Mass Incarceration Mental Health

A Crisis Hidden Behind Bars: Mental Health, Solitary Confinement, and the Battle for Justice

By Havann Brown on May, 28 2024

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As we observe Mental Health Awareness Month, a glaring issue casts a long shadow over our criminal legal system—the inhumane treatment of incarcerated individuals with mental health conditions. A recent class-action lawsuit in New York exposes egregious violations where the state’s prisons have consistently failed to uphold reforms intended to abolish long-term solitary confinement for individuals living with mental health issues. Since the reform was enacted, more than a quarter of those in solitary have been diagnosed with mental health conditions, displaying a blatant disregard for the law. The ongoing situation paints a distressing picture of how these individuals are treated. They are often isolated in cells for the majority of their day, in conditions that closely mimic the solitary confinement they were supposed to be shielded from.  

The current legal battle is not just about policy but about the lives of people like Stephanie Peña, who suffers from post-traumatic stress and antisocial personality disorders. Despite laws designed to protect vulnerable individuals like her from the horrors of solitary confinement, she finds herself repeatedly isolated in a cell barely the size of a parking spot, facing conditions that anyone would find unbearable. The systemic failures underline the critical need for mental health advocacy to recognize and address the unique challenges and barriers faced by individuals with mental health conditions within the carceral system. 

The relationship between mental health conditions and incarceration is troublingly disproportionate. Approximately 40% of the individuals in local, state, and federal jails and prisons are diagnosed with at least one mental health condition, many of whom also struggle with substance abuse issues. Our criminal legal system has become over-reliant on incarceration as a default response. Experts estimate that between 200,000 to 300,000 incarcerated individuals have significant psychological conditions, yet about 63% of those with histories of mental health conditions receive no treatment while behind bars. This neglect reflects a carceral system that not only fails to support those in need but also uses constructs of criminality, race, and class to marginalize and control populations deemed “undesirable,” perpetuating a cycle of oppression and exploitation. 

The realities faced by incarcerated individuals with mental health conditions are grim. Prisons and jails, which have become the largest providers of mental health care in the U.S., are ill-equipped for this role, often leading to catastrophic outcomes for those with serious psychological conditions. The reality is that many people who are incarcerated with mental health conditions are placed in solitary confinement seemingly for their own protection, due to a lack of appropriate accommodations. This neglect can exacerbate existing conditions, leading to new health crises—effectively making incarceration a potential death sentence for many. 

The lawsuit highlights the state’s reliance on narrow definitions and inadequate policies that fail to protect those deemed not “seriously mentally ill” under a restricted scope of diagnoses, leaving many vulnerable individuals without protection and subject to isolation. Without a nuanced understanding of how mental health intersects with the carceral system, efforts to dismantle oppressive systems often fall short, merely shifting individuals from one form of incarceration to another, whether these are labeled as institutions for health, criminality, or protection. 

As we commit to dismantling mass incarceration, we must place mental health advocacy at the core of our efforts. This is why Common Justice supports the Treatment Not Jail Act, which acknowledges the struggles that people living with mental health conditions face by providing treatment rather than a jail sentence. We must develop non-coercive, consent-based solutions that genuinely address the acute needs of those most brutalized by these systems of control. The current model of incarceration exacerbates the vulnerabilities of individuals with mental health conditions, often worsening their condition to lethal consequences. This is not care; it is a cruel extension of systemic violence. The lawsuit serves as a stark reminder of the pressing need for change, urging us to envision and work toward a world that is just, humane, and inclusive for all. 

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