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Waiting for an Echo: The Madness of American Incarceration
Galvanized by her work in our nation's jails, psychiatrist Christine Montross illuminates the human cost of mass incarceration and mental illness
Dr. Christine Montross has spent her career treating the most severely ill psychiatric patients. Several years ago, she set out to investigate why so many of her patients got caught up in the legal system when discharged from her care--and what happened to them therein.
Waiting for an Echo is a riveting, rarely seen glimpse into American incarceration. It is also a damning account of policies that have criminalized mental illness, shifting large numbers of people who belong in therapeutic settings into punitive ones.
The stark world of American prisons is shocking for all who enter. But Dr. Montross' expertise--the mind in crisis-- allowed her to reckon with the human stories behind the bars. A father attempting to weigh the impossible calculus of a plea bargain. A bright young woman whose life is derailed by addiction. Boys in a juvenile detention facility who, desperate for human connection, invent a way to communicate with one another from cell to cell. Overextended doctors and correctional officers who strive to provide care and security in environments riddled with danger. In these encounters, Montross finds that while our system of correction routinely makes people with mental illness worse, just as routinely, it renders mentally stable people psychiatrically unwell. The system is quite literally maddening.
Our methods of incarceration take away not only freedom, but also selfhood and soundness of mind. In a nation where ninety-five percent of all inmates are released from prison and return to our communities, this is a practice that punishes us all.
Dr. Christine Montross has spent her career treating the most severely ill psychiatric patients. Several years ago, she set out to investigate why so many of her patients got caught up in the legal system when discharged from her care--and what happened to them therein.
Waiting for an Echo is a riveting, rarely seen glimpse into American incarceration. It is also a damning account of policies that have criminalized mental illness, shifting large numbers of people who belong in therapeutic settings into punitive ones.
The stark world of American prisons is shocking for all who enter. But Dr. Montross' expertise--the mind in crisis-- allowed her to reckon with the human stories behind the bars. A father attempting to weigh the impossible calculus of a plea bargain. A bright young woman whose life is derailed by addiction. Boys in a juvenile detention facility who, desperate for human connection, invent a way to communicate with one another from cell to cell. Overextended doctors and correctional officers who strive to provide care and security in environments riddled with danger. In these encounters, Montross finds that while our system of correction routinely makes people with mental illness worse, just as routinely, it renders mentally stable people psychiatrically unwell. The system is quite literally maddening.
Our methods of incarceration take away not only freedom, but also selfhood and soundness of mind. In a nation where ninety-five percent of all inmates are released from prison and return to our communities, this is a practice that punishes us all.
331 pages, Hardcover
First published July 21, 2020
151 people are currently reading
3,273 people want to read
About the author
Christine Montross
4books59followersChristine Montross is Assistant Professor of Psychiatry and Human Behaviour at Brown University and a practising inpatient psychiatrist with an MFA in poetry. Her writing has appeared in literary journals and women’s magazines as well as the New York Times. She lives in Providence, Rhode Island.
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August 22, 2020
Shocking and illuminating
If your attitude towards incarcerated people is something along the lines of "If they're in prison, they deserve to be there", or "If you can't stand the time, don't do the crime", I challenge you to read this book.
Author Christine Montross is a psychiatrist who, along with her position in an inpatient psychiatric facility, performs Competency to Stand Trial evaluations for those accused of crime.
In Waiting for an Echo: The Madness of American Incarceration, she uncovers the evils of the American prison system. It is even worse than I previously thought.
From locking up the mentally ill to throwing children in solitary confinement for up to a year, our "justice" system is a system that creates criminals instead of reforming human beings.
Dr. Montross relates the stories of many individuals she's encountered, both in her work in the hospital and in her work in prisons. Often this doesn't work for me in nonfiction. I want the facts and nothing else, no personal stories.
However, this approach works brilliantly for this book. We get to know and truly see the humanity of the people Dr. Montross discusses. We see the similarities in behavior between the hospitalized and those in prisons and we see how starkly different is our treatment of these two groups who have the same problems.
We learn that many people in prison are incarcerated not because they deserve punishment but because of their race, their addiction, their poverty, their mental illness. As a society, we in America want revenge. "An eye for an eye!" is the mentality of many people.
However, when an eye does not bring back an eye, it is lunacy to treat people barbarically. We exacerbate their mental illness or create mental illness in those who were previously psychiatrically stable. Our cruel punishments ensure many people will go on to commit more crime because in treating people like monsters, we often turn them into monsters.
Dr Montross brings much compassion and insight into the discussion of our penal system. She highlights where and how we are doing it wrong. She shows how our current practice of vengeance and punishment destroys people rather than reforms them.
She asks, "When do we stop seeing someone as a person deserving of our sympathy and care and start seeing her as a criminal in need of punishment who deserves to suffer?".
Our current rate ofrecidivism in the United States is 83%. More than three quarters of all people, upon leaving prison, will find themselves locked up again for committing new offenses. Clearly we are doing something wrong.
Dr Montross also analyzes the Scandinavian system which is the exact opposite of the American system. It is remarkable. Instead of treating the incarcerated as violent and evil monsters, they see the humanity in everyone. They look for the reasons people commit crime in the first place. Prison sentences are seen as an opportunity to reform people rather than punish them. Time spent incarcerated is time where inmates learn job and communication skills, receive mental health and substance abuse treatment, and more.
Their approach works. Norway, for instance, previously had arecidivism rate of 60-70%. It is now 20%.
Unfortunately, as long as we in America are intent on maximizing punishment and revenge, there is little hope of reform. We need to learn to see people with compassion, understand why people commit crime in the first place. Admit that often people are locked up for little more than their race or their poverty.
There will always be people who are mentally unstable and who pose a threat to themselves or others. These, in my opinion, are the only people who should be locked up. And even they, even the most insane psychopaths, should be treated with compassion and dignity, not abuse and torture.
If we commit evil against those we consider to be evil, are we not then evil ourselves?
Consider the following about those in American prisons:
� 70% of incarcerated women are mothers to minor children..... children who are then traumatized by having their mother taken away from them and as a result often end up in the foster care system.
•Our prisons contain an estimated 365,000 people with serious mental illness but only 35,000 people with serious mental illness are being treated in state hospitals. That is ten times more mentally unwell people are being punished instead of treated for their illness.
•People spend an average of 7 months injail before being tried, many of whom will be found to be innocent of the charges which had them arrested in the first place.
•Because of what they witness in their workplace, 34% of our correctional officers have PTSD and they are more than four times as likely to commit suicide than the general population and twice as many as police officers.
•In 2014 in American prisons, there werebetween 80,000 and 100,000 people locked in solitary confinement "fortwenty-two to twenty-three hours per day for thirty days or more". This number does not include children, those in jails, immigration detention centers, or the military.
•We have entire prisons built exclusively to keep people in solitary confinement even though the UN condemns the practice as torture and human rights violations.
�Children can be kept in solitary confinement for up to a year for such minor infractions as swearing.
The author asks us to imagine that, because your child swears, you decide to lock him in his bedroom for a week. No electronics, nothing to do, only a pot to pee in. How long do you think it will be before Child Protective Services comes in and takes your child away from you?
And yet we routinely do this to children in juvenile detention centers. Lock them in tiny closet-like cells for up to a year.
The meaning behind the title of this book is heartbreaking. In a juvenile detention center, the author witnessed young boys standing on their toilets speaking into vents in the ceiling. When she asked why, she was told that the boys are communicating with each other.
