There is a considerable conversation surrounding the impact of incarceration on individuals with mental health conditions and whether the lack of rehabilitative resources inhibits their ability to succeed upon their release. Many of those incarcerated struggle with mental health, according to the U.S Justice Department over one third of incarcerated individuals in the U.S suffer from some form of mental illness yet surprisingly 66% of incarcerated people reported not having access to mental health care according to the Prison Policy Initiative. In the U.S the topic of mass incarceration is a divisive issue because while some believe more punitive measures make society safer more than half of those who are in the U.S prison system are there for nonviolent offenses. Most commonly nonviolent drug offenses composing 44% of inmate offenses as reported by the Federal Bureau of Prisons.
It leads us to contemplate whether the punishment based approach in the prison environment does more harm than good due to the psychological impact it has on those who are incarcerated, the majority of which struggle from some form of mental health. The main concept of my research asks the question, has the lack of mental health resources in prison worsened our mass incarceration crisis? As well as inquiring, does the implementation of mental health resources impact recidivism rates and allow incarcerated individuals to improve their behaviors ? Through examining evidence and studies of mental health in prison from the last four years, I hope to emphasize the impact of the penitentiary structure on those with mental health conditions and recognize the ability for treatment and rehabilitative measures to help to reduce future recidivism.
Mental Health Statistics in U.S State Prison System
There has been notable research done considering the scale of which those in prison struggle with mental health and whether the conditions of prison exacerbate this. A 2022 journal article published on behalf of the American Society of Criminology details the disparities in treatment of those with mental illness within the prison system. Setting the tone for this research, sociology professors Jessica T Simes of Boston University and Bruce Western of Columbia University have a background in studying the impact of mass incarceration and social inequalities. In their introduction the authors detailed how the closure of state psychiatric hospitals, led many individuals with mental illness to be committed to prison because they were stigmatized in society as dangerous (Simes, Western). This point highlights a concept of the mental hospital to prison pipeline which details how often those who do not have access to mental health resources in the outside world can end up within the Prison system, especially those dealing with factors such as homelessness or addiction who are unable to afford treatment.
The purpose of Simes and Westerns research is to showcase the criminalization of mental health, particularly how incarcerated individuals struggling with mental health are more likely to be penalized in the prison structure than those who do not have mental health conditions. Bringing attention to how the same punishment is administered to those with mental illness despite being aware of an inmate’s mental condition. Their research exposes an almost “three times higher rate of solitary confinement” based punishment among mentally ill individuals in contrast to those who do not have any mental illness (Simes, Western). Examining data of mental health screenings from the Pennsylvania Department of Corrections which are conducted for all those entering Pennsylvania Prisons, inmates are classified into four categories A through D which takes into account their current mental state as well as mental health history. Their calculations were determined from analyzing misconduct charges determining whether the misconduct were violence, threats, or defiance and misconduct tickets administered that led to solitary confinement along with the time inmates spent in solitary under those same mental health classifications. This revealed that men with the highest classification of mental illness, were spending “22 to 26 days in solitary confinement annually” compared to an “8 day average for men who had no history of mental illness” (Simes, Western). Emphasizing how mental health conditions can be exacerbated by the rigid environment of prison particularly the long term effects of isolation in solitary confinement. Which highlights the disadvantages of a punishment based justice system when the vast number of those incarcerated struggle with mental health. This brings into question the availability of mental health resources for those incarcerated as well whether prison staff and administration are properly equipped to handle cases of mental illness.
Solitary Confinement Cell
So what would an alternative solution be to handling incarcerated people with mental illness if not in a restrictive housing structure? A 2021 academic study from the American Journal of Preventive Medicine highlights the differences of a therapeutic holding environment from a restrictive holding environment on inmates in North Carolina where they have established Therapeutic housing units. Author Molly Remch from The UNC Chapel Hill Department of Epidemiology in collaboration with Charles Mautz from the North Carolina Division of Adult Correction and Juvenile Justice highlights the implementation of “Therapeutic Diversion Units” that have slowly been introduced in a number of states. How these units differ is through their use of cognitive therapy that help inmates to “develop effective emotional regulation and self-management skills… and prepare for re-entry into a less restrictive environment” (Remch, Mautz). The study makes the point that a disproportionate amount of inmates in prison with mental health disorders are not placed in adequate environments while incarcerated which exacerbates their condition. Results of this study gathered from data of North Carolina’s prison records from 2016-2019 found that those in therapeutic housing environments were three times less likely to commit infractions and had improved levels of mental health than those in restrictive housing. The results Remch and Mautzs arrived at showcase how restrictive prison structures for those with mental health conditions can inflict psychological distress which in turn causes those struggling with mental health more likely to lash out and commit infractions. This finding builds on Simes and Westerns study where they highlighted how time in solitary confinement stemmed from a disproportionate number of infractions written out to those who suffered from mental illness. These were mostly for nonviolent violations where they “on average received nearly .6 misconduct tickets a year in a given prison term, compared with an average of .2 to .3 misconducts a year for those reporting no history of mental illness” (Simes, Western). This takes into account how symptoms of mental illness can take the form of defiant behaviors when symptoms are misunderstood or not properly addressed.
