Medical Anthropology Quarterly Early View

This is an excellent article explaining how the values and social structures of a U.S. prison affect a correctional officer's discretionary responses to situations involving mentally ill inmates. Sections of this article cover: prisons as local moral worlds and the construction of illness categories; correctional officers, "people work", and mentally ill inmates; the research context-Pacific Northwest Penitentiary (PNP); research methods; institutional policy and relationships between staff and inmates; the institutional illness category of the "mentally ill inmate" and knowledge about mental health; correctional officers' responses to mentally ill inmates-observation, flexibility and discretion in enforcing the rules, and trust and respect during an inmate's help-seeking request; and a discussion of this analysis. "Officers’ discretionary responses to mentally ill inmates included observations to ensure psychiatric stability and flexibility in rule enforcement and were embedded within their role to ensure staff and inmate safety. Officers identified housing, employment, and social support as important for inmates’ psychiatric stability as medications. Inmates identified officers’ observation and responsiveness to help seeking as assisting in institutional functioning. These findings demonstrate that this prison's structures and values enable officers’ discretion with mentally ill inmates, rather than solely fostering custodial responses to these inmates’ behaviors. These officers’ responses to inmates with mental illness concurrently support custodial control and the prison's order" (p. 1).