These children, whose brains are still forming and who desperately need stimulation and human contact, are forced to stand in awkward positions on a toilet in order to have any contact at all with each other. They are desperately waiting for an echo, the voice of another human being, someone to connect with.
If that doesn't disturb you, I don't know what will.
It should be equally disturbing that we torture adults like this too. We know that solitary confinement damages people, often irreparably, and yet we do it anyway. You might believe that people are locked up like this because they are a threat to those around them. You would be wrong. In the state of New York for instance, 85% of people in solitary confinement are there for nonviolent infractions. Simply refusing to eat all of your meal, disgusting as it is, can land you in segregation.
Picture your bathroom. If you have a large bathroom, picture instead your closet. Now imagine living in that bathroom or closet twenty-three hours a day for years on end.
Who is deserving of such torture? The answer should be "No one".
If we want to lessen crime and make our country a safer place to be, we need to stop prioritizing vengeance and suffering over justice and rehabilitation.
As the author notes, "If our goals for our society are truly to have less crime and safer societies, then we must let go of our drive for vengeance to achieve them. There is no tenable way to hold fast to both desires."
I highly recommend Waiting for an Echo to everyone. Aside from being an eye opener, it is a page turner. It is a book that will make you think and make you think some more. Dr Montross is an engaging writer and her compassion shines through on every page. This is a well-written, insightful account, horrifying and yet hopeful, as she concludes the book with ways we can begin to reform our current broken system.
You need to read this book for yourself.
5 stars all the way.
If your attitude towards incarcerated people is something along the lines of "If they're in prison, they deserve to be there", or "If you can't stand the time, don't do the crime", I challenge you to read this book.
Author Christine Montross is a psychiatrist who, along with her position in an inpatient psychiatric facility, performs Competency to Stand Trial evaluations for those accused of crime.
In Waiting for an Echo: The Madness of American Incarceration, she uncovers the evils of the American prison system. It is even worse than I previously thought.
From locking up the mentally ill to throwing children in solitary confinement for up to a year, our "justice" system is a system that creates criminals instead of reforming human beings.
Dr. Montross relates the stories of many individuals she's encountered, both in her work in the hospital and in her work in prisons. Often this doesn't work for me in nonfiction. I want the facts and nothing else, no personal stories.
However, this approach works brilliantly for this book. We get to know and truly see the humanity of the people Dr. Montross discusses. We see the similarities in behavior between the hospitalized and those in prisons and we see how starkly different is our treatment of these two groups who have the same problems.
We learn that many people in prison are incarcerated not because they deserve punishment but because of their race, their addiction, their poverty, their mental illness. As a society, we in America want revenge. "An eye for an eye!" is the mentality of many people.
However, when an eye does not bring back an eye, it is lunacy to treat people barbarically. We exacerbate their mental illness or create mental illness in those who were previously psychiatrically stable. Our cruel punishments ensure many people will go on to commit more crime because in treating people like monsters, we often turn them into monsters.
Dr Montross brings much compassion and insight into the discussion of our penal system. She highlights where and how we are doing it wrong. She shows how our current practice of vengeance and punishment destroys people rather than reforms them.
She asks, "When do we stop seeing someone as a person deserving of our sympathy and care and start seeing her as a criminal in need of punishment who deserves to suffer?".
Our current rate ofrecidivism in the United States is 83%. More than three quarters of all people, upon leaving prison, will find themselves locked up again for committing new offenses. Clearly we are doing something wrong.
Dr Montross also analyzes the Scandinavian system which is the exact opposite of the American system. It is remarkable. Instead of treating the incarcerated as violent and evil monsters, they see the humanity in everyone. They look for the reasons people commit crime in the first place. Prison sentences are seen as an opportunity to reform people rather than punish them. Time spent incarcerated is time where inmates learn job and communication skills, receive mental health and substance abuse treatment, and more.
Their approach works. Norway, for instance, previously had arecidivism rate of 60-70%. It is now 20%.
Unfortunately, as long as we in America are intent on maximizing punishment and revenge, there is little hope of reform. We need to learn to see people with compassion, understand why people commit crime in the first place. Admit that often people are locked up for little more than their race or their poverty.
There will always be people who are mentally unstable and who pose a threat to themselves or others. These, in my opinion, are the only people who should be locked up. And even they, even the most insane psychopaths, should be treated with compassion and dignity, not abuse and torture.
If we commit evil against those we consider to be evil, are we not then evil ourselves?
Consider the following about those in American prisons:
� 70% of incarcerated women are mothers to minor children..... children who are then traumatized by having their mother taken away from them and as a result often end up in the foster care system.
•Our prisons contain an estimated 365,000 people with serious mental illness but only 35,000 people with serious mental illness are being treated in state hospitals. That is ten times more mentally unwell people are being punished instead of treated for their illness.
•People spend an average of 7 months injail before being tried, many of whom will be found to be innocent of the charges which had them arrested in the first place.
•Because of what they witness in their workplace, 34% of our correctional officers have PTSD and they are more than four times as likely to commit suicide than the general population and twice as many as police officers.
•In 2014 in American prisons, there werebetween 80,000 and 100,000 people locked in solitary confinement "fortwenty-two to twenty-three hours per day for thirty days or more". This number does not include children, those in jails, immigration detention centers, or the military.
•We have entire prisons built exclusively to keep people in solitary confinement even though the UN condemns the practice as torture and human rights violations.
�Children can be kept in solitary confinement for up to a year for such minor infractions as swearing.
The author asks us to imagine that, because your child swears, you decide to lock him in his bedroom for a week. No electronics, nothing to do, only a pot to pee in. How long do you think it will be before Child Protective Services comes in and takes your child away from you?
And yet we routinely do this to children in juvenile detention centers. Lock them in tiny closet-like cells for up to a year.
The meaning behind the title of this book is heartbreaking. In a juvenile detention center, the author witnessed young boys standing on their toilets speaking into vents in the ceiling. When she asked why, she was told that the boys are communicating with each other.
These children, whose brains are still forming and who desperately need stimulation and human contact, are forced to stand in awkward positions on a toilet in order to have any contact at all with each other. They are desperately waiting for an echo, the voice of another human being, someone to connect with.
If that doesn't disturb you, I don't know what will.
It should be equally disturbing that we torture adults like this too. We know that solitary confinement damages people, often irreparably, and yet we do it anyway. You might believe that people are locked up like this because they are a threat to those around them. You would be wrong. In the state of New York for instance, 85% of people in solitary confinement are there for nonviolent infractions. Simply refusing to eat all of your meal, disgusting as it is, can land you in segregation.
Picture your bathroom. If you have a large bathroom, picture instead your closet. Now imagine living in that bathroom or closet twenty-three hours a day for years on end.
Who is deserving of such torture? The answer should be "No one".
If we want to lessen crime and make our country a safer place to be, we need to stop prioritizing vengeance and suffering over justice and rehabilitation.
As the author notes, "If our goals for our society are truly to have less crime and safer societies, then we must let go of our drive for vengeance to achieve them. There is no tenable way to hold fast to both desires."
I highly recommend Waiting for an Echo to everyone. Aside from being an eye opener, it is a page turner. It is a book that will make you think and make you think some more. Dr Montross is an engaging writer and her compassion shines through on every page. This is a well-written, insightful account, horrifying and yet hopeful, as she concludes the book with ways we can begin to reform our current broken system.
