Untreated mental health in prison has considerable consequences

Recently I shared an article on LinkedIn titled “How Being in Prison Might Affect Your Mental Health” from the VerywellMind website. In the post, I quoted the second paragraph, which said:

"Being in prison can take a serious toll on an individual’s psychological well-being. New conditions often develop, and pre-existing conditions may worsen. Sadly, many justice-involved individuals are released back into the community without ever receiving any type of treatment."

The article continued by stating the toll that prison takes on psychological well-being, including a perceived lack of purpose in life, the loss of sense of self, separation from loved ones, a stressful physical environment, exposure to violence, and the effects of solitary confinement (e.g., anxiety, insomnia, paranoia, aggression, and depression). 

“About 37 percent of people in prison have a history of mental health problems, according to a 2017 report from the U.S. Department of Justice. More than 24 percent have been previously diagnosed with major depressive order, 17 percent with bipolar disorder, 13 percent with a personality disorder and 12 percent with post-traumatic stress disorder. The numbers are even higher for people in jail, where one-third have been previously diagnosed with major depressive disorder and almost one-quarter with bipolar disorder,” according to the American Psychological Association.

Given the complexity of the reentry process (returning to the community following a period of incarceration), one's health status, both in and out of prison, likely influences additional aspects of reentry, such as abstaining from crime or adhering to parole terms. 

Comments about the prison mental health post.

My post on LinkedIn got 2,764 impressions, 13 comments, and 17 reposts. Of those 13 comments, most were from those with lived experience of incarceration or from advocates who thanked me for sharing and advocating to the public about such concerns. One comment was from a gentleman advocating for the occupational stress and fatigue that corrections staff experience (rightly so…I know how stressful it can be for corrections staff who also receive so little pay for the essential work they do.)

One sarcastic comment from a director at the Department of Corrections, however, touched on something I’ve seen several times in various social commentaries, which is something along the lines of “why should we be concerned about the mental health of criminals?” and “they should just rot in jail to pay for what they did to another human being.” Indeed, this viewpoint has validity – we must consider the needs of the victims and their families in our discussions about the criminal justice system.

I am not saying we should fail to consider the mental health of victims and their families. No one would reasonably argue that people who are found guilty do not deserve prison time (even many of the offenders I interviewed in my year-long research project would agree). Instead, I’m saying that addressing the mental health of the person convicted of a crime is also important. In addition to our concerns for victims and families, I also advocate for the rehabilitation of those who are incarcerated.

Many times, those who experience incarceration are released back into the community with their mental health issues never identified or treated in any way, which results in the person re-offending and returning to prison.

Untreated mental health.

The problem with untreated mental health conditions among the prison population is that it takes a toll not only on the affected individual, but on society, in the form of taxpayer’s money. People who have mental health and well-being concerns may have higher rates of unemployment and/or live on social assistance, they may struggle financially, live in conditions of poverty, and have problems coping with day-to-day life. These problems may lead to conflict with the law and re-arrest or re-incarceration, or additional costs to process an individual through the criminal justice system. Every time an individual enters the criminal justice system, it costs taxpayers an average of $39,000 per inmate annually. In California, with the largest state prison system in the country, it costs $106,131 per individual annually to incarcerate an inmate in prison. 

Recidivism is the rate at which individuals return to prison after release from former incarceration. If we fail to provide adequate mental health services, people with mental illness will have a high rate of recidivism when they are released. 

Studies show that people who serve time in prison tend to commit more and increasingly severe crimes when they get out. Locking low-level offenders in with hardened career criminals tends to result in more hardened criminals who have been “taught” more tricks of the criminal trade. As those low-level offenders are released with their newly learned “skills,” they are too often alienated and unable to secure honest work and many will return to a life of crime.

It is worth considering the impact incarceration has on the whole family, not just the person convicted. Marriages become strained, households lose the breadwinner, and children lose their parents to the penal system, often for years. Incarceration is a tremendous cost to taxpayers, family members, and communities. 

Rehabilitation: Addressing mental health.

In a 2020 study involving a large, multi-state sample of formerly incarcerated males who were followed from prison to release into the community, researchers found that better mental health decreases the likelihood of recidivating. “For formerly incarcerated individuals, maintaining good mental health while in the community is a critical component of avoiding reincarceration” (Wallace & Wang, 2020, p. 9). 

Rehabilitation programs benefit budgets and public safety. More than 95 percent (link: https://bjs.ojp.gov/content/pub/pdf/reentry.pdf) of those who go to prison will someday return to their communities. Yes, imprisoning an offender removes the person from the community for a short time, but eventually they’ll be back, making it imperative that they leave prison better people—not worse—than when they were imprisoned. Unfortunately, it seems that prison generally has the opposite effect.

Reducing recidivism by addressing mental health contributes to stabilizing the lives of formerly incarcerated people and their families, lowering costs associated with incarceration, and reducing crime rates. It also saves taxpayers money, and it results in safer communities. 

“Incarceration is not meant to be fun, of course. But a combination of strict sentencing guidelines, budget shortfalls and a punitive philosophy of corrections has made today's prisons much more unpleasant--and much less likely to rehabilitate their inhabitants--than in the past, many researchers say,” according to the American Psychological Association. (link: https://www.apa.org/monitor/julaug03/rehab)

Rehabilitation programs, especially those that focus on mental health and well-being, help break this vicious cycle. 

Preventing further criminal behavior should have a higher priority than exacting retribution. 

What do you think?