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Sandra Caramela-Miller


Overcrowded prison system conditions can significantly worsen mental illness. Compassionate prison segregation options required for substantive mental health care are lacking. Death with Dignity is not a current legal solution for terminal psychiatric illness in the United States. How mental health care providers in Washington State perceive psychiatric Death with Dignity for treatment-resistant, severely mentally ill prisoners has illuminated scholarly research. An anonymous, qualitative, online survey of 15 Washington State mental health care providers serving severe, persistent, mentally ill prisoners having expressed suicidality was conducted. The concept of discontinuing a mentally ill prisoner's psychiatric care was explored during data gathering. The phenomenological data from four open-ended survey questions were hand-coded using continual comparison. The data revealed five key themes consistent with the elemental research framework, including the Washington State Death with Dignity Policy. The survey results indicated a need for psychosocial awareness of mentally ill prisoner welfare before psychiatric Death with Dignity legalization may be considered in the United States. Social ambivalence could be reversed through intellectual discussion comparing societal and provider perspectives on mental health care in future studies. A discussion on free will may be instrumental in initiating positive social change through the recognition of paternalism. Providers may now support ethical release for severe, persistent, mentally ill prisoners from psychiatric pain by Death with Dignity.

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