You need to read this book for yourself.
5 stars all the way.
April 9, 2024
3.5 "thoughtful, compassionate yet not quite finished...." stars !!!
Thank you to Netgalley, the author and Penguin Press for an ecopy. This was released July 2020. I am providing an honest review.
This is an extended exploration of a psychiatrist and her involvement with the American incarceration system. She works with the severely mentally ill population in a hospital setting as well as providing competency assessments for the forensic system. She comes across as deeply compassionate and clinically skilled. Through this book she gives the reader an inside look at the cruel and abysmal state of the carceral state and how many prisons have become clearing houses for the severely mentally ill as there is little hospital/community care. She provides many case examples and we are taken inside the worlds of people who are extremely ill, extremely poor and with impoverished histories and intersectional marginalizations. She also compares newer models from Scandinavia. She also writes beautifully and lucidly. You simply cannot argue against her points of inhumane and cruel mistreatment of a population that is utilized to expand corporate profits and falsely keep communities safe. She also makes cogent and powerful arguments for the ending of extended segregation of prisoners.
In my opinion, however, her book falls short on a number of different areas
-the differences between nuisance, drug, non-violent and violent offenders
-the role of malignant personality disorders in both psychiatric and non-psychiatric inmates and the challenges of treatment and rehabilitation
-an almost complete lack of exploration of what victims and their loved ones need to heal and flourish and how this might inform a reformed forensic system
-the misuse of money and the business of forensics for both law and medical professionals
Overall a very good read that helped this reader understand American forensic system a little bit better.
December 10, 2020
Once he’s within the prison’s orbit, what power does one man have to resist the pull of the dehumanizing fortresses of containment? What amount of force is required to tear away from these industrial complexes of trauma and punishment and exile?
The U.S. carceral system is maddening—for those whose minds are tested against solitary confinement and debasement inside concrete walls, and for those who have or will come to realize just how counterproductive and misaligned these prisons really are. It is a maladaptive cycle that leads to less secure communities and ablation of accountability and a recidivism rate of 83 percent.
Juxtapose this with prisons in Norway and Sweden. In the former, high recidivism rates in the 1980s and 90s have since become next to none. Their philosophies are “aligned with what will work, with what will reduce crime and diminish violence, with what will increase the safety of the communities and thus the nation.�
When has our empathy and compassion morphed into fear and vengeance? In Waiting for an Echo, I was endlessly impressed with how well psychiatrist Christine Montross weaves together anecdotes and statistics that shed light on the mentally ill population in the US prison system and the broader experience inside jails to supermax facilities. There are too many heartbreaking stories and facts to recount, whether teenages in solitary standing on toilets just to hold a conversation with each other or the fact that “roughly a quarter million children in our country live with their lone caregiver in jail.�
And it’s easier to believe that we are where we are because we are morally superior to the people who are not free to do these things. But the truth more often lies in the privilege of circumstance—or in sheer luck—than in any difference of moral character.
And I think we have to lean into that uncomfortable conception. This is privilege staring coolly at our faces in the mirror, whether due to our race or socioeconomic status. I’ll be reading soon; even the author recommends this as reading to get at the crux of race, especially the overrepresentation of African Americans, leading to mass incarceration.
If you strip away inefficacious state laws and cruel punishments, you only have to observe systems across the globe to see a path forward for criminals built upon humanity and rehabilitation. If that’s what we want, we don’t need to conjure some impossibly rosy utopia. Since when did those ever work, anyway? Waiting for an Echo, with that one-two punch of empathy and logic, is on a mission to shatter our presuppositions and reveal the vulnerability at the core of the people we lock away, if nothing else.
August 7, 2021
I agree with this author’s basic premise that American jails and prisons are in desperate need of serious reform, and that our system of incarceration is often counterproductive, serving to exacerbate the problems of racism, poverty and mental illness without actually rehabilitating inmates, who are returned to the streets with even less ability to lawfully support themselves than they had before. That said, this isn’t a good book.
Basically this is an extended op-ed, in which the author writes about her minimal and brief encounters with prisons and inmates, and a whole lot about her opinions and feelings, without contributing either an effective narrative or new insights or research. I can see why it has a high average rating (if you already feel strongly about something, it can be validating to read opinion pieces by people who agree with you), but the low number of ratings for a book on such a hot topic should have given me pause. or this is not.
Dr. Christine Montross does not work in a prison, so my hopes for a thoughtful insider’s view of working in the justice system—like a couple other excellent books I’ve read this year, (about policing) and (probation and parole)—were dashed. She actually works in a psychiatric hospital, but now and again she’s called to a jail or prison to perform one-time competency evaluations of inmates to determine whether they’re able to stand trial. Aside from conducting these interviews, she takes a few tours of various facilities. While that is more time than the average upper-middle-class white American spends in prisons, she never meets any inmate more than once, or gets to know anyone affected by the system well enough to share more from their lives than scattered anecdotes. So her narrative winds up being about her, but since she’s just passing through there isn’t a lot to say there. And because she focuses so much on her own experience, there isn’t as much data as there could be and the organization gets lost.
That said, there is food for thought in her arguments, and points that need to be made. Montross makes a strong argument for why solitary confinement is a terrible thing that leads to severe mental health problems, and yet it’s practically unregulated; some facilities even use it on juveniles, and for up to a year (!). As she points out, parents who decided to lock their child up alone in a bathroom for a week for swearing at them would likely find him removed from their care, but in institutions this is apparently a good plan. She also makes some strong points about how devastating it is to be removed from everyone and everything one cares about for years or even decades; many people would likely prefer physical punishment if given the choice, but as a society we’ve decided one is barbaric and the other totally fine.
And there is the way we assume people who are locked up are simply bad people, when the privileged have often committed plenty of crimes themselves but never been caught or gotten off lightly. There’s a bit where the author, her wife, and six of their gainfully employed, PTA-attending friends get together and confess all the crimes they’ve committed without consequence, and I don’t know whether to say it’s eye-opening or that Montross has bad taste in friends, because some of that definitely went beyond what I expected. The book also addresses the way that people’s behavior generally conforms to the way they’re treated—so prisons that treat people like animals for “security� reasons tend to find themselves swamped by security threats from prisoners behaving accordingly, while those that show more respect tend to produce people who deserve it—and that some extreme prison behavior, such as self-harm or chucking bodily fluids at guards, can be the only way prisoners have to get themselves noticed or responded to. And of course, she writes about the needs of mentally ill people who are unable to conform their behavior to others� expectations—which puts them on a collision course with prison rules when they wind up in an environment where deviations are harshly punished.
Where the book is less successful is in discussing solutions. Montross visits Halden Prison in Norway, a favorite destination for prison reform advocates, and expresses great admiration for the place. While its inmates are serious criminals, it’s extremely cushy by American standards, resembling a college campus/job training program whose participants just happen to live on-site. Halden has been extremely successful at reducing recidivism, probably because rather than in spite of the way it treats its inmates like humans and addresses the needs that brought them there in the first place.
