Prison Madness

TERRY KUPERS M.D., a psychiatrist and professor at the Wright Institute in Berkeley, is cochair of the Committee on the Mentally Ill Behind Bars of the American Association of Community Psychiatrists. He has served as an expert witness in more than a dozen class action lawsuits concerning the conditions of confinement and the adequacy of mental health services in jails and prisons. Kupers has also served as a consultant to the Civil Rights Division of the U.S. Department of Justice and to Human Rights Watch.

• Foreword ixPreface xvAcknowledgments xxxiIntroduction 1Part I: The Mental Health Crisis1. The Mentally Ill Behind Bars 92. Why So Many Prisoners Develop Mental Disorder 393. The Failure of Current Mental Health Programs 65Part II: What Goes on Behind Bars4. Racism: A Mental Health Hazard 935. Special Programs for Women 1136. Rape and Posttraumatic Stress Disorder 1377. Lack of Contact with Loved Ones 1578. Prison Suicide 175Part III: An Immodest Proposal9. The Possibilities and Limits of Litigation 19310. Recommendations for Treatment and Rehabilitation 21711. The Folly of Law and Order 257Endnotes 275For Further Reading 287About the Author 291Index 293

"A passionately argued and brilliantly written wake-up call to America about the myriad ways our penal systems brutalize our entire culture. Dr. Kupers not only diagnoses the problem, he also offers a set of solutions. I hope this book will be read by all concerned citizens and voters, for it conveys truths that are vitally important to all of us." (James Gilligan, Department of Psychiatry, Harvard Medical School, and author of Violence: Reflections on a National Epidemic) "A chilling picture of how American prisons have become among the most barbaric in the world driving petty offAnders and dangerous people alike into madness. We must consider the madness of a public policy that routinely turns nonviolent offAnders into dangerous misfits who threaten our safety when released." (Joseph D. McNamara, research fellow, the Hoover Institution, Stanford University and retired police chief, San Jose, California) "Dr. Kupers reminds us that cruel, inhuman, and degrading treatment of inmates-particularly those who are mentally ill-violates their rights, betrays our national commitment to decency, and jeopardizes the safety of our communities. A splendid book." (Jamie Fellner, associate counsel, Human Rights Watch) "Prison Madness reveals the disturbing realities of prisons and jails as places of coerced refuge for poor and mentally disordered people. With this powerful and provocative analysis of the intersecting crises in the public mental health and prison systems, Terry Kupers shows us how to contest the racism and the criminalization of poverty that have helped to produce these dangerous dilemmas." (Angela Y. Davis, professor, University of California, Santa Cruz) " . . . Kupers had free access and unfettered contacts that few outsiders are afforded, and has credibility that few outsiders can acquire." (Hans Toch, from the Foreword) "Prison Madness--with its cogent analysis of our correctional system and the mental health crisis within it--can serve as a much-needed beacon." (Readings: A Journal of Reviews and Commentary in Mental Health)