Prisons, prevention and policy
By Robert K. Ax, PhD
Congratulations to Dr. Femina Varghese for creating the Criminal Justice Section Newsletter, “The Gavel,” which marks an important step in the ongoing development of the Criminal Justice Section. I also want to thank her for inviting me to write a piece for the launch issue. In this space, I’d like to offer a slightly different perspective on our specialty, and something of a challenge.
Why do we lock so many people up here in the United States? Obviously, it’s partly because we can. Despite our huge national debt, America’s GDP is the world’s largest, and for the past 40 years, we’ve spent liberally on prisons and jails. Now we have the highest incarceration rates in the world for both adults and juveniles. For all the scholarly literature, the intercession of correctional psychologists and other health care professionals, and the handwringing of policy wonks and do-gooders during those decades, the prison population didn’t plateau until the federal government hit a cash flow problem about four years ago.
According to the latest available figures (Glaze & Parks, 2012), the total census is declining slightly, but we’ve seen this trend before. Between 1960 and 1970, the national incarceration rate (sentenced prisoners, state and federal institutions) fell from 117 to 96 per 100,000, and corresponding populations decreased from 212,953 to 196,441 (Minor-Harper, Marbrook, Baldea, & Stanford, 1986), only to begin ticking up again as increasingly harsh laws – largely having to do with street drugs – were passed at the state and federal level. When the economy recovers, perhaps the national desire to incarcerate will be reinvigorated. Initiatives to legalize marijuana possession (as occurred in Washington and Colorado this past election; note that it remains illegal under federal law) and modifications of three-strikes laws (as took place in California in November) may prove to be grudging and temporary concessions to economic realities, not sincere reappraisals of the nation’s criminalizing impulse.
Neither am I sure that the future of prison policy will mean a more rational and humane disposition of persons with serious mental illness, who are more likely to be arrested and confined for the same or similar, often minor, offenses than those not SMI-challenged (Teplin, 1984; Valdisseri, Carroll, & Hartl, 1986). It is similarly uncertain whether racial disparities in incarceration will be addressed. The incarceration rate for Black non-Hispanic males is more than 6 times that of White non-Hispanic males (West & Sabol, 2009). There is now an entirely separate federal prison system: the Immigration and Customs Enforcement (ICE) detention centers. ICE facilities have an aggregate daily census of over 30,000 persons (Government Accountability Office, 2008), and over half of their residents are from Mexico and other Central American nations (Kerwin & Yi-Ying Lin, 2009). In addition to housing violent offenders who present a genuine risk to the community, prisons and jails have become America’s default repositories for inconvenient people.
Mostly, though not entirely, correctional psychologists are in the rehabilitation business. Maybe incarceration is the component of the criminal justice system where most of the jobs are and most of the available research grant money is for those who think of themselves as correctional psychologists. That is to some extent our own doing. It’s the professional space we’ve created for ourselves. However, in an increasingly cost-conscious health care environment, putting most of our chips on rehabilitation is a long-shot bet.
We’re already fighting a steep state-dependent learning gradient, that is, teaching inmate-patients life skills, habits, and attitudes we hope will transfer from total institutional settings to the community. Hoping to achieve high rates of rehabilitation with individuals already in prison, particularly in light of the obstacles to their productive reintegration into society, is analogous to expecting high cure rates among medical patients in intensive care units. Too often, prisoners, especially juveniles, are people who have been failed by other societal institutions – family, educational, religious, and health/mental health. Once arrested, they’re usually branded with a criminal record, a further impediment to turning their lives around. Psychologists can appreciate that raising the response cost of pro-social living to unrealistic levels is one way to design a system that will fail – or to design a system to fail, if one takes the cynic’s viewpoint that the intention is to keep as many offenders confined as possible.
Therefore, how few people can we incarcerate in the first place?
In the popular media, discussions of prison and criminal justice reform easily veer in the direction of keeping violent criminals in prison. Granted that real thugs need to be confined, but let’s look at the other end of the spectrum, at individuals who are going to prison and being burdened for life with felony convictions for non-violent and often – I use the term cautiously here – victimless crimes. Beyond that, let’s think about adolescents, and children, and infants, and their parents, and what we – you and me, people with advanced degrees and specialized knowledge and authority – can do on their behalf. Preventing involvement in the criminal justice system and its attendant iatrogenic effects is where considerably greater return on investment can occur in both human and economic terms.