All well and good, but Montross seems to naively believe that Halden could be reproduced in the U.S., likely because she’s viewing prisons outside the context of the society as a whole. Okay, Norway also has a significant minority population these days, but what it doesn’t have is the U.S.’s desperate, grinding poverty, which most(?) of our electorate has absolutely no interest in relieving; the very notion gets a significant number foaming at the mouth. Treating prisoners better than law-abiding citizens (Halden’s inmates, for instance, get nice private rooms with en suite bathrooms and their own TVs, while America’s poor are often homeless, doubled-up, couch-surfing, constantly facing eviction and utility shut-offs, living in dilapidated housing full of mold and roaches that nevertheless eats up most of their paycheck in rent, etc. etc.) is never going to happen and probably shouldn’t—it creates rational incentives to commit crime, and anyway, how well would Norway’s newly rehabilitated prisoners do in an American environment, with the barriers they’d face to decent housing, employment, medical care, and being treated like a worthwhile citizen? I realize this is a deeply cynical paragraph, but you can’t sensibly look at prisons outside the context of the wider society, as Montross is trying to do.
Finally, I was unimpressed with the way Montross idealizes involuntary commitment and locked psychiatric wards (the institution where she actually works). I realize that, in the real world, for some people who are poor, lack a support system, and have a mental illness that causes them to act out publicly in ways others find threatening, jail and the psych ward may be the only realistic options and the psych ward is probably better than jail. However, having read of involuntary commitment/stays in American psychiatric hospitals—and discovering that of those, the author whose portrayal of that experience is the most positive ultimately because his own experience of being locked up was too traumatic to allow him to continue visiting clients in jail—I’m skeptical of this view. And Montross doesn’t help her own case by, early in the book, quoting approvingly an official who argues that, “If mental-health advocates are still talking about civil rights, they have outlived their time.� So let’s write about what we think is best for others without listening to their voices, eh?
So overall, yeah, didn’t think much of this one. Our jails and prisons have all kinds of problems but surely someone has written a better book about them.
Basically this is an extended op-ed, in which the author writes about her minimal and brief encounters with prisons and inmates, and a whole lot about her opinions and feelings, without contributing either an effective narrative or new insights or research. I can see why it has a high average rating (if you already feel strongly about something, it can be validating to read opinion pieces by people who agree with you), but the low number of ratings for a book on such a hot topic should have given me pause. or this is not.
Dr. Christine Montross does not work in a prison, so my hopes for a thoughtful insider’s view of working in the justice system—like a couple other excellent books I’ve read this year, (about policing) and (probation and parole)—were dashed. She actually works in a psychiatric hospital, but now and again she’s called to a jail or prison to perform one-time competency evaluations of inmates to determine whether they’re able to stand trial. Aside from conducting these interviews, she takes a few tours of various facilities. While that is more time than the average upper-middle-class white American spends in prisons, she never meets any inmate more than once, or gets to know anyone affected by the system well enough to share more from their lives than scattered anecdotes. So her narrative winds up being about her, but since she’s just passing through there isn’t a lot to say there. And because she focuses so much on her own experience, there isn’t as much data as there could be and the organization gets lost.
That said, there is food for thought in her arguments, and points that need to be made. Montross makes a strong argument for why solitary confinement is a terrible thing that leads to severe mental health problems, and yet it’s practically unregulated; some facilities even use it on juveniles, and for up to a year (!). As she points out, parents who decided to lock their child up alone in a bathroom for a week for swearing at them would likely find him removed from their care, but in institutions this is apparently a good plan. She also makes some strong points about how devastating it is to be removed from everyone and everything one cares about for years or even decades; many people would likely prefer physical punishment if given the choice, but as a society we’ve decided one is barbaric and the other totally fine.
And there is the way we assume people who are locked up are simply bad people, when the privileged have often committed plenty of crimes themselves but never been caught or gotten off lightly. There’s a bit where the author, her wife, and six of their gainfully employed, PTA-attending friends get together and confess all the crimes they’ve committed without consequence, and I don’t know whether to say it’s eye-opening or that Montross has bad taste in friends, because some of that definitely went beyond what I expected. The book also addresses the way that people’s behavior generally conforms to the way they’re treated—so prisons that treat people like animals for “security� reasons tend to find themselves swamped by security threats from prisoners behaving accordingly, while those that show more respect tend to produce people who deserve it—and that some extreme prison behavior, such as self-harm or chucking bodily fluids at guards, can be the only way prisoners have to get themselves noticed or responded to. And of course, she writes about the needs of mentally ill people who are unable to conform their behavior to others� expectations—which puts them on a collision course with prison rules when they wind up in an environment where deviations are harshly punished.
Where the book is less successful is in discussing solutions. Montross visits Halden Prison in Norway, a favorite destination for prison reform advocates, and expresses great admiration for the place. While its inmates are serious criminals, it’s extremely cushy by American standards, resembling a college campus/job training program whose participants just happen to live on-site. Halden has been extremely successful at reducing recidivism, probably because rather than in spite of the way it treats its inmates like humans and addresses the needs that brought them there in the first place.
All well and good, but Montross seems to naively believe that Halden could be reproduced in the U.S., likely because she’s viewing prisons outside the context of the society as a whole. Okay, Norway also has a significant minority population these days, but what it doesn’t have is the U.S.’s desperate, grinding poverty, which most(?) of our electorate has absolutely no interest in relieving; the very notion gets a significant number foaming at the mouth. Treating prisoners better than law-abiding citizens (Halden’s inmates, for instance, get nice private rooms with en suite bathrooms and their own TVs, while America’s poor are often homeless, doubled-up, couch-surfing, constantly facing eviction and utility shut-offs, living in dilapidated housing full of mold and roaches that nevertheless eats up most of their paycheck in rent, etc. etc.) is never going to happen and probably shouldn’t—it creates rational incentives to commit crime, and anyway, how well would Norway’s newly rehabilitated prisoners do in an American environment, with the barriers they’d face to decent housing, employment, medical care, and being treated like a worthwhile citizen? I realize this is a deeply cynical paragraph, but you can’t sensibly look at prisons outside the context of the wider society, as Montross is trying to do.
Finally, I was unimpressed with the way Montross idealizes involuntary commitment and locked psychiatric wards (the institution where she actually works). I realize that, in the real world, for some people who are poor, lack a support system, and have a mental illness that causes them to act out publicly in ways others find threatening, jail and the psych ward may be the only realistic options and the psych ward is probably better than jail. However, having read of involuntary commitment/stays in American psychiatric hospitals—and discovering that of those, the author whose portrayal of that experience is the most positive ultimately because his own experience of being locked up was too traumatic to allow him to continue visiting clients in jail—I’m skeptical of this view. And Montross doesn’t help her own case by, early in the book, quoting approvingly an official who argues that, “If mental-health advocates are still talking about civil rights, they have outlived their time.� So let’s write about what we think is best for others without listening to their voices, eh?
So overall, yeah, didn’t think much of this one. Our jails and prisons have all kinds of problems but surely someone has written a better book about them.
August 27, 2020
You have to fully support any book that outlines the horrors of aspects of social policy even when they present little that surprises. It is an important read. Montross exposes the ease with which the mentally ill can find themselves thrust into the penal system and the atrocious conditions and treatment that they, and other prisoners, are subjected to. Once exposed the author moves on to suggest alternative and more enlightened approaches, leaning heavily on examples from Scandinavia. All very admirable! Unfortunately, the one thing that really did hit home for me was the discussion of Nutraloaf, an apparently foul tasting mess that meets dietary requirements and is often given to inmates in the US who misbehave. I couldn’t help thinking how the book is talking of enlightening people about more humane ways of treating inmates when those presently responsible for and involved in prisons are really not the least bit interested in being humane. Please read!
