Psychiatrist: America’s ‘Extremely Punitive’ Prisons Make Mental Illness Worse

Psychiatrist Christine Montross has spent years treating people with serious mental illnesses — sometimes in hospitals, other times in jails or prisons.

“The patients that I was seeing in my hospital were indistinguishable many times from the men and women that I was evaluating in jail,” Montross says. “But the environments were so markedly different. One [is] charged with … trying to help and heal, and the other [is] really designed to control and punish.”

Montross is a 2015 Guggenheim fellow and an associate professor of psychiatry and human behavior at Brown University’s medical school. In her new book, Waiting for an Echo: The Madness of American Incarceration, she writes that in the U.S., people with serious mental illnesses are far more likely to be incarcerated than they are to be treated in a psychiatric hospital — despite the fact that incarceration often makes mentally ill people worse.