Notwithstanding the likelihood that most of us will continue to focus on incarcerated populations, let’s also examine points of intervention further back in the pipeline that leads people to prison. To do this, an enhanced and expanded definition of the field of correctional psychology is in order, one that encompasses and permits collaborations with those involved in community psychology, educational psychology, child and family psychology, and their counterparts in other health care fields, particularly reproductive health. Ensuring as much as possible that every child is wanted, properly cared for, and adequately educated is good public health policy – and good criminal justice policy. Further, alliances with interested advocacy groups such as the National Alliance for the Mentally Ill, Families against Mandatory Minimums, the NAACP, the John Howard Society and the Elizabeth Fry Society should be considered as a means of promoting more informed laws and policies.
The rehabilitation of incarcerated persons, generally speaking, constitutes tertiary prevention. Interventions like drug and mental health courts, focused on individuals at intermediate points in the arrest-trial-incarceration pipeline, may be considered secondary prevention. Primary prevention efforts – potentially the most cost-effective – are those that help at-risk individuals avoid arrest and incarceration altogether. The Washington State Institute for Public Policy (2006) has a list of empirically-supported, prevention-oriented (primary, secondary, and tertiary) criminal justice programs. Unfortunately, funding for prevention efforts is particularly vulnerable during economic downturns. Notably, reproductive health services providers such as Planned Parenthood have recently been targeted for budget cuts or elimination.
You as a correctional psychologist could advocate for better access to reproductive health services, just as the American Academy of Pediatrics does. In fact, a recent policy statement (American Academy of Pediatrics, 2012) audaciously supported the proactive prescription of “emergency contraception” medications for adolescent girls younger than 17 (those 17 and older can obtain them without prescriptions) to ensure its availability in the event of unplanned, unprotected sexual intercourse. Further, the statement stipulated, “At the policy level, pediatricians should advocate for increased nonprescription access to emergency contraception for teenagers regardless of age and for insurance coverage of emergency contraception to reduce cost barriers” (p. 1179). This is primary prevention in terms of both criminal justice and public health policy.
If this seems too far beyond your professional frame of reference, closer to home might be advocacy on behalf of improved gun control. For example, reinstituting the assault weapons ban as a means of preventing atrocities such as the massacre of 26 persons, 20 of them small children, in Newtown, Connecticut, in December of last year is prevention of crime and incarceration. Conversations about these increasingly common events often focus on the alleged mental problems of the perpetrators, unfortunately to the relative exclusion of considering issues of access to the weapons involved. Of course, as a correctional psychologist, you could also raise your voice on behalf of rebuilding the mental health service system in this country, which has been gutted over the past half century. Doing so could, among other things, prevent the incarceration of many persons with mental illness.
All of this said, tertiary prevention remains a worthy goal, and innovation is still possible within the traditional rehabilitation framework. Since 1994, federal law has blocked prison inmates from applying for Pell Grants. Correctional psychologists could advocate for a reversal of this policy. With the advent of massive open online courses (MOOCS; Lewin, 2012) that offer the advantage of a wide variety of education and training at greatly discounted rates, inmates supported by Pell Grants would have the opportunity to learn marketable skills and get certified for jobs that pay a living wage. Utilizing technology in this way might enable many to break the cycle of crime and incarceration. In the spirit of collaboration with your colleagues in correctional education, how about writing to your elected representatives and requesting that they support modification of the Violent Crime Control and Law Enforcement Act of 1994 to permit, once again, prison inmates to be eligible for Pell Grants? Using your psychological expertise, explain the beneficial effects of education as they relate to community readjustment (Gaes, 2008; Lockwood, Nally, Ho, & Knutson, 2012).
To put all this in terms of self-interest, developing, implementing and/or advocating for effective prevention efforts may help correctional psychologists, as health care providers, survive and perhaps even thrive in the 21st century health care marketplace. Doing good and doing well are not mutually exclusive. There is, of course, a certain risk: trying to keep marginalized people out of prisons is still a politically tenuous proposition for legislators (and possibly for you). However, we may be reaching a crisis point here in the United States, one where economic constraints combine with demographic trends to compel a sincere reconsideration of the rush to incarcerate. I’m not optimistic, but I’m hopeful. Correctional psychologists can and should help inform research, practice and policy at all points within and beyond the criminal justice system, not just inside the walls.
Finally, I’d like to call readers’ attention to the North American Correctional and Criminal Justice Psychology Conference, which will have its third iteration in 2015. Division 18 co-sponsored this event in 2007 and 2011. Both were extremely successful, and I would like to suggest – or advocate – that readers begin thinking now about attending and especially about submitting program proposals for N3 on themes of prevention and policy. Policy, after all, is what largely determines the nature and function of your job in a correctional facility or a university, including whether or not you have a job at all.
Collaborate, advocate, innovate. Prevent.
Suggested Further Reading
Giglan, A., Flay, B. R., Embry, D. D., & Sandler, I. N. (2012). The critical role of nurturing environments for promoting human well-being. American Psychologist, 67, 257-271. A macro-view of the individual and societal benefits of preventing emotional, mental and behavioral disorders.
Wojcik, E. (2012, October). Innovative education. Monitor on Psychology, 43(9), 66. A counseling program with an advocacy component.
American Academy of Pediatrics. (2012, December 1). Emergency contraception: Policy statement. Pediatrics, 130, 1174-1182. Retrieved December 9, 2012, from http://pediatrics.aappublications.org/content/130/6/1174.full.pdf+html
Gaes, G. (2008, February 18). The impact of post-release education programs on post-release outcomes. Paper presented at the Reentry Roundtable on Education, John Jay College of Criminal Justice, New York (March 31 and April 1, 2008). Retrieved December 10, 2012, from http://www.jjay.cuny.edu/centersInstitutes/pri/pdfs/GaesTheEffectivenessofPrisonEducationPrograms.pdf
Glaze, L. E., & Parks, E. (2012, November). Correctional populations in the United States, 2011 (Bureau of Justice Statistics Special Report, NCJRS 239972). Retrieved November 29, 2012, from http://bjs.ojp.usdoj.gov/content/pub/pdf/cpus11.pdf
Government Accountability Office. (2008, June 4). Alien detention standards: Observations on the adherence to ICE’s medical standards in detention facilities (GAO Report #GAO-08-869T; accessible text file). Retrieved June 13, 2009, from http://www.gao.gov/htext/d08869t.html
Kerwin, D., & Yi-Ying Lin, S. (2009, September). Can ICE meet its legal imperatives and case management responsibilities? Migration Policy Institute. Retrieved December 16, 2012, from http://www.migrationpolicy.org/pubs/detentionreportSept1009.pdf
Lewin, T. (2012, November 20). College of future could be come one, come all. New York Times, A1, A14.
Lockwood, S., Nally, J. M., Ho, T., & Knutson, K. (2012). The effect of correctional education on postrelease employment and recidivism: A 5-year follow-up study in the State of Indiana. Crime & Delinquency, 58, 380-386.
Minor-Harper, S., Marbrook, M., Baldea, M., & Stanford, J. (1986, October). State and federal prisoners, 1925-1985. (Bureau of Justice Statistics Special Report, NCJ 102494). Washington, DC: US Department of Justice.
Teplin, L. (1984). Criminalizing mental disorder: The comparative arrest rate of the mentally ill. American Psychologist, 39, 794-803.
Valdisseri, E. V., Carroll, K. R., & Hartl, A. J. (1986). A study of offenses committed by psychotic inmates in a county jail. Hospital and Community Psychiatry, 37, 163-165.
Washington State Institute for Public Policy. (2006, October). Evidence-based public policy options to reduce future prison construction, criminal justice costs, and crime rates (Document No. 06-10-1201). Retrieved January 7, 2009, from http://www.wsipp.wa.gov/rptfiles/06-10-1201.pdf
West, H. C., & Sabol, W. J. (2009, March). Prison inmates at midyear 2008: Statistical tables (Bureau of Justice Statistics Special Report, NCJRS 225619). Retrieved August 22, 2009, from http://www.ojp.usdoj.gov/bjs/pub/pdf/pim08st.pdf