March 24, 2020
Was given an advance readers copy of this book, and all I can say is: wow. Going into this situation somewhat ignorant of the current situation in America, I was dumbfounded at how bad it really was. Montross explains the prison systems very well, and explains her case for a reformed system in a realistic manner. It really helped me see prisons and criminals in a new light and helped me to reevaluate my current views towards these issues. Anyone who is interested in prison systems and alternative ways to deal with criminals will definitely enjoy this book.
January 29, 2025
This was so well written and paced. The language was clinical enough but not confounding. I really implore everyone to read this, because the justice system is completely broken and we need to look elsewhere for answers. This was heartbreaking and full of evidence and research rooted in lived experience. As a clinician who works in the justice system I really appreciated this perspective and information, but I think anyone would benefit and should read this.
January 21, 2024
Highly recommend for anyone looking to understand healthcare within the criminal justice system better, and why reform is needed.
Read
June 17, 2023DNF hard to read the stories of our prison system that fails the mentally ill. I tried the first third but just wasn't compelled to keep going.
August 8, 2024
A deep, painful look into our nation's carceral policies; their departure from those of other developed countries, their perpetuation of a broken system, their lasting effects. Highly recommend, but warning there is no happy ending :/
March 1, 2021
This is not an easy book to read, not because of poor writing, but because it requires us to use empathy and to think outside our comfort zone’s. I found myself viewing the ideas in this book through several lenses such as Christian, rape survivor, the niece of a convicted felon, and married mother/grandmother. I could feel resistance in myself during some of the chapters, while other chapters open my eyes and helped me to face my own desires for safety, vengeance, mercy, and the health of my community. I have been contemplating volunteering for a ministry that works by sending letters back-and-forth with people who are in prison. This book has helped me examine some of my fears and doubts as well as giving me some encouragement to take the next step forward. I still have some doubts about some of the authors ideas, and I think she would be OK with that since it means I’m beginning to think about subjects where my mind was formerly closed. One of the biggest assumptions she asks me to examine is that all people in prison deserve to be there and that all people who are there have committed violent crimes. I think she has proven solidly that I am wrong in believing that everyone in prison has committed a violent crime. If I can admit that I am wrong about that part of things, maybe I am wrong about other things as well. I think this is a book I will need to revisit in the future as I continue to let God open my heart and examine what is really true versus reality of my own making.
Read
August 19, 2020As an abolitionist, I found this book fascinating.
Dr. Montross does not purport to be an abolitionist. Twice, she specifically says that she is NOT one. And yet the rest of her writing and thought seem to contradict that statement. It usually is followed by "I've had a patient who murdered 34 people, so I can't believe that prison can't exist". But I wonder if prison doesn't need to be the way that the person who murdered 34 people is cared for (if you can even use that word for prisons). Why does abolition stop at mental health disparities or sociopathy? It's certainly a puzzle, but I was frustrated that she never addressed her ideas about solving it.
Otherwise, a remarkable book. Montross is eloquent, and thoughtful about her views on the PIC, and makes extremely persuasive arguments for its abolition -- despite her claims not to.
I would recommend this book to anyone who is reading about prisons and/or abolition. Whether you are well versed, or just starting out, this book makes an impact.
Dr. Montross does not purport to be an abolitionist. Twice, she specifically says that she is NOT one. And yet the rest of her writing and thought seem to contradict that statement. It usually is followed by "I've had a patient who murdered 34 people, so I can't believe that prison can't exist". But I wonder if prison doesn't need to be the way that the person who murdered 34 people is cared for (if you can even use that word for prisons). Why does abolition stop at mental health disparities or sociopathy? It's certainly a puzzle, but I was frustrated that she never addressed her ideas about solving it.
Otherwise, a remarkable book. Montross is eloquent, and thoughtful about her views on the PIC, and makes extremely persuasive arguments for its abolition -- despite her claims not to.
I would recommend this book to anyone who is reading about prisons and/or abolition. Whether you are well versed, or just starting out, this book makes an impact.
March 4, 2024
My medical ethics professor at Brown gave me her copy of this book after I repeatedly showed up in her office to discuss my Incarceration and Health class, an openly abolitionist elective in which we interviewed healthcare workers and inmates associated with Rhode Island’s ACI (where Dr. Montross works). The elective was led by the ACI’s former medical director, and the stories we heard were consistent with what Dr. Montross describes: COs openly abusive and knowingly complicit in acts of physical and sexual brutality within prison walls, inmates with no history of mental instability driven to self harm and suicide after months of solitary confinement, their friends forced to take their bodies down from nooses; forced to clean their blood and feces from the walls of their cell.
Montross is an insightful and compassionate narrator of these events, as well as her experiences in diverse carceral environments in the United States and Norway. I appreciate the way she weaves her clinical experience as a psychiatrist in with her experience in carceral settings, as well as the context she provides of the history of prisons and asylums (we effectively eliminated the latter only to funnel the seriously mentally ill into the former). She doesn't propose many specific short-term policy solutions contextualized within the US, but I don't expect this of her, as she's writing from a clinician's perspective. I do wonder how she'd respond to criticisms of involuntary psychiatric treatment as carceral in and of itself? There isn't a ton of reflection on that; clearly she indicates that there were serious problems with the Asylums of Yesteryear but there are still many legitimate criticisms of the US's contemporary approach to involuntary psychiatric holds, Baker Acting, etc.
Likewise, Montross is not herself abolitionist, though clearly a criminal justice system she would find morally acceptable within the United States would be completely unrecognizable compared to the present. Her main argument against complete abolition is that there exist Very rare examples of truly sadistic and harmful people who will always be a danger to the communities in which they live; to my knowledge this not a problem that abolition denies exists? But also, many of the formerly incarcerated people we heard from in my class, who themselves had experienced extreme brutality within the ACI, shared this opinion. I don't think having a reformist perspective devalues the experiences these people, or Dr. Montross, bring to the table re: the criminal justice system for those who Do promote complete abolition.
One thing I did notice and have questions about is the fact that Montross is unflinching in her description of recorded abuse from COs within various distant prison systems (Rikers comes to mind, as she describes COs knowingly subjecting ‘difficult� inmates to sexual violence and ‘providing rubber gloves� to known rapists to facilitate it), but does not describe encountering abusive COs in the course of her personal experience; everyone she describes meeting in prison is trying to do their best to respect and protect inmates. My assumption is that she was somewhat well-respected within the ACI, but based on the firsthand accounts I’ve heard: the ACI is no better than her tales about Rikers, and the COs who had positive interactions with the healthcare workers we spoke to were the same ones beating inmates and turning a blind eye to them being raped in their cells. I don’t consider this a fault of Dr. Montross’s writing! But it did make me think about what visiting staff are shown and not shown within prison walls.
Overall, loved the book. Thank you
Montross is an insightful and compassionate narrator of these events, as well as her experiences in diverse carceral environments in the United States and Norway. I appreciate the way she weaves her clinical experience as a psychiatrist in with her experience in carceral settings, as well as the context she provides of the history of prisons and asylums (we effectively eliminated the latter only to funnel the seriously mentally ill into the former). She doesn't propose many specific short-term policy solutions contextualized within the US, but I don't expect this of her, as she's writing from a clinician's perspective. I do wonder how she'd respond to criticisms of involuntary psychiatric treatment as carceral in and of itself? There isn't a ton of reflection on that; clearly she indicates that there were serious problems with the Asylums of Yesteryear but there are still many legitimate criticisms of the US's contemporary approach to involuntary psychiatric holds, Baker Acting, etc.
