Working inside the walls

Abstract This chapter describes what it is like to work as a psychiatrist inside the walls of carceral settings, particularly prisons and large jails. It paints a picture of what new staff can expect to encounter when entering one of these facilities by discussing the physical environment, security considerations, and typical challenges encountered. It describes the different levels of security within a carceral system and how an incarcerated person is classified to these levels. Important aspects of the subcultures of incarcerated persons and custodial staff are presented. Concerns of interest to mental health professionals who may be interested in a career in carceral settings are discussed, such as personal safety and liability risk. The chapter includes a brief review of relevant statutes and case law. While a jail or prison is not the setting most clinicians would prefer for their patients with serious mental illness, incarceration is an opportunity to connect marginalized persons with necessary treatment.