One of the greatest challenges a prisoner will face is mental illness. It is such a powerful force in one’s life, that left unchecked, mental illness can be devastating. Because of the spectrum of illnesses and the unique way they manifest in individuals, it’s difficult to explain, with any gravity, the scope of the problems. I will explore my own personal experiences with mental illness during the phases of being a “free citizen” to arrested suspect, on to incarcerated prison, and finally the post-release. It is necessarily limited, this discourse will illustrate the larger issues.
The first significant issue is the lack of a substantial mental health system or even an awareness of what mental health is, out in society at large. I spent five years in the state hospitals in Massachusetts, from 1987 until 1992. I have seen every kind of disorder and I’ve experienced their worst manifestation and treatments. Not every mentally ill person is obviously afflicted. (Think of McMurphy from One Flew Over the Cuckoo’s Nest.) The lack of understanding and empathy by society, in general, can cause some of us to get worse, sicker.
As a person with mental illness, I can often get stuck in my head. This is manifested as extreme loneliness, depression, self-mutilation, attempted suicide, and heavy drug use. It also results in extreme violence as I would lash out at my “tormentors.” Drug and alcohol use is very common among untreated mentally ill people. Very much in the same way that the body will crave foods that contain needed nutrients, a person’s brain will seek the chemicals that can alleviate the symptoms. This is usually, obviously, a bad decision. When you’re suffering the “quick fix” relief beats a logical conclusion every time.
Once in police custody, you enter into the real nightmare. At this point, literally, everybody wants to hurt you. If you have any paranoid issues, you’re in for it. If you have any emotional dysregulation issues, you’re in for it. If the voices told you things were bad before… well things may actually seem better. No. I’m just kidding. You’re in for it.
My point is that no matter what flavor of mental illness, no matter its severity, whether you have PTSD, or bipolar, or have schizophrenia, being in police custody will only make it worse. Much worse.
Out there in society, people are uncaring, cold, uninterested, aloof. They really don’t know you nor do they really want to. In here? Everyone knows you and they are looking for ways to exploit you. Whether it’s getting amusement by making fun, stealing your stuff, beating you up, or raping you. Every imaginable degradation awaits you here. It’s hell for anyone, let alone a person with vulnerabilities. Trying to get treatment in this environment is difficult to best and potentially disastrous. The reasons for this are the same in prison as they are in society. Lack of funding for treatment and general ignorance. There are so many mentally ill people in prison, only the most severe, obvious cases will get the help they need. (I use the word “help” liberally here.)
Keep in mind there is no real mental health system in the “free world.” All of us who should have been in treatment are now in prison. Hundreds of us here in New Hampshire. Hundreds of thousands of us across the country. There are less than a dozen mental health workers here.
Once you’re arrested your mental illness will only come into question to determine when and where you will be locked up. Not if you were less culpable or “not guilty.” If gods forbid, you’re found to be incompetent to stand trial, you are sent to a prison psychiatric ward for treatment. If and when you are ever found to be competent to stand trial, you’ll be tried and then sent to prison to serve your time. All the many years you may spend in the treatment do not count as pretrial time served. This can be dozens of years!
You need to realize, prison is America’s fastest-growing business. Look it up. Putting you in prison is just good for business. Mental health treatment is not. It bleeds profits from both ends. It costs money to provide treatment and if done right it keeps people from returning to prison or ever going there, to begin with. A lot of money. What business does that on purpose?
Once in prison seeking treatment will result in one of several options. The first and most common is medication. Here, “take this.” “I’ll redo the script in a year” approach to treatment is the norm here. Both medical and mental health issues are pilled away.
A second most common route is group therapy. These therapy sessions are designed for behavioral modification, not to address mental illness. In fact, we don’t have “mental health” here, we have “behavioral health.” No kidding. Ain’t that something? The only is the treatment less than helpful, the group is made up of a bunch of predatorial criminals court-ordered to take the group. They will use what they learn about you in the group as weapons later. I’ve seen it far too many times. Remember, everyone here knows everyone here. Just imagine as you drive down the street that you know everyone you see they all knew you all your secrets, so all your sins, all your weaknesses, and they’re all waiting for the opportunity to hurt you. Just imagine that. It’s worse than you can imagine. Even the staff here have their axes to grind.
There are exceptions, of course, not everyone is out to get you. But it is fair to say that being in prison is like being behind enemy lines. Everyone hates you and you can’t trust anybody. Do so at your own peril. For the mentally ill? The Devil Himself couldn’t have created a better hell.
Assuming that suicide, murder, or civil commitment doesn’t preclude it, eventually, you’ll be released. Now is the time when you will regret the lack of treatment the most because everyone develops habits in prison. You eat faster, walk-in counter-clockwise circles, you flush the toilet while using it. It’s called a “courtesy flush” in here. Our toilets don’t need to refill.
The way you react to things changes. Little things like hearing keys jingle or hearing a CB or walkie-talkie will make you flinch and look around for cops. Hearing a door slam or an alarm will take you right back to the cell block. Things like getting confrontational, maybe physically, with people who cut you in line or misinterpreting things, like people looking at you, as a precursor to being stabbed.
All these new habits create, for the returning citizen, or hurdles they must clear in order to stay free. If you have a mental illness it has likely gotten worse. Now you are handicapped. If you’re on probation or parole you’re probably in trouble. unless you have the rare understanding and compassionate officer, your handicaps are violations and you’re going back to prison.
If you get lucky you will have good insurance and get involved with some legitimate treatment. If not then you’ll need to hope you can avoid the big problems. This will often take the form of isolation and then, ultimately, drug use. I think it will repeat it though. It’s tragic but it’s even more tragic that less than 10% of our country gives a hoot. And 90% of that number are people with mental illness… figures.
By: Gregory LaVallee