Likewise, Montross is not herself abolitionist, though clearly a criminal justice system she would find morally acceptable within the United States would be completely unrecognizable compared to the present. Her main argument against complete abolition is that there exist Very rare examples of truly sadistic and harmful people who will always be a danger to the communities in which they live; to my knowledge this not a problem that abolition denies exists? But also, many of the formerly incarcerated people we heard from in my class, who themselves had experienced extreme brutality within the ACI, shared this opinion. I don't think having a reformist perspective devalues the experiences these people, or Dr. Montross, bring to the table re: the criminal justice system for those who Do promote complete abolition.
One thing I did notice and have questions about is the fact that Montross is unflinching in her description of recorded abuse from COs within various distant prison systems (Rikers comes to mind, as she describes COs knowingly subjecting ‘difficult� inmates to sexual violence and ‘providing rubber gloves� to known rapists to facilitate it), but does not describe encountering abusive COs in the course of her personal experience; everyone she describes meeting in prison is trying to do their best to respect and protect inmates. My assumption is that she was somewhat well-respected within the ACI, but based on the firsthand accounts I’ve heard: the ACI is no better than her tales about Rikers, and the COs who had positive interactions with the healthcare workers we spoke to were the same ones beating inmates and turning a blind eye to them being raped in their cells. I don’t consider this a fault of Dr. Montross’s writing! But it did make me think about what visiting staff are shown and not shown within prison walls.
Overall, loved the book. Thank you
July 20, 2022
Easily one of the best books on the subject of American corrections. It is by turns nauseating and motivating to learn how badly mental health is mishandled in jails, prisons, detention centers, etc. Dr. Montross is an exceptionally talented writer, delivering a humanistic, holistic perspective that drives a thought-provoking conversation from start to finish. I've worked in the field of mental health and I also teach college - to be sure, Waiting for an Echo will be required reading.
March 16, 2022
Another depressing book that shows us the way we approach crime, justice, and punishment is so backdated, and inhumane - compared to those in the Scandinavian countries. So much so, it starting to seem like keeping crime off the street is secondary, and ensuring “payback and retribution� and “making the criminal suffer� - in the name of survival and fear - where we see fit is primary.
August 14, 2020
Amazingly written and an excellent case for near-abolition.
March 25, 2024
Read this. It is well researched, well written, and an indicting account of how wrongheaded our approach to incarceration is in the US. We are far more focused on revenge than on rehabilitation, and that is awful for prisoners and our society alike. I highly recommend this book.
October 31, 2020
An absolutely riveting summation of what we are getting wrong with mass incarceration, mandatory sentencing, treating children as adults, and our prison system. The language, while scientific and laden with technical terms, is understandable for a lay reader. Strong recommendation, particularly for people with an interest in criminal justice reform. If you liked Just Mercy, this is in your wheelhouse.
March 24, 2024
As I start this review, I'm not sure I have much more to say about this book than, it's a must read. I was given it as gift during my Forensic Psychiatry rotation, and I'm so glad I was. So many of the themes that Dr. Montross touches on were so relevant to the rotation. Taken together, this was an extremely illuminating month rotating through the prisons and psychiatric hospital of RI. The bottom line for me is that we need to reevaluate what the point of prison even is. Why are people being sent to prison for years on end for their crimes, especially non-violent crimes? What do we hope to accomplish by removing them from society, depriving them of their liberty, and putting them in inhumane living conditions? Even more, what is the point when their "crime" stems from a medical disease, such as schizophrenia or substance use disorder? How do we expect people to rehabilitate themselves by putting them in such horrific conditions and not giving them access to proper treatment or skills training programs? None of it makes sense.
Dr. Montross talks about the progression of punishment for crimes as progressing from public humiliation and punishment (eg, being placed in the public square and whipped or placed in stocks) to very private, hidden punishment, in prisons far removed from others and with no interaction between those on the inside and those on the outside. Prior to this month, I had genuinely no idea where the Rhode Island state prison was, despite the fact that I've driven past it probably a hundred times. My interaction with anyone who had been incarcerated is limited to the handful of patients I had treated at the hospital who had come from the ACI. There are so many problems with this. By hiding the prisons away, it puts them out of sight and out of mind for most citizens. How can we have any accountability for what goes on in prison if no one even knows where the prison is or thinks about it? We as a society are responsible for sending these people to prison. We are responsible for what happens to them in prison. We are responsible for their rehabilitation and re-entry into society. And we have a vested interest in their success! We want people to succeed in prison, to get treatment, to gain marketable skills - all of these things so that they will contribute positively to society. The way that people are currently treated in prison cannot possible facilitate their positive re-entry into society. Dr. Montross also visits a prison in Norway, where prisoners are treated with respect, given jobs within prison and lots of training, and are allowed to come and go from prison for doctors appointments or family visits. She also notes that Norway's prison system looked much like ours just 30 or 40 years ago. There is hope, and there is a way to create positive prison systems here in the US.
The one other aspect from the book I wanted to touch on was "seg," short for "segregation," or solitary confinement. Seg is frequently practiced in the US. I think I had a naive hope that solitary confinement is a relic of an older era, something that was done at Eastern State Penitentiary or Alcatraz, but is no longer. Boy was I wrong. Seg is alive and well in our prisons today. Many people will spend 23 hours a day in seg, literally just sitting in their cell alone with nothing. How can people possibly rehabilitate themselves in such conditions? It sounds like prisoners in RI are lucky, as they get recreation time together in 10 ft x 10 ft x 10 ft middle cages indoors in the middle of the seg area, whereas folks elsewhere don't even get recreation time together. But the conditions are still beyond inhumane. In addition, seg is not something that a judge hands down, or that a jury weighs in on. Seg is handed out completely at the discretion of correctional officers. Inmates can be sent to seg for infractions as minor as walking out of line or if their words are perceived by an officer the wrong way. People can also spend huge amounts of time in seg. Dr. Montross talks about meeting someone in a CT prison who was in seg for 7 and a half years. Can you imagine??? What do we possibly expect to come of that?? As Dr. Montross points out, I think the only possible outcome is loneliness, anger, and frustration at best, and crippling mental illness at worst.
Dr. Montross's conclusion is that our entire prison system in the US is in need of complete overhaul, and I have to agree. I was asked by a friend if I was ever scared around the inmates, and frankly, I wasn't. There was maybe one instance during the entire month where I felt any fear, and that was while being berated by someone with severe mental illness. Otherwise, there is nothing to fear about them. They are humans. Even if their kindness is only a front in order to proceed in a transaction with us where they receive medical care, they at least are human enough to know that and to behave appropriately. We treated them with dignity and respect within the medical encounter, and they treated us with respect in return. I may be being naive, but I believe that for most people, it is as simple as that. Respect. Honoring their dignity as a human. That is why, as Dr. Montross says, the role of the correctional officer needs to be completely re-thought. Currently, the power dynamic between officer and inmate is what I believe perpetuates the "poor behavior" of inmates, as they are put in a role and deprived of dignity and respect, and have no choice but to respond by lashing out. She points out that correctional officers in Norway have much more of a mentor/teacher role, where each CO acts as a mentor to two inmates and is responsible for their rehabilitation. They eat together, work on projects together, and seem to generally live together while at the prison. It just makes sense to me. If you want people to treat those around them with respect, you need to treat them with respect first. Get on their level. Show them that they are your equal and companion, not someone less than. Only then can we expect positive results from prisons.
