Running Head: CAGED IN 1

Caged In: The Psychological Effects of Prisons on Nonviolent Offenders

Daejah A. Majette

First Colonial High School, Legal Studies Academy

Abstract

This legal research paper explores the topic of flaws in the correctional mental health care

system as well as the effect it has on nonviolent offenders who have been imprisoned. The author

begins with an analysis of the issue regarding the main points in reference to society. This is

followed by explications of cases and laws that are relevant to the main problems with the

psychological element of prisons. The author then goes into detail about how mental health is

regarded in the American prison system and follows up with an introduction to nonviolent

offenders. Within the nonviolent offenders explanation, the author connects nonviolent offenders

to the lacking mental health system within the prisons of the nation. Once this connection is

made, the author explains life post prison and then goes into a comparison with America and

other countries. Finally, the author concludes with possible resolutions to the main issues as well

as a final statement on the topics at hand.

Caged In: The Psychological Effects of Prisons on Nonviolent Offenders

No one is perfect; this is common knowledge. With imperfection and opportunity for

mishap when hard times come along there comes lapses in thinking or moral judgement leading

to devastating mistakes. Valuable years should not be taken away for minor infractions with law.

Many people would agree to such statements, but the correctional system within the United

States proves otherwise. Minor offenses from nonviolent criminals can lead to decades in prison

where there is also a failing system for dealing with the psychological trauma that comes with

being incarcerated. The violence and confinement of the prison system can cause psychological

problems, and could be dangerous for anyone to live in. There needs to be a change. The current

correctional mental health system within the United States creates an unsafe environment for all

inmates, especially nonviolent offenders, by providing inadequate care.

Why is this an Issue?

Sympathy

Inmates in America do not receive any sympathy from the general population of society.

There is a popular idea that those who are currently imprisoned will most likely reoffend, so

discrimination towards former inmates is widely perceived as acceptable. However, acting out on

this leads to the exclusion of released offenders, creating a self fulfilling prophecy from the

public when the exclusion turns into a reoffense. Society ostracizing released offenders prevents

employment because of bias, which in turn could lead to homelessness and a dependency on

drugs and alcohol. With no hope left, those who have come from a life of crime turn back to

what they know how to do, criminal activity. Those who reoffended within a year claimed that

they were discriminated against after their initial release in relation to finding jobs (Boag &

Wilson, 2014). It makes sense that an increase in empathy from the public could reduce
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prejudice while providing a higher tolerance for those who have made a mistake in the past

(Collier, 2014). In the psychological aspect of prison, there is an idea from the public that those

in prison do not deserve a certain amount of rights or relief from the stress of everyday prison

life. In the words of David Krassner, a prison psychiatrist, “Being in prison is the punishment for

their crime. How they do the time is not the punishment” (D. Krassner, 2011).

Misconceptions

There a few misconceptions about prison which can lead to the lack of sympathy from

those on the outside. However, the most prominent is the thought that prison is a somewhat

pleasant place to be. While the general population does indeed have the idea that prison is not an

ideal humble abode, there is a facade of prisons by examples that are seen on a television screen.

These society named “country club prisons” with minimal security, television access, and yoga

classes are for white collar nonviolent offenders with short sentences. They are not the norm of

life in an average state or federal prison (D. Krassner, 2011 ; Depaulo, 2013).

Introduction of Inadequate Mental Health Care

A major component of this issue is the psychological effects that prison can have on

offenders, as well as the inadequate mental health care provided. The imprisoned do not have

the right to the same standard health care provided to the community outside of prison walls

(Dubler, 2014). Privileges such as Medicaid, Medicare, and Social Security are no longer

effective in prison, thus preventing some from receiving the proper treatment they need because

of costs (Collier, 2014).

Case Law/ Legislation

Rights and Acts ( Eighth Amendment)

The Eighth Amendment in the Constitution is a recurring theme in the cases that came to

surface through research. This amendment protects against cruel and unusual punishment of

prisoners, which has been the deciding factor in the cases surrounding the topic of correctional

health services in prisons. When there is a failure of adequate services to the inmates who need

them, it is considered cruel and unusual since they are being kept from a basic human right

causing them to suffer in ways they should not have to.

