Under Lock & Key

Prison Madness: the Mental Health Crisis Behind Bars and What We Must Do About it
Terry Kupers, M.D.
Jossey-Bass Publishers
1999

Dr. Terry Kupers is an ally in the struggle to abolish Control Units in prisons, and more generally to provide basic humyn needs for those incarcerated. While this book focuses on mental health, Kupers takes a systematic look at the prison system and the criminal injustice system in general, but he does it from a liberal perspective. This book is written for a general audience and provides an introduction to conditions in u$ prisons for those who are unfamiliar. For those who have been there or who read Under Lock & Key on a regular basis, the anecdotes of his clients will be nothing new. Some of the most interesting aspects of the book are the facts explaining the effects of isolation and medication on mental health and Kupers' alternative recommendations for group therapy and normal humyn interactions for rehabilitating people. Prison Madness by Terry Kupers, M.D.

What Kupers does not say is that mental health in a system of oppression requires an adaptation to that oppression that can either be done through acceptance and denial or through struggle. He only goes part way, saying that racism in arrests, imprisonment and treatment in prisons is a major factor in creating mental health problems in the oppressed who feel they have no recourse to defend themselves. He also acknowledges social ills in the general community that are taking a toll. But without pointing his finger at the system behind the symptoms, his book only calls for reforms of that system.

As someone who spends a lot of time in court rooms, arguing against prison officials and repressive district attorneys, you can see how this may have shaped the forms of the arguments made in his book. Kupers stresses the logic of helping prisoners to become better adapted to society so that they can be productive members when they get out; and over 90% will get out some day. (p.87) This is usually a good place to start when discussing Control Units with someone who is skeptical of our campaign to shut them down. But at other times Kupers goes too far in accepting some of the positions of the tough on crime politicians by minimizing them and not flat out rejecting them.

For instance, in taking on the accusation that most of the prisoners are faking mental illness to get attention and the better conditions of the mental health units he says, "some are faking their symptoms- but not as many as the guards and mental health staff accuse." (p.34) This comes after a paragraph of discussing the various reasons that prisoners resort to throwing feces at guards and other inmates. He argues that some do it because they feel no other recourse against guards, and others do it in retaliation to a mentally ill prisoner who had hit them first. So what we see is all of the prisoners (and guards as well) reacting to an oppressive situation. In other words they are acting how they deem to be appropriate in the situation they are given, to say that some actions are 'fake' skirts the real issue. Some will react better than others, and be able to deal better than others. But to say that they are therefore "faking it" when they act in certain ways is contradictory to the position Kupers takes elsewhere on the inhumane conditions of Control Units and their effects on humyn beings. Even if a prisoner is consciously acting that way to get attention, there is nothing fake about it, it is an act of self-preservation in the face of extreme oppression. When the system is the problem it becomes irrelevant to draw a line between the 'fakers' and the truly sick. This is especially true when in the majority of suicide cases Kupers has looked into, the person had a note in their chart saying they were "manipulating," meaning they were faking their mental problems. (p.184)

Similarly, in his chapter on 'Recommendations for Treatment and Rehabilitation,' he writes, "We need to stop sending nonviolent drug offenders and mentally disordered felons onto prison yards with murderers and rapists". Again, we are dealing with degrees of sickness here. The "tough on crime" media and politicians like to talk about "murderers" and "rapists" as if that is what some people are from cradle to grave. But those being labeled "murderers and rapists" are a product of the same social system as all of us. Here we are dealing with a situation where questions of individual mental health are far less important than questions of social sickness. Kupers' point that we need to keep the small time criminals away from the violent criminals is a good argument under the current system because we see the effects of such integration in u$ prisons. It is an environment that forces most people into choosing between joining the ranks of the violent criminals or becoming a victim. But if we broaden our goals to actually overthrowing the current system and instituting a system where healthy behavior was promoted even within prisons, we can move away from the myth that there is a new breed of "super criminals" that can only be killed or put in isolation for the rest of their lives.

Prisoners suffering from mental illness that are lucky enough to get treatment in prison usually just get put on medications. Not only does this not solve the problem, but it can make life more dangerous for the prisoner due to delayed reactions and increased fears of leaving their cell. Kupers describes meds as a band-aid for the symptoms of mental illness; if not accompanied by group treatment and socialization then there will be no meaningful improvements. He even cites cases that demonstrate that the need for meds decrease when prisoners leave the Control Units. This fact alone is a damning one for any who tries to argue for the necessity of Control Units.

