Evaluating privilege requests from mentally ill prisoners

Psychiatrists working in prisons are frequently presented with inmate requests for special privileges and living arrangements. Although recommendations to reduce stress are often indicated for seriously mentally ill prisoners, the injudicious use of special privileges can interfere with treatment and with the functioning and security of the prison environment. Guidelines are suggested for evaluating privilege requests that include exploring alternatives to granting requests; reserving privileges primarily for individuals with serious mental disorders; relying upon objective findings; and utilizing a multidisciplinary decision-making process.