Skip navigation
The Habeas Citebook: Prosecutorial Misconduct - Header

Mental Illness in Prison - Inmate Rehabilitation & Correctional Officers in Crisis, SpearIt, 2009

Download original document:
Brief thumbnail
This text is machine-read, and may contain errors. Check the original document to verify accuracy.
Mental Illness in Prison: Inmate Rehabilitation & Correctional Officers in Crisis
Berkeley Journal of Criminal Law, Vol. 14, p. 227, 2009

Saint Louis University Legal Studies
Research Paper No. 2009-18

SpearIt
Saint Louis University School of Law

This paper can be downloaded without charge from
the Social Science Research Network electronic library at:
http://ssrn.com/abstract=1646652

Electronic copy available at: http://ssrn.com/abstract=1646652

SPEARIT (277-302)

8/3/2009 6:53:42 PM

Mental Illness in Prison:
Inmate Rehabilitation & Correctional
Officers in Crisis
SpearIt†

INTRODUCTION
In July 2005, the state of California Department of Corrections (CDC)
adopted “Rehabilitation” as a part of its official title, becoming the “California
Department of Corrections and Rehabilitation” (CDCR). 1 This change in
name, however, has not inspired a change in substance, and there is much doubt
as to whether rehabilitation can be realized in any meaningful sense. Since the
word “Corrections” was already extant in the title, the symbolic change of
name must signify that “Rehabilitation” has a different meaning than
“Corrections.” From the outset, then, we must understand rehabilitation as
something that moves beyond mere punishment for corrective purposes.
Exactly what rehabilitation means in the prison context remains a mystery, and
as the following research suggests, the mental health crisis in California prisons
poses a challenge to the CDCR in carrying out the additional task of
rehabilitation. To be sure, the quest for rehabilitation may be aggravated by
CDCR policy through its reliance on supermax units, prisons that achieve
maximum control over inmates, which were not designed for rehabilitation and
instead cripple the possibility of rehabilitation. 2
Although the reentry of rehabilitation into the CDCR’s regime is official,
it is not so evident what this practically entails. On the CDCR website, for
†
The author earned a Master’s in Theological Studies from Harvard University in 2000
and Ph.D. from the University of California, Santa Barbara in Religious Studies in 2006.
Currently he is a J.D. candidate at the University of California, Berkeley School of Law, class of
2009 and teaches for the Prison University Project at San Quentin State Prison. Special thanks to
Professors Kathy Abrams and Hila Keren, who, along with the students from the Boalt Hall
course, “Law & the Emotions,” catalyzed my concerns for the themes discussed in this article.
1. Office of the Governor, Governor Schwarzenegger Signs Legislation to Transform
California’s Prison System, press release (2005), http://gov.ca.gov/index.php?/pressrelease/1935/.
2. SASHA ABRAMSKY, AMERICAN FURIES: CRIME, PUNISHMENT, AND VENGEANCE IN THE
AGE OF MASS IMPRISONMENT 136 (2008).

277

Electronic copy available at: http://ssrn.com/abstract=1646652

SPEARIT (277-302)

278

8/3/2009 6:53:42 PM

BERKELEY JOURNAL OF CRIMINAL LAW

[Vol. 14:277

example, “Adult Programs” is mentioned as the “heart of rehabilitation
activity,” listing as its three primary goals:
• Provide effective evidence based programming to adult offenders
• Create strong partnerships with local government, community based
providers, and the communities to which offenders return in order to
provide services that are critical to offenders’success on parole
• Establish and nurture collaborative partnerships linking Department
facilities and communities in which they are located 3
Beyond these bold statements, the website provides little additional detail
explaining how any of the above is supposed to be carried out. For example,
the notion of “evidence-based programming” has been described as the attempt
to answer the question, “What works?” 4 In terms of prison programming,
“what works” would mean employing a program that “has been rigorously
tested and has been shown to have a meaningful and statistically significant
effect on the outcome for which the program was designed (e.g. reducing
recidivism).” 5 Yet in spite of the CDCR’s advocacy of tested programming
and the CDCR’s other stated goals, it is difficult to imagine how the CDCR can
successfully implement these programs in California’s gargantuan system,
where resources are scarce and overcrowding is severe. When the very
methods for achieving rehabilitation are either limited or unavailable, it is a
challenge to see how rehabilitation is supposed to find success.
Although the CDCR’s plan for prisoner-rehabilitation is far from evident,
there are other unanswered questions surrounding this plan. For example, is
“rehabilitation” a self-evident concept? Does it have the same meaning to the
prisoners and institution? Does every prisoner need rehabilitation? Or at an
even more basic level, what is rehabilitation’s goal? These deceptively simple
questions become complex and convoluted when one considers the role of the
officers who tend to the twenty-four hour custody of inmates. 6 Of all prison
personnel, these officers spend the most time with prisoners, yet they often
have a negligible role in the rehabilitation process. At the very least, one might
wonder how correctional officer training techniques have responded to the
growing menace of mental illness behind bars. It has long been noted that
introduction of treatment goals, like rehabilitation, within prisons has resulted
in conflicting role definitions for officers. 7 The question of treatment versus
3. CAL. DEP’T OF CORR. & REHAB., DIVS. AND BDS.—ADULT PROGRAMS (2008),
http://www.cdcr.ca.gov/Divisions_Boards/Adult_Programs/index.html.
4. Howard N. Snyder, Research’s Two Modes for Discovering Evidence-Based
Programming, CORRECTIONS TODAY, April 2006, available at http://www.aca.org/research/pdf/
researchnotes_april06.pdf.
5. Id.
6. “Line” officer is used somewhat interchangeably with “rank and file” and “peace”
officer. As used throughout the rest of this study by different sources, these terms intend to
indicate those who oversee to the day to day custodial care of inmates.
7. Eric D. Poole & Robert M. Regoli, Alienation in Prison: An Examination of the Work

Electronic copy available at: http://ssrn.com/abstract=1646652

SPEARIT (277-302)

2009]

8/3/2009 6:53:42 PM

MENTAL ILLNESS IN PRISON

279

security has also been called the “adversarial relationship between treatment
facilitators and correctional officers,” 8 which can often produce confused
results. In the fusion of roles, officers must maintain discipline over prisoners
with a heavy hand, the same hand that has to deliver food and medication.
Other questions surround the notion of rehabilitation and our basic
understanding of the term. Yet despite uncertainties about rehabilitation, as a
result of recent legislation, 9 the law requires the CDCR to implement a plan to
obtain additional rehabilitation and treatment services for prisoners. 10
Etymologically, the word rehabilitate is composed of the latin re (again) and
habitare (make “fit”); the notion of rehabilitate has therefore historically meant
something like “to make fit again” or “to restore.” 11
Determining exactly what “fit” means is no easy task. One quantitative
gauge for the success of rehabilitation is the rate of inmate recidivism. 12
Although this is not the sole indicator, attention to recidivism is one way of
monitoring how effective prisons are at rehabilitating. 13 Currently, as Joan
Petersilia in Understanding California Corrections reports, “Only 21% of
California parolees successfully complete parole—half the national average—
and two out of three inmates returning to prison are parolees.” 14 The most
recent accounting by the CDCR puts the total number of parole returns at
93,279 of the total number that entered prison in 2007. 15 These figures indicate
that only a fraction of ex-prisoners are successfully restored to society,
regardless of the underlying causes of recidivism; 16 yet for prisoners with
severe mental illness, approximately 80% recidivate. 17
The quest for rehabilitation might be further complicated when
correctional officers do not subscribe to a rehabilitation philosophy. In a recent
Relations of Prison Guards, 19 CRIMINOLOGY 251, 257 (1981).
8. DON A. JOSI & DALE K. SECHREST, THE CHANGING CAREER OF THE CORRECTIONAL
OFFICER: POLICY IMPLICATIONS FOR THE 21ST CENTURY 123 (1998).
9. See generally DEP’T OF CORR. & REHAB., DIVS. AND BDS.—AB 900 JAIL
CONSTRUCTION FUNDING (2007), http://www.cdcr.ca.gov/Divisions_Boards/CSA/CFC/AB900_
Jail_Construction_Funding.html.
10. See CAL. PENAL CODE § 2062.
11. Online Etymology Dictionary, http://www.etymonline.com/index.php?l=r&p=8.
12. LISE MCKEAN & CHARLES RANSFORD, CURRENT STRATEGIES FOR REDUCING
RECIDIVISM 8 (2004), http://www.impactresearch.org/documents/recidivismfullreport.pdf.
13. Id.
14. JOAN PETERSILIA, UNDERSTANDING CALIFORNIA CORRECTIONS 2 (2006). There are
other complications which make these numbers inflationary. For example, in California, technical
violations account for a significant percentage of entering prisoners; as the same report notes,
California has a “catch-and-release crime policy that churns inmates back and forth between
prison and community…” Id. at 75-76.
15. DEP’T OF CORR. AND REHAB., CALIFORNIA PRISONERS AND PAROLEES 2007 (2008).
16. Mark W. Lipsey & Francis T. Cullen, The Effectiveness of Correctional Rehabilitation:
A Review of Systematic Reviews, ANN. REV. L. & SOC. SCI. 297 (2007) (offering meta-analysis of
literature on recidivism and rehabilitation).
17. Council on Mentally Ill Offenders, Incarcerated Mentally Ill: A Growing Issue in
California, http://www.cdcr.ca.gov/COMIO/Legislation.html.

