Livie Jacobs

Professor Bohrer
PHIL 125
December 13, 2016

Emotional Lockdown: Mental Illness in American Prisons

There are twice as many people suffering from mental illnesses who are in the prison

system than there are in all psychiatric hospitals in the United States combined.1 The existence of

practices such as solitary confinement, denial of basic needs, sexual assault, and the lifelong

stigma of criminality within the prison system provoke psychological distress. In this paper, I

will argue that prison practices are psychologically destructive and inhumane. Because the prison

and the practices it employs are two separate entities, there are feasible ways in which the prison

can cease exacerbating and engendering mental illness.

Solitary confinement, or the practice of isolating a prisoner as punishment, is used in

United States prisons. It has religious roots, and was originally intended to be rehabilitative.

Prison abolitionist Angela Davis writes that in 1756, Enlightenment thinkers demanded prison

reform based on “order, classification, cleanliness, good work habits, and self-consciousness.”

The existing prisons were criticized as having prisoners who “were not severely restricted”

enough.2 At the time, religious practice was becoming more individualized. Spiritual reflection

required little external distraction or interaction. Therefore, more isolation and confinement “was

assumed to have an emancipatory effect” that would “allow the soul to flourish.”3 In 1829, the

Pennsylvania prison model “emphasized total isolation, silence and solitude,” and was endorsed

by the Quakers as a methodology intended to transform one’s thinking and eradicate deviant

1
​Davis,​ Are Prisons Obsolete?​, 10.
2
Angela Y. Davis, ​Are Prisons Obsolete?​ (New York: Seven Stories Press, 2003), 53.
3
​Davis, ​Are Prisons Obsolete?​, 48.
behaviors.4 In the twentieth century, the length of a prisoner’s stay in solitary confinement was

quite short, lasting for a maximum of two weeks.5 Nearly a century later, the supermax prison

was born in Marion, IL. in which “prisoners were confined to their cells 23 hours a day. This

lockdown became permanent.”6 Prisoners are currently being held in solitary confinement for

decades. What began as a technique for spiritual improvement and transformation has evolved

into an inhumane disciplinary measure.

Today, solitary confinement causes widespread psychic manipulation of those trapped

inside prison walls. A 1997 Human Rights Watch report describes how “congregate activities

with other prisoners are usually prohibited; communication with other prisoners is prohibited or

difficult; visiting and telephone privileges are limited.”7 Humans thrive on social interaction and

a sense of community or strong relationships: “Placement in general population allowed

individuals to form tight relationships and create community with other incarcerated people,

especially cellmates, which multiple people said helped to reduce their sense of isolation and

vulnerability.”8 Thus, it is no surprise that solitary confinement, or administrative segregation (ad

seg) is “likely to cause or exacerbate mental and physical ill-health of those incarcerated [such

as] rage, loss of control, paranoia, hallucinations, and self-mutilations.”9 Based on a study done

in 2004, 73% of all California prison suicides occurred in solitary confinement.10 In addition,

4
​Davis, ​Are Prisons Obsolete?​, 47.
5
Kirsten Weir, "Alone, In The 'Hole'", ​Apa.Org​, 2012, http://www.apa.org/monitor/2012/05/solitary.aspx.
6
​Davis, ​Are Prisons Obsolete?​, 49.
7
​Davis, ​Are Prisons Obsolete?​, 50.
8
Pascal Emmer, Adrian Lowe and R. Barrett Marshall, ​This Is A Prison, Glitter Is Not Allowed: Experiences Of
Trans And Gender Variant People In Pennsylvania's Prison Systems​ (Philadelphia: Hearts on a Wire Collective,
2011), 20. http://socialproblems.voices.wooster.edu/files/2011/08/heartsonawire.pdf.
9
Liat Ben-Moshe, "Disabling Incarceration: Connecting Disability To Divergent Confinements In The USA",
Critical Sociology​ 39, no. 3 (2011): 398., DOI:10.1177/0896920511430864.
10
​Seth Ferranti, "How Solitary Confinement Can Drive Inmates To Suicidal Thoughts", ​Vice​, 2015,
http://www.vice.com/read/how-solitary-confinement-can-drive-inmates-to-suicidal-thoughts-610.
denying an individual basic health services is common in solitary. Victims report that the “denial

