The Prisoner's Dilemma


According to the International Centre for Prison Studies, 743 US citizens out of every 100,000 are incarcerated, while Rwanda, Russia, and Georgia have the next three highest rates of 595, 568, and 547, respectively. This means that despite America, unlike Rwanda and Georgia, having had a stable government for centuries, it has 25 percent more inmates than those countries. America is not contending with the political instability these countries but still leads the world in number of incarcerated criminals. The question that remains is whether the punishments handed down by US judges are effective deterrents to crime.

One of the causes of the United States' large prison population is the mandatory minimum: a statutory requirement that judges give convicted offenders a minimum length of imprisonment. For example, these laws frequently give nonviolent drug addicts sentences of 15 years to life. Currently, about 500,000 inmates are incarcerated for drug crimes. These lengthy prison terms are coupled with the treatment of many petty crimes – like writing bad checks – as offenses worthy of incarceration.

The ludicrously high prison population has beleaguered prisons across the country for years. In 2006, California declared a state of emergency over its prison system, which housed over 15,000 inmates in “gymnasiums, dayrooms, and other common areas not commonly designed as living units, frequently in double or triple bunks.” The proclamation will be terminated on July 31, 2013, however, due to a lower prison population. It is hardly a triumph for a system that has lowered inmate levels primarily by re-shuffling prisoners: California has moved 8,900 inmates to private, out-of-state prisons, and ordered that lower-level felons be held in county jails, not state prisons. The euphemism for such shuffling is “realignment” – inmates are spatially realigned to places where, for now, there is more room.

Unfortunately, the Congressional Research Service reported that in 2011, federal prisons were operating, on average, at 39 percent overcapacity, and the prison population has increased about 790 percent since 1980. Sooner, rather than later, the United States must learn that reshuffling prisoners is a bandage, not a cure.

The Congressional Research Service (CRS) reported in 2011 that the risk for recidivism (a released inmate’s return to crime, as measured by re-incarceration rates) is highest for offenders on probation in the first year after release. This indicates that incarceration is having little effect on curbing criminal impulses once offenders reenter society. It has been known since 1979 that “fear of official punishment is not one of the more important correlates of delinquency,” and thus, the prison system must look to rehabilitating inmates. The CRS report also states that a treatment program, followed by surveillance probation, in which an inmate is monitored by or meets regularly with a probation officer, is more likely to reduce the recidivism rate. Incarceration may keep inmates reasonably subdued in strict daily routines but fails to provide any sort of motivation or deterrent once an offender is released. Making prison a one-time occurrence for most offenders, and thus reducing the prison population, requires rehabilitation, not merely retribution.

Though there is no cure-all rehabilitation program, “Risk-Need-Responsivity” (RNR) is one of the most reputable sources in combating recidivism. RNR was validated by a meta-analysis conducted by Carleton University professor of psychology D. A. Andrews and his colleagues. Andrews et al. concluded that both sentencing without rehabilitation and sentencing with rehabilitation that was not specifically matched to the offender are ineffective at reducing recidivism. ‘Responsivity’ refers to the rehabilitation service provided. Andrews advocates for focusing on higher risk cases, targeting “criminogenic need” (that is, the dynamic risk factors that can affect rehabilitation), and matching the learning style of prisoners to programs.

RNR lowers recidivism and, studies show, would not require increases in prison budgets: A 2012 article in Psychology, Public Policy, and Law meta-analyzed the correctional services used by Andrews and found that RNR was not significantly more expensive than inappropriate rehabilitation or traditional incarceration. In fact, inappropriate services, in which offenders and programs were not assessed to determine risk level and efficacy, were found to be more expensive, perhaps due to the length of provision.

Ineffectiveness of incarceration was illustrated twenty years ago in Georgia, when the state extended prison terms for parole-eligible criminals. Harvard University professor Peter Ganong found that an extra year in prison reduced the three-year recidivism rate by six percent, but concluded that the costs incurred by the prison system during prolonged incarceration outweighed any benefits of preventing crime. RNR, on the other hand, provides a reliable reduction in recidivism without incurring dead costs.

Some states are realizing the benefits of treating criminals rather than just punishing them. A 2012 article in American Educator described a Missouri juvenile rehabilitation program that substituted therapy and education for incarceration. The program successfully and definitively reduced recidivism – and cost less than incarceration. A year ago, Seattle launched Law Enforcement Assisted Diversion (LEAD), which makes a few nights a month a “green-light night.” When police officers find drug addicts and minor dealers on these nights, they divert the offenders away from the prison system – and not just to private or out of state jails. The offenders are instead sent to a social worker where they receive immediate care and long-term housing, job training, and drug addiction services. The program is intended to remove frequently re-incarcerated drug offenders and dealers from the prison system and to treat, not punish, their addictions. Drug dealers selling more than three grams still go to prison. LEAD and the Missouri rehabilitation center are signs that justice systems around the country are realizing that for most, the traditional prison system simply does not work.

Victim Offender Reconciliation Programs (VORP) are another example of the slow reconfiguring of the justice system from retribution to remediation. In these programs, offenders meet the victim face to face and talk about the crime in the presence of a mediator, and, together, the victim and offender choose a “mutually agreed upon restitution.” Studies have found that participating criminals have lower recidivism rates.