Coleman v. Wilson (1995)

In 1995, the case Coleman v. Wilson focused on the California Department of Corrections

and Rehabilitation (CDCR) and their inadequate mental health care access. Since inmates were

not provided with the bare minimum mental health care access that prisons are required to offer,

the court ruled for a remedial process to fix the violations. The goal was to better their suicide

prevention, medication distribution, screening, treatment programs, staffing, and to make sure

that their records were accurate and complete. This process took 17 years in total, meaning not

all the violations were covered until the year 2012 (Force, n.d. ; Coleman v. Wilson). While the

court case may have been over 20 years ago, the fact that the problems could not be fixed until

just five years ago says something about the need to reform our correctional mental health care

system.

Parsons v. Ryan (2015)

A class action suit was filed in 2012 by over 30,000 prisoners in the Arizona

correctional system. In 2015, the prisons were ordered to repair over 100 health care issues

including more attention to preventable death and injury, as well as their excessive use of

solitary confinement. The court determined that prisoners with serious illnesses do not deserve

to be in solitary confinement where they would only be out of their cell for an hour out of the 24
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they get in a day. These prisoners should also be controlled with less violent restraints with

pepper spray being determined as the last resort. The court explained that there needs to be more

focus on mental health treatment within Arizona prisons as well. Despite what was ordered two

years ago, as of October 27 of this year, Arizona was found to have not complied with court

orders. Consequently, their correctional system will be fined $100 for each prisoner who has

been mistreated ("Parsons v. Ryan," 2017).

Alabama Court Case (2017)

In 2014, the Southern Poverty Law Center, the Alabama Disabilities Advocacy Program,

and the two law firms Zarzaur Mujumdar and Debrosse all filed a lawsuit against the Alabama

Department of Corrections (ADOC) for their inadequate mental health care system. The

Alabama Prison System is one of the most overcrowded, yet understaffed in the country (See

Appendix “A”). They have failed to identify suicidal prisoners, contributing to their high suicide

rates, and do not provide adequate individual treatment to those deemed mentally ill. The

correctional system in Alabama, like many other prison systems in America, focuses on

discipline rather than treatment. Instead of trying to ensure the inmates are being treated

correctly for their illness, prisons tend to segregate them from the rest of prison society in order

to correct behavior when inmates are in need of more than that for their condition. During the

case, testimonies from inmates described to the judge the appalling conditions they lived in. One

of them by the name of Jamie Wallace pleaded with the court saying such things as, “Please get

me out of here... this place is killing me.” Ten days later he was found deceased in his cell

(SPLC, 2017).

After reviewing the case, judge Myron H. Thompson saw clearly the issues within the

Alabama Department of Corrections and their involvement with their prisoners calling, “... the
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ADOC’s mental-health care … horrendously inadequate.” The officials knew of the issues and

showed “deliberate indifference” to them, only intensifying the problems. The issues lay in a

goal of saving money in any possible way, instead of focusing on the fact that these inmates are

still human beings, that deserve basic dignity even behind bars. There is no hope for recovery for

the mentally ill if there is no treatment within the prison walls (SPLC, 2017).

NCCHC

The National Commission on Correctional Health Care (NCCHC) is an organization that

was established in 1983 after the American Medical Association (AMA) found a vast amount of

substandard health services throughout the jails in the nation. Today, the standards for prison

health services stem from this organization. As years have progressed, the NCCHC has

developed multiple standards for prisons to follow, the latest update for mental health care being

published in 2015. Not only does this organization create standards, but they also conduct or

consult research in order to keep up to date with issues within their field ("NCCHC," n.d.).

Standards. The goal of the mental health standards publications are to eliminate the

mental health issues at the time. Those who were given the job of creating these new and updated

standards wanted to ensure a safer environment for both the inmates with mental health care

issues as well as the staff who has to work with them. There is more of a focus on treatment

options than other organizational standards such as the American Correctional Association

(ACA) who predominantly focuses on security issues. Overall, the NCCHC wants to allow those

inmates who have been identified to have mental health problems to live as close to fully

functioning as they possibly can. Examples of what is required in prisons are group counseling,

individual counseling, treatments and follow ups with the inmates, and medication management.

All of this is required no matter the size of the prison or the number of staff members in the
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facility. Prisons who have more inmates that will be behind bars for a longer period of time are

required to have more in depth programs available. When it comes to mental health, the NCCHC

does not believe that treatment should be bare minimum medication. There should be extensive

treatment plans as well as ways to prevent serious relapses. These standards are simple to follow;

however, prisons in the United States are tightfisted and do not want to put in the money or effort

to ensure these standards are followed ("NCCHC," n.d.).

