The moment someone walks out of prison, their sentence is supposed to end: the past behind them and their chains unshackled. This is seldom the case. Often, incarceration is measured by years lost; however, time is not the only thing being stripped away from prisoners—their mental stability erodes, too. Mental health decline is a common pattern perpetuated by ongoing violence, isolation, and inadequate access to mental healthcare support necessary in prisons. This decline negatively impacts individual reentry processes for the formerly incarcerated, hindering a smooth societal reentry.

Current conversations about reentry for former inmates, such as those in The Francisco Homes, commonly focus on housing and employment barriers. Yet the ethics of prison-induced mental-health deterioration in inmates is overlooked, specifically for those serving longer sentences (usually 10 years or more), which significantly affects individual reentry experiences and increases the risk of recidivism after incarceration. Solitary confinement represents one of the most extreme sources perpetuating this deterioration, mirroring psychological harms reflected extensively across U.S. general prison systems.

This gap in conversation must be addressed by recognizing that meaningful reform requires eliminating the use of solitary confinement, strengthening mental-health resources inside both general and isolated prisons, and reframing reentry and recidivism as processes shaped by the psychological conditions inmates endure both during and after incarceration.

Implementations of U.S. incarceration measures as extreme as solitary confinement date back to the late 18th century, initially being used as a method of punishment by which John Howard, an English sheriff whose work greatly contributed to the development of the American prison system, reasoned it would bring about “hours of thoughtfulness and reflection.” However, that expectation quickly plummeted following the rise of inhumane protocols in penitentiaries, and harsh institutional practices—conditions reflected in solitary confinement in contemporary times. Presently, inmates are confined to their cells for around 23 hours each day, with release only permitted for showers or for recreational time on prison lawns, though still bound by chain-link fencing. They aren’t able to participate in educational opportunities, rehabilitation programs, and are regularly denied counseling. With no clock or time markers to discern reality, a negative shift in psychological well-being occurs: prisoners become out of touch with the present, oftentimes being in a mental fog, having obsessive thoughts, hallucinating, and experiencing other forms of distress.

Policies within the U.S. hardly ever mitigate these accounts; invisible restraints banning prolonged solitary confinement, administrative segregation, and limitations in mental health resources in prisons further perpetuate psychological and emotional struggles. Not only is this form of imprisonment morally unethical, but the intentional displacement of prisoners into these types of penitentiaries long-term without proper access to necessary mental health support is corrupt. UC Berkeley Law School professor Jonathan Simon has substantiated the disastrous intersection between policy and psychological damage among inmates, writing that public policy governing prisons enforces punishments so severe as to be inherently degrading, threatening an individual’s personal integrity, with these threats to human dignity woven into the structure of solitary confinement itself. This idea of solitary confinement as a cruel and unusual course of action, along with where policy fails to address the long-term implications of mental health in prisoners during and after incarceration, highlights why it is critical to abolish U.S. solitary confinement practices. Otherwise, former inmates leave prison psychologically worse than when they arrived, harming their reentry transitions.

Over time, the U.S. has gradually advanced administrative policies in prisons to tackle the issue of neglected mental health deterioration in inmates. In solitary confinement prisons, step-down programs are implemented as systems designed to help inmates in isolated holding cells gradually transition to the general prison population. These systems utilize cognitive behavioral therapy interventions as a core component, intended to help inmates manage the thoughts, emotions, and disruptive behaviors that contribute to psychological distress. Step-down programs target reduced sensory deprivation in prisoners by extending time outside prison cells, in conjunction with offering reintegration preparation. However, these solutions are insufficient.

Elena Vanko, a senior policy advisor with the Vera Institute of Justice, has noted that loops are another potential pitfall of step-down programs, occurring when someone progresses through phases of a program and then violates a rule, and the automatic response is to demote them back to the first phase. Pitfalls like these keep prisoners trapped in penitentiaries long-term, perpetuating a cycle of advancing through multiple constructive behavioral measures only to find themselves back at square one after a single incident, effectively creating a system perceived as unfair and impossible to progress through. Addressing these unhealthy cycles starts with modifying the prison environment itself, which is inherently re-traumatizing. Research shows ongoing violence, both within solitary confinement and the general prison setting, intensifies anxious, depressed, irritable, confused, aggressive, and suicidal feelings over time, with inmates committing suicide despite increased monitoring, suggesting that simple monitoring is not sufficient and that psychological support is required. Tackling the gap in conversation around necessary mental health policy, not only in isolated prisons but in general prisons as well, ensures that inmates circumvent as much psychological damage as possible, shaping positive reentry experiences and reducing their risk of recidivism post-incarceration.

