Excerpt from Waiting for an Echo by Christine Montross, plus links to reviews, author biography & more

My profession has allowed me to witness that there are forces that determine mental health that we can control and other forces that we cannot. There is suffering brought about by brutal diseases that we do not yet know how to conquer or cure—schizophrenia, with its hallucinations, delusions, and functional decline, is one of the foremost examples.

And then there is suffering brought about by preventable causes—by social ills, by racial and economic disparities, by injustice. There is suffering that we intentionally inflict upon one another. These are all wounds that can be studied, fought against, and rectified. Some can even be prevented altogether. After years of pain and broken reform, the question is whether, as a society, we truly want to work at diminishing this suffering.

Many important books and a great deal of meticulous journalistic coverage have established unequivocally that our legal system distributes justice with prejudice and without uniformity. These are truths. They are facts of the world.

This book maintains a focus on mental health and mental illness: my areas of expertise. However, my examination of our legal system is at all times held within a framework of understanding that people of color are disproportionately over-represented in correctional populations, African American men exponentially so. Michelle Alexander's incontrovertible analysis of the racial injustice at the core of mass incarceration, The New Jim Crow, is required reading on this subject.

The aim of this book—its only aim—is to look closely at the psychiatric effects of American punishment and ask whether the results we yield align with the societal standards to which we hold ourselves and with the goals we set out to achieve. This is a question with enormous stakes for all of us—free and imprisoned alike.

We say that we incarcerate people in America because we want safer communities and justice, yet our current practices provide neither. Our practices are antithetical to these aims. My years of study of the human mind underscore this fact: when we condemn our citizens to the punitive conditions of our jails and prisons, we sentence those men and women and children not only to time but to a life in which they are less able to engage productively with society and less likely to demonstrate accountability for their actions. As a nation we say we want safety and justice, but our methods of punishment actively obstruct these very goals. And yet we double down on our current practices. Why?

The third part of this book, therefore, is about the choices that face us. If we look objectively at our prisoners and our prisons and determine that our current practices are failing us, then what are we to do about it?

The plain fact that I have learned in writing this book, as a Swedish prison worker once told me, is that prison is sometimes good but it is always bad. Bad for the mentally ill, without question, but also bad for human beings in general and even bad for the very communities that prisons are ostensibly designed to protect.

Before I began working in our nation's jails, I did not understand this. I believe that we as a society do not understand this. Even those in charge of our justice system—the very lawyers and judges who send people to prison for years—do not understand this.

"In law school, I never heard about corrections," the former Supreme Court justice Anthony Kennedy said in a 2015 congressional hearing. "Lawyers are fascinated with the guilt/ innocence adjudication process. Once [it] is over, we have no interest in corrections. Doctors and psychiatrists know more about the corrections system than we do."

Justice Kennedy was right that it will take mental-health professionals, whose vocation it is to help those in acute distress, to find a way through the maddening system we have created. Corrections, as we have currently and historically enacted them, are a profoundly broken enterprise. This is not news. But we haven't fully comprehended what our jail and prison system is doing to the mental health of all incarcerated people, what it is doing to our fellow citizens, and what it is doing to our society. The pound of flesh we require is not just time. It is the sanity of all involved.

From Waiting for an Echo by Christine Montross, published by Penguin Press, an imprint of Penguin Publishing Group, a division of Penguin Random House LLC. Copyright © 2020 by Christine Montross.