What Does Performance Theory Have to Teach Us About the Treatment of Severe and Persistent Mental Illness (SPMI) in Prison?

Deinstitutionalization of psychiatric hospitals, which occurred in the 1970\u27s, led to an overwhelming number of mentally ill individuals within jails and prisons. In fact, correctional facilities have become the mainline providers of mentally ill inmates; however, these facilities\u27 primary form of intervention is psychotropic medication. Although beneficial in some instances, when viewed through the lens of Goffman\u27s theories of performance and stigma, simply providing medication promotes the role of mental patient. Arguably, within correctional facilities, medication management assists in maintaining security in the institution (i.e., external change); however, this prohibits the inmate from internal change, which might otherwise be facilitated via a secure therapeutic relationship. Given the stripping of one\u27s former identity upon entrance to correctional facilities, performing the role of mental patient may be an enticing way to serve a sentence. In other words, it is a stigmatized identity; thus, less demanding. This paper will explore changing society\u27s view of what is normal in hopes of de-stigmatizing the role of mental patient. This would include accurately identifying those with organic mental illness and those who are behaviorally motivated, with an emphasis on providing a therapeutic environment centered upon secure attachments between patient and provider. Keywords: Goffman; severe and persistent mental illness; performance theory; stigma; and prison