Psychology in Prison

Common Mental Health Issues

The most common mental health issues seen within the prison system are anxiety,

depression, and Post Traumatic Stress Disorder. According to Willar Baum, a social worker who

has been involved in correctional health care for two years, but has had a career in mental health

for over 40 years, stated that she sees a large proportion of inmates with Bipolar disorder as well.

While there are cases in which inmates may come in with mental health problems prior to

incarceration, it is known that prisons can intensify or create symptoms for the previously

mentioned illnesses as well (W. Baum, Personal communication, November 22, 2017).

Prison Safety

The lack of safety for prisoners is a large contributor to the psychological toll that being

behind bars can take on inmates. Most commonly inmates experience violence and/or sexual

assault from other inmates or even guards who are supposed to be around to maintain order.

Over 70,000 inmates are sexually assaulted each year according to the Department of Justice,

and this number increases when it comes to women, who are more likely to experience sexual

violence from guards. The high stress environment accompanied by some corrupt tendencies

within guards can lead to guard on inmate violence (Villines, 2013). Private prisons, which are
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prisons funded by government agencies, have a higher tendency of violence because of

understaffing. In these government funded prisons, for every one guard there are 120 or more

prisoners. This leads to a 50% increase of guard on inmate violence and a 60% increase of

inmate on inmate violence compared to non-profit prisons (Vittana.org, 2017). This lack of

safety on top of general inadequate prison conditions is inhumane. The trauma of prisons can

lead to psychological conditions that did not exist prior to incarceration such as anxiety, post

traumatic stress disorder, and depression (Villines, 2013).

Problems in Correctional Mental Health Care

A majority of those who are in either jail or prison have been diagnosed with a mental

health issue. Statistically, 64% of jail inmates, 54% of state prisoners, and 45% of federal

prisoners have a mental health issue (Collier, 2014). With such a large population of mentally ill

inmates, there should be a decent and effective way of caring for them as they serve their time.

Prison attempts to solve psychological conditions by focusing on When it comes to mental

health, the NCCHC does not believe that treatment should be bare minimum medication.

Therapy is rare within the correctional health system, which can cause previous conditions to

intensify when added along with the stress of prison life. The psychological issues that can

develop or worsen in jail, if gone untreated can lead to a recurring cycle of time behind prison

bars (Villines, 2013).

A main issue within the correctional mental health care system surrounds what is

considered “minor” mental health issues such as anxiety and depression. These conditions do

not receive the same attention that the common “ major” mental health issues such as

schizophrenia do. If issues appear to be non severe then the prison system will not go out of its

way to ensure that the condition is treated (Villines, 2013 ; D. Krassner, 2011). These minor
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issues are observed just as often as the major issues; however, unless these inmates were

receiving care outside of prison walls, they will not be treated for their symptoms while they are

serving their time. (W. Baum, Personal communication, November 22, 2017).

Solitary Confinement

Solitary confinement is designed to keep more dangerous prisoners out of the general

population to avoid any issues that could arise in regards to safety. These inmates are kept away

in solitude for 23 hours a day and could be in solitary for up to 25 years. While time to oneself

can be a method to calm down emotions, at the extreme that solitary confinement is can augment

or create a variety of psychological issues such as panic, anxiety, hallucinations, rage, and

depression. Craig Haney, a PhD professor at the University of California Santa Cruz, studied the

psychological effects of prisons in his career. He has personally observed cases where inmates

who were not diagnosed with any mental health issues prior to being incarcerated and were then

put into solitary confinement have developed mental illnesses (Collier, 2014).

Non-Violent Offenders

Who are Non-violent Offenders?

Non Violent offenders are in variety of categories across the legal spectrum; however,

one constant between all of them is that they have not harmed another person. The offenses

considered non violent are property crimes (such as larceny, arson or theft), drug offenses, and

prostitution. These offenders make up almost half of the inmates in the United States prison

system. (Izzi, 2017) Despite the fact that they have not harmed others in their acts against the

law, some of them receive sentences just as steep or steeper than their more violent counterparts.
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They can be in jail for decades at a time for something they did at an age where they were young

and dumb or when they were doing what they needed to do to get by.

