When someone is convicted of a crime and sentenced to prison, they usually understand they’ll be surrendering some of their rights. But for many, incarceration comes with an unexpected side effect: development or worsening mental illness.

US Department of Justice conducted a survey in 2011-2012 to assess the prevalence of symptoms of mental disorders among the population held in prison and jail. According to the Bureau of Justice report, 14% of prisoners in State and Federal facilities and 26% of those in jail reported experiences of serious psychological distress. Respectively 37% and 44% had been told in the past by a mental health professional that they had a mental disorder.

Some people enter the prison system with mental health disorders, while others develop them during imprisonment. Prison life, solitary confinement, loneliness, disconnection from family – all these factors contribute to the development of mental health problems during incarceration.

Since people in prison lose certain rights and freedoms, the question remains whether incarcerated men and women with mental health illnesses are getting the treatment they need. The answer may have a lot to do with the equity in the justice system in terms of resources and delivery of care to those behind bars.

Common therapies for mental health disorders include cognitive-behavioral therapy (CBT), dialectical behavioral therapy, and counseling. Prescription medication therapy is also used to reduce symptoms of certain mental conditions. But many prisoners with mental illnesses do not get treatment.

In addition, many of them have little to no access to treatment before imprisonment. A 2011-12 survey on the indicators of mental health problems reported by prisoners and jail inmates showed that prisoners with mental health problems were more likely to have received treatment once imprisonment at their current facility. The survey also shows that half of prisoners (54%) who met the criteria for SPD had received prescription medication, counseling, or therapy.

The current policy of many jails concerning a [mentally ill prisoner] is to transfer the person to a state psychiatric hospital for treatment. However, hospitals are usually filled to capacity and treatment is not delivered in most cases.

At the federal prison level, more than two-thirds of prisoners said in a survey they did not receive mental or behavioral health counseling while in federal prison. Of those who did receive, more than 50% did not find it helpful.

The lack of effective treatment may be linked to a shortage of certified mental health professionals, such as psychologists and psychotherapists, providing services to prisoners. Prison and jail officials are not usually trained or equipped to deal with inmates who have a mental disorder, neither are correctional officers or staff trained to provide psychiatric medication. Regardless, they must house and manage hundreds of thousands of prisoners with serious mental illnesses.

There are also limited programs, inadequate facilities, and a culture of lack of sympathy for providing treatment to convicted criminals or jail inmates branded as society’s rejects. As such, prisoners are treated with other options, such as restraining devices and solitary confinement. These options may worsen the symptoms of their illness.