Two Latino inmates in a maximum-security federal prison shout back and forth in Spanish and gesture excitedly, perhaps alarming nearby correctional officers.

"Your job as a correctional worker is to make sure that the institution is safe and that you go home alive," said psychologist Corinne N. Ortega, PhD, at APA's 2005 Annual Convention. "They are talking very loudly with their hands. What are you going to think? Maybe that there is a security issue."

But in all likelihood the inmates could be just discussing what's for dinner. And it falls to psychologists to educate prison officials about how culture shapes inmates' behavior--to explain how, in this case, for example, dramatic hand gestures and loud voices are features of everyday conversation in Latino culture, said Ortega at a convention session on mental health services for diverse populations in U.S. prisons, sponsored by APA's Board for the Advancement of Psychology in the Public Interest and Div. 18 (Psychologists in Public Service).

At the same time, psychologists face the challenge of providing mental health care to Hispanic inmates and educating them about what's appropriate in America, said Ortega, a psychologist at the John Jay College of Criminal Justice who has worked in corrections for 12 years.

One of the fastest-growing minority populations in America, Hispanics make up 30 percent of federal inmates, and their cultural backgrounds complicate their prison experiences, said Ortega, who in her convention presentation outlined language barriers and other unique circumstances surrounding Latino inmates and how correctional psychologists can provide culturally competent care for them.

Ortega said mental health professionals must walk a fine line between being culturally sensitive and not indulging immigrant cultural norms that conflict with the U.S. legal system. When working with Latino inmates, she said, practitioners need to ask themselves, "Are they behaving appropriately and responding to the world according to their culture, or are they jumping all over that as an excuse to not take responsibility for their behavior?"

Cultural re-education

Language is a primary concern when working with Latino prisoners, said Ortega. Even if a prisoner speaks English well enough to function on an everyday level, they may not possess the language skills to convey the emotional nuances that so often communicate psychological problems.

Moreover, she said, Latino inmates often report physical problems like stomach pains and headaches instead of expressing, for example, that they might be depressed. She advised prison psychologists to educate medical staff that a Latino inmate with physical symptoms might be suffering from depression and is unable to convey the problem in those terms.

Ortega encouraged psychologists to acknowledge an inmate's different cultural background but also to explore how--and explain to an inmate how--that culture might differ from American laws and culture. For example, she worked with a 20-year-old male prisoner who was incarcerated for having sex with a 16-year-old girl. In his mind, he had done nothing wrong because he obtained permission from her parents and intended to marry her--culturally appropriate steps in his home country.

"How do we respect those traditions and honor those values that are in marked contrast with our own values?" Ortega said. "The trick is to say to the prisoner, at some point, 'Okay I get that, but as long as you're in the United States, if you keep doing that, permission or no, you are going to keep going back to prison.' We can't let people use their backgrounds, no matter how real and valid they may be, as an excuse to continue to engage in behavior that is going to get them into prison."

A balancing act

Correctional psychologists also have to balance their obligation to the inmates with the needs of the prison and the taxpaying public, Ortega noted. Often, she said, what's in the best interest of one group might not be in the best interest of another.

For example, it's in inmates' best interest to have easy access to translators and mental health providers, but it's hard to provide an adequate number of these professionals because of funding-related staffing shortages. Ortega called for culturally competent psychologists to try bridging the gap between these obligations.

"Working as a psychologist in a correctional setting, safety and security of the institution, the public, staff and other inmates come first," she explained. "The role that you have to provide rehabilitation and treatment is always secondary to maintaining the security of the institution, and that can be the core barrier to overcome."

Also speaking at the symposium, were:

  • Dennis Waite, PhD, of the Virginia Department of Juvenile Justice, on the mental health needs of incarcerated juveniles.

  • Angela Browne, PhD, of Harvard University, on the mental health needs of incarcerated women and girls.

  • Rebecca S. Allen, PhD, and Laura Phillips, of the University of Alabama, on alternative care options for older adults in prison.

  • Jeffrey D. Strain, of Indiana State University, on identifying and meeting the mental health needs of lesbian, gay, bisexual and transgendered prisoners in correctional facilities.

The session was chaired by Allan S. Noonan, MD, dean of the School of Public Health at Morgan State University.