Alice Marie Johnson. Alice Marie Johnson is 62 years old and has spent 21 of those

serving a life sentence in federal prison for a non-violent drug offense. She has no opportunity

for parole because it is not an option within the federal prison system. She lost her 10 year career

and struggled to make ends meet for her family. In a desperate attempt to make some fast money,

she involved herself in the drug world. This life sentence she has been carrying out has prevented

her from witnessing the birth of grandchildren and great grandchildren. On top of that, she was

not able to be with either of her parents before they passed away. She has been a model prisoner,

showcasing the fact that she is not a threat to society in any way, shape, or form; however, she

has still not received any type of progression towards leaving the system. (Horowitz &

Ciesemier, producers, 2017)

Mandatory Minimum Sentencing, Overcrowding, & Understaffing

Mandatory minimum sentences are laws that require prison terms for a specific crime in

certain states. However, these laws are outdated and cause more issues than they resolve.

Mandatory minimums do not look into the reasons behind a person’s decisions or their life

before an incident. It is a one-size-fits all sentence, but that is ineffective since not every person

is the same. A majority of these sentences are established against drug offenses, a nonviolent

crime. This could lead to someone who only has one strike to be imprisoned over a minor

offense. This leads to overcrowding within prisons because more people are being convicted and

sentenced rather than given more positive alternatives. Overcrowding can cause decreased

psychological stability and increased suicide risk (Collier, 2014). When there is overcrowding,

there is understaffing. There are an abundance of prisoners but a lack of staff creating dangerous
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environments for both parties (FAMM, n.d.). Mandatory minimums need to be done away with.

Without them, nonviolent offenders can avoid being imprisoned and can be given second

chances or more adequate alternative options.

Statistics

As of August 2017, 80,944 or 46.2% of prisoners were considered to be nonviolent drug

offenses in comparison to 5,588 or 3.2% who had committed violent offenses such as homicide,

kidnapping, and assault (Inmate Offenses, 2017 ; See Appendix “B”) According to Lauren-

Brooke Eisen and Inimai Chettiar of Time Magazine, 39% of prisoners should not be

incarcerated. In fact over 25% would be better suited with an alternative punishment such as

community service, probation, or drug treatment (Eisen & Chettiar, 2016). Over 3,000 people are

serving a life sentence without parole in prison for a nonviolent offense, 79% of which are drug

offenders. (Horowitz & Ciesemier, producers, 2017)

Connection to Psychology

With such a large population of non-violent criminals in prison, it is logical to conclude

that they at least make up some of the population of mentally ill inmates.When these non-violent

criminals are put in a high stress environment around violent inmates, it can cause them to

develop violent tendencies. In a correctional system that lacks in areas of treating psychological

issues that come along with the stress of prisons, these nonviolent offenders are put in a hole that

they will struggle to dig themselves out of. One in five of released nonviolent offenders were

convicted again for a violent offense within three years of their release (Durose & Mumola,

2004). This is not a product of the criminal, but the product of a failed correctional system.

Despair is a product of prison environments, which can lead to an abundance of issues when

released (Irwin, Ziedenberg, & Schiraldi, 2005). Feeling as if there is no hope can lead to a strain
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on anyone’s psychological state. The goal of the prison system is to keep the public safe, but if

the prisoners who will be released are not in a strong state of mind there will never be safety or

sanity for them and others outside of prison walls.

Post Prison; Recidivism

Life after prison for released offenders is far from an easy experience. After being behind

bars for years at a time, adjusting to life in society is difficult. The exclusion that they experience

from the general population along with employers can only lead to unfavorable consequences.

75% of previously imprisoned people in the population experience long term unemployment.

Without money to provide for themselves, these released offenders can become homeless and

depressed. Depression then can lead to drug and alcohol dependency (Boag & Wilson, 2014).

Chronic Social Exclusion can also play a part into the post prison experience. Chronic

Social Exclusion is , “a [prolonged] perceived risk of deficit in belongingness.” In basic terms,

people do not feel as if they are accepted into society for an extensive period of time. When

released from prison, the general population does not want to associate with former criminals,

leading to unwanted ostracization for the released offenders. Without any positive social

interaction, people will turn to antisocial behaviors (Boag & Wilson, 2014).

Exclusion in addition to no opportunity to live a better life only leads to recidivism, “the

tendency to relapse into a previous condition or mode of behavior; especially: relapse into

criminal behavior” ("Recidivism," n.d.). These released offenders have no money, home, or

decent social interaction. In order to survive, they will turn to what is known to work for them,

which is usually a criminal activity. Recidivism is increased when untreated inmates are being

released as well. Inmates are not required to have a psychological evaluation before they are
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released back into the general population. Despite the fact that jails and courts can recommend

this, it does not commonly happen (W. Baum, Personal communication, November 22, 2017).