SPEARIT (277-302)

280

8/3/2009 6:53:42 PM

BERKELEY JOURNAL OF CRIMINAL LAW

[Vol. 14:277

study on California correctional officers’ attitudes toward rehabilitation, one
researcher found:
While about 46% agree that rehabilitation should be a central goal of
incarceration, there is reasonable consensus that it should not be the
only, or even the primary, purpose of a prison. Instead, a majority of
correctional officers believe that both rehabilitation and punishment
should be goals of a prison. 18
These findings raise questions about how rehabilitation might function in
an environment where a minority of correctional officers subscribe to the
Department’s philosophy. This data clearly conflicts with the CDCR’s stated
goals and mission. Whether the State and CDCR can construct a viable
rehabilitation programs depends on how successfully they can deal with the
problems outlined in this article.
Section I examines the shifts in health and criminal policies that have
persisted in the incarceration of mentally ill offenders, which includes the
practical and psychological influences of mentally ill prisoners in the lives of
other inmates. Section II examines the training of correctional officers
considers the additional stress of mentally ill prisoners and how this affects
inmate rehabilitation. This work concludes with a final commentary on the
study of mental illness and rehabilitation in California prisons.
I. THE PRISON AS ASYLUM AND DRAGNET OF THE MENTALLY ILL
Mental illness is prevalent in U.S. prisons. 19 The Bureau of Justice
Statistics reports that over half of all prison and jail inmates nationwide have
mental health problems—totaling well over one million inmates. 20 In
California, a report published on CDCR’s website by the Council on Mentally
Ill Offenders notes that “in 1998, people with severe mental illness accounted
for 11% of [the] state prison population. In 2003, it was 16%. In 2006, it was
estimated to be 20%.” 21 Although there is no conclusive study that explains
how this crisis came about, how the state’s mentally ill population nearly
18. Amy E. Lerman, Learning to Walk “the Toughest Beat”: Quasi-Experimental Evidence
on the Role of Prison Context in Shaping Correctional Officer Attitudes towards Rehabilitation
(Nov. 18 2008) (Berkeley Center for Criminal Justice Roundtable); see also Francis T. Cullen et
al., The Correctional Orientation of Prison Guards: Do Officers Support Rehabilitation?, 53
FED. PROBATION 33, 40 (1989).
19. See Pamela M. Diamond et al., The Prevalence of Mental Illness in Prison, 29 ADMIN. &
POL’Y IN MENTAL HEALTH 21 (2001).
20. Doris J. James & Lauren E. Glaze, Mental Health Problems of Prison and Jail Inmates
(2006), available at http://www.ojp.usdoj.gov/bjs/pub/pdf/mhppji.pdf; in 2000, the American
Psychiatric Association reported estimates that as many as one in five prisoners were seriously
mentally ill. Am. Psychiatric Ass’n, Psychiatric Services in Jails and Prisons, at xix (2d ed.
2000); see also Impact of Mentally Ill Offenders on the Criminal Justice System: Hearing Before
the Subcomm. On Crime of the H. Comm. of the Judiciary, 106th Cong. 10 (2000) (statement of
Rep. Strickland).
21. Council, supra note 17.

SPEARIT (277-302)

2009]

8/3/2009 6:53:42 PM

MENTAL ILLNESS IN PRISON

281

doubled in eight years, it is a noteworthy transformation that demands further
exploration.
Mental illness is an expansive term and can include milder forms of
illness, such as anxiety or depression, as well as more severe forms of illness,
including bi-polar disorder, schizophrenia, and full-blown decompensation.
For prisoners, it is not uncommon to display comorbid disorders. Further
complicating these considerations is the fact that a person’s mental condition is
not static; rather, it can be temporarily improved through treatment only to
relapse later.
As a result of these institutional trends, the path to mental health treatment
has changed. One study reports that by 2005, jails had become the “primary
source” of treatment for Californians, 22 and some scholars have even suggested
that prisons are the primary mental health care provider for Americans. 23 This
phenomenon has been articulated in Ill Equipped: U.S. Prisons and Offenders
with Mental Illness, a decade-long study published in 2003 that explains the
historical and sociological contours of mental health in prisons: “Fifty years
ago, public mental health care was based almost exclusively on institutional
care and over half a million mentally ill Americans lived in public mental
health hospitals. Beginning in the early 1960s, states began to downsize and
close their public mental health hospitals, a process called
‘deinstitutionalization.’” 24
The closure of many state mental facilities without sufficient outpatient
services may have led to the incarceration or homelessness of many of these
former patients. 25 California’s current overcrowded condition has stretched
resources to the point of making correctional officers something of a new
therapist, a role perhaps better left to trained psychologists. The likelihood of
officers making medically-impacting decisions is especially acute during
evening hours when mental health staff is not present. 26 In the face of
psychotic, abnormal, or even violent behavior by an inmate, officers often lack
the training to recognize the difference between genuine mental illness and an
22. CAL. BD. OF CORR., MENTALLY ILL OFFENDERS CRIME REDUCTION GRANT: ANNUAL
REP. TO THE LEGISLATURE 2 (June 2004), available at http://www.bdcorr.ca.gov/cppd/miocrg/
2004_annual_report/miocrg_2004_annual_report.doc.
23. See e.g., Gerald E. Nora, Prosecutor as "Nurse Ratched"?: Misusing Criminal Justice as
Alternative Medicine, 22 CRIM. JUST. 23 (2007) (discussing the transition from mental hospitals as
primary caretaker for the mentally ill to the present, where prisons fulfill that function); Jamie
Fellner, A Corrections Quandary: Mental Illness and Prison Rules, 4 HARVARD C.R.-C.L. L.
REV. 391, 391 (2006).
24. HUMAN RIGHTS WATCH, ILL EQUIPPED: U.S. PRISONS AND OFFENDERS WITH MENTAL
ILLNESS (2003), available at http://hrw.org/reports/2003/usa1003/usa1003.pdf (last visited Nov.
6, 2008).
25. Stephen Allen, Mental Health Treatment and the Criminal Justice System, 4 J. OF
HEALTH & BIOMED. L. 153, 157-58 (2008).
26. Jamie Fellner, Prison Reform: Commission on Safety and Abuse in America’s Prisons: A
Conundrum for Corrections, A Tragedy for Prisoners: Prisons as Facilities for the Mentally Ill,
22 WASH. U. J.L. & POL’Y 135, 143 (2006).

SPEARIT (277-302)

282

8/3/2009 6:53:42 PM

BERKELEY JOURNAL OF CRIMINAL LAW

[Vol. 14:277

inmate who is purposefully breaking the rules or faking illness. 27
In the prison environment, having a mental illness predisposes prisoners
to engage in the type of erratic, destructive behavior likely to lead to a
disciplinary hearing or a trip to solitary confinement. 28 This situation is only
inflamed when illness is left untreated. Yet even in the face of this glaring
institutional malady, prisons are unrelenting in their approach toward
punishment as the mentally ill are disproportionately represented among
prisoners in segregation. 29 In addition, those with severe mental illnesses have
more difficulty adapting to prison when compared to the rest of the
population. 30 And among mentally ill prisoners, suicide is an extreme, yet
prevalent, marker of poor adjustment to incarceration. 31 These facts suggest
that untreated mental illness is likely to result in abnormal behavior, behavior
over which an inmate has limited control, and which is likely to illicit the most
severe punishments from prison staff.
These vast shifts in social and prison policy have brought us to the present
where “thousands of mentally ill persons across the country are being
punished—not for being criminal, but for being sick.” 32 On the street,
untreated illnesses and related behaviors are likely to attract the attention of
police, resulting in jail or imprisonment. This point was illustrated in a study
revealing that 90% of mentally ill inmates in the Los Angeles County Jail were
repeat offenders and that nearly 10% of those offenders had been previously
incarcerated at least ten times. 33 With this county jail providing the main
pipeline to California prisons, it is easy to see why the system is clogged with
mentally ill prisoners—they are being funneled in from the jails, where rates of
mental illness are even higher than in prison. 34
Still, understanding the socio-legal factors that have gone into the mental
health problems in prison does not say anything about what happens inside the
prison proper. As noted above, mental illness enters prisons via individuals
with pre-existing mental conditions. Additionally, the punishment of solitary
confinement has been shown to trigger and aggravate mania and other types of
27. Id. at 143.
28. Abramsky, supra note 2, at 143.
29. David W. Ball, Mentally Ill Prisoners in the California Department of Corrections and
Rehabilitation: Strategies for Improving Treatment and Reducing Recidivism, 24 J. CONTEMP.
HEALTH & POL’Y 1, 17 (2007); Fellner supra note 26, at 402.
30. T. Howard Stone, Therapeutic Implications of Incarceration for Persons with Severe
Mental Disorders: Searching for Rational Health Policy, 24 AM. J. OF CRIM. L. 283, 299 (1997);
see also Terry Kupers, PRISON MADNESS: THE MENTAL HEALTH CRISIS BEHIND BARS AND
WHAT WE MUST DO ABOUT IT, at xvi (1999).
31. Stone, supra note 30 at 299.
32. Allen, supra note 25, at 180.
33. Mentally Ill Offender Treatment and Crime Reduction Act of 2003: Hearing on S.1194
Before the Subcomm. on Crime, Terrorism and Homeland Security of the H. Comm. on the
Judiciary, 108th Cong. (2004) (statement of Cheri Nolan, Deputy Assistant Att’y Gen., Office of
J. Programs).
34. James, supra note 20.

