BookBrowse Reviews Waiting for an Echo by Christine Montross

BookBrowse:

A thorough and impassioned report of research conducted firsthand at correctional facilities around the United States featuring the troubling stories of individuals deemed a danger to society because of mental illness.

Dr. Christine Montross had been a practicing psychiatrist for nearly a decade when she decided to expand her work into the carceral system by performing competency-to-stand-trial evaluations of jail inmates. It was immediately apparent to her that the prison system is utterly ill-equipped to meet the needs of people with mental illnesses and that incarceration exacerbates many of the symptoms associated with these illnesses. She expanded her research on the subject, visiting jails and prisons across the United States and beyond, and presents in Waiting for an Echo a disturbing picture of neglect and human rights abuses. She demonstrates how easy it is for a person with a mental illness to get caught up in the legal system, often for committing very minor infractions. And how once said person is ensnared by that system, it is virtually impossible for them to extricate themselves.

At the Manson Youth Institution in Connecticut, Montross learns that incarcerated adolescents can be placed in solitary confinement for up to a year, a practice that child psychologists assert can be severely damaging to their still developing brains. For young people and adults alike, solitary has been shown to worsen symptoms of mental illnesses. The author quotes the American Academy of Child and Adolescent Psychiatry, which notes that among other concerns, "the majority of suicides in juvenile correctional facilities occur when the individual is isolated or in solitary confinement."

Montross explains that marginalized individuals (including people of color and LGBTQ+ people) are more likely to be arrested and imprisoned, but she goes beyond that to show precisely how privilege works when it comes to encounters with law enforcement, taking mental illness into consideration. She recalls, for instance, making a long list of crimes she and some friends had committed over the course of their lives during a dinner party, mostly consisting of traffic offenses and minor drug use. These friends were all members of the professional class and presumably not prone to signs of mental illness. Only one of them had gotten into any sort of trouble — a ticket and a day in traffic court. Just about everyone else, including the author herself, recalled an instance where they had easily talked their way out of trouble with law enforcement.

Compare that to the situation of a mentally ill, ethnically Chinese man without English-language fluency Montross meets who has been in prison for "many years" after a solicitation charge compounded with spitting on a corrections officer. At the time of her visit, the man has been in solitary confinement for seven years. Due to his mental illness and language background, he has trouble communicating within the U.S. prison and legal systems. He is stuck in maximum security and solitary despite being non-violent and guilty of what is basically a minor infraction because of an "administrative issue"; his mental illness means he may not be safe among the general population. How could a person who is not able to effectively communicate during legal procedures understand and take part in their own defense? How could said person be convicted on a minor infraction and go on to spend "many years" in a maximum security facility? Our prisons are full of people contending with similar circumstances.

At a Chicago jail, Montross observes a rare glimpse of genuine care at a group cognitive behavioral therapy session where inmates are encouraged to explore their past traumas in order to investigate the events that led to their incarceration and better understand themselves. Yet even here, in another wing of the jail, she watches as "officers and detainees alike seethe with hostility" toward one another. The problems here are systemic and comprehensive.

Montross provides astute commentary backed up with voluminous research detailing how the U.S. carceral system fails to reduce crime or provide any level of rehabilitation to the individuals it houses. She goes on to describe a trip she took to a markedly different kind of prison in Norway (see Beyond the Book), a country that boasts some of the lowest recidivism rates in the world.

The concerns Montross expresses in Waiting for an Echo are exceedingly relevant to the present moment in which many Americans are reevaluating the role of police in society and the inequity inherent in the justice system (as well as the appalling lack of concern for health and safety within many prisons). It's a system that "prioritizes vengeance over social good" and disproportionately punishes the most marginalized and vulnerable. According to the National Institute of Mental Health, one in five adults in the U.S. lives with a mental illness, meaning this is an issue that could touch any of our lives in a variety of ways. Dr. Montross puts a human face on the suffering of mentally ill people who are incarcerated and makes a compelling argument for compassion and change on their behalf.

This review was originally published in The BookBrowse Review in August 2020, and has been updated for the August 2021 edition. Click here to go to this issue.