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Furthermore, substance use treatment should be available for individuals who have engaged in substance use as a coping mechanism. Individuals should have access to education and employment assistance, which allows for appropriate, adequate income regardless of their former incarceration or detention status. Employment discrimination based on former incarceration or detention status only encourages participation in criminalized moneymaking activities. Access to appropriate health care and housing is essential, especially during the process of attaining a stable and adequate income.

What does trauma-informed care look like?

Early intervention with people who have experienced trauma is crucial. The success of early intervention is extremely reliant on widespread understanding of how to identify and intervene children who have experienced trauma. Public awareness of trauma, in addition to public understanding of the intense potential effects of trauma, are crucial in ensuring that we create a new understanding of the adaptive attitudes and behaviors of children who experience trauma.

Complex trauma theory outlines six core components of intervention: safety, self-regulation, self-reflective information processing, traumatic experiences integration, relational engagement, and positive affect enhancement. The first three components are important for restoring or implementing a new set of understanding and skills for the individual. Assuring individuals that they are safe and capable of unlearning their adaptive attitudes and behaviors, allows for unpacking and processing their trauma in a healthier way. (Cook et al. 2005)

Traumatic experiences integration allows the individual to explore their experience with trauma in a way that allows them to acknowledge and mourn their experience as well as develop healthy coping strategies in the case of triggers or symptoms. Relational engagement and positive affect enhancement focus on relearning how to make meaningful, healthy connections with others as well as develop an overall sense of confidence that allows for productive, positive thinking and self-esteem. For marginalized individuals, culturally informed intervention that acknowledges the oppression they experience is absolutely necessary for their specific needs. 

SOURCES

Cook, Alexandra, Joseph Spinazzola, Julian Ford, Cheryl Lanktree, and Margaret Blaustein. 2005. “Complex Trauma In Children and Adolescents.” Psychiatric Annals 35(5):390–98. Retrieved April 19, 2016 

Michelle, Ta Lynn. 2012. “Trauma-Informed Care Emerging As Proven Treatment for Children, Adults with Behavioral, Mental Health Problems - National Center for Youth Law.” National Center for Youth Law. Retrieved April 20, 2016

Basic Facts

Trauma is defined by Substance Abuse and Mental Health Services Administration (SAMHSA) as the following

“Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening and that has lasting adverse effects on the individual's functioning and physical, social, emotional, or spiritual well-being … These events and circumstances may occur as a single occurrence or repeatedly over time” 

In 2010, the Justice Policy Institute noted that between 75% and 93% of the 93,000 youth in juvenile detention have experienced at least one traumatic event ranging from abuse, neglect, or vicarious trauma compared to 34% of all children in the United States (Adams 2010)

Complex trauma has the ability to affect attachment or interpersonal connection, behavioral control, regulation of emotions and communication, and self-concept which can lead to low self-esteem and deep senses of shame or guilt (Cook 2005).

This can lead to behaviors that might include substance abuse as a means of self-regulating or coping with emotional shame or violent behaviors as a result of affected behavioral control and inability to perceive the needs of others, both of which may be criminalized

For marginalized youth, experiences with trauma and the juvenile justice system are correlated even closer.

Youth of color are faced with institutional and social racism that does not have an effect on their white peers (Adams 2010)

Youth of color, particularly black youth, have a higher likelihood of growing up in areas experiencing disproportionate amounts of poverty, are also more likely to be exposed to criminalized behaviors, community violence (including violent interaction with police), and community stress or trauma

The “School to Prison Pipeline,” which credits harmful practices and policies in the education and childhood experiences of vulnerable children for their increased interaction with both the juvenile justice system and criminal justice system (What Is)

This, coupled with experiences of trauma-adapted behavior, positions youth of color in a place of extreme disadvantage in terms of chances of experiencing the juvenile justice system

The effects that untreated trauma can have on behavior and the high number of youth in juvenile detention who have experienced trauma is unlikely to be a coincidence. Examining preventative strategies, including trauma-informed care prior to and during detention/incarceration, is crucial to imagine a better future for these disadvantaged individuals.

SOURCES

Adams, Erica J. 2010. “HEALING INVISIBLE WOUNDS: Why Investing In Trauma-Informed Care for Children Makes Sense .” Justice Policy Institute 1–15. Retrieved April 19, 2016 

Cook, Alexandra, Joseph Spinazzola, Julian Ford, Cheryl Lanktree, and Margaret Blaustein. 2005. “Complex Trauma In Children and Adolescents.” Psychiatric Annals 35(5):390–98. Retrieved April 19, 2016 

“Substance Abuse & Mental Health Services Administration.” Trauma and Justice, Substance Abuse and Mental Health Services Administration. Retrieved April 19, 2016 

Inmates with mental illness spend more time in both jails and prisons than inmates without mental illness (The Treatment of 2014)

Inmates with mental illness are less likely to be bailed out of jail or be forced to stay because of ‘bad behavior’

Inmates with mental illness are more likely to receive longer sentences, which can sometimes be attributed to staying in jail without bail

Inmates with mental illness are more likely to encounter traumas like physical abuse, sexual abuse, and solitary confinement. (The Treatment of 2014)

You can learn more about the traumatic nature of solitary confinement here.

A majority of inmates with mental illness do not receive treatment for their illness before or after their time in jail. (James & Glaze 2006)

In county jails, 42.7% of inmates with mental illness had ever received treatment, and only 17.5% received treatment after time in jail.

In state prisons, 49.3% of inmates with mental illness had ever received treatment, and 33.8% received treatment after time in prison.