While VORP matches offenders with victims, other programs succeed by matching offenders with specific rehabilitation programs that address their crimes. A report by the Australian Criminology Research Council (CRC) in 2009 report found that the programs – including cognitive skills, anger management, drugs and alcohol, and victim awareness – had reduced recidivism by 35 percent. While 100 hours of program time was optimal, the primary key was RNR – channeling high-risk offenders into specific behavioral rehabilitation programs. The CRC reported that RNR rehabilitation had been clearly established in Australia just five years after initiation. This heartening success story should be an impetus for all justice systems.

In considering prisoner rehabilitation, however, sufficient attention must be given to mental health medication. Mental health care in US prisons is often seen as a privilege, bestowed primarily upon the recalcitrant. A 2010 study in Kansas of adult male inmates found “the amount of mental health treatment an inmate received was associated with problematic institutional behavior (i.e., increased severity and number of disciplinary infractions).” It is curious that mental health care is largely the result of disobedience after incarceration. All inmates are guilty of problematic behavior and all should have equal access to mental health care, regardless of their behavior in prison. Instead, inmates who follow the rules are released with no new psychological tools to re-navigate the world from which they were removed.

Furthermore, prisons contribute to a decline in mental health, likely precipitating higher rates of recidivism. In December 2012, the Journal of Health and Social Behavior published an article examining psychiatric disorders and incarceration. The study found that incarceration was a robust predictor of later mood disorders such as major depressive disorder, bipolar disorder, and neurotic depression. Because inmates are frequently released in a more volatile mental state than when they were incarcerated, incarceration does not make for a better society. The justice system should not be merely about punishment: It should be about reparation and cure.

Cures are all the more important when considering that prisons and jails treat more mentally ill Americans than hospitals do. The Bureau of Justice Statistics released a 2006 report that found mental health issues elevate the likelihood of criminal risk factors. About 75 percent of inmates with mental health problems abused, or were dependent upon, illegal substances or alcohol. They were twice as likely to have been homeless and three times as likely to have been physically or sexually abused.

The mentally ill seem to be on a direct path to prison, but the treatment they receive is not centered on the illness that brought them there. The report found that mental health problems afflict more than half of inmates in prison and jail. Only 12 percent of federal inmates and 17 percent of state inmates received mental health care, even though 50 percent had major depression, mania, or psychotic disorders. Furthermore, the report found that inmates with mental health problems were more likely to violate rules and twice as likely to engage in fights. These encounters often lead to more punitive measures that contributed to the inmate’s decline in mental health.

An example of a jail with a high proportion of mentally ill inmates is Rikers Island in New York. The second largest inpatient psychiatric ward in the country, Rikers is notorious for alleged abuse of inmates within its walls. There are reports of inmates being beaten and raped, and even of inmates killing themselves by swallowing soap. A chaplain returning to Rikers immediately saw a fight in which an inmate was critically wounded. He said, “If I had forgotten violence during my week's break, once again I am confronted with the folly of this world of isolation and emptiness.” Prisoners are quarantined and subject to inhumane conditions, not taught to live better lives. At Rikers, mentally ill people are increasingly placed in “punitive segregation,” a form of solitary confinement that usually exacerbates mental health problems and offers no constructive treatment.

This is where the problem lies. Mental illness can increase susceptibility to crime, even more so when combined with a bad environment. The legal system takes hundreds of thousands of mentally ill people and puts them into an environment that is not conducive to mental health rehabilitation. It is no wonder that incarceration is not effectively deterring crimes when inmates are released. The often-inhumane treatment sets a poor example for release into a world where inmates have learned nothing about how to treat humans humanely.

Mental health problems increase criminological risk factors, prison increases mental health problems, and when released, a prisoner is in a worse state of mind than before. The justice system should ensure criminals receive proper health care and therapy in prison. This way, we truly treat the crime, instead of just punishing it; prison should not simply be a holding area for the mentally ill.

In rehabilitating, consideration must be given to the biochemical causes of crime. Rehabilitation should incorporate antidepressants that correct serotonin or dopamine imbalances and mood stabilizers like lithium for bipolar disorder. This treatment must be continued after release. Currently, offenders are given only a short supply of medication and usually there are no follow-up appointments. A 2002 study of New Jersey jails found that almost every jail surveyed “reported providing no real release planning” for mentally ill inmates and ten of the 21 jails “provide aftercare plans for fewer than 10 percent of inmates with serious mental illness.” To effectively treat crime, the justice system must prepare a release plan to keep criminals from sliding back into mental health decline and crime.

Prisons rarely offer rehabilitation, medicine, or psychological tools to help criminals function once they return to society. Most inmates are released with no different an outlook on life and no means of continuing the drug treatment they received in prison, and will likely return to the life they knew before. Offenders’ friends, spouses, children, and neighbors may be pulled into crime—and instead of one person returning in the next five years, offenders might bring six acquaintances with them.

Simply put, American prisons are overloaded. The financial and social strain is draining and unnecessary. Prison centers should work on identifying how to improve criminals’ lives by providing the correct therapy or drugs. Fewer than one in four federal inmates with mental health issues receive treatment and this is simply not enough. Plans need to be introduced to increase the number of treated inmates and to continue treatment outside prison to ensure mental health issues do not further precipitate crime. All inmates should be subject to participation in RNR programs, a proven and cost-effective method of reducing recidivism by focusing on the practical use of risk factors. Rehabilitation has been proven to work; the only way to stop the cycle of crime is to treat crime, not merely punish it. If the justice system focuses on rehabilitating individuals, and not merely punitive measures, we would live in a dramatically safer society.