The imprisonment binge of recent decades has landed over two million people currently in jails and prisons, where nearly fifty percent are African American. In the same decades, while the prison population was multiplying exponentially, the proportion of prisoners suffering from serious mental illness was also expanding. There are now ten times as many prisoners with serious mental illness behind bars as there are in state and federal psychiatric hospitals. I have had the privilege of appearing as a psychiatric expert witness in class action lawsuits challenging harsh conditions of confinement and inadequate correctional mental health services, violations of the Eighth Amendment’s prohibition of cruel and unusual punishment. Crowding was the main condition challenged in class action lawsuits in the 70’s and 80’s. With crowding there was more violence, more psychiatric breakdown, and more suicide.
In the late 80’s, a historic wrong turn occurred. The violent jails and prisons seemed out of control. Instead of down-sizing the population and expanding rehabilitation programs – reasonable and safe measures that would have effectively resolved the crisis – the powers that be decided to lock up “the worst of the worst” in solitary confinement, often in special facilities called supermax prisons. There, relatively stable prisoners experienced serious emotional distress while prisoners with mental illness experienced severe exacerbation of their disorder and eventually, magnified psychiatric disability.
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Ryan’s story (not his real name) is dreadfully representative. Ryan entered the large maximum security prison in the Midwest at age seventeen, before he had anything but peach fuzz on his cheeks. He was tried as an adult and sentenced to five years in a maximum security prison. White, five foot six inches tall and slight, he was what’s known as a “fish,” “meat,” or “bait” in a maximum security prison.
Tikkun 2018 Volume 33, Number 1/2:71-72