Structured life in jail a benefit to psychiatric patients

TILBURG – Dutch psychiatrist Jan Cees Zwemstra, who recently defended his dissertation, contends that jailed patients have an advantage over those admitted to regular psychiatric institutions. Prisoners respond well to psychiatric treatment because life in penitentiaries is more structured, has defined rules and regular routines. The pressure on prisoners to conform should no longer be off limits for mental patients but should be seen as an opportunity that is necessary and unavoidable. This approach merits more regulatory and legal support, according to the physician who is employed as the head of a forensic psychiatric institute. He advocates conditional parole with weekly urine testing for monitoring prescription adherence and illicit drug usage with penalties for violations within a legal framework. The current treatment models presume that the patient is able and willing to follow treatment when this approach obviously fails certain groups of people. Their non-compliance frequently causes a descent into despair and in some cases serious criminality. Zwemstra thinks that firm action will also help schizophrenic patients who often require longer treatment than their incarceration allows, requiring a modified legal framework (in the Netherlands) after their release from prison.