SPEARIT (277-302)

2009]

8/3/2009 6:53:42 PM

MENTAL ILLNESS IN PRISON

283

psychological afflictions. 35 The general problem of mental illness is only
exacerbated by neglect in treatment, which, in California’s case, has forced
federal authorities to take over the state’s prison health services. 36 Perhaps
now more than ever the state is learning that prisons were never intended to
serve as mental health facilities. 37
A. Ill by Punishment
The empirical literature on solitary confinement has painted an ominous
picture when describing its negative effects on inmates. 38 In many prisons, this
confinement is typically twenty-two to twenty-three hours a day, with breaks
every other day for exercise and showers. In the U.S. federal prison system,
solitary prisoners are detained in a “Special Housing Unit” (“SHU”), whereas
California’s version is designated as “Security Housing Unit” (also “SHU”).
Studies on California prisons have demonstrated how mental illness can be
manufactured behind bars. In Prison Madness, a study that focused largely on
California SHUs, the author asserts that harsh conditions in prison have a
“particularly deleterious effect on the mental health of all prisoners.” 39 In
solitary confinement, “prisoners with preexisting psychiatric disorders are at
even greater risk of suffering psychological deterioration while in
segregation.” 40 From the earliest days of Quaker penitentiaries to modern
supermax facilities, research on solitary confinement has amounted to one long
warning about the ill effects of prolonged isolation. 41
As early as the 1830s, empirical evidence began to show an increased
incidence of mortality and physical morbidity in prisoners exposed to rigid
forms of solitary confinement. 42 More recently, studies offered by plaintiffs in
Madrid v. Gomez indicate that today even the healthiest of SHU inmates runs a
significant risk of hyper-responsiveness and severe forms of anxiety. 43 The
risk of hyper-response is critical in prison since a glance or accidental bump
typically must be tolerated. However, for one prone to over-responding, such
an innocuous event might be interpreted as being disrespected, a challenge, or
any similarly imagined threat. Thus, although prison administrations have an
35. Stuart Grassian, Psychopathological Effects of Solitary Confinement, 140 AM. J.
PSYCHIATRY 1450, 1450 (1983).
36. See Summary, 2008 Developments in Juvenile Justice: Realignment, Proposition 6, and
Changes to Competency Decisions, 14 BERKELEY J. CRIM. L. 125.
37. Fellner, supra note 26, at 137.
38. See Craig Haney & Mona Lynch, Regulating Prisons of the Future: A Psychological
Analysis of Supermax and Solitary Confinement, 23 N.Y.U. REV. L. & SOC. CHANGE 477, 508
(1997).
39. Kupers, supra note 30, at xvi.
40. Fellner, supra note 23, at 403.
41. See Grassian, supra note 35.
42. DAVID ROTHMAN, THE DISCOVERY OF THE ASYLUM 87 (Aldine Transaction) (1971).
43. Sally Mann Romano, If the SHU Fits: Cruel and Unusual Punishment at California’s
Pelican Bay State Prison, 45 EMORY L.J. 1089, 1130 (1996).

SPEARIT (277-302)

284

8/3/2009 6:53:42 PM

BERKELEY JOURNAL OF CRIMINAL LAW

[Vol. 14:277

interest in minimizing environmental stressors in prison, the effects of solitary
confinement will against this possibility.
The maddening tendencies of California’s SHUs have not gone unnoticed
by mainstream media outlets. To illustrate, in a front-page article entitled “The
Cruelest Prison,” the L.A. Times Magazine reports that these units are “turning
inmates into mental cases,” the effects of which are “hallucination;
hypersensitivity to external stimuli; paranoia; panic attacks; hostile fantasies
involving revenge, torture, and mutilation. . .smearing oneself with feces or
biting chunks of flesh from one’s own body.” 44 The report details case after
case of prisoners who spent large blocks of time in solitary confinement,
sometimes up to seven years, to be released to the public after a mere two
weeks’ time to readjust to light, conversation, and other stimulants. 45 In this
environment, it has been asserted that the ultimate measure of the SHU’s
violence is the “intensity and prevalence of the insanity they create.” 46 At the
very least, this type of isolation intensifies the pains of prison with little
concern for the long term psychological consequences to prisoners, 47 which
directly inculcates the question of rehabilitation. Although there is no research
focused specifically on the mental state of officers who work in solitary units,
“there is reason to believe that the level of fear and uncertainty is higher among
them than guards working in the general prison population.” 48
Prisoners have also been widely known to hurt themselves under the stress
and frustration of solitary confinement. The effects of an environment in which
a prisoner typically spends nearly twenty-four hours a day locked in an eightby-ten feet cell, 49 the effects of isolation can take their toll rapidly. This
environment is known to induce intense rage and disorientation in prisoners. 50
As the report above soberly reminds us, the most pressing fact in these
scenarios is that most of the prisoners in SHUs will one day be freed to return
to society, albeit angrier, more impulsive, and more unbalanced than ever. 51
Sometimes these individuals do not even make it back out—as one study on the
CDCR shows, segregated inmates are prone to suicide; in 2003, 74% of all
inmate suicides took place in administrative segregation. 52 The various

44.
45.
46.

Vince Beiser, A Necessary Evil?, L.A. TIMES MAG., Oct. 19, 2003.
Id.
CHRISTIAN PARENTI, LOCKDOWN AMERICA: POLICE AND PRISONS IN THE AGE OF
CRISIS 207 (2000).
47. Haney, supra note 38, at 566.
48. Haney, supra note 38, at 528.
49. Scott N. Tachiki, Indeterminate Sentences in Supermax Prisons Based upon Alleged
Gang Affiliations: A Reexamination of Procedural Protection and a Proposal for Greater
Procedural Requirements, 83 CAL. L. REV. 1115, 1123 (1995).
50. Kupers, supra note 30, at XVIII.
51. Beiser, supra note 44.
52. Raymond F. Patterson & Kerry Hughes, Review of Completed Suicides in the California
Department of Corrections and Rehabilitation, 1999-2004, 7 JAIL SUICIDE MENTAL HEALTH
UPDATE 9 (2008), available at http://www.ncianet.org/Fall%202008.pdf.

SPEARIT (277-302)

2009]

8/3/2009 6:53:42 PM

MENTAL ILLNESS IN PRISON

285

negative effects of solitary confinement, beyond merely frustrating the goals of
rehabilitation, can also inflict long-term psychological damage on inmates.
B. Deficiencies in Mental Health Care
In addition to the punishments described, the question of rehabilitation
must confront the consequences of high rates of mentally ill offenders and the
poor treatment, if any, they receive. At the national level, former-President
George W. Bush’s New Freedom Commission on Mental Health in 2002
reported that mental health in the United States was in “shambles.” 53 In the
prison environment, an entire body of jurisprudence addressing mental health
has developed, and recent legislation has seen the passing of the Mentally Ill
Offender Treatment and Crime Reduction Act of 2004. 54
Yet despite such statements and legislation, deficiencies in mental health
care in prison persist to the present. In 2005, the Commission on Safety and
Abuse in America’s Prisons described the effects of neglect in mental health
care:
Without the necessary care mentally ill prisoners suffer painful
symptoms and their conditions can deteriorate. They are afflicted with
delusions and hallucinations, debilitating fears, and extreme and
uncontrollable mood swings. They huddle silently in their cells and
mumble incoherently or yell incessantly. They refuse to obey orders or
lash out without provocation. They assault other prisoners or staff.
They beat their heads against cell walls, smear themselves with feces,
self-mutilate, and commit suicide. 55
In spite of the real possibility of psychological damage from punishments,
at the federal level, the Prisoner Litigation Reform act of 1995 (PLRA) and the
Anti-terrorism and Effective Death Penalty Act of 1996 (AEDPA) present a
nearly “impenetrable wall” against prisoners’ legal redress for human rights
violations. 56 For example, section 1197(e) of the PLRA provides that “no
Federal civil action may be brought by a prisoner confined in a jail prison, or
other correctional facility, for mental or emotional injury suffered while in
custody without a prior showing of physical injury.” 57 For the mentally ill in
federal prisons, claims have been made even more difficult by courts that
simultaneously disregard the fact that severe mental distress often has a
physical substrate and deny that some kinds of mental suffering constitute

53. See RICHARD G. FRANK & SHERRY A. GLIED, BETTER BUT NOT WELL 2 (2006).
54. See generally Ralph M. Rivera, The Mentally Ill Offender: A Brighter Tomorrow
Through the Eyes of the Mentally Ill Offender Treatment and Crime Reduction Act of 2004, 19
J.L. & HEALTH 107 (2004).
55. Fellner, supra note 26, at 137.
56. TARA HERIVEL & PAUL WRIGHT, PRISON NATION: THE WAREHOUSING OF AMERICA’S
POOR 279 (2002).
57. 42 U.S.C. § 1997e(e)(2006).