For former long-term inmates coming from both isolated and general prisons, such as those in The Francisco Homes, a Los Angeles-based reentry service for formerly incarcerated men, their risk of recidivism is much higher. This is often a negligent consequence of psychological trauma experienced during prison, and the long-term mental health struggles that inmates endure post-incarceration. Many end up struggling to adjust to life after release, navigating new, unfamiliar environments that contrast distinctly with the world they were accustomed to in prison. Professor Craig Haney has emphasized the mental and emotional turmoil many formerly incarcerated prisoners experience, writing that the dysfunctional consequences of institutionalization may first occur in the form of internal chaos, disorganization, stress, and fear, yet institutionalization has taught most people to cover their internal states, and not to openly or easily reveal intimate feelings or reactions. Haney’s research points to prisoners feeling the need to mask critical mental health concerns to adjust accordingly in society, appearing as if everything is alright. Unfortunately, this is often due to maladaptive behavioral strategies learned through incarceration, such as hypervigilance, emotional withdrawal, or heightened guardedness.

Masking not only negatively affects psychological health down the line, but also impacts recidivism for inmates post-incarceration. As a consequence of masking to ease psychological trauma, former inmates become more likely to be at risk of seeking treatment for substance abuse and relapse, especially those with a history of misuse. A study by psychology researchers Kamaluddin and colleagues found that after being released, over two-thirds of participants expected to require some assistance to deal with alcohol or other substance issues, and nearly 70 percent reported having been prescribed medication for mood, behavior, or emotional issues.

Notably, former inmates who fail to seek treatment heighten their risk of recidivism, usually manifesting as a return to destructive habits, a violation of probation orders, or a return to counterproductive environments. Ultimately, individual reentry processes for the formerly incarcerated become halted, further highlighting the risk of recidivism post-incarceration as a consequence of varying, compounded psychological and behavioral struggles experienced during and after prison.

Nevertheless, it must be acknowledged that for the formerly incarcerated, prison-induced psychological and behavioral deterioration is not the sole perpetrator of adverse reentry experiences and heightened recidivism risk. Societal stigma and labeling, in conjunction with limited family support and contact during incarceration, are also significant. Categorizations like “ex-convict” or “ex-felon” weaken confidence and deteriorate individual identity. There must be adequate measures taken to ensure that formerly incarcerated individuals’ lives are no longer a representation of their past. In addition, weak communication with social support networks while incarcerated impacts reentry even more negatively.

Researchers at the Urban Institute have found that simply maintaining contact with family members is difficult, as intimidating security procedures, geographic distances, and the time-consuming nature of visits severely inhibit them, and even long-distance phone calls can be problematic. Considering this, prison systems jeopardize inmates’ familial ties through unaddressed institutional barriers, leading to a higher risk of recidivism for former inmates who failed to maintain family connections while incarcerated, and decreasing the likelihood of successful reintegration.

Limits to familial contact and challenges regarding societal stigma during and after incarceration are key contributors to negative reentry experiences and heightened recidivism risk for the formerly incarcerated; however, these issues are ethically secondary to the profound psychological harm shaped by the prison system itself. William Marez, a formerly incarcerated resident of The Francisco Homes, described chilling first-hand accounts of riots by correctional officers, recalling that guards would put inmates in lines inside a gymnasium with no medical attention and no help from the pepper spray, hidden from public view and in a state of perpetual trauma, in a system designed to put pressure on them around the clock. After prison, Marez said he began having panic attacks walking down park streets, all trauma-related, with no idea how to cope.

Experiences like these inflict long-term psychological trauma, increasing the likelihood of developing maladaptive behavioral patterns in adjusting to life after prison. This positions inmates toward past cycles and patterns, heightening their risk of recidivism. Thus, while societal stigma and minimal opportunities to build family bonds during incarceration are real concerns, primarily addressing where prison systems are negligent in tackling inmates’ chronic psychological deterioration reduces negative reentry experiences more effectively, and lowers recidivism post-incarceration.

Addressing inmate mental health in the processes of reentry and recidivism post-incarceration is crucial, as policy discussions often neglect this gap by focusing on employment and housing alone. For those serving longer sentences in general and solitary confinement prisons, psychological deterioration worsens, intensified by feelings of anxiousness, depression, and suicidal ideation that are often masked by inmates. These emotions are perpetuated by ongoing violence, isolation, and inadequate access to necessary mental healthcare support in these institutions. Government-mandated policies like cognitive behavioral therapy are simply insufficient, and more work must be done to abolish solitary confinement, ensure reentry becomes a smooth transition, and reduce the risk of recidivism. Only then can we be certain that prisoners will carry positive mental and emotional states into life after incarceration.

Photo Credit: Getty/Brian Casella