People tend to prioritize punishment and justice when looking at a prison. What people tend to forget, however, is the far-reaching impact incarceration has at the individual level from a psychological standpoint. For quite some people, imprisonment either instigates new mental health concerns or exacerbates existing ones.
There are approximately 10.6 million jail admissions and 600 thousand prison admissions every year in the U.S. A substantial percentage of this population enters prison with pre-existing mental conditions, while others start showing symptoms post-incarceration.
An individual’s emotional and psychological health is vulnerable to an unparalleled range of impacts from prison. He/she might develop anxiety, emotional and clinical depression, PTSD, and a plethora of mental disorders. To make it worse, a significant number of inmates do not receive treatment prior to their release, leaving them in a worse mental state than when they first arrived.
Widespread Mental Health Challenges in Prison
According to the National Academy of Engineering, about 44% of prisoners have some form of diagnosed psychological disorder. The same percentage from state facilities stands at 73% for women and 55% for men, showing qualified mental disorders.
Substance use problems are often encountered together with other mental disorders, forming an intricate system of health problems. This is more troubling for marginalized communities: Black and Hispanic communities are overrepresented in prison populations and tend to receive disproportionate treatment throughout the justice system.
Approximately 6% of the U.S. population suffers from some form of serious mental illness, whereas the figures for prisons are between 10% to 25%. Numerous others endure some form of chronic depression, anxiety, or trauma, some of which arise during the course of incarceration.
What is particularly worrying is how frequently these conditions go untreated or misdiagnosed. Inmates are subjected to behavioral assessments that lack a normal operating environment framework, leaving those suffering without proper treatment, support, or intervention.
The Psychological Toll of Incarceration
There are significant effects on the psychological well-being of a prisoner once their imprisonment begins. Let’s have a look at some of the common feelings and experiences of prisoners.
Loss of Purpose
Over the course of their sentence, individuals gradually lose any sense of direction. Most lack the means to care for family and friends, and must either languish unpaid or participate in meager prison work, and inexorably start to feel purposeless.
Loss of Identity
Prisoners are denied the identity tag of an artist, parent, or any other professional and are instead labeled as mere ‘inmates.’ The loss of self-suffering contributes to profound emotional suffering.
Isolation from Family and Friends
As with any community, the confinement of an individual in prison cuts them off from their families and peers. Being absent from crucial moments like attending their children’s milestones, their aging parents’ illness, or other issues brings them unbearable suffering, remorse, and solitude.
Physically Stressful Environment
A sanitized environment, absence of natural lighting, and little to no activity designed to promote stimulation makes a prison a highly stressful and, at times, demeaning place to be. Captivity becomes mentally suffocating when coupled with operational understaffing, the lack of open spaces, and infrequent access to the outdoors.
Witnessing and Experiencing Violence
A large subset of incarcerated individuals either witness or experience some proclaimed violence. Increased stress levels associated with the enduring danger of violence make post-incarceration reintegration extremely difficult, whilst bearing psychological damage.
The act of placing one in solitary confinement
Being alone for 23 hours a day has been shown to strip a person’s will. Paranoia, depression, violence, and suicidal beliefs greatly heighten during isolation. Ironically, the people who endure mental illness and struggle on a day-to-day basis tend to be the same individuals placed into seclusion, aggravating their conditions.
Not enough resources for mental medical care
Even in cases where mental disorders are diagnosed or treated, there are extremely few resources available to treat them due to budgetary constraints, insufficient staff, and limited medication. In fact, prisons are known to ignore all other supporting cases unless they are the most severely impaired and tend to struggle alone.
If offered, therapeutic services are not likely to be trauma-informed or tailored to individual needs. For numerous incarcerated people, longitudinal records detailing their medical history are unavailable, meaning that prior professional evaluations and mental health treatments during pre-incarceration life are nullified. Additionally, it is plausible that those on medications before incarceration lose access to their prescriptions upon arrival.
Regarding treatment, data suggests that only around 38% of inmates undergo behavioral therapy, while less than 8% receive treatment for substance abuse co-occurring with mental health issues.
The consequences of insufficient care
Neglecting mental healthcare for the incarcerated population affects more than just the imprisoned individuals. Their families, friends, communities, and entire judicial system become interwoven in this tapestry of neglect. Furthermore, lack of intervention plays a big role in recidivism rates, as untreated mental illness is a significant factor. Research states that inmates who possess psychiatric illnesses are almost 30% more likely to reoffend and return to prison.
One study conducted in 2020 outlined the correlation between inadequate mental health treatment during incarceration and exacerbated chances of recidivism, suggesting imprisonment could increase the likelihood of reoffending by as much as 68%. These individuals lack essential tools and support systems, crucial for fostering the resilience necessary to navigate employment, rebuild relationships, or engage with society without getting into trouble.
The impact of closing state hospitals
The United States’ move away from long-term psychiatric institutions in the 70s was meant to propel the country towards community-focused mental health care. However, this transition was accompanied by a severe lack of funding, which led to these community-based facilities being understaffed and under-resourced.
Throughout the years, an increasing number of people who would have benefited from receiving long-term psychiatric care are instead being jailed. The Treatment Advocacy Center states that jails now have 10 times more people with serious mental illnesses than state psychiatric hospitals.
California Jails Under The Spotlight
While the national picture is dreary, there are bright spots. Cali, for example, has been actively trying to amend the ways mental health care is administered in jails.
Most counties have instituted specialized mental health services as part of the corrections system. These units serve inmates through clinical and psychosocial therapy, as well as psychiatric assessment and intervention. In addition, California’s Mental Health Services Act (MHSA) provides funding for counties seeking to address issues of recidivism through pre- and post-incarceration mental health treatment.
In certain California counties, enthusiastic adoption of the Stepping Up Initiative helps shift people with mental health issues away from jails and into community-based programs. Collaborative courts, including mental health courts, are also aiding in addressing the justice needs of people through psychological care instead of punishment-focused solutions.
In addition, some jails grant access to peer support counselors. These counselors develop re-entry plans focused on mental health services, enabling seamless transitions back into society with continued support pre-wrapped post-care.
While California’s approach is not perfect, it illustrates that reform is achievable when there is sufficient political will and public funding.
Final Summary
Disclosing their mental health history, or even the absence of it, should be encouraged for all individuals who encounter the criminal justice system, as it might help them get additional support.
With that being said, the problem requires more radical changes. Providing better access to mental health services both inside and outside of prison, maintaining continuity of care after release, and implementing proactive measures are crucial to resolving the issue of incarceration and untreated illness.
Real change will emerge only when mental health is regarded as a central concern of justice, instead of relegating it to secondary status.