'Prison Madness' looks at the various cyclical aspects of the system that help create people that are harder to reform due to worsening mental states. He argues that many prisoners suffer from Post-Traumatic Stress Disorder (PTSD) upon arrival in prison from things like sexual abuse and witnessing extreme violence at a young age. Yet, being isolated in a cell, with no humyn contact or activities to occupy the body or mind, is itself a cause of PTSD, which only encourages worse behavior and worsening of the persyn's mental health. Movement to isolation usually means being moved farther from family, which translates into less visits from loved ones and once again, a worsening mental state. Estimated suicide rates in prisons are two times that in general u$ population and rates in jails are nine times more common than on the outside. (p.175)

We must point out however, that Kupers' discussion of PTSD does not serve our struggle very well. He is quick to grant the diagnosis to the majority of oppressed nation youth as well as wimmin who end up in prison. But the symptoms of PTSD can include very understandable actions like throwing things at someone who keeps you locked in a cage all day. With an open-ended diagnosis like PTSD it almost serves to further criminalize those groups, because hey, they've been traumatized and might act crazy as a result. He gives this as a reason for the increased imprisonment of oppressed youth, as well as for why they end up in isolation. Once again, we see the shortcomings of psychology and the need for a class analysis. Instead of using the histories of current inmates as way to argue that the problem is societal, let's just look at the society and recognize how it is set up and in our case which groups have power over other groups and how that is transforming the interactions of those groups. If we really want to tackle systematic problems we have to use a systematic approach, we need to connect the millions of people that know that this is a system of oppression, not keep people stuck on their own individual past and problems.

Kupers' interest in changing the horrifying conditions he describes in 'Prison Madness' is made clear in the third part of his book dedicated to recommendations and courses of action. For the most part we don't disagree with any of it except that it doesn't go far enough. In talking about litigation, where he has spent some time, he includes a healthy dose of skepticism as to how much it can accomplish. He puts forth a nice mental health program for u$ prisons and then criticizes the "tough on crime" culture. While the examples of the Danish prison system he describes are encouraging, that is a small scale system in a wealthy imperialist country. To provide a model for what a prison system would look like in the hands of the oppressed we would point to socialist China as the prime example. Not only was there a focus on study, exercise and participation in the greater society but it also dealt with crime from the perspective of the oppressed. Within the context of a socialist economic system, this provided for the quickest and most widespread eradication of criminal behavior in modern history.

Kupers puts forth concrete examples where litigation has actually improved the conditions in prisons, but goes on to warn that there is a strong tendency for the Department of Corrections (DOC) to retaliate. (p.209-10) A loss in court puts them on the defensive and only emboldens their reactionary side. This is somewhat contradictory to Kupers talk of "bad apples" when discussing racism in prisons. (p.106) To put forth the "bad apples" theory is to deny that the injustice system is inherently oppressive. Just as in most places, we can sometimes find allies within the prison system itself, but we can see from 'Prison Madness' and from decades of our own work that the DOC is one of the most reactionary institutions of the state. More importantly than that, the prison system exists as a form of political repression. The fact that the majority of prisoners in the u$ are Black when only 12% of the population is, is not the product of a few racist "bad apples." It is the product of a tool that systematically serves the interests of the ruling class by repressing those who tend to oppose it. We work with dozens of prison organizations that have faced repression due to their successful organizing, often across lines of nation and affiliation that the CO's use to divide them. Kupers cites a case of this where the Santa Cruz Women's Prison Project was expelled by the California Department of Corrections because guards complained that the empowerment of the wimmin undermined their authority. (p.252)

'Prison Madness' is an accurate and fairly comprehensive look at the u$ prison system, with a focus on the mental health of those being confined in it. That alone makes it worthwhile, as most amerikans remain ignorant of the realities of prison life. The proposed solutions in the book do not address the source of the problem nor does it explain the full nature of oppression in u$ prisons, but there is much to unite with and to build on in those demands.

While campaigning to abolish Security Housing Units in prisons, we are frequently asked "What's your alternative?" This question usually comes from people familiar with the prison system who know that there is a lot of violence in prisons and that putting certain people in the same space is enough to instigate such violence. So they argue that the SHU provides security to help avoid such petty confrontations.

In practice however, it is the prison system and the Correctional Officers who promote and even create the violent situations rather than defusing or preventing them. This is the product of a system that is set up to be every man for themselves, where snitching is rewarded and violence is promoted as the way to solve problems. It's the same old divide and conquer techniques used in a more concentrated form within the controlled communities of prisons. When a majority of the people in an institution are there against their will, facing repression and inhumane conditions, the minority running the institution doesn't want them interacting in a cooperative way that might lead to organizing against their captors.

When addressing the question of abolishing the SHU we have to make it clear that MIM is not a reformist organization. We are fighting this campaign within the context of overthrowing the whole system and replacing the current criminal injustice system with justice for the people. Our goal is to transform society to eliminate the social causes of crime. Our long-term answer to the question of what to do with violent criminals is to build a system of re-education, reform and reintroduction to society for those who previously posed a threat to society.

In the short term we must fight to limit the oppression of the current system and abolishing the SHU is part of that fight. We know that the SHU is used for political repression. We know that everyone in the SHU suffers mentally and physically regardless of why they are in there. Therefore we often point out to those who are reluctant to sign our petition to abolish the SHU that these people are usually going to get out of prison some day and will only be more maladjusted then when they entered as a result of the isolation and torture they faced. Prisons can be made safer under the current system, but this goes counter to the interests of the prison administration to keep power over the imprisoned. Therefore until the oppressed decide who goes to prison and how the prison system is used there will be torture and violence in prisons.

