With about seven of every 1,000 people in prison, the United States leads the world in this sorry statistic.

Per capita, the land of the free now imprisons more than seven times as many as Italy, Germany or Denmark. An estimated 12 percent of African-American men age 20 to 34 are behind bars -- seven times the rate for white men. (see "Two Million ..." in the bibliography).

Some credit for the high rate goes to long mandated sentences and "three strikes and you're out" laws. But drug convictions alone account for 20 percent of state prisoners -- and nearly 60 percent of federal prisoners.

As the numbers have soared, conditions in prisons have grown harsher. No longer are they seen as places of rehabilitation. "Prison is supposed to be punishment, that's the mission and direction we've been given by the people, legislature and governor of California, as opposed to rehabilitation, training in life skills, that sort of thing," says Russ Heimerich, a spokesperson for the California Department of Corrections.

But some doctors who have worked with prisoners say harsh punishment takes a psychological toll on prisoners. "Prisons are places of forced idleness and disconnection from family and community. Even in medium or minimum security, that produces a person who is institutionalized, and is deeply affected by that," says Corey Weinstein, a physician and volunteer with the advocacy group California Prison Focus. "What the custody service wants is a herd of cattle that will not make trouble, will accept its fate, wake up, shuffle off to chow, to petty jobs, go back to the cell or the yard, where they will chew their cud ... accept the sameness, blandness, boredom, disconnection with anything outside of their grazing field."

Humane considerations aside, Weinstein says such treatment can backfire. "The 95 percent who get out and return to society are not very capable of beginning to make their own decisions, figure things out for themselves, make choices and build relationships, be in an ordinary social setting, and especially an urban setting, without a sense of fear."

SHU Syndrome
Matters are even worse in the relatively new "supermax" prisons built to segregate and punish violent prisoners. In this type of facility, sometimes called a Security Housing Unit (SHU), prisoners may spend 23 hours a day in the cell, with no jobs, little contact with other prisoners, or not much else to pass the time.

SHU confinement, Weinstein says, is an "extreme psychic assault, social isolation and reduced environmental stimulation. This really fractures peoples' minds, causes extreme depression, a lot of aberrant behavior. It leaves them damaged for life. People talk about PTSD, I think of this as continuous traumatic stress disorder."

Terry Kupers, a psychiatrist from Oakland, Calif. who has testified in court about prison conditions, says, "Anyone who is prone to depression or psychosis will probably be thrown over the edge, or have a breakdown, because the setting induces those kind of tendencies in anyone. People who are relatively well adjusted will have problems in segregation, but if they have a history of taking antipsychotic medication or depression, in segregation, almost all will have a breakdown, or attempt suicide."

"The Rock," Alcatraz prison, sits on an island in San Francisco Bay. It's now a somber historical site. Photo: National Park Service.

(The Why Files tried without much success to find scientific literature on the psychological effects of imprisonment. Apparently, either social scientists are not interested in the subject, or funding agencies are not interested in paying for studies. In 1971, however, a psychologist at Stanford University set up a mock prison for study. Then, after six days, he shut it down prematurely because the "guards" were getting sadistic and the "inmates" were suffering psychologically. Check out their fascinating website.)

Treated, or getting the treatment?
And while Heimerich insists that mentally ill prisoners in California are, per federal court order, given treatment, Kupers says the California Department of Corrections tends to water down diagnoses. "I have see many people, in all prison units, who were schizophrenic prior to incarceration... and were diagnosed as malingering because the custody system did not believe they were mentally ill."

If guards do not believe an inmate is, for example, acting violently "because a voice is telling them to do it," the prisoner will be punished and transferred to supermax. The process becomes a downward spiral, Kupers says. "They are most vulnerable to the effects of conditions, and are the most likely to be sent there, and then their time [sentence] is extended because of the mental illness."

Heimerich sees an entirely different situation, in which supermax is used to punish and control the most violent, gang-affiliated prisoners, those who make trouble for everybody at less-secure prisons. "SHU is further punishment, and is for people who have proven that they cannot or will not abide by the rules. ...The road into the SHU is easy, so is the road out." Prisoners who renounce gang membership and obey the rules can return to the more tolerable conditions of the general prison, he says.

So is prison psychologically harmful to prisoners? The California Department of Corrections, which now houses 160,000 people (up 1.4 percent in 12 months), is not interested in finding out, says Heimerich. "For many, when they come in, their cheese has already slipped off their cracker. I don't imagine it does them a whole lot more good to be inside, but whether it makes them harder, we don't know. We have not studied that, it's not part of our mission."

A prison in Green Haven, New York, that was built in 1941, shows the tiers of cell blocks long favored in prison construction. Photo: Library of Congress.

Smart decision?
With the national prison population now above 2 million, the idea of treating or rehabilitating prisoners seems to be regarded as a liberal delusion. But prisons that are "tough on criminals" may also be tough on society, because most prisoners are eventually released.

In 2000, Stuart Grassian, a psychiatrist at Harvard Medical School who has studied prisoners in SHUs, told a newspaper that extreme confinement was "taking sick people and making them sicker. Mentally ill people need treatment, not disciplinary punishment" (see "SHUs Take..." in the bibliography).

Supermax conditions, Grassian said, are creating "time bombs.... New York State is discharging prisoners who are sick, alienated, angry, rageful and as psychologically disturbed as you can imagine."

Does time in a SHU make an inmate more crazy? "Yes, it does happen," said Heimerich, "but it's not that we are putting them in [the SHU] because they are crazy."

Weinstein says the whole concept of locking people up without any effort at rehabilitation is bound to fail. "Prisons are called warehouses, but that's an inappropriate term. You cannot warehouse people. The human is not capable of being put on a shelf and held in suspended animation. Things happen to a human that don't happen to a nonperishable good."

Do some time at our prison bibliography.

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