More MIM articles on Control Units and Mental Health

U.S. Prisons Prove Maddening

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

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.

MIM has been building public opinion to shut down isolation units for years and we have recently begun to unite a nationwide movement with our statement against all such units, which can be found online at We encourage those who are concerned about the well-being of the mentally ill in prisons to join us in this campaign.

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