Alright that's probably enough for this review, I mostly just wanted to get down some of my thoughts from my month of Forensic Psych. More thoughts will be coming when I review the New Jim Crow. Bottom line: read this book. No matter who you are, what your interests are, this is a must read.
Dr. Montross talks about the progression of punishment for crimes as progressing from public humiliation and punishment (eg, being placed in the public square and whipped or placed in stocks) to very private, hidden punishment, in prisons far removed from others and with no interaction between those on the inside and those on the outside. Prior to this month, I had genuinely no idea where the Rhode Island state prison was, despite the fact that I've driven past it probably a hundred times. My interaction with anyone who had been incarcerated is limited to the handful of patients I had treated at the hospital who had come from the ACI. There are so many problems with this. By hiding the prisons away, it puts them out of sight and out of mind for most citizens. How can we have any accountability for what goes on in prison if no one even knows where the prison is or thinks about it? We as a society are responsible for sending these people to prison. We are responsible for what happens to them in prison. We are responsible for their rehabilitation and re-entry into society. And we have a vested interest in their success! We want people to succeed in prison, to get treatment, to gain marketable skills - all of these things so that they will contribute positively to society. The way that people are currently treated in prison cannot possible facilitate their positive re-entry into society. Dr. Montross also visits a prison in Norway, where prisoners are treated with respect, given jobs within prison and lots of training, and are allowed to come and go from prison for doctors appointments or family visits. She also notes that Norway's prison system looked much like ours just 30 or 40 years ago. There is hope, and there is a way to create positive prison systems here in the US.
The one other aspect from the book I wanted to touch on was "seg," short for "segregation," or solitary confinement. Seg is frequently practiced in the US. I think I had a naive hope that solitary confinement is a relic of an older era, something that was done at Eastern State Penitentiary or Alcatraz, but is no longer. Boy was I wrong. Seg is alive and well in our prisons today. Many people will spend 23 hours a day in seg, literally just sitting in their cell alone with nothing. How can people possibly rehabilitate themselves in such conditions? It sounds like prisoners in RI are lucky, as they get recreation time together in 10 ft x 10 ft x 10 ft middle cages indoors in the middle of the seg area, whereas folks elsewhere don't even get recreation time together. But the conditions are still beyond inhumane. In addition, seg is not something that a judge hands down, or that a jury weighs in on. Seg is handed out completely at the discretion of correctional officers. Inmates can be sent to seg for infractions as minor as walking out of line or if their words are perceived by an officer the wrong way. People can also spend huge amounts of time in seg. Dr. Montross talks about meeting someone in a CT prison who was in seg for 7 and a half years. Can you imagine??? What do we possibly expect to come of that?? As Dr. Montross points out, I think the only possible outcome is loneliness, anger, and frustration at best, and crippling mental illness at worst.
Dr. Montross's conclusion is that our entire prison system in the US is in need of complete overhaul, and I have to agree. I was asked by a friend if I was ever scared around the inmates, and frankly, I wasn't. There was maybe one instance during the entire month where I felt any fear, and that was while being berated by someone with severe mental illness. Otherwise, there is nothing to fear about them. They are humans. Even if their kindness is only a front in order to proceed in a transaction with us where they receive medical care, they at least are human enough to know that and to behave appropriately. We treated them with dignity and respect within the medical encounter, and they treated us with respect in return. I may be being naive, but I believe that for most people, it is as simple as that. Respect. Honoring their dignity as a human. That is why, as Dr. Montross says, the role of the correctional officer needs to be completely re-thought. Currently, the power dynamic between officer and inmate is what I believe perpetuates the "poor behavior" of inmates, as they are put in a role and deprived of dignity and respect, and have no choice but to respond by lashing out. She points out that correctional officers in Norway have much more of a mentor/teacher role, where each CO acts as a mentor to two inmates and is responsible for their rehabilitation. They eat together, work on projects together, and seem to generally live together while at the prison. It just makes sense to me. If you want people to treat those around them with respect, you need to treat them with respect first. Get on their level. Show them that they are your equal and companion, not someone less than. Only then can we expect positive results from prisons.
Alright that's probably enough for this review, I mostly just wanted to get down some of my thoughts from my month of Forensic Psych. More thoughts will be coming when I review the New Jim Crow. Bottom line: read this book. No matter who you are, what your interests are, this is a must read.
May 11, 2022
So I struggled with writing a review for this book. I am somebody who suffers from different mental illnesses, and as a teenager was put into the justice system. And I can honestly say having a mental illness and being incarcerated is not an easy thing. There are many parts of this book I agree with. There are some I definitely disagree with. But she makes some valid points about they're not being enough mental health services in the justice system and them using force. You don't realize how many flashbacks and nightmares you still have even going on over 10 years out of that type of facility.
July 15, 2022
I have conflicting feelings about this book. The subject matter and the stories told are so incredibly important. However, it was really hard for me to get past the fact that she wasn’t in support of abolition
June 1, 2021
Psychiatrist gives a tour of our incarceration system, starting with her work evaluating defendants� competence to stand trial. Great observations about the ways juvenile “justice� does the absolutely wrong things for young people’s development and how the pervasive use of solitary confinement damages mental health. In the next to last chapter she visits Norway and Sweden who are trying the remarkable project of preparing prisoners for productive lives when they return to the community.
June 28, 2022
This was such a fantastic book. The author presented the issue well through stories and was vulnerable in sharing her own shortcomings in the way she noticed her feelings and stereotypes about prisoners.
February 22, 2025
While I don’t agree with every point presented by the author, I think this is necessary reading for anyone interested in crime and punishment.
February 5, 2021
When will we open our eyes?
Listened to this via Audible- narrated by the author herself. Amazing. Gripping.
Listened to this via Audible- narrated by the author herself. Amazing. Gripping.
August 8, 2020
By far one of the greatest things I’ve read this year, if not ever. A clinical psychiatrist with extensive experience in prisons who also happens to be an award-winning poet. This book is not only knowledgeable, it’s written in an incredibly beautiful way. As somebody who works with people living in prison, I was at the same time inspired and sickened. It’s infuriating that we keep doing more of the things that clearly don’t work when it comes to our prison and punishment systems. But it also makes me even more motivated to bring light and hope and compassion to people who experience the daily trauma of incarceration. Read this book!!
August 7, 2020
Such an eye-opening book that examines that intersection of the mental health crisis within the criminal justice system in America. It is stunning, especially when the author compares our system in the U.S. to the prison system in Norway, which is far more forward-looking. This book asks some tough questions, and I think we, as a nation, need to wrestle with those answers if we really believe in human rights.
March 16, 2021
Christine Montross is a psychiatrist who examines mental health in the American jail/prison system in WAITING FOR AN ECHO. In her professional life, she performs competency exams for prisoners. She describes in this book how mental illness and incarceration are connected. Individuals with mental illness are often arrested for crimes that may stem from their mental health (e.g., hearing voices, paranoia, etc.) and instead of receiving mental health care, they are often put in the prison system. And the treatment within prisons will often exacerbate and cause mental health problems. She cites, as many due, the 1960's when mental health hospitals discharged much of their populations (deinstitutionalization). In theory, this was a positive, as there was supposed to be a correlative outpatient community option for these individuals, which was not delivered on. Thus, prisons became defect mental health institutions (transinstitutionalization). This is a nice companion piece to the excellent book The New Jim Crow and highlights many of the same problems with the system. She spends the final part of the book highlighting another country's system- Norway, which spends not that much more on their prisoners but the philosophy is completely different than America's. Think of revenge versus of rehabilitation and respect. While I did not feel this book offered a whole lot of new knowledge about the prison system, it was still an interesting book.
