Punishment Fails. Rehabilitation Works.
James Gilligan, a clinical professor of psychiatry and an adjunct professor of law at New York University, is the author of, among other books, “Preventing Violence” and “Why Some Politicians Are More Dangerous Than Others.”
If any other institutions in America were as unsuccessful in achieving their ostensible purpose as our prisons are, we would shut them down tomorrow. Two-thirds of prisoners reoffend within three years of leaving prison, often with a more serious and violent offense. More than 90 percent of prisoners return to the community within a few years (otherwise our prisons would be even more overcrowded than they already are). That is why it is vitally important how we treat them while they are incarcerated.
How could we change our prison system to make it both more effective and less expensive?
The only rational purpose for a prison is to restrain those who are violent, while we help them to change their behavior and return to the community.
We would need to begin by recognizing the difference between punishment and restraint. When people are dangerous to themselves or others, we restrain them – whether they are children or adults. But that is altogether different from gratuitously inflicting pain on them for the sake of revenge or to “teach them a lesson” – for the only lesson learned is to inflict pain on others. People learn by example: Generations of research has shown that the more severely children are punished, the more violent they become, as children and as adults. The same is true of adults, especially those in prison. So the only rational purpose for a prison is to restrain those who are violent from inflicting harm on themselves or others, while we help them to change their behavior from that pattern to one that is nonviolent and even constructive, so that they can return to the community.
It would be beneficial to every man, woman and child in America, and harmful to no one, if we were to demolish every prison in this country and replace them with locked, safe and secure home-like residential communities – what we might call an anti-prison. Such a community would be devoted to providing every form of therapy its residents needed (substance abuse treatment, psychotherapy, medical and dental care) and every form of education for which the residents were motivated and capable (from elementary school to college and graduate school). Getting a college degree while in prison is the only program that has ever been shown to be 100 percent effective for years or decades at a time in preventing recidivism. Prisoners should be treated with exactly the same degree of respect and kindness as we would hope they would show to others after they return to the community. As I said, people learn by example.
My colleague Bandy Lee and I have shown that an intensive re-educational program with violent male offenders in the San Francisco jails reduced the level of violence in the jail to zero for a year at a time. Even more important, participation in this program for as little as four months reduced the frequency of violent reoffending after leaving the jail by 83 percent, compared with a matched control group in a conventional jail. In addition to enhancing public safety, this program saved the taxpayers $4 for every $1 spent on it, since the lower reincarceration rate saved roughly $30,000 a year per person. The only mystery is: Why is this program not being adopted by every jail and prison in the country? Why are taxpayers not demanding that this be done?
- Prison vs. Rehab: What Really Works
By Dr. Howard Samuels
Is being in prison going to make Cameron Douglas stop craving, using or selling drugs? Will he restructure his life so he can live without crystal meth? I think not.
His father Michael Douglas says Cameron has been using drugs since he was 13 years old. At 31, that’s more than half his life. His inability to stay sober for any length of time is not going to be deterred by being behind bars.
He needs treatment with his incarceration, otherwise he will just walk out—still imprisoned by the disease of addiction—and repeat the cycle like hundreds of thousands of other inmates who come out, only to go back into the system as repeat offenders.
We need treatment alternatives to jail time, with access to adequate drug rehabs as sentencing. We can punish people for the crimes committed to get the drugs, but that’s not the solution for treating the mental illness associated with the offenses.
Unlike a lot of parolees who walk out of prison with nothing and nowhere to go, Cameron Douglas will have resources and family, but that doesn’t mean he won’t still be craving drugs and resort to the same behavior that got him behind bars in the first place. The disease isn’t going to give Cameron a break, and respect him more because he’s the son of the rich and famous.
It’s wonderful that his father is taking some responsibility for his son’s drug use, but now we as the taxpayers have the burden of taking care of him along with almost every other inmate in jails across America who has used and continues to use drugs daily—despite being behind bars. More than half of the prison population is addicted.
25 years ago, I was shooting heroin and cocaine and had been since I was a teenager. I ended up in jail. The judge offered me prison or rehab. I chose rehab and was locked up for a year. Treatment saved this convicted felon’s life, and that is why I am so passionate about the need for prison reform for recovery. I would have wound up a career criminal or dead if my family and the courts had not intervened to stop my insanity.
Whether Cameron Douglas will ever be able to fully right the wrongs he has done to the people he sold drugs to, or the hurt it’s inflicted on their families remains to be seen, but he should be given a chance at recovery in order to possibly become a truly productive member of society.
Families must work alongside the very prosecutors, court officials and legislators charged with putting their loved ones away, petitioning them for mandatory court-ordered treatment for drugs and alcohol as their prison sentence. No less than one to two years of treatment is essential.
It may be sobering to be in jail, but being locked up doesn’t ensure real sobriety.
Treatment is also a less expensive cost to the taxpayer. For those like Cameron Douglas with financial resources—-let them pay for their rehab—and for the others, rehabilitation would cost a quarter of what it does for keeping them in prison.
The war on substance abuse is fought successfully by helping the individual become drug free. Sound treatment is the only weapon we share in the fight against drugs. We support the illegal drug market when we send users and dealers back on the streets without treating the problem.
- Rehabilitate or punish?
Psychologists are not only providing treatment to prisoners; they’re also contributing to debate over the nature of prison itself.
By ETIENNE BENSON
It’s not a very good time to be a prisoner in the United States.
Incarceration is not meant to be fun, of course. But a combination of strict sentencing guidelines, budget shortfalls and a punitive philosophy of corrections has made today’s prisons much more unpleasant–and much less likely to rehabilitate their inhabitants–than in the past, many researchers say.
What is the role for psychologists? First and foremost, they are providing mental health services to the prison population, which has rates of mental illness at least three times the national average.
More broadly, they are contributing a growing body of scientific evidence to political and philosophical discussions about the purpose of imprisonment, says Craig Haney, PhD, a psychologist at the University of California, Santa Cruz.
“Psychology as a discipline now has a tremendous amount of information about the origins of criminal behavior,” says Haney. “I think that it is important for psychologists to bring that information to bear in the debate on what kind of crime control policies we, as a society, should follow.”
The punitive turn
Until the mid-1970s, rehabilitation was a key part of U.S. prison policy. Prisoners were encouraged to develop occupational skills and to resolve psychological problems–such as substance abuse or aggression–that might interfere with their reintegration into society.
Indeed, many inmates received court sentences that mandated treatment for such problems.
Since then, however, rehabilitation has taken a back seat to a “get tough on crime” approach that sees punishment as prison’s main function, says Haney. The approach has created explosive growth in the prison population, while having at most a modest effect on crime rates.
As a result, the United States now has more than 2 million people in prisons or jails–the equivalent of one in every 142 U.S. residents–and another four to five million people on probation or parole. A higher percentage of the population is involved in the criminal justice system in the United States than in any other developed country.
Many inmates have serious mental illnesses. Starting in the late 1950s and 1960s, new psychotropic drugs and the community health movement dramatically reduced the number of people in state mental hospitals. But in the 1980s, many of the mentally ill who had left mental institutions in the previous two decades began entering the criminal justice system.
Today, somewhere between 15 and 20 percent of people in prison are mentally ill, according to U.S. Department of Justice estimates.
“Prisons have really become, in many ways, the de facto mental health hospitals,” says former prison psychologist Thomas Fagan, PhD. “But prisons weren’t built to deal with mentally ill people; they were built to deal with criminals doing time.”
The mentally ill
The plight of the mentally ill in prisons was virtually ignored for many years, but in the past decade many prison systems have realized–sometimes with prodding from the courts–that providing mental health care is a necessity, not a luxury, says Fagan.
In many prison systems, psychologists are the primary mental health care providers, with psychiatrists contracted on a part-time basis. Psychologists provide services ranging from screening new inmates for mental illness to providing group therapy and crisis counseling.
They also provide rehabilitative services that are useful even for prisoners without serious mental illnesses, says Fagan. For example, a psychologist might develop special programs for substance abusers or help prisoners prepare for the transition back to the community.
But they often struggle to implement such programs while keeping up with their regular prison caseloads. “We’re focused so much on the basic mental health services that there’s not enough time or emphasis to devote to rehabilitative services,” says Robert Morgan, PhD, a psychologist at Texas Tech University who has worked in federal and state prisons and studies treatment methods for inmates.
Part of the problem is limited resources, says Morgan: There simply aren’t enough mental health professionals in most prisons. Haney agrees: “Many psychologists in the criminal justice system have enormous caseloads; they’re struggling not to be overwhelmed by the tide.”
Another constraint is the basic philosophical difference between psychology, which is rehabilitative at heart, and corrections, which is currently punishment-oriented.
“Right now there’s such a focus on punishment–most criminal justice or correctional systems are punitive in nature–that it’s hard to develop effective rehabilitative programs,” says Morgan.
To help shift the focus from punishment to rehabilitation, psychologists are doing research on the causes of crime and the psychological effects of incarceration.
In the 1970s, when major changes were being made to the U.S. prison system, psychologists had little hard data to contribute.
But in the past 25 years, says Haney, they have generated a massive literature documenting the importance of child abuse, poverty, early exposure to substance abuse and other risk factors for criminal behavior. The findings suggest that individual-centered approaches to crime prevention need to be complemented by community-based approaches.
Researchers have also found that the pessimistic “nothing works” attitude toward rehabilitation that helped justify punitive prison policies in the 1970s was overstated. When properly implemented, work programs, education and psychotherapy can ease prisoners’ transitions to the free world, says Haney.
Finally, researchers have demonstrated the power of the prison environment to shape behavior, often to the detriment of both prisoners and prison workers.
The Stanford Prison Experiment, which Haney co-authored in 1973 with Stanford University psychologist and APA Past-president Philip G. Zimbardo, PhD, is one example. It showed that psychologically healthy individuals could become sadistic or depressed when placed in a prison-like environment.
More recently, Haney has been studying so-called “supermax” prisons–high-security units in which prisoners spend as many as 23 hours per day in solitary confinement for years at a time.
Haney’s research has shown that many prisoners in supermax units experience extremely high levels of anxiety and other negative emotions. When released–often without any “decompression” period in lower-security facilities–they have few of the social or occupational skills necessary to succeed in the outside world.
Nonetheless, supermax facilities have become increasingly common over the past five to ten years.
“This is what prison systems do under emergency circumstances–they move to punitive social control mechanisms,” explains Haney. “[But] it’s a very short-term solution, and one that may do more long-term damage both to the system and to the individuals than it solves.”