of medical treatment, health maintenance services, and food were sometimes added

punishments.”11

Even if a prisoner is never isolated and remains with the general population of prisoners,

witnessing or being victim to sexual assault and violence causes psychological problems. The

likelihood of being a victim of gender-based violence outside of solitary confinement increases if

the prisoner deviates from heteronormative society. For example, a study on gender variant and

transgender individuals found that “general population exposed some participants to

gender-based violence, including physical and sexual assault, which was often overlooked by

prison guards and sometimes encouraged and perpetuated by guards themselves.”12 This violates

the inherent right of American prisoners to be free of sex crimes and sexual harassment.13 One

may argue that prison does not cause mental illness because many individuals have been

diagnosed prior to incarceration. However, this is a moot point when one considers how

“conditions of confinement may cause ​further​ mental deterioration in prisoners entering the

system with diagnoses of mental illness or intellectual disabilities.”14 Prisons can transform the

most emotionally sound individuals. Simply being witness to these assaults and abuse of power

is enough to traumatize general population prisoners. They are at risk of developing complex

post traumatic stress disorder (C-PTSD), a condition that “results from chronic or long-term

exposure to emotional trauma over which a victim has little or no control and from which there is

11
​Pascal Emmer, Adrian Lowe and R. Barrett Marshall, ​This Is A Prison, Glitter Is Not Allowed, ​23.
12
​Pascal Emmer, Adrian Lowe and R. Barrett Marshall, ​This Is A Prison, Glitter Is Not Allowed​, 20.
13
"Know Your Rights", ​American Civil Liberties Union​, 2016, https://www.aclu.org/know-your-rights?topics=88.
14
​Liat Ben-Moshe, "Disabling Incarceration,” 398.
little or no hope of escape.”15 Long term imprisonment and torture, and entrapment or

kidnapping, can trigger the disorder.

The horrific psychological effect of imprisonment does not disappear once a prisoner is

released due to the stigma of criminality. Lifelong hardship comes with a prison sentence.

Michelle Alexander gives the testimony of a recently released African-American man who said,

“My felony conviction has been like a mental punishment...two times I got very depressed and

sad because I couldn’t take care of myself as a man.”16 To add to any traumatic experiences from

inside the prison, this man faces unemployment, homelessness, disenfranchisement, and social

exclusion upon release. The stigma surrounding formerly imprisoned citizens creates a “negative

field of silence and estrangement” in communities.17 This is essentially the more subtle, social

version of the physical isolation one may have experienced in solitary confinement. Particularly

for African Americans, even those who have never spent time behind bars, there is a “suggestion

that a shameful defect lies deep within them” because of the public’s association of criminality

with people of color.18 Thus, the individual risks internalizing the negative stereotype leading to

harmful effects on self-esteem. An Oxford University study found that ex-offenders with mental

illness are more likely to offend.19 This is unsurprising given the added stressors associated with

re-entering society.

15
​"Complex Post Traumatic Stress Disorder (C-PTSD)", ​Out Of The FOG​, 2015,
http://outofthefog.website/toolbox-1/2015/11/17/complex-post-traumatic-stress-disorder-c-ptsd.
16
​Michelle Alexander, ​The New Jim Crow: Mass Incarceration in the Age of Colorblindness​, Paperback ed. (New
York: New Press, 2012), 163.
17
​Alexander, ​The New Jim Crow​, 169.
18
Alexander, ​The New Jim Crow​, 165.
19
Sarah Boseley, "Ex-Prisoners With Mental Health Problems 'More Likely To Reoffend'", ​The Guardian​, 2015,
https://www.theguardian.com/society/2015/sep/03/ex-prisoners-mental-health-problems-more-likely-reoffend-study.
 The rampant mental deterioration of American prisoners does not discriminate across

gender, race, class, or age boundaries. It affects white, Black, brown, heterosexual and

homosexual, cisgender and transgender, the young and old. A 1999 survey of prisoners is

evidence of this: “29 percent of white females, 20 percent of black females and 22 percent of

Hispanic females in State prison were identified as mentally ill. Nearly four in ten white female

inmates aged twenty-four or younger were mentally ill.”20 Although anybody is susceptible to

mental illness, those who are caught up in the criminal justice system are more likely to be from

impoverished communities and are therefore more vulnerable than their advantaged counterparts.