SPEARIT (277-302)

286

8/3/2009 6:53:42 PM

BERKELEY JOURNAL OF CRIMINAL LAW

[Vol. 14:277

physical injuries in their own right. 58 Thus for some who suffer psychological
damage from incarceration, there may be little legal redress.
In California prisons, many medical conditions go untreated and those
who do receive treatment likely receive such “poor mental health services” that
many prisoners are left with inappropriate types or amounts of psychotropic
medication that further impairs their ability to function. 59 As Judge Henderson
found in Plata, “The Court does not believe that the Constitution can
reasonably be construed to require the court to sit idly by while people are
needlessly dying.” 60 Some of these problems are a direct result of poor prison
policy and antiquated record keeping and computing. Often a simple matter
like drug treatment is interrupted when prisoners are transferred between
prisons or when lockdown procedures forbid the delivery of medication. 61 In
addition to lack of treatment, the prison experience itself has been shown to
have generally negative effects on prisoners. 62
Widespread deficiencies in mental health care in California were first
exposed in the massive Madrid v. Gomez class action suit. 63 Filed on behalf of
some 3,600 Pelican Bay prisoners in 1993, the 1995 decision was decided in
favor of prisoners. Judge Thelton Henderson held that prisoners had been
subject to excessive violence, cruel and unusual punishment, and that mentally
ill inmates could no longer be confined in the SHU. 64 Furthermore, the
decision held that the “Eighth Amendment simply does not guarantee that
inmates will not suffer some psychological effects from incarceration or
segregation.” 65 But Judge Henderson was quick to temper its meaning:
However, if the particular conditions of segregation being challenged
are such that they inflict a serious mental illness, greatly exacerbate
mental illness, or deprive inmates of their sanity, then defendants have
deprived inmates of a basic necessity of human existence—indeed,
they have crossed into the realm of psychological torture. 66
It is telling that ten years after this decision, Henderson would end up
ordering the prison over to a special master. This was a drastic move against
the state since a special masters’ job is to ensure that court orders are carried
out. With the federal judiciary micromanaging the State’s actions, the
appointment of the special master was a sign that California’s mental health
58. Developments in the Law - The Law of Mental Illness, 121 HARV. L. REV. 1145, 1151
(2008).
59. Fellner, supra note 23, at 391.
60. Plata v. Schwarzenegger, No. C01-1351TEH, 2005 U.S. Dist. LEXIS 8878, at *23-24
(N.D. Cal. May 10, 2005).
61. Ball, supra note 29, at 11.
62. See generally Alison Liebling & Shadd Maruna, THE EFFECTS OF IMPRISONMENT 10-13
(Willan 2005) .
63. Madrid v. Gomez, 889 F. Supp. 1146 (N.D. Cal. 1995).
64. Id. at 1146.
65. Id. at 1264.
66. Id.

SPEARIT (277-302)

2009]

8/3/2009 6:53:42 PM

MENTAL ILLNESS IN PRISON

287

system, far from being able to provide effective treatment, was itself in need of
rehabilitation.
In 1995 the court also decided Coleman v. Wilson, where it held the entire
mental health system operated by the California Department of Corrections
(CDC) as unconstitutional and that prison officials were deliberately indifferent
to the needs of mentally ill inmates. 67 Today, all thirty-three institutions in the
CDCR are in receivership to evaluate the CDCR’s compliance with the court’s
order. 68 In this ongoing supervision, the department has not been able to fulfill
its bare constitutional requirements in health care and as a result, the
department has established a “decentralized system of mental health care.” 69
The response of decentralizing care is evident in places like San Quentin State
Prison, whose mental care facilities were practically non-existent before the
appointment of the special master. Yet as of this writing, there is construction
on a new medical facility for San Quentin that includes beds for mental health
treatment. 70
Although California prisons have proven a failure in mental health, there
are other, more effective models for providing effective mental health services
for inmates 71 the use of which could perhaps avert further entrenchment in the
prison mental health crisis. For example, the Pace program in Boulder County,
Colorado, prominently diverts the mentally ill from prison. 72 The County
Sheriff credited the Pace program with cutting down on clients’ “cumulative
jail time from roughly 10,800 days a year to only 800.” 73 Although such a
remarkable success is not dispositive of its ability to succeed in a state as
troubled as California, it may point to the simple idea that actively trying to
divert the seriously mentally ill from prison may alleviate many problems in the
first place.
Taken wholly, the deficiencies in mental health care in California prisons
are drastic, and existing mental illness is often exacerbated through lack of
treatment. As the next section shows, mental illness does not simply linger in
the untreated individual, rather, it negatively impacts the entire prison
67. Coleman v. Wilson, 912 F. Supp. 1282 (E.D. Cal. 1995).
68. California Prison Health Services, Frequently Asked Questions, http://www.cphcs.ca.
gov/faq.aspx.
69. REPORT OF THE CORRECTIONS INDEPENDENT REVIEW PANEL: REFORMING
CORRECTIONS (2004), http://cpr.ca.gov/Review_Panel/ (follow “From Intro to 6” hyperlink or
“From 7 to 11” hyperlink).
70. California Prison Health Care Receivership Corp., San Quentin Medical Facility Plan
Status, June 14, 2007, available at http://www.cprinc.org/docs/projects/SQ_Medical_Facility_
Plan_Status061407.pdf.
71. CRIMINALIZING THE SERIOUSLY MENTALLY ILL: THE ABUSE OF JAILS AS MENTAL
HOSPITALS, A JOINT REPORT OF THE NATIONAL ALLIANCE FOR THE MENTALLY ILL AND PUBLIC
CITIZEN’S HEALTH RESEARCH GROUP 89 (E. Fuller Torrey, et al. eds., 2002).
72. Kris Hudson, Boulder’s PACE Program Diverts Mentally Ill from Prison, DENV. POST,
April 10, 2005, at C-06.
73. Id. For other developments in the de-institutionalization of mental illness, see Allen,
supra note 25, at 171.

SPEARIT (277-302)

288

8/3/2009 6:53:42 PM

BERKELEY JOURNAL OF CRIMINAL LAW

[Vol. 14:277

population, beginning with other prisoners.
C. Collateral Impacts on Prisoners: Spread and Inflammation
This section looks at the collateral effects of mixing mentally ill prisoners
with the general prison population. As mentioned above, such mixing is
largely due to overcrowding in prison, which effectively stretches resources to
their minimum. Kupers’ study showed that prisoners “who have never suffered
a significant psychiatric disturbance in the past report worrisome psychiatric
symptoms for the first time.” 74 How much of this is causally connected to
mentally ill prisoners or imprisonment itself is speculative at best. But as the
following hopes to show, prisoners with untreated mental illnesses tend to
compromise the mental health of others with whom they share living space,
meals, and recreation time; or as one study on California prisons describes,
“With little or no meaningful health care, the mentally ill free-fall in an ever
increasing maelstrom of madness. For those prisoners forced to live with and
around the mentally ill, subsequent damage to their own mental health is
inevitable.” 75
The CDCR’s management of one of the largest incarceration operations in
the world makes the issue of overcrowding even more complicated. Currently,
the state’s thirty-three adult prison facilities are organized into four security
levels ranging from Level I (least restrictive) to Level IV (most restrictive). In
California, prisons operate at nearly double capacity and overcrowding has
interfered with the current responsibilities of the special master. 76 In this
constrained environment, mentally ill prisoners affect other prisoners in
substantial ways, and as one study concluded, “Just being locked up in the
same dorm or same cell with someone suffering from mental illness heaps
added stress on the already full plates of prisoners without emotional problems.
For those not afflicted with psychiatric problems, life in prison is enough in
itself to wear away one’s mental health.” 77
Having a cellmate who suffers from psychosis, paranoia, or a host of other
conditions is not an appealing prospect. As one researcher puts it, “[O]thers
don’t realize how current prison policies are traumatizing formerly ‘normal’
prisoners and making them angry, violent and vulnerable to severe emotional
problems.” 78 The same may perhaps hold true for correctional officers, but
there is little if any research in this area. It might be natural to suspect,
however, that beyond merely complicating or frustrating the daily chores of

74. Kupers, supra note 30, at 48.
75. Herivel, supra note 56, at 170.
76. See generally California State Senate Republican Caucus, Briefing Report:
Receivership/Overcrowding Crisis Aggravation (“ROCA”), http://cssrc.us/publications.aspx?id=
2992.
77. Herivel, supra note 56, at 169.
78. Kupers, supra note 30, at xv.

