Improving Prison Mental Health Services in Norway

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Norwegian law prohibits the imprisonment of someone who has committed a crime while suffering from psychosis.  In this instance, a person is sentenced to psychiatric care and is involuntary committed to a forensic psychiatric ward in a mental institution.  In contrast, criminals who suffer from mental illness (but were not psychotic at the time of the crime), serve their sentences in prisons and receive healthcare from the prison health service.

While the prison health service is an extension of Norway’s national health system, some prisons do not offer full-time or full-spectrum health services, or lack mental health services.  Additionally, mental health institutions in Norway are not equipped to handle mentally ill prisoners on a psychiatric ward.  The end result is that many severely mentally ill prisoners in Norway are held in solitary confinement because the prisons lack the resources and professional competence to manage the prisoners’ mental health needs, and the national health system lacks the resources to manage the security needs of mentally ill prisoners.  This is a violation of prisoners’ human right to health and human right to the protection against torture and ill treatment.

Ila Prison cell of a mentally ill inmate who has smeared feces on the wall. Photo:  Karin Beate Nøsterud

Ila Prison cell of a mentally ill inmate who has smeared feces on the wall. Photo: Karin Beate Nøsterud

Several recent media reports have highlighted the situation.  Some mentally ill prisoners have been sitting in solitary confinement for years, with only short and inadequate admissions to psychiatric facilities.  Prison clergy and the Norwegian National Crime Prevention Council have petitioned the Minster of Health to address the problem.  The warden of Ila Prison has petitioned the Minister of Justice to intervene.  Neither ministry has proposed a long-term solution that would promote the health and human rights of these vulnerable prisoners.

The Norwegian Ministry of Justice and the Ministry of Health must develop and fund a comprehensive plan for the secure treatment of mentally ill prisoners in psychiatric institutions.  For example, regional public hospitals should have well equipped and fully staffed penitentiary medical and psychiatric wards, in addition to specialist training programs in penitentiary medicine and psychiatry for both physicians and nurses. Providing adequate mental health services to inmates will prevent inhuman and degrading treatment of prisoners, decrease recidivism, and improve the overall mental health of Norwegian society.

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2 Responses to “Improving Prison Mental Health Services in Norway”

  1. elizabethchung2014 Says:

    The problem is truly a difficult issue with arguably all countries in the world struggling with the crossover of mental health services and the criminal system. The blog highlights the problem in Norway, and several of the links are in Norwegian. It would be helpful to have all links also translated into English. Lack of budgeting and lack of awareness of the extent of the problem are contributors. The blog attempts to increase awareness and argue how addressing this concern will essentially improve overall health for the entire Norwegian society. More supporting data and maybe a trend with a timeline would also be helpful. The picture of the inmate’s room painted with feces is quite compelling. Without further details, the fact that a person is doomed to live in such an unsanitary situation without appropriate help because he or she did not fit a certain criteria seems horrible. Help must be found!

  2. citizen365 Says:

    I came across this blog post while looking for articles on the issue of the criminalization of the mentally ill (a troublesome terminology) and the degree of contrast between the United States and Scandanavian countries.

    First of all, I have taken note that at least Norway’s prohibition on imprisonment of someone who was psychotic at the time of the crime is superior to the US standard. However, it appears there is a pitfall that may produce at least some similar outcomes as the US standard, where the fallacious McNaughton places the subject at the mercy of a system where jurors are tasked with trying to decision on whether a person known to be mentally ill knew right from wrong or lacked the capacity to appreciate the nature of his or her actions. First of all, the McNaughten test is egregiously flawed and asks questions that do not reconcile with medical science, so the task put before them is based on a flawed test. Secondly, pscychosis is confounding to most humans and when jurors do get it right and find the accused not guilty by reason of insanity, it is most often an intuitive judgement, not one based on the medical reality of the disease state of the accused.

    In Norway, who decides if someone was psychotic? How is pcychotic defined in this adjudication process? Although the Norway acknowledgement of psychosis as prohibitive is superior to the US system, there is still a very questionable and treacherous divination that is being made about the state of consciousness that may have existed during a crime, a sort of arbitrary deliminter being established in the case of a disease (such as schizophrenia) characterized by severe, persistent, chronic thought and consciousness disorder…possibly exacerbated by anosognosia.

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