American Prison System v. The World

“It is said that no one truly knows a nation until one has been inside its jails. A nation

should not be judged by how it treats its highest citizens, but its lowest ones.” - Nelson Mandela

America

America is an “Incarceration Nation” (Collier, 2014). More money is spent on preparing

to imprison the population than on public schools and colleges. In actuality, state and local

spending on prisons has been three times more than that for public education in the last 30 years

("Report: Increases in Spending on Corrections Far Outpace Education," 2016 ; Irwin,

Ziedenberg, & Schiraldi, 2005). One in 100 adult Americans are incarcerated in the country,

which is five to 10 times more than that of western European countries. For every 100,000

people, 707 of them are incarcerated. To put that statistic into perspective, China is 124-127 per

100,000, Iran is 284 per 100,000, and North Korea (the closests in relation to the United States)

is about 600 for every 100,000 (Collier, 2014).

Other Countries

Despite the United States of America being the highest nation for imprisonment, the

psychological standards do not improve much throughout the other countries either. Worldwide

the suicide rate is 10 times higher within prisoners than that of the general population ("Mental

Health," 2017).

Canada. Canada is perceived as one of the most relaxed countries by Americans. Social

media users have compared the country to an amusement park more than a nation with actual

laws. However, their correctional mental health system is not much better than that of the United
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States. Prisoners in Canada are not covered under their National Health Care Act. The

expectation is that Canadian prisoners are to be adequately taken care of within the penitentiary

by officials. The prison system in Canada lacks in a plethora of areas similar to the United States.

There is a lack of adequate mental health care units, mental health professionals, and bed space

in psychiatric hospitals. It is obvious that this not only a nationwide issue within America, but a

worldwide issue from human error (Government of Canada, Public Safety Canada, 2016).

Brazil. In 2013, Brazil had debated over a mandatory sentencing bill for nonviolent drug

offenders. If passed, this would enforce a minimum of five to eight years. Since their 2006 drug

law was passed, their prison population has massively increased. This caused the new 2013 law

to be unpopular (Bateman, 2013). According to an article from The World Post, this is proven to

be ineffective for prison systems. When America started mandatory minimums, the prison

population increased exponentially and did nothing to improve the drug problem within the

country. The only thing that mandatory sentences will do is create a system where more money

is put into prisons rather than more important aspects such as education (Papa, n.d.). The fact that

this bill was so unpopular displays the fact that mandatory minimums, such as those that are

enacted in the United States, are ineffective, harsh on nonviolent offenders, and need to be

changed worldwide.

Resolutions

The correctional mental health system along with the overkill of imprisonment involving

nonviolent offenders are elementary restorations. The government could save billions each year

with finding alternate services such as drug treatment for nonviolent offenders. Offering long

term sentences for miniscule drug offenses in a day and age where people are praised for taking

advantage of the marijuana industry is absurd. Keeping these nonviolent offenders out of prison,
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but still punishing them in a way that will allow them to learn a lesson while more than

adequately preparing them to live a more productive life in the general population will save the

nation money while allowing citizens who may have been in a rough patch of life to upgrade for

the better. The money saved here could go into the education system or even into correcting the

flaws of the correctional mental health care system.

As for the psychological aspect of prisons, more money should be put into staffing and

providing standard mental health care to prisoners who are in need of it. Intermediate Care Units,

which will aid in moving the mentally ill from inpatient care to the general population of prison,

should also be enforced. With these units in place, it allows for those who have serious mental

illnesses to have a smooth transition rather than a movement that will intensify their

psychological condition symptoms (Collier, 2014). As for the “minor” mental illnesses such as

depression and anxiety, more attention should be paid to those inmates who suffer from them.

With more money into this system, more staff could be provided to help them, thus decreasing

the alarming suicide rate within the prison system.

Conclusion

The point has been brought up time and time again of the American correctional system

needing reform from such outdated ideas. A great deal more is wrong than just nonviolent

offenders and subpar mental health facilities within prisons; however, starting here is a basis for

more changes to come. The United States along with many other countries can do more for its

citizens than what is already in place. What seems to be forgotten is that inmates in prison are

still human. Humans make mistakes, but those that are far from detrimental to society should not

suffer a lifelong punishment mentally and socially, when there are better alternatives. These
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prisoners still deserve some basic human rights, which America fights so hard for. The lowest

citizens are still citizens and should be treated as such.

Apendix

A.

B.

(e). Nonviolent drug offenses, (g) Violent offenses

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