SPEARIT (277-302)

2009]

8/3/2009 6:53:42 PM

MENTAL ILLNESS IN PRISON

289

correctional officers, mentally ill prisoners may also compromise the emotional
well being of other inmates. Although this issue awaits further academic
attention, there is little doubt that mentally ill patients negatively impact
inmate’s lives. As the next section shows, correctional officers receive little
training that focuses on mentally ill prisoners, despite their massive numbers in
prison.
II. DOWN BY LAW: TRAINING FOR CORRECTIONAL OFFICERS
The Section explores California law and the CDCR training materials to
see what, if any, training is devoted to preparing officers on how to interact
with mentally ill prisoners. It also examines the additional stressors placed on
correctional staff as a result of the massive increase of mentally ill inmates; this
part includes analysis of the psychological and emotional burdens that attend
prison work in general, and how these are complicated by the ever growing
presence of mental illness in prison. In this scenario, over-burdened
correctional officers are ill equipped to ward over mentally ill prisoners or
sometimes themselves, trends that negatively impact inmate rehabilitation as
well as the emotional well being of officers.
The statutory training requirements for correctional officers have been
mandated by California Penal Code § 6035(a), which charges the State with
raising a competent force of corrections officers. 79 According to the statute,
the training of correctional officers is set by the standards of the board (Board
of Corrections), which as of July 1, 2005 was renamed the Corrections
Standard Authority (CSA). 80 Revisions are made at the discretion of the
CSA. 81 Section 6036 spells out the CSA’s power to approve or certify training
and certification of courses at institutions for officers, among other
responsibilities. 82 Under state law, then, the CSA is responsible for developing
and presenting training courses that prepare prison personnel for their
employment by the state. This task, in turn, has been left largely to the
auspices of the CDCR’s Correctional Training Center. 83 As will be shown,
although there are hundreds of hours dedicated to training officers, hardly any
of this time is allocated on training officers how to interact with mentally ill
inmates or even how to maintain their own mental health.
The CDCR’s training program has been criticized in the media repeatedly,
and in 2005 it was reported that on the job training “credit” was being given to
79.
80.

CAL. PENAL CODE § 6035(a) (West 2008).
DEP’T OF CORR. & REHAB., DIVS. AND BDS.—CSA—MAJOR DUTIES AND
RESPONSIBILITIES (2008), available at http://www.cdcr.ca.gov/Divisions_Boards/CSA/Admin/
About_us/CSA_Major_Duties_And_Responsibilities.html.
81. Id.
82. CAL. PENAL CODE § 6036.
83. DEP’T OF CORR. & REHAB., DIVS. AND BDS.—CSA—MAJOR DUTIES AND
RESPONSIBILITIES (2008), available at http://www.cdcr.ca.gov/Divisions_Boards/CSA/Admin/
About_us/CSA_Major_Duties_And_Responsibilities.html.

SPEARIT (277-302)

290

8/3/2009 6:53:42 PM

BERKELEY JOURNAL OF CRIMINAL LAW

[Vol. 14:277

officers for completing crossword puzzles. 84 From such training activities, it is
difficult to understand how such training contributes to the “Vision” statement
on page 1A of the Cadet Handbook. In this statement the CDCR states it “will
end the causes and tragic effects of crime, violence, and victimization,” yet in
the pages therein, there is little to indicate exactly how the new cadet will
contribute to this purpose. 85
A. Deficiencies in Mental Health Training
Over the last half century in California, prison work has shifted towards
appearing more professionalized and paramilitary in image. The CDCR’s
website has featured cadets-in-training wearing military uniforms, gas masks,
and brandishing firearms.
The historical transition from “guard” to
“correctional officer” is a shift in perception that has been largely guided by the
California Correctional Peace Officers Association (CCPOA), a union
established in 1957. 86 The union has since ballooned in size and in 2008 there
were nearly 30,000 “rank and file” members, representing one out of every
seven people employed by the State. 87 The union has typically shunned the use
of the term “guard” in favor of “correctional officer,” perhaps to propagate an
authoritative alignment with police officers; in fact, the CCPOA’s current
slogan is “CCPOA: Representing the men and women who walk the toughest
beat in the state,” 88 perhaps an attempt to liken their rounds behind bars to the
“beat” of a police officer on the street. In California, “cadets” must graduate
from the Basic Correctional Officer Academy in order to become a full-fledged
correctional officer. 89
The union’s goal of reimagining its work as something more than merely
guarding, however, may be mostly in name. Noting this semantic affinity, one
scholar has noted, “Correctional personnel tend to prefer ‘correctional officer’.
. .a kind of ‘white wash’ which signifies no real change in the work and
responsibilities.” 90 Criminologist Hans Toch has raised further doubts as to
whether a name change has any meaning in prison. 91 From such attitudes it is

84. John Gittelsohn, Prison Guard Training Criticized, ORANGE COUNTY REGISTER, April
16, 2005, available at http://www.ocregister.com/ocr/sections/news/news/article_484076.php.
85. Basic Corr. Officer Academy, supra note 95, at 1A.
86. California Correctional Peace Officers Association – About Us, http://www.ccpoa.org/
aboutus.shtml.
87. Elizabeth Hill, Correctional Officer Pay, Benefits, and Labor Relations (2008), available
at http://www.lao.ca.gov/2008/stadm/ccpoa_pay_020708/ccpoa_pay_020708.pdf. In addition to
correctional officers this number includes other classifications such as youth correctional officers,
parole agents, and corrections counselors. Id. at 5.
88. See http://www.ccpoa.org/.
89. CAL. DEP’T OF CORR. & REHAB., PAY & BENEFITS, available at http://www.cdcr.ca.gov/
CareerOpportunities/POR/JobPostings/payandbenefits.pdf.
90. PRISON GUARD, CORRECTIONAL OFFICER: THE USE AND ABUSE OF THE HUMAN
RESOURCES OF PRISONS 83 (Robert R. Ross, ed., 1981).
91. See generally Hans Toch, Is a “Correctional Officer,” by any Other Name, a “Screw?”,

SPEARIT (277-302)

2009]

8/3/2009 6:53:42 PM

MENTAL ILLNESS IN PRISON

291

not evident that adopting the title “officer” made much of a difference in the
job itself, except perhaps in the perception of officers.
In California, candidates seeking to become a Correctional Officer must
attend a sixteen-week Training Academy and a two-year Apprenticeship
Program. 92 CDCR Peace Officers are trained at the Basic Peace Officer
Academy in Galt, California. 93 The curriculum consists of training in the areas
of firearms, chemical agents, non-lethal impact weapons, and arrest and control
techniques. Cadets must also successfully complete the Peace Officer Standards
and Training courses (POST). 94 Upon graduation from the academy, cadets are
sworn in as State Peace Officers at a graduation ceremony. Due to the physical
and mental aspects of the job and the institutional environment, candidates are
expected to be mature, physically fit and emotionally stable. 95 The primary
text used beyond cadet training is called the Adult Corrections Officer Core
Training Course Manual, whose “primary purpose” is to present the core
curriculum and design specifications for the Adult Corrections Officer Core
Course. 96 This “essential” training information is also meant to offer
“significant benefit to local corrections departments in the training of new adult
corrections officers.” 97
“STC” refers to the “Standards and Training for Corrections,” which is a
trainee’s gateway to becoming a line officer. The STC manual embodies 176
hours of instruction that is broken up into units and modules. Of particular
concern is the Monitoring Psychological and Physical Health unit, which
affords fifteen hours of instruction to cover six modules: Legal Issues, Mental
Health Issues, Suicide Issues, Indicators of Substance Abuse, Indicators of
Physical/Mental Problems, and Assisting Medical Personnel in the Distribution
of Medication. 98 Of these hours, about half are devoted to leaning how to
identify the potential signs of mental health issues in inmates
In an accompanying training manual, Adult Corrections Officer
Knowledge and Skills Maps, the section on “Crisis Intervention” continues the
theme that officers should be competent in identifying mental conditions. 99
3 CRIM. JUST. REV. 19 (1978).
92. Dep’t of Corr. & Rehab., Divs. and Bds.—Peace Officer Careers, http://www.cdcr.ca.
gov/Career_Opportunities/POR/COTraining.html.
93. Id.
94. Id.
95. STATE OF CAL., BD. OF CORR., ADULT CORR. OFFICER CORE TRAINING COURSE
MANUAL at i, available at http://www.cdcr.ca.gov/Divisions_Boards/CSA/STC/Publications/
ACO_Core_Training_Manual.pdf.
96. STATE OF CALIFORNIA—BOARD OF CORRECTIONS, Adult Corrections Officer Core
Training Course Manual, available at http://www.cdcr.ca.gov/Divisions_Boards/CSA/STC/Public
ations/ACO_Core_Training_Manual.pdf.
97. Id.
98. Id.
99. STATE OF CAL.—BD. OF CORRECTIONS, Adult Knowledge and Skills Map, available at
http://www.cdcr.ca.gov/Divisions_Boards/CSA/STC/Publications/ACO_Knowledge_and_Skills_
Maps.pdf.

