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The Madness of American Incarceration
by Christine Montross
Book Reviewed by:Galvanized by her work in our nation's jails, psychiatrist Christine Montross illuminates the human cost of mass incarceration and mental illness
Dr. Christine Montross has spent her career treating the most severely ill psychiatric patients. Several years ago, she set out to investigate why so many of her patients got caught up in the legal system when discharged from her care--and what happened to them therein.
Waiting for an Echo is a riveting, rarely seen glimpse into American incarceration. It is also a damning account of policies that have criminalized mental illness, shifting large numbers of people who belong in therapeutic settings into punitive ones.
The stark world of American prisons is shocking for all who enter it. But Dr. Montross's expertise--the mind in crisis--allowed her to reckon with the human stories behind the bars. A father attempting to weigh the impossible calculus of a plea bargain. A bright young woman whose life is derailed by addiction. Boys in a juvenile detention facility who, desperate for human connection, invent a way to communicate with one another from cell to cell. Overextended doctors and correctional officers who strive to provide care and security in environments riddled with danger. In these encounters, Montross finds that while our system of correction routinely makes people with mental illness worse, just as routinely it renders mentally stable people psychiatrically unwell. The system is quite literally maddening.
Our methods of incarceration take away not only freedom but also selfhood and soundness of mind. In a nation where 95 percent of all inmates are released from prison and return to our communities, this is a practice that punishes us all.
INTRODUCTION
Sonia and I are sitting in the lactation room of the prison where she is incarcerated. Neither of us needs the room for its designated purpose, but it's a room with a door. So it is one of the only places where I can conduct an evaluation without her answers being overheard by guards or other inmates. I arrange my papers, click open my pen, and ready myself to ask the questions that will help me determine whether Sonia has psychiatric symptoms severe enough to interfere with her ability to understand her charges and how the legal system works, or to prevent her from working constructively with her attorney to assist in her own defense.
Sonia is fifty years old. Her black hair is streaked with gray and pulled back into a tidy bun. She is neatly dressed in this prison's standard attire—loose denim pants with an elastic waistband, a maroon T- shirt, an oversize gray crewneck sweatshirt, and white slip- on canvas shoes. On my way to this room, I passed women ranging in...
The concerns Dr 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). She 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...continued
Full Review
(806 words)
(Reviewed by Lisa Butts).
David C. Fathi, Director of the American Civil Liberties Union National Prison Project
An uncommonly beautiful writer, Dr. Christine Montross brings a scientist's rigor and a clinician's compassion to her examination of the profoundly broken U.S. incarceration system. Waiting for an Echo lays bare the appalling human suffering that occurs every day in our prisons and jails—and points us toward a better way. Sister Helen Prejean, author of Dead Man Walking
'What the eye does not see the heart cannot feel,' the saying goes. In this vivid account, Dr. Montross takes us to see close-up her encounters with a tiny percent of the 350,000 mentally ill people in U.S. prisons and jails. What are these anguished souls doing there? They need healing help and a place of safety, not a punishing environment, quick to maintain order with tear gas, beatings, solitary confinement...or with unconscionable neglect. In my 30 plus years of prison work, I've met all too many of these trapped, suffering souls. Let us trust in the goodness of our citizens, that moved by Dr. Montross's vivid witness, eyes will see and hearts will feel to shoulder the urgent reform of a system long in need of radical change. Susannah Cahalan, author of The Great Pretender and Brain on Fire
Waiting for an Echo is a towering indictment, a shocking expose, and somehow also an elegiac ode to those that society has left behind. Christine Montross, a psychiatrist, writes from inside the ranks of our broken mental health system, but she does so with a poet's eye, bringing to life the human toll behind the horrifying statistics. The result is a rallying cry that is both personal and universal—and, hopefully, one that we will not be able to ignore.
Since its opening in 2010, Halden Prison, located in Norway's Østfold region, has been held by many who believe in the necessity of prison reform to be a model institution due to its humane treatment of inmates and emphasis on rehabilitation. In Waiting for an Echo, Dr. Christine Montross visits Halden for a tour and contrasts the facility with the detention centers she has investigated in the United States.
Staff at Halden operate under a system referred to as "dynamic security," in which guards circulate around the prison interacting and developing relationships with inmates rather than surveilling from a fixed location. In Waiting for an Echo, Montross is shown a "seclusion room" by the prison's governor Are Høidal that...
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