, and printed vinyl backdrops have succeeded the painted murals.
“Decriminalization is easy,” said Capaz. “You write down that if people are caught doing illegal things, the sanctions are administrative and not criminal. The hard part is making treatment available. It works for us because it works with our health care system — drug users who want treatment can get it for free.”
For example, some individuals may need to be confined for a period of time, 24 hours a day, 7 days a week, in secure locked facilities known as jails and prisons. Calling this facility by a different name does not change the fact that it is a prison or jail.
Unethical procedures that impact incarcerated individuals and correctional staff, the relativism of respect as people and not just prisoner’s; the safety of all inmates and correctional staff, are all issues worth continuous reflection....
My point is not that all U.S. residents have the resources they need to cover their medical care; certainly many do not. My point is that prisoners have none of the choices just enumerated. If the correctional institution's staff denied care, the inmate would have no alternatives. In the past two decades, a substantial number of prisons and jails have decreed that prisoners must pay at least part of the bill for their medical services . These policies always include the provision that indigent prisoners will receive medically necessary, urgent care regardless of their financial status. It is evident that society has embraced the concept that, when incarcerated, a person cannot see to his or her own medical needs, and, therefore, society must do so.
Beyond the legal mandate, there are fundamental ethical reasons why prisoners should be given medical care. Free persons may or may not have health insurance, based, at least in part, on their decisions about how to prioritize the use of their money. Some who decide against buying insurance have the option to pay cash for the health services they seek. The very poor, the aged, and the disabled are generally provided with assistance in the form of federal and state Medicare and Medicaid programs. Even the so-called "working poor," loosely defined as those who earn too much to qualify for assistance and too little to afford to pay for health care, have the option to use or borrow cash when they need medical treatment. Moreover, federal law requires that hospitals provide medically necessary emergency health services regardless of a patient's health insurance status or ability to pay.
Health care is given to prisoners for social reasons too. The vast majority of inmates will return to society within a few years. Proper care helps to preserve their physical function, which makes it possible for ex-inmates reintegrating into society to embark on productive activities and avoid becoming a burden to all. For example, hypertension and diabetes treatment are known to prevent strokes, heart attacks, and other sequelae that would burden society with long-term care of disabled persons. It is in society's best interest that recently released prisoners be free of disabling diseases.
To reiterate, however, the dominant view is that mental illnessexists and there is a variety of ways to understand it. Modernpsychiatry has primarily embraced a scientific approach, looking forcauses such as traumatic experiences or genetic vulnerabilities,establishing the typical course of different illnesses, gaining anunderstanding of the changes in the brain and nervous system thatunderlie the illnesses, and investigating which treatments areeffective at alleviating symptoms and ending the illness. One ofthe central issues within this scientific framework is how differentkinds of theory relate to each other (Ghaemi, 2003; Perring,2007). Reductionist approaches try to reduce social explanationsof mental illness to explanations at “lower” levels such as thebiological, while pluralist approaches encourage the co-existence ofexplanations of mental illness at a variety of levels.