Therapeutic Housing Unit at the Missouri Department of Corrections
In Remch and Mautzs study when inmates spent time in Therapeutic Diversion Units the rate of infractions decreased in contrast to restrictive housing where “the rate of infractions [in restrictive housing] was about 3 times as high, the rate of specifically A-level infractions was 5 times as high, the rate of inpatient mental health admissions was 4 times as high, the rate of self-injury‒related incidents was about 3.5 times as high, and the rate of self-injury events was 4 times as high” (Remch, Mautz). This is reflective of Simes and Westerns statement in their research which expresses how “Ascriptions of dangerousness applied to people with mental illness interact with a struggle for self-advocacy and conformity with rules and norms. As a result, behavioral problems associated with mental illness are vulnerable to punishment and a reduction in life chances” (Simes, Western). Illuminating how stigmas surrounding mental health can perpetuate a level of misunderstanding that causes those with mental illness to be punished more frequently rather than treated for their conditions in a restrictive housing model. Remch and Mautzs study points to the effectiveness of these therapeutic housing programs in preventing an increase in harmful behaviors. Suggesting how serving time in a therapeutic environment could improve inmates chances for rehabilitation.
We can further examine limitations in mental health resources for those who are incarcerated through examining the experiences of inmates with mental illness and how they were impacted based on whether they received adequate treatment while in prison. A 2022 study published in Frontiers in Psychiatry detailed obstacles to abstaining mental health care and treatment within the prison system in which those with mental illness who were formerly incarcerated provided insight into the challenges they faced when it came to psychiatric care. Kelli Canada from the University of Missouri School of Social Work and Stacey Barrenger from Northeast Ohio Medical University Psychiatry detail various stressors present in the prison system that create barriers to incarcerated individuals alleviating their mental health crises. Such obstacles include “differences in the ability to adapt to prison, limited healthcare and programs within prisons, social isolation, segregation, and stress resulting from risk of violence and prison conditions” (Canada, Barrenger). These factors highlight the difficulty of managing mental health struggles in an environment which is disruptive and where issues of mental health often go unnoticed which can escalate these struggles. Drawing comparisons to Remch and Mautzs study, when inmates were subject to more restrictive housing environments it was more difficult for them to manage their behaviors because the conditions of being in an isolating, sometimes chaotic, and un therapeutic environment made it difficult for them to have control over their conditions.
Canada and Barrenger established a sample group of “43 adults with mental illnesses who were formerly incarcerated recruited from three different sites in the Midwest and East Coast” and asked “What was your experience like in prison” (Canada, Barrenger). Their intentions were to gather insight into accessibility of mental health services and the treatment of those with mental health conditions from those who had experienced it firsthand. When it came to prison healthcare participants shared a similar experience of “not being believed and not getting problems addressed” (Canada, Barrenger). This occurrence further exhibits an element of mistrust between staff and inmates along with an aspect of stigma that inmates are being dishonest about their symptoms that creates an obstacle between access to treatment. This element of stigma from prison staff is relevant to findings of Simes and Western which indicate that “the largest effects of mental health stigma emerge in the high-discretion stage of prison discipline, where line staff write misconduct tickets” (Simes, Western). Depicting the level of misunderstandings between an inmate suffering from a form of mental illness and staff who may believe they are simply acting up or disobeying the rules. Another notable point details how “One participant described being diagnosed with bipolar disorder and schizophrenia while he was in prison. He perceived that the experience of being incarcerated brought on these conditions” Highlighting the reality of the experience of incarceration being traumatic for some individuals (Canada, Barrenger). While the study does not focus on the ability for mental health disorders to emerge while incarcerated, there is a collective notion of experiencing a loss of control and being placed in an unpredictable punishment based environment that can often exacerbate conditions for incarcerated individuals with mental health conditions.
These sociological and psychological studies are relevant to repairing the crisis of mass incarceration, because they can help pave the way to instituting more widespread changes to our justice system bringing forth the possibility of restorative and therapeutic alternatives to a punitive justice system. Aiming to reduce recidivism through prioritizing treatment based mental health care to the large percentage of inmates who struggle with mental health. They express relevant points of concern regarding issues of mental health within the U.S prison system and detail how it can be transformed to better represent and serve those within it. They further display the issue of stigmas surrounding mental health and help to address the need to diminish these stigmas, altering how those with mental illness are treated in prison.
Canada, Kelli, et al. “Multi-Level Barriers to Prison Mental Health and Physical Health Care for Individuals With Mental Illnesses.” Frontiers in Psychiatry, vol. 13, 2022, pp. 777124–777124, https://doi.org/10.3389/fpsyt.2022.777124.
Remch, Molly, et al. “Impact of a Prison Therapeutic Diversion Unit on Mental and Behavioral Health Outcomes.” American Journal of Preventive Medicine, vol. 61, no. 5, 2021, pp. 619–27, https://doi.org/10.1016/j.amepre.2021.05.023.
Simes, Jessica T., et al. “Mental Health Disparities in Solitary Confinement.” Criminology (Beverly Hills), vol. 60, no. 3, 2022, pp. 538–75, https://doi.org/10.1111/1745-9125.12315.
“Mental Health .” Prison Policy Initiative , Prison Policy Initiative , www.prisonpolicy.org/research/mental_health/#:~:text=Percent%20of%20people%20in%20state,care%20while%20incarcerated%3A%2066%25%20%2B.
No comments yet.