In federal prisons, 35.3% of inmates with mental illness had ever received treatment, and 24% received treatment after time in prison.

SOURCES

April 2014 “The Treatment of Persons with Mental Illness in Prisons and Jails: A State Survey” Treatment Advocacy Center and National Sheriff’s Association

“Deinstitutionalization - Treatment Advocacy Center.”Deinstitutionalization - Treatment Advocacy Center.

1800s to the 1970s

Persistent resistance against the incarceration of persons with mental illness in the United States (and horrid prison conditions in general) led to many areas of reform

In 1833, a new psychiatric hospital was opened in Worcester, MA in response to the exposing of these conditions

Over 50% of the first year’s admissions were people with mental illness who were transferring out of incarceration

Dorothea Dix is credited with having visited 300 county jails and 18 state prisons to continue exposing the conditions inmates with mental illness were forced into

In 1880, there were 75 public psychiatric hospitals, and the federal census noted that less than 1% of people in prisons were classified as “insane”

The 1880 census is described as having “the most complete enumeration of mentally ill people ever carried out in the United States, before or since” (TAC Report)

Over the next 100 years, people with mental illness were generally understood as patients of psychiatric hospitals instead of prisoners

1970s and Deinstitutionalization

Reflective of resistance to conditions for incarcerated people with mental illness in the 1800s, the deplorable conditions of many psychiatric hospitals nationwide led to a call for the end of hospitalization of people with mental illness (Deinstitutionalization - Treatment Advocacy Center).

The beginnings of deinstitutionalization sparked when chlorpromazine, the first effective antipsychotic medication, was introduced in 1955

The idea that people with mental illness could be treated outside of an institutional setting became more popular with the knowledge of conditions in psychiatric institutions alongside the emergence of pharmaceuticals to treat mental illness

SOURCES

April 2014 “The Treatment of Persons with Mental Illness in Prisons and Jails: A State Survey” Treatment Advocacy Center and National Sheriff’s Association

“Deinstitutionalization - Treatment Advocacy Center.” Deinstitutionalization - Treatment Advocacy Center.

20% of inmates without high school diplomas spend time in restrictive housing compared to 15% inmates with high school diplomas. 30% of lesbian, gay, and bisexual inmates spend time in restrictive housing compared to 17% of straight inmates (BJS 2015). 

Trans* individuals report higher rates of being placed in solitary confinement as a means of ‘safety’ than Two-Spirit, cisgender men (including gay men), cisgender women (including lesbian women), and other queer individuals surveyed in the aforementioned study (Lydon et al. 2015). 

For incarcerated LGBTQ individuals, solitary confinement may often be used as protective custody. Increased experiences of harassment and abuse in prisons for LGBTQ people, particularly LGBTQ people of color, leads to higher uses of solitary confinement (Lydon 2015). The lack of evidence-based support for solitary confinement increasing safety in addition to the unsafe mental health effects refutes the credibility of this practice.

The disproportionate use of solitary confinement for LGBTQ people is discriminatory in itself. However, time spent in solitary confinement prevents individuals from participating in education and work programs within the prison . Not only do these programs allow for possible rehabilitative activities for inmates, they can often be used as support for inmates seeking to lessen their sentences or gain other privileges. Disproportionate placement of trans* inmates in solitary confinement is increasingly discriminatory because they are barred from accessing these programs and potential advantages.

SOURCES

DOJ Releases Data on Use of Segregation & Solitary Confinement in Prisons and Jails Human Rights Campaign 27 October 2015

Lydon, Jason; Carrington, Kamaria; Low, Hana; Miller, Reed; Yazdy, Masha. Coming Out of Concrete Closets: A Report on Black & Pink’s National LGBTQ Prisoner Survey  Black & Pink October 2015

The negative effects of solitary confinement of humans are not news amongst scholars or the public. In 1919, the International Journal of Ethics featured a piece which described solitary confinement as something that “...is everywhere regarded as a mode of punishment peculiarly severe, and is looked upon by many as a form of torture so peculiarly dreadful that it should be prescribed only in exceptional cases, and in civilized countries not at all” (Howerth 1919). 

In 1829, solitary confinement was first used in the United States in the hopes that isolated prisoners would spend their time in isolation repenting and redefining themselves with only a Bible in the room. However, this experiment was ended when most prisoners had negative mental effects and many even committed suicide (Sullivan 2006). Incidents of solitary confinement in prisons continued to pop up throughout the next 150 years. In the 1980s, solitary confinement as we often see it today - 23 hours per day in lockdown with no extra activities - began to take off in a limited number of institutions. As mass incarceration and the presence of supermax prisons expanded so did solitary confinement.  In 2005, the US Bureau of Justice Statistics reported that over 80,000 people were housed in ‘restricted housing,’ i.e. solitary confinement (Sullivan 2006). 

Today in the United States, solitary confinement is mainly used as a means of punishment when rules aren’t followed or as a means of protecting an inmate and their peers for a number of reasons. Though these reasons may seem valid on the surface, the use of solitary confinement in the United States is entirely problematic. Rehabilitation is listed as a primary goal and component of the carceral system in the United States (Kifer 2003). Rehabilitation and the safety of an individual are both compromised by the harsh effects of solitary confinement.

SOURCES

Howerth, I.W. The Great War and the Instincts of the Herd International Journal of Ethics 1919 

Kifer, Misty; Hemmens, Craig; Stohr, Mary K. Goals of Corrections: Perspectives from the Line Criminal Justice Review 2003