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Prison Psychosis
M. GRAYSON L. TAYLOR, a published writer, spent most of his 20s and early 30s in Georgia State Prison. Since his release in February 2000, he has resided and worked in Atlanta. TERRY A. KUPERS, a psychiatrist, teaches at the Wright Institute in Berkeley, California, and is an active member of Critical Resistance and California Prison Focus. He is the author of Prison Madness (with Hans Toch, Jossey-Bass, 1999) and co-editor of Prison Masculinities (Temple University Press, 2001). He has served as an expert witness in more than a dozen cases on conditions of confinement and mental health services.
Introductory Comment
THE PSYCHIATRIST IS SUPPOSED TO BE THE EXPERT ON PSYCHOSIS AND OTHER FORMS of mental illness in prison. Psychiatrists do know how to make a diagnosis: hallucinations and delusions suggest schizophrenia, whereas extreme mood cycles suggest manic-depressive disorder. A psychiatrist is supposed to be a masterful psychopharmacologist, prescribing the correct medication for each distinct diagnostic entity and making certain side effects do not reach toxic proportions. Yet does this mean that the psychiatrist understands the mind of the convict, or cares about the patient's suffering? There are caring clinicians among correctional mental health workers, but I have found in too many cases that the caring eventually wanes as burnout occurs.
Burnout results from having too many experiences visiting a prisoner in her cell and beginning to hear about horrendous traumas -- past and present -- and feeling an absolute inability to offer anything that will help her with her pain. Perhaps the medications will quell the most blatant symptoms. Perhaps they will not -- if, for instance, the symptoms are induced by prison rapes that will not cease or by too long a stint in solitary confinement. The psychiatrist who cares may also soon be confronted by a corrections officer who refuses to follow the psychologist's clinical recommendation and orders him to leave the prisoner's cell before extraction begins. The psychiatrist learns to keep his mouth shut and the huge caseload reduces him to visiting each prisoner for a few minutes and yelling through the cell door in earshot of others: "How do you like the new medication? Are you still hearing voices?" Moreover, what use are the diagnosis and the prescription...