When it does come time to build a new justice system in the interests of the people, we look toward the model of the prison system in socialist China (i.e. China under Mao). People who were successfully reformed through that system include two amerikan students (Allyn and Adele Rickett) and the last Emperor of the Manchu dynasty, Pu Yi. All three of them have written about their experiences and provide some great insights into the socialist prison system. In our review of the Ricketts' book, Prisoners of Liberation, we wrote, "a psychological approach to antisocial behavior takes agency away from the individual and the masses, and has as its goal teaching people to learn to adjust to their oppressive conditions (or their role as an oppressor) rather than struggling for political change."(1) Individualism leads bourgeois society to use psychology to explain and then treat crime rather than the sociological viewpoint of class struggle. "In the contradiction between individuals and society, universality is the principal aspect and particularity is the secondary aspect. By focusing exclusively in the secondary aspect of the contradiction, metaphysicians cannot understand the individual or society."(2) By focusing on the societal sources of humyn problems we can actually eliminate their source.

The difference between our plan for prisons and the current prison system is that we see prisons as a means of re-education not punishment. When we bring up re-education under socialism suddenly white liberals get indignant. This violates their individualist value system that looks at identity as a sacred and static being rather than a reaction and an ever changing product of society. Because reeducating people to interact better with other people is taboo in amerika, we are left with the option of punishment to deal with those who don't play the game or who aren't allowed to play.

Curiously, isolation and physical torture do not illicit the same indignance from these people as any mention of 're-education' does. This can be explained by the fact that it is oppressed nations who are disproportionately suffering at the hand of the current punitive system. Especially in extreme instances of repression like the SHU we see the targeting of Black nationalists, Spanish speakers, members of lumpen organizations like B.L.O.O.D. or ALKQN, or others whose behavior is outside the norm set by white society. Meanwhile the biggest criminals in the world are living it up within u$ borders with no fear of reprisal by the current system. To talk about replacing this system with one that reeducates people to work together in a socialist economy turns the tables, making white amerikans the biggest target. While the Black man selling rock on the street will be quick to give it up for a means of supporting himself by building his community rather than destroying it, the white man making millions by allowing that product to enter the country in the first place will be a lot more reluctant to change his ways. And he sure as hell doesn't want the economy socialized.

But some people are just crazy

It may or may not be true that some people are born crazy and are therefore incorrigible. But to quote the band Propagandhi, "Ordinary people do fucked up things, when fucked up things become ordinary." In other words, behavior is relative to the material conditions of a society.

While holding out for proof of biologically-induced insanity, we can say with certainty that the vast majority of people who have committed crimes against other people are not crazy and can be reformed. Evidence that crime can be largely eliminated can be seen in a comparison of violent crimes committed in the world today. Amerikans are willing to accept the idea that there are all these incorrigible crazies out there because our society has succeeded in creating excessive violence in individuals and the media turns around and feeds that to the populace as a scare tactic. A quick glance at an amerikan prison yard will tell you something is not right when the vast majority of the people are not white, while white people still make up a majority of the u$ population. Unless one believes in racist behavioral genetics then one must admit that there are social factors involved in who goes to prison.

The same individualism that leads people to be more concerned about some static idea of identity than about physical abuse and mental torture is what allows people to act against the norms and interests of the society that they live in. Communists favor class struggle over the psychological approach. For example, "Rather than giving moralizing sermons, China strove to create in individuals a social conscience."(3) In this way we can combat all sorts of social ills, from drug addiction and eating disorders to violence and other neuroses. Rather than brushing these problems under the rug, by trying to lock their victims up in prison and isolate them, we can involve those people in building a better society so that they understand the importance of their lives and the negative effects of their former behaviors.(4)

A prerequisite to eliminating 'antisocial' behavior is to accept that we in fact live in a society that sets norms for how we behave. In fact, much of what is labeled 'antisocial behavior' in our society today is actually encouraged by our society; it does not exist because of some innate humyn characteristics. Amerikans look at how they think and see that their friends think the same. They've all been taught by the same school system, the same media, the same culture. And then they assume that that is how all people behave at all times. As Mao said, "what [petty-bourgeois intellectuals] call human nature is nothing but bourgeois individualism."(5)

So for all who want to know what our alternative to the SHU is, it is building a communist society where no one has power over other people, where people see their importance as a part of a society rather than seeing every persyn as an island, and where social problems are addressed and reconciled rather than repressed and locked away to fester.

Notes:
(1) MIM Theory 9: Psychology and Imperialism, p. 39
(2) MT9, p.48
(3) MT9, p.36
(4) For more on this read "Psychological Practice in the Chinese Revolution" in MT9
(5) Mao Zedong, "Yenan Forum on Art and Literature," in Selected Works, op. cit., Volume 4, p.90