SPEARIT (277-302)

292

8/3/2009 6:53:42 PM

BERKELEY JOURNAL OF CRIMINAL LAW

[Vol. 14:277

Yet this section explicitly mentions that under “Rules & Concepts” officers are
to report behaviors, not opinions regarding inmate behavior. 100 Even more
definitive is the statement that a “corrections officer is not a mental health
professional.” 101 The bent of training and instruction is clear: officers must be
able to recognize mentally ill prisoners, report them, and be aware of the
correct protocol for interactions. Correctional Officers are limited as to what
medical assistance they can offer to inmates, and their role in rehabilitation is
relegated mostly to alerting medical staff to problems and to administering
medication. 102 This limited training session is the only instruction correctional
officers formally receive on the topic.
Although correctional officers have limited training in mental illness or
the rehabilitation of prisoners, they are better trained and assessed in other
areas seen as important to their job. As the Minimum Academic Standards
outlines, cadets are required to pass the Penal Code (PC) 832 Examination, a
four-pronged test that includes an arrest and firearm component. 103 There is an
additional firearms training component that acquaints cadets with the weapons
found specifically in California prisons. Penultimately, there is a major
physical training requirement, from which no cadet is excused and which must
be attended. 104 The fourth and final requirement is proficiency in Tactical
Skills, which is specific training in expandable baton, arrest and control, and
alarm response. 105 Overall, the Cadet Academy dedicates a tremendous
amount of time and resources to teaching cadets how to interact physically with
prisoners—yet skimps on one of the most important aspects, namely assistance
and supervision of mentally ill inmates.
The rules that govern a correctional officer’s behavior are the Director’s
Rules. 106 According to Rule 3391, prison employees must be “alert, courteous,
and professional in their dealings with inmates, parolees, fellow employees,
visitors, and members of the public. Employees shall not use indecent, abusive,
profane, or otherwise improper language while on duty. 107 Later the Handbook
defines “alertness”: “Employees must not sleep or be less than alert and in full
possession of all faculties while on duty.” 108 Although these rules may reflect
the priority of duties for the prison, it is difficult to fathom that they are always
adhered to—during many trips to California prisons, this author has witnessed
these rules repeatedly violated. 109

100.
101.
102.
103.
104.
105.
106.
107.
108.
109.

Id.
Id.
Id. at 81.
Id.
Id. at 29.
Id.
Id. at 39.
Id.
Id.
The author has researched in Lancaster State Prison and has taught courses at San

SPEARIT (277-302)

2009]

8/3/2009 6:53:42 PM

MENTAL ILLNESS IN PRISON

293

There is no reason a correctional officer’s role in rehabilitation needs to be
minimized, as it is in California. One psychologist has described ways in
which line officers can be used to greater effect since they are with inmates
twenty-four hours a day. 110 This system envisions a fuller use of correctional
staff within a system of mental health treatment comprising of “1) counseling
and psychotherapy—talking with inmates, 2) consultation—talking about
inmates, 3) special housing, activities, and behavioral programs, and 4)
medication.” 111 Within this framework, line officers play a much greater role
than simply delivering medication and pointing out illness for reporting
purposes—instead they play an active role in the rehabilitation process. In
California, officers are not able to participate in such rehabilitative efforts, and
worse, their lack of training in interacting with mentally ill inmates may hurt
rehabilitative potential and contribute to a negative work environment. As the
next section shows, there is also lack of training for officers’ own emotional
and psychological well being, which all too often get sacrificed for the job;
high stress combined with few coping skill can impact not just officers who
suffer high levels of stress, but the prisoners they guard as well.
B. Stress and Emotion at Work
The mental health crisis in prison adds to the many layers of stress that
entails the work of a correctional officer. Whether told by academics, the
media, or officers themselves, prison work is stressful and emotionally
draining. One comparative study has shown that occupational stressors do not
differ significantly between police officers and correctional officers. 112 Like
the dangers faced by police on the street, threats in prison are ever-looming for
correctional officers; significantly, a portion of this violence originates from
mentally ill prisoners. 113 Research is unified in showing that fear of danger is
the prominent stressor for prison staff. 114 Given the threatening atmosphere,
mental endurance and stability are critical for correctional officers wishing to
achieve professional longevity in an environment of high turnover rates. 115

Quentin State Prison.
110. Joel A. Dvoskin & Erin M. Spiers, On the Role of Correctional Officers in Prison
Mental Health, 75 PSYCH. Q. 1 (2004).
111. Id.
112. Risdon N. Slate, et al., Police Stress: A Structural Model, 22 J. POLICE & CRIM. PSYCH.
102, 109 (2007).
113. See e.g., AMERICAN PSYCHIATRIC ASS’N, VIOLENT BEHAVIOR AND MENTAL ILLNESS:
A COMPENDIUM OF ARTICLES FROM PSYCHIATRIC SERVICES AND COMMUNITY PSYCHIATRY
(1997).
114. See Susan Philliber, Thy Brother’s Keeper: A Review of the Literature on Correctional
Officers, 4 JUST. Q. 9, 17 (1987).
115. Id at 15. In California, turnover is not solely attributable to unbearable work conditions.
There are other factors at play, including that corrections work may simply be temporary work for
many on the way to some other job, especially police work. Thus, turnover in California is in part
due to employees’ strategic job-searching.

SPEARIT (277-302)

294

8/3/2009 6:53:42 PM

BERKELEY JOURNAL OF CRIMINAL LAW

[Vol. 14:277

Although these sobering conditions for officers warrant serious attention,
prison scholarship has tended to focus on prisoners, and by comparison
correctional officers have largely been forgotten. 116
Generally speaking, the intense emotional strains of prison work were
recognized as early as 1833, when Alexis de Tocqueville and Gustave de
Beaumont carried out their famous study on American prisons. 117 In this
pioneering study, their praise for American prisons is tempered by their
description of conditions for guards in Sing Sing Prison in New York State:
“The safety of the keepers is constantly menaced. In the presence of such
dangers, avoided with such skill but with difficulty, it seems to us impossible
not to fear some sort of catastrophe in the future.” 118 A century and a half later,
the Encyclopedia of American Prisons (1996) traced modern signs of trouble to
the 1920s, when psychologists had begun raising red flags due to the “social
distance” between the prison staff and administration. 119
There are other indications of the high stress associated with prison work.
The website of the CCPOA notes that several studies have estimated life
expectancy of correctional officers at 59 years. 120 Police officers in the
“United States have an estimated life-expectancy ranging from fifty-three to
sixty-six years.” 121 By comparison, the Police Policy Studies Council reports
that in the United States, non-police males have a life-expectancy of seventythree years. In addition to shortened lives, the divorce rate for correctional
officers is purportedly twice the national average, 122 and high rates of
alcoholism and suicide are found among line officers. 123 One of the most
comprehensive studies on correctional officer stress concluded that illnesses
related to stress at work, including hypertension, ulcers, and heart disease were
abnormally high among correctional officers. 124
116. LUCIEN X. LOMBARDO, GUARDS IMPRISONED: CORRECTIONAL OFFICERS AT WORK 1
(Elsevier 1981).
117. GUSTAVE DE BEAUMONT AND ALEXIS DE TOCQUEVILLE, ON THE PENITENTIARY
SYSTEM IN THE UNITED STATES AND ITS APPLICATION TO FRANCE (Francis Lieber trans., Carey,
Lea & Blanchard 1970) (1833).
118. Id. at 200.
119. ENCYCLOPEDIA OF AM. PRISONS 118 (Marilyn D. McShane and Frank P. Williams III
eds., Garland Publishing 1996) (“The low status of the guards was viewed as stress-producing.
Often manipulated by the prisoners, officers felt themselves as much imprisoned as those they
guarded.”).
120. Ron Holman, Taking off the Uniform: Understanding Command Presence and How It
can Affect Your Family, available at http://www.ccpoa.org/uniform.shtml.
121. Thomas J. Aveni, Shift Work and Officer Survival, S&W Academy Newsletter (Summer
1999), available at http://www.theppsc.org/Staff_Views/Aveni/Shift-Survival.htm.
122. ENCYCLOPEDIA, supra note 119, at 129.
123. Id.; Recently, a blog entitled “Thoughts of a California Corrections Officer about
Prisoners, Inmates, and their Keepers” featured a correctional officer who had expressed dismay at
the high rate of suicide among officers. Cal. Progress Report, Thoughts of a California
Correctional Officer About Prisons, Inmates, and Their Keepers, http://www.californiaprogressre
port.com/2007/02/thoughts_of_a_c_1.html (Feb. 14, 2007).
124. See generally F.E. Cheek & M.D.S. Miller, The Experience of Stress for Correctional

SPEARIT (277-302)

2009]

8/3/2009 6:53:42 PM

MENTAL ILLNESS IN PRISON

295

Scholars have depicted guard/correctional work as alienated, cynical,
burned out, stressed but unable to admit it, and frustrated beyond
imagination. 125 So it is unsurprising that there are many obstacles to ensuring
that officers maintain a balanced and healthy emotional disposition. As the
training described above reveals, officers are given little training on how to
maintain their own psychological and emotional welfare, even though some
researchers have advocated making such training available to all officers.126
Although the CDCR occasionally distributes flyers that encourage ways of
coping with stress, beyond this there is not much support. 127 In this State, there
is no mandatory counseling or routine psychological check-ups for correctional
officers. Even though routine counseling might provide correctional officers
with much needed psychological support, the fact is that few officers want to be
associated with such services. In an environment where counseling and clinical
support should be the norm, it is too often the exception. For officers, it
typically may be a matter of pride or of not being perceived as mentally weak
by prisoners or other staff; they seek to avoid being seen as soft or in need of
help. 128
Correctional officers also have difficulty shaking off the effects of prison
work while off the job. To learn more about life as a prison guard, one
researcher actually went undercover and worked as a correctional officer at
Sing Sing prison. Entitled Newjack (2001), this work paints a portrait of Ted
Conover, an experienced journalist and recipient of a doctoral degree, who
details his own behavior and how he treated both prisoners and his family. 129
After becoming a guard, his stress and aggression skyrocketed; he even began
to hit his child. 130 Even when on vacation he found himself traumatized by
dreams about the prison, recalling, “All I knew then was that even though my
body was two thousand miles away, my mind was still trapped in Sing
Sing.” 131 Although Conover’s study was arguably as novel as it was
unorthodox, other inquiry has documented similar effects of prison
employment on officers:
Most officers recognized the changes that had taken place in
themselves and spoke of those changes with sorrow and bitterness in
the interviews. Many of their young marriages were in trouble or
destroyed. Some officers were so burnt out that they could not go into
Officers: A Double-bind Theory of Correctional Stress, 11 J. OF CRIM. JUSTICE 105 (1983).
125. Philliber, supra note 115, at 9.
126. Jo Paton et al., Prisoner Officers Experiences of Identifying and Managing Mental
Health Problems (2004).
127. See Appendix A.
128. LYNN ETTA ZIMMER, WOMEN GUARDING MEN 25 (1986) (“Because overt displays of
fear by some members can be detrimental to the entire work group, subcultural norms and values
stress the importance of overcoming fear through displays of masculinity and machismo.”).
129. TED CONOVER, NEWJACK: GUARDING SING SING (Vintage 2001).
130. Id. at 244.
131. Id. at 115.

SPEARIT (277-302)

296

8/3/2009 6:53:42 PM

BERKELEY JOURNAL OF CRIMINAL LAW

[Vol. 14:277

supermarkets or take their children to the zoo. Others were so drug
dependant that they had to get drunk before going to work on the 7
a.m. shift. Some were so angry and frustrated that they punched holes
in the walls of their homes and abused those whom they loved. The
suffered severe headaches, hypertension, nightmares. Most of all, they
were desperately unhappy and despaired that life could ever seem good
again. 132
Similar conclusions are found in Lucien X. Lombardo’s Guards
Imprisoned (1990), an investigation into the guard lifestyle and its bipolar mix
of chaos and boredom. 133 Faced with danger and a sense of powerlessness, it
describes the guard as “a classic example of an alienated worker. To cope with
these frustrations he resigns himself to the inevitability of forces beyond his
control and finds alternatives to or strikes out against situations within his
grasp.” 134 More recently, prison guards at Guantanamo Bay have been
reported to suffer psychological trauma as a result of the harsh environment,
which is further testimony to the effects treatment of prisoners can have on
their keepers. 135
From de Tocqueville’s observations, nearly two centuries ago, little has
changed about the dangerous nature of prison work and the effects of stress on
prison personnel. 136 In addition to the stress that originates from inmates,
service staff, other officers, visitors, and administrative superiors, 137 officers
today bear the added brunt of managing unprecedented numbers of mentally ill
inmates, which only heightens stress. Since mentally ill prisoners are more
difficult to manage and more violent than the general prison population, their
growing presence means more emotional strains for officers which typically
including alcoholism, drug addiction, and domestic problems. Under the
custody of such individuals, the question of inmate rehabilitation begins to look
like a purely theoretical construct; far from being able to manage inmates and
contribute to rehabilitation, officers sometimes cannot even manage
themselves.
CONCLUSION
The aggregate impact of the mentally ill population on prisoners and
correctional officers cannot be overstated.
In general, scholars, the
government, and the media all characterize California’s prison system as

132. KELSEY KAUFFMAN, PRISON OFFICERS AND THEIR WORLD 212 (1988).
133. Lombardo, supra note 116, at 140.
134. Id.
135. James Randerson, Guantanamo Guards Suffer Psychological Trauma, THE GUARDIAN
(Feb. 25 2008), available at http://www.guardian.co.uk/science/2008/feb/25/guantanamo.guards.
136. Id. at 129.
137. See generally Richard Tewksbury, Prison Staff and Work Stress: The Role of
Organizational and Emotional Influences, 30 AM. J. OF CRIM. JUST. 247-256 (2006).

SPEARIT (277-302)

2009]

8/3/2009 6:53:42 PM

MENTAL ILLNESS IN PRISON

297

deeply flawed or completely broken. 138 Consequences of this crisis will
certainly arise in the coming decades as tens of thousands of psychologically
damaged inmates return to society without proper acclimation. 139 Virtually all
researchers writing in the area of inmate psychology acknowledge that
prisoners are adversely affected by SHUs. 140 What is not as evident, however,
is whether any credible data suggests that SHUs produce any widespread
beneficial effects. 141 Independent of these considerations, there is “little doubt
about not only [their] capacity to inflict widespread psychological pain but also
[their] potential to significantly undermine already tenuous chances for
subsequent adjustment.” 142
From the purview of contemporary criminal justice, these issues, as they
relate to mental illness, should be of utmost concern. Due to the sparse training
in the area of mental illness, management of inmates is made all the more
difficult. 143 Thus, the system’s substantive instrument of punishment, the
penitentiary, is defective in ways that pose challenges to its rehabilitative
purpose. Moreover, history has shown at the idea of rehabilitation has not
always been welcomed by inmates, and at times prisoners have rejected the
system’s notion of rehabilitation; 144 rather than submit to whatever is done to
them in the name of rehabilitation, they have altogether rejected treatment.145
This author has heard anecdotal evidence from numerous prisoners who claim
that the rehabilitation relationship is backward—that the criminal system needs
rehabilitation, not they. 146 From the point of view of these prisoners, there is
no question of “rehabilitation” because there is no problem. The problems,
instead, come from corrupt policing tactics, court room biases, racial profiling,
unfair sentencing laws, parole technicalities, and incompetent prison
administrations. For these inmates, a wholesale emphasis on rehabilitation
allows the state to ignore the systemic inequalities of the criminal justice
system and lays the full burden of crime on the prisoner—a gross
oversimplification. These critiques of rehabilitation policy, however, are only
peripheral to the core question of how to acquire success in a criminal justice
138. See e.g., ANGELA DAVIS, ARE PRISONS OBSOLETE? (Open Media 2003).
139. Abramsky, supra note 2, at 144; see also Kupers, supra note 30, at xxvi-xxvii (“[I]t is
especially foolish, costly, and dangerous to warehouse [inmates] in overcrowded prisons, deny
them adequate psychiatric attention, and leave them to become the victims and perpetrators of
violence.”).
140. Haney, supra note 38, at 534.
141. Id.
142. Id. at 568.
143. Bonnie J. Sultan, The Insanity of Incarceration and the Maddening Reentry Process: A
Call for Change and Justice for Males with Mental Illness in the United States, 13 GEO. J.
POVERTY L. & POL’Y 357, 371 (2006).
144. DAVID GARLAND, THE CULTURE OF CONTROL: CRIME AND SOCIAL ORDER IN
CONTEMPORARY SOCIETY 55 (The University of Chicago Press 2001).
145. Id.
146. The author has researched in Lancaster State Prison and has taught courses at San
Quentin State Prison.

SPEARIT (277-302)

298

8/3/2009 6:53:42 PM

BERKELEY JOURNAL OF CRIMINAL LAW

[Vol. 14:277

system that has been described as failing its mentally ill prisoners “at every
step.” 147
This is not to say that there is not a need for rehabilitation. Research has
already pointed out that California provides fewer rehabilitation programming
that comparable states. 148 What scant services that are provided must
counteract the huge problems of drug addiction, lack of education, and lack of
job skills. Although California has pledged an additional 10,000 beds for
medically and mentally ill prisoners, 149 due to recent financial woes it is
unlikely that the state can make good on this promise and uncertain what effect
fulfilling the promise would have on conditions behind bars.
Due to the many problems outlined in this article, the CDCR faces an
uphill battle to fulfill the goals its title implies. Without a change in the
CDCR’s “culture of failure,” 150 there will be little opportunity for meaningful
rehabilitation, especially as it relates to the training of new officers and
measures to secure their psychological well-being and that of prisoners. The
mental health crisis has been brewing for more than three decades and cannot
be fixed overnight with a name change that, more than anything, resembles a
public relations tactic than a substantive change. Although some researchers
believe that the line officer is in the best position to assist in the rehabilitative
potential of inmates, 151 California has not welcomed this suggestion. Due to
the high levels of stress that officers already face, some may not be in an
effective position to help rehabilitate inmates.
Until the mental health crisis is brought under control there will likely be
little chance for the CDCR to implement a meaningful rehabilitation strategy.
As it currently stands, the California Expert Panel has reported that nearly half
of all prisoners released in 2006 sat idle—not participating in a work or other
rehabilitation program—for their entire stay in prison.152 These dismal figures
show that there is already a tremendous shortage of rehabilitation programs.
When considered alongside California’s budgetary woes and inability to
comply with the orders of its court-ordered special master, the flaws and
incompetency of CDCR’s current system are evident. Under the current penal
philosophy and practices, the realization of rehabilitation begins to look like a
distant, almost theoretical notion; without serious attempts to contain the
mental health crisis the idea of rehabilitation will remain just that—an idea.

147. Ball, supra note 29, at 5.
148. Petersilia, supra note 14, at 39.
149. Office of the Governor, Gov. Schwarzenegger Unveils Comprehensive Prison Reform
Proposal (2006), http://gov.ca.gov/index.php?/print-version/press-release/4972/.
150. Ball, supra note 29, at 35.
151. WILLIAM C. COLLINS, CORRECTIONAL LAW FOR THE CORRECTIONAL OFFICER 1
(American Correctional Association 2003).
152. CAL. DEP’T OF CORR. & REHAB, California Expert Panel on Adult Offender Recidivism
Reduction Programming: A Roadmap for Effective Offender Programming in California: Report
to the California State Legislature (2008), http://www.cdcr.ca.gov/news/ExpertPanel.html.

SPEARIT (277-302)

2009]

8/3/2009 6:53:42 PM

MENTAL ILLNESS IN PRISON

299

Without a genuine attempt to treat the mental hell behind bars, the CDCR may
as well change its “R” from “Rehabilitation” to “Recidivism,” to reflect more
accurately its achievements.

SPEARIT (277-302)

8/3/2009 6:53:42 PM

300

BERKELEY JOURNAL OF CRIMINAL LAW

[Vol. 14:277

Appendix A

YOUR HEALTH
Tips for Staying Healthy from
The Office of Employee Well ness

fC""'
"" _ _ "bIOj••• ; ',;
Sponl _ _ . _. . . IIl _ _

, _ . " " ...... - .

__"iK*lIl<il'

~ _ . n..~f

..-.gb' ..
.. ""I*v _ _
.... _ ...... "" ...... Jol>_ ... _ _
~_

-""
_

..

"'~

,.
I ..
....- .. _
..
II

•

'-'

_ _ your_"

~IoIOO_loo.lOon_"'IOO

........... ~ . . IM! ..... <iI'*-a._-._.:l .. _ _

-..-Io ....

It 1o<o1_11O)o.wlo .... d«NInd. of _ _ ond PI<-..I 11<0. For moot POQIlIo.

~r.

.

ongoing ~ 10 _

t_lIJo. _

... _.,.,."

ond molnI8In """"""1 " key._ '"
"''*''r t _jO<llWl
.... ........,._. bHllorl'O'J'

~.Iog-T_._.d
ond
•.,.

.........-.
lot OC> 0I'f\' out ol go.-.

. . Doddo_._.. . _

_<lolof""' __ n:uIoworl<_

e..c"'~"_

ot

....don'' ' ' ' rdon' __

SPEARIT (277-302)

2009]
o

o
o

8/3/2009 6:53:42 PM

It._

MENTAL ILLNESS IN PRISON

301

y<>Ur Umo _ Orgor>ize _J"OI<l to.... eff\cIonO;ly. Dolng 000 or
two 0:..<1. oIloundry..,..ry day ""herlhan ...,;"g ~ .. "" your (loy 011,
.nd runnirlg."..rv:tt n t>at<:Mo ra","" ""'" goirQ ~ and to<lh .._
time> ora good pla<t.o k>~. A """""ly farnly caleo<l'r oI;mportonl
_ . n d • d.iI)Ilitl 0 1 _ ..... " " ' l'OO .'o<>id _
poOiO,
_Ink your elo.nlnsl .land.rd. - An .....- t>..:l ... _ 01 di1)'
wont mpoct tflo QlJoIity oI)'O<lr lile, 00 _
' - 0 to .. done and
Itt! ttlo _ go,
Nunura y<>UrsoIf - Sot • ..,. _
- " da~ for an odi'o'ity that l'OO ",*,y,
ouch •• walking. working out or btOl'ling to n'O.lOic. lIr'!'M"ld.-.-..:

d_

_a~,

o Set •• ldo ono nlghtHehw..klorrKraOllon_ T.k.lhO ~offtht
hook. power dOwn lhO oompo.JIt< on<!
oIIthe TV, 0;..",
__
)'O<l can do _
your part_, f0""Y'" frIond.. ","king limo f o r _
)'O<l anjoy";l rajwon.te)'>IJ,
o f'rol",,'
d.y ott _ Try to ochedUo """'" 01 your routlno chore. 00
_.yo 00 'ha' your <Ioyo olio", ITIO<ft fIlIo>ing.
• Got onough .IMp _ lMra'. fI(lIIW>g ......afulond pOlMti.1y
d.1"qOf'OOS •• """"'io'lg ......... ,.,..,... ~ .
o
y o u r . _ .ystorn - G.... jOUttoIf lhO gill 01 a trustod JrIooo:l
or ~orlO tolk Ioitll <\ur'olg _
0 1 _ htr<loNl>. Enoura you
ha... tnIste<l f\iondo ... ralatMls """ can os
you _
you"- '"
or lr1l...-l "" your job_

'Llm

1''''''

_to,

" "' 0_

aalance doesn't m....n doln9 evervthlnll. Enmin" your
pdorlile. ond set bound.ri.... B" firm In what y<>u can ond
eannot do. Only y<>u tan
hormony 10 y<>u' lIfe.tyl~.

..,.to""

Please do not respond to this e-mail
For ITIO<ft OIIorrnatoo plo'" >\Oil 'no 0I'fI00 01 EmpIoyeo Welln...

I'oebsite hlli>:ln""onotlHRIOEWldoflluU... p

"""""""'---_ _-_._
"'_...-.-0_- _-"'---"""

0uesti00lI ... - . "" lui..... topjcs moy .. <lrecttd 10 >.I""",,," Brooks a'
,,",""Io.b<ook.~dcr.c.,gov

.

_"""'"'"""". _ _ ....... " ... O'b"

~

E_W_._COCR
.

-

"""""""". _ " ' ........;>OM" -"'>roo.....,--._"
_""'"'''- ........
•"""_...."...
_, __,_ " _ " ""'_"I'
oj,,,
_ol
_ _,
"'......... ..- .....
~ _ , _ ·

SPEARIT (277-302)

302

8/3/2009 6:53:42 PM

BERKELEY JOURNAL OF CRIMINAL LAW

[Vol. 14:277

 

 

The Habeas Citebook: Prosecutorial Misconduct Side
Advertise here
Disciplinary Self-Help Litigation Manual - Side