A brief essay on prison & mental health: What is your opinion?

by David W. Oaks, Director, MindFreedom International

Today, we frequently hear those who are calling for more funding for the current mental health services say, “The prisons have become the new mental health institutions. The largest psychiatric institutions are, in effect, the prisons because so many people with severe mental and emotional problems are now in prison.”

We then hear the statement from those calling for more funding for the current mental health system, “People deserve help not prison.”

That is a powerful sound bite. It would take a book or more to fully respond.

The following is a brief exploration, that cannot possibly cover all of the issues this question brings up.

If anything this is a time to ask a lot of questions, and create a public dialogue about these difficult questions.

In other words, it’s time for democracy to get hands on with these issues.

But in the mean time we can make a few points and raise a few questions that hopefully will encourage people to dig more deeply into this topic than a few sound bites.

First, does society have a right to ever restrict the liberty of a citizen in any way? Almost all of us — with the exception of a very few interesting theorists and philosophers, etc. — would say, “Yes, of course.” MindFreedom agrees, of course. Society does have the right to restrict freedom when a legitimate law is violated that is applied equally to all people and due process is followed.

The question then becomes what we as a society ought to do when we restrict a citizen’s freedom. What kind of restrictions are appropriate? How long should a person’s “sentence” and probation be, when they are deprived liberty?

For example, some individuals may need to be confined for a period of time, 24 hours a day, 7 days a week, in secure locked facilities known as jails and prisons. Calling this facility by a different name does not change the fact that it is a prison or jail.

However, putting any being in simply a cage — just four walls, small space, low stimulation, never out doors, a brutal environment — is harmful.

Any prison or jail therefore needs to be as humanely deigned as possible, with support services. Solitary confinement for example can be inherently traumatizing to any being. In fact, animal studies show that strict solitary confinement with no stimulation can actually cause brain damage and self-destructive behavior even in animals.

The bottom line is that all people who are denied liberty by society deserve equal treatment, in any way, including rehabilitation, voluntary alternatives for support, etc.

Only deny liberty based on due process using laws that apply to all citizens.

If an individual seeking to fund the current mental health system says, “People deserve help not prison,” go deeper: What kind of help? Too often this sound bite is a way, ultimately, to promote more drugging. There is literally a captive population in the USA in prisons and jails. Those calling for mental health care need to know that this often translates into drugs, drugs, drugs, drugs, drugs, and more drugs.

We are seeing the emergence of a “chemical prison industry” that uses forced drugging as a supplement or even replacement for steel bars and concrete. However, many of these drugs can cause brain damage, and even kill.

In sum, any deep change in the mental health system requires deep change in the prison justice system, too. All citizens who are denied liberty by our society — 100 percent — ought to have their rights protected, all are experiencing some form of trauma if only because they are out of step with our society, all ought to be in a humane environment.

All in the criminal justice system, whether or not in prison or in a community release program, ought to be offered a range of voluntary care and options including:

• job training
• peer support
• counseling
• nutritional approaches
• exercise
• nature
• and other psychosocial alternatives

Some individuals directed to prison or jail may be redirected to diversion programs. For example, an individual who drives while drunk may in some appropriate instances be offered an education program about alcohol and driving. Their acceptance or rejection of such a program should not shorten or lengthen the time of their “sentence.” Attending a professionally run educational program is not inherently intrusive and brain damaging.

However, and this is very important:

Any kind of coerced procedure that involves administering drugs such as neuroleptics amounts to a kind of psychosurgery, which is never appropriate for those denied liberty. Forced drugging, especially long term and at high dosages, can cause brain damage and amounts to forced psychosurgery. Just as the use of forced psychosurgery within the criminal justice population is wrong, so is coerced psychiatric drugging and electroshock.

An individual’s sentence — the length of time they are denied liberty — ought not to be affected by their decision to take prescribed psychiatric drugs, or other services. Any kind of coerced or forced drugging can amount to brain damage, and is therefore cruel and unusual punishment.

In sum, a nonviolent revolution in the mental health system is intertwined with a nonviolent revolution in the criminal justice system. Yes, society has a right to at times restrict the liberty of those who violate equally-applied laws, after due process is followed. But all — 100 percent — especially those in prison or jail, ought to be offered a range of voluntary services, and none ought to be coerced into having procedures that can cause brain damage. 

Let’s hear your opinions. Let’s welcome a diversity of views, even if different, expressed in a civil way.

Let’s help democracy get hands on with prison justice issues, and with issues involving mental and emotional well being care. 

Today, a number of prison justice groups sure have their hands full, with so many struggles. I notice that often in their positions there is a brief mention of mental health, and unfortunately it becomes a sound bite such as “more mental health programs in prison,” or “more diversion programs from prison to mental health.”

But sound bites alone like that can be worse than nothing.

A number of prison justice groups are eager to hear from psychiatric survivor/mental health consumer groups about questions and suggestions about how to work more closely together.

Let’s take them up on the offer. Let’s help democracy get hands on with prison justice and mental health. Let’s submit essays and articles to prison justice publications. Let’s show up at prison justice events. Let’s work together for a vision of a nonviolent revolution in not only the mental health system, but also the prison justice system.

If you have feedback on this essay, please direct these by e-mail to David W. Oaks at MindFreedom office, c/o office at mindfreedom.org.