August 4, 2022
- i honestly believe that this book should be required reading for like, everyone that lives on planet earth? this is definitely one of, if not the best, non-fiction book i read this year. and i think a lot of it had to do with how much i learned about the topic at hand, but also the author’s ability to answer all of my questions.
- first off, dr. montross writes brilliantly and effectively. she’s a psychiatrist first and foremost and she evaluates prisoners� psychological capacities to see if they are able to understand the basic aspects of their case. although she doesn’t have direct experience working in prisons, her journalism that takes place when she visits different prisons around the states and the interviews she conducts are very thoughtful and well researched. i also really enjoyed how she connected her own personal experiences helping mentally ill patients at the hospital.
- the argument that is spelled out in this book is simple: western modern prisons don’t work, especially for the mentally ill, which make up a HUGE chunk of the prison population. in turn, solitary confinement is very very very bad!! like super bad!! it leads to more aggressive behaviour, more mental health issues, more problems with socialization after prison. and when prisoners get out, they have no where to go due to our abismal support systems to help them reintegrate back into society, so they usually just end up reoffending. it has an even worse affect on adolescent brains, but prisons still can keep them in solitary confinement too. some people are there for 20+ years?!? that’s absolutely fucking inhumane.
- there were parts in this book where i almost started crying because dr. montross makes all of the prisoners she speaks to into human beings (and they are!!) and she also does a great job at trying to get the reader to empathize with the people trapped in this system. i think it takes a lot for people to think differently about this topic, especially if they don’t have any education in criminology/sociology/psychology or if they’ve had personal experiences with crime in some way. but it really did feel like she was answering every “what if� i had and giving me an answer i could ponder and agree with.
- the other part i loved about this book is when dr montross visits halden, the famous “liberal� prison in norway. i don’t know why anyone would have a problem with anything they do at this prison, it sounds honestly great and could solve MANY of the problems with regular prisons we have now. the fact that the prisoners get their own privacy and can help learn a trade before they get out…enlightening to say the least. it was just such a humane section to read about when the others before it sounded so hopeless. however, could we do this in the states or canada? i unfortunately don’t think we could any time soon because people suck/need to get educated. it’s a nice thought though!
- i am absolutely not an abolitionist, and neither is dr. montross. i think prisons are needed in society, but i also think we need to focus more on rehabilitation and less on control and punishment. i think that alone would help alleviate some of the other societal problems we’ve got going on right now. perfect book for the sociological buff like me! i will likely be talking about this one for months
- first off, dr. montross writes brilliantly and effectively. she’s a psychiatrist first and foremost and she evaluates prisoners� psychological capacities to see if they are able to understand the basic aspects of their case. although she doesn’t have direct experience working in prisons, her journalism that takes place when she visits different prisons around the states and the interviews she conducts are very thoughtful and well researched. i also really enjoyed how she connected her own personal experiences helping mentally ill patients at the hospital.
- the argument that is spelled out in this book is simple: western modern prisons don’t work, especially for the mentally ill, which make up a HUGE chunk of the prison population. in turn, solitary confinement is very very very bad!! like super bad!! it leads to more aggressive behaviour, more mental health issues, more problems with socialization after prison. and when prisoners get out, they have no where to go due to our abismal support systems to help them reintegrate back into society, so they usually just end up reoffending. it has an even worse affect on adolescent brains, but prisons still can keep them in solitary confinement too. some people are there for 20+ years?!? that’s absolutely fucking inhumane.
- there were parts in this book where i almost started crying because dr. montross makes all of the prisoners she speaks to into human beings (and they are!!) and she also does a great job at trying to get the reader to empathize with the people trapped in this system. i think it takes a lot for people to think differently about this topic, especially if they don’t have any education in criminology/sociology/psychology or if they’ve had personal experiences with crime in some way. but it really did feel like she was answering every “what if� i had and giving me an answer i could ponder and agree with.
- the other part i loved about this book is when dr montross visits halden, the famous “liberal� prison in norway. i don’t know why anyone would have a problem with anything they do at this prison, it sounds honestly great and could solve MANY of the problems with regular prisons we have now. the fact that the prisoners get their own privacy and can help learn a trade before they get out…enlightening to say the least. it was just such a humane section to read about when the others before it sounded so hopeless. however, could we do this in the states or canada? i unfortunately don’t think we could any time soon because people suck/need to get educated. it’s a nice thought though!
- i am absolutely not an abolitionist, and neither is dr. montross. i think prisons are needed in society, but i also think we need to focus more on rehabilitation and less on control and punishment. i think that alone would help alleviate some of the other societal problems we’ve got going on right now. perfect book for the sociological buff like me! i will likely be talking about this one for months
This entire review has been hidden because of spoilers.
October 28, 2020
The author, a psychiatrist who has spent time in correctional settings, generally advocates for reforming America's prison systems to better reflect those seen in Nordic countries, such as Norway and Sweden - where those incarcerated undergo a rehabilitative process through something akin to a restorative justice lens. People are generally treated humanely, recidivism rates are some of the lowest in the world, and inmates given greater agency. Montross is not an abolitionist, despite being very critical of the practices used in America's correctional facilities, particularly in juvenile centers and the use of solitary confinement. What she makes evident is that, under the guise of promoting public safety, our correctional facilities punish and 'other'-ize. They do not heal, rehabilitate, or demonstrate faith in the ability for positive human growth and change.
What's lacking in the argument for establishing a Nordic system of incarceration, for one, is the social, cultural, and economic differences between Nordic countries and the United States. We don't offer the same social safety net, and although Montross sort of touches on the strength of these European countries' social services and opportunities, she doesn't really bring that into her argument for the reformation of America's prison systems. Arguably, this is something that does and will need to be addressed - greater investment in preventing crime and violence through addressing their association with determinants such as access to healthcare, housing stability, poverty, education, etc. The work of reforming a punitive system that cages people, shuts them out from the world, and dehumanizes them (within the frame of abolition or not) needs to coincide with movements to dismantle other systems of oppression that perpetuate that violence.
As someone who is critical of the institution of psychiatry in the United States, I also had an issue with some of her conceptualizations of mental illness, effective treatments, and behavior. So it goes. Still, got something out of this, even if I don't fully agree with some of Montross' conclusions.
(NOTE: This review as of 10/27 is literally just a couple key takeaways upon finishing, but does not address all core aspects of the book, including Montross' explanation of the intersection between mental illness and mass incarceration, with roots in the deinstitutionalization movement (I'm a some-pros, some-cons on that myself) and what may very well be considered a criminalization of mental illness. May edit later.)
What's lacking in the argument for establishing a Nordic system of incarceration, for one, is the social, cultural, and economic differences between Nordic countries and the United States. We don't offer the same social safety net, and although Montross sort of touches on the strength of these European countries' social services and opportunities, she doesn't really bring that into her argument for the reformation of America's prison systems. Arguably, this is something that does and will need to be addressed - greater investment in preventing crime and violence through addressing their association with determinants such as access to healthcare, housing stability, poverty, education, etc. The work of reforming a punitive system that cages people, shuts them out from the world, and dehumanizes them (within the frame of abolition or not) needs to coincide with movements to dismantