Serving the Forgotten: A Psychiatrist’s Advocacy for Incarcerated Individuals

As part of PRMS’ ongoing commitment to behavioral health, we invited Dr. Saranyan Senthelal to be featured as a guest blogger this month. Dr. Senthelal reflects on his choice of working to improve mental healthcare within correctional facilities. Dr. Senthelal is a Supervising Psychiatrist and Associate Executive Director at NYC Health and Hospitals/Correctional Health Services at Rikers Island, NY, and Newsletter Editor for the Queens County Psychiatric Society (QCPS).

The following is republished from the Summer 2025 QCPS QC Newsletter, a member newsletter of the Queens County Psychiatric Society. 

Breaking the Stereotype: What Psychiatry Really Looks Like

The media often portrays psychiatrists as professionals whose workday consists of sitting across from patients lying on large leather couches in luxurious offices on Park Avenue. While this may be the reality for a small minority of psychiatrists, those in the mental health field know that this is far from the norm. When I explain to family and friends that I chose to begin my career at Rikers Island, their reactions are often ones of surprise. Many are shocked that I would willingly put myself at risk and question my decision-making.

At a surface level, these concerns may seem valid. However, a closer look at the facts reveals compelling reasons why a psychiatrist might choose to work in a correctional facility. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the prevalence of mental illness is strikingly high in incarcerated populations: 56% in state prisons, 45% in federal prisons, and 64% in local jails—compared to just 20% in the general population (SAMHSA, 2012). These statistics are staggering, and the disparity between the need for mental health services and the number of providers available in these institutions only exacerbates the problem.

Incarcerated and Overlooked: The Hidden Need for Psychiatric Care

Incarcerated individuals are a frequently overlooked population, particularly when it comes to healthcare. These individuals exist at a complex intersection of mental illness, trauma, poverty, and systemic neglect. Several of my patients have shared with me that their only access to psychiatric treatment comes during their time in jail. One patient, a man in his 40’s recently convicted of murder, confided that he had struggled with depression since childhood but had never received mental health care until his incarceration.

Carceral Psychiatry: A Field of Purpose and Impact

These alarming statistics and personal accounts were significant factors in my decision to work in a correctional setting. However, it was my direct experience with each incarcerated individual that truly solidified my commitment. Reflecting on why I pursued a career in medicine, I recognize that my motivation has always been to help others. People with mental illness who are incarcerated often face intense stigma, and the opportunity to serve this vulnerable population may be one of the most meaningful ways I can contribute to my community.

As I begin my new role as Associate Executive Director and Supervising Psychiatrist at Correctional Health Services, I am committed to advocating for those with mental illness as they navigate the legal system. My goal is to raise awareness about the field of carceral psychiatry and continue to improve mental healthcare within correctional facilities.

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