This is because poverty or unemployment often leads to individuals desperately participating in

the illegal economy (eg. selling drugs) in order to survive. Prior to being incarcerated, these

poverty-stricken individuals often experience unstable childhoods due to unreliable housing,

absentee parents, access to alcohol/drugs, and exposure to violence at a young age.21 Poverty can

“cause a variety of impairments and disabling conditions” but in addition, “the prison

environment itself is disabling [due to] poor air quality, circulation of drugs and unsanitary

needles, and lack of medical equipment and medication.”22 All of these factors leave prisoners of

lower socioeconomic status emotionally, and in some cases physically, compromised.

Queer individuals are also, perhaps more explicitly, targeted as criminals simply based on

their sexual and gender identities as Mogul, Ritchie, Whitlock discussed in their book. Therefore,

many end up behind bars. They too are emotionally at-risk in prison because hormone therapy is

given “without accompanying psychological support...leading to an increased likelihood of

20
​Liat Ben-Moshe, "Disabling Incarceration,” 397.
21
​Florida Council For Community Mental Health, ​Mental Illness And Poverty: A Fact Sheet​ (Tallahassee, 2007),
http://www.fccmh.org/resources/docs/mentalillnessandpovery.pdf.
22
​Liat Ben-Moshe, "Disabling Incarceration,” 397.
suicide attempt.”23 Many times, these inmates are denied their hormones altogether, which can

prove deadly because “the rapid withdrawal of hormone therapy can lead to severe psychiatric

symptoms and self-injurious behavior.”24 American prisoners are guaranteed the right to

‘adequate’ mental and physical health care, but these practices are anything by adequate in that

they neglect an individual to the point of death or permanent damage to one’s health.25

As evidenced, imprisonment engenders emotional neglect. Abusive practices like solitary

confinement have persisted over time because they promote the emotionally-unstable-inmate

archetype, which is a useful method of social control. Prisons themselves are said to “function

ideologically as an abstract site into which undesirables are deposited.”26 The more mentally ill

individuals are criminalized and stigmatized, the more ‘undesirable’ they become to mainstream

society. The archetype of the dangerous and “crazy” individual is similar to the term

“criminalblackman” coined by legal scholar Kathryn Russell.27 Making somebody’s skin color a

mark of their danger to society serves to perpetuate fear and promote harsh crime laws. This in

turn promotes prison expansion as more and more ‘undesirable’ individuals are profiled and

incarcerated. Politics also plays a crucial role in the incarceration of mentally ill individuals

because greater incarceration rates mean greater profit for corporate businesses backing the

private prison industry. President Clinton’s Personal Responsibility and Work Opportunity

Reconciliation Act which imposed a five-year limit on people using welfare or food stamps is an

example of how laws can help fill prisons at the expense of an individual’s psychological

23
​Joey L. Mogul, Andrea J. Ritchie, and Kay Whitlock, ​Queer (in)justice: The Criminalization of LGBT People in
the United States​ (Boston: Beacon Press, 2011), 112.
24
​Mogul, Ritchie, and Whitlock, ​Queer (in)justice​, 112.
25
​"Know Your Rights", ​American Civil Liberties Union​.
26
​Davis, ​Are Prisons Obsolete?​, 16.
27
​Alexander, ​The New Jim Crow​, 107.
well-being.28 Closing or eliminating funding to welfare programs and public mental health

treatment facilities increases homelessness, unemployment, and participation in the illegal

