With as many as 1 in 5 inmates suffering from a major mental illness, it’s not surprising that prisons are frequently called the new asylums. This fact can be seen as part of the broader failure within the justice system to engage in rehabilitative efforts, a position that has especially damaging effects in the case of mentally ill individuals. These inmates often present behavioral problems that make it difficult for them to coexist with others in a prison and evidence suggests that mentally ill inmates are substantially over-represented in solitary confinement. This is a big problem because it has long been documented that such measures cause long-term, and often permanent, harm to inmates' mental health. It should thus come as no surprise that studies in multiple state prison systems have shown a clear connection between inmates suffering from severe mental health conditions and suicide. Indeed, it is plausible that a majority of suicides in prison are committed by those suffering from severe mental health conditions.
This is obviously a tragedy, but a critique of this approach may be to ask what the state is supposed to do about this problem. After all, having a mental health disorder does not fully remove agency or culpability. Is the alternative just letting dangerous criminals run free because we're too nice to punish people who have these conditions? Are disorders an excuse to avoid justice? But people who ask these questions are missing the whole point. To come to the conclusion that we shouldn't do anything about this massive fundamental problem in our legal system requires taking for granted that brutally incapacitating people is otherwise an effective long-term solution to crime. It isn't.
This becomes especially apparent when you think about the fact that many offenders first interact with the system as juveniles. I don't think you really need rigorous scientific research to understand why temporarily shoving young people in cages when they transgress is bad for their long-term likelihood of being a positive contributor to society. There is, however, a ton of evidence for this. Juvenile detention is linked to a variety of negative outcomes, including increased likelihood of learning disabilities, decreased stability in employment, and of course mental health illness. One psychologist found that one-third of incarcerated youth with depression developed the condition after being incarcerated. This relationship is especially damning when you consider that 70% of juvenile inmates are detained for non-violent offenses.
Many people are familiar with the phrase 'school to prison pipeline' referring to the path that individuals are sent down when behavioral issues in school lead to juvenile detention which in turn leads to adult incarceration. But I fear there's a disconnect where people hear this phrase and don't internalize how formative each of these steps is in the creation of a marginalized class. Individuals aren't simply moving through an unpleasant, but ultimately passive, system. Our society is set up such that children with challenging lives who understandably present deviant behavior in class are met with punishment from an early age, and denied meaningful support. This pattern continues, becoming progressively more brutal and dehumanizing as the individual gets older, cementing negative self-perceptions, weakening interpersonal skills, and ultimately driving harmful behavior. Biases and cultural stereotypes and judgements shape this process, creating a justice system that reflects systemic racism and classicism at every level and every age group.
Mental illness is complicated. There are massive debates about nature vs nurture and undoubtedly there is a certain percentage of the population that will commit atrocious crimes and need to be incapacitated even with a well-intentioned justice system. But that proportion is not reflected in the current reality of mass incarceration and it's not hard to see why. While elements of mental health illnesses are related to biology and genetic predispositions, there is a growing body of psychology and psychiatry that is exposing the link between childhood trauma and negative mental health outcomes. This suggests that the onset of depression for incarcerated teens is likely more than a correlation; it is the natural result of receiving society's worst treatment. We need to internalize why people who grow up facing racial stigma, economic scarcity, and immense threats to their safety are more likely to commit harm. This is not a cultural problem and it is certainly not an individual one, it is an inevitability of oppression in a vastly unequal, heavily policed state. People can't function at their best when they're denied access to their basic needs and frequently exposed to pain and trauma without receiving support or being assisted in working through it.
So what do we do?
There are a host of obstacles to take into account here. Our social welfare system is extremely underdeveloped, and the kind of work required to rehabilitate young people who are struggling with mental illness and engaging in criminal activity takes a lot of talent and investment that is not there. It is nevertheless crucial to invest in this work. The prevalence of mental illness is not random. At the very least, the way people live with mental illness is hugely variable based on the way they are treated by society. Currently, society tells offenders with mental illness that they belong on the margins and that there is nothing to be done about them. We need to invest in a stronger system of social support that intervenes positively and earlier in people’s life.
There are no cures for severe mental health conditions, but individuals can live relatively healthy lives when they receive proper care and have their basic needs met. Evidence suggests that intervening early is significantly more likely to be effective at preventing negative mental health outcomes. Currently, many people simply cannot feel enough empathy for mentally ill incarcerated people to support programs like restorative justice in many cases. However, the development of alternatives to incarceration for mentally ill youths may be better received by a general public that is skeptical about rehabilitative, non-punitive measures. RJ practitioners and others who work with juvenile offenders can be trauma-informed and can actively work towards the prevention and mitigation of severe mental health and behavioral issues, rather than applying more punishment. It is critical that we recognize the roles that the state and American culture play in perpetuating criminal behavior and other forms of harm. The way we currently think about how people develop desirable and undesirable qualities creates bad policy, and more importantly, it's completely inhumane.