economy. This serves to funnel even more mentally ill and emotionally-at-risk citizens into the

prison system. As such, prisons become “storehouses of the living dead” because inmates feel

hopelessly maltreated.29

On moral and ethical grounds, many practices used in prisons are inhumane. They violate

the supposed right of American prisoners to basic mental and physical healthcare and freedom

from sexual assault. However, there are ways in which the emotional health of prisoners can be

improved without the abolition of the prison itself. The first step in humanizing prisons and

reimplementing their rehabilitative aims is by eliminating solitary confinement, putting measures

in place to eliminate sexual and physical abuse of prisoners by other prisoners and/or guards, and

improving the availability of psychological care both inside and outside of the prison. In order to

do so, we must “link struggles for personal transformation and healing with struggles for social

justice.”30 Considering one in five adults experiences mental illness, it should not be difficult to

come together in the struggle against emotional neglect in prisons.31 This would involve a shift

“toward preventative supportive and independent living care [which] can help keep those most

impacted from ending up in handcuffs or dead on the street.”32 Mainstream anti-prison and

28
​Alexander, ​The New Jim Crow​, 57.
29
​Mogul, Ritchie, and Whitlock, ​Queer (in)justice​, xiii.
30
​“Critical Resistance Statement on Gender Violence and the Prison Industrial Complex,” ​INCITE! Women, Gender
Non-Conforming, and Trans people of Color Against Violence, ​published 2001,
http://www.incite-national.org/page/incite-critical-resistance-statement​.
31
​"NAMI: National Alliance On Mental Illness | Mental Health By The Numbers", ​Nami.Org​, 2015,
http://www.nami.org/Learn-More/Mental-Health-By-the-Numbers.
32
Jose Martin, "Policing Is A Dirty Job, But Nobody's Gotta Do It: 6 Ideas For A Cop-Free World", ​Rolling Stone​,
2014,
http://www.rollingstone.com/politics/news/policing-is-a-dirty-job-but-nobodys-gotta-do-it-6-ideas-for-a-cop-free-w
orld-20141216.
anti-violence movements are not currently doing enough for mental health. In their mission

statement, INCITE! Women of Color Against Violence cited “slashing, suicide, the proliferation

of HIV, strip searches, medical neglect and rape of prisoners” as problems overlooked by these

movements.33 An editorial in the American Academy of Psychiatry and the Law cites

“innovative and comprehensive treatment programs in prisons, coupled with state-of-the-art

diversionary measures for mentally ill arrestees and community reentry programs” as the key to

diminishing rates of mental illness in prison.34 Eliminating the funneling of mentally ill

individuals into prisons, and improving the psychological treatment of those already incarcerated

must be prioritized in order to make prisons in the United States tolerable and just.

American prisons are neglecting the rights of prisoners by allowing practices like solitary

confinement, sexual abuse, and the denial of basic healthcare to continue. These cause emotional

distress and often lead to staggering rates of mental illness both inside and outside the prison

walls. Instead of rehabilitating mentally ill offenders in treatment centers, prisons are

exacerbating symptoms and causing further harm. Even emotionally healthy prisoners are at risk

for developing mental illnesses like C-PTSD due to sexual abuse and/or violence they witness or

are victims of while incarcerated. In order to prevent further harm to incarcerated, or previously

incarcerated Americans, the country must come together to strengthen mental health services and

examine abusive penitentiary practices in the hopes of one day eliminating them. Doing so

would reap benefits much greater than improved mental health. By dismantling criminal

archetypes like the deranged-inmate and criminalblackman, implicit discrimination and stigma

will diminish. Poorer communities will have access to mental health care and welfare programs,

33
​“Critical Resistance Statement on Gender Violence and the Prison Industrial Complex,” ​INCITE!.
34
​ Daniel Anasseril, "Care Of The Mentally Ill In Prisons: Challenges And Solutions.”
alleviating poverty, homelessness, crime, and unemployment. Dismantling the prison practices

that neglect mental health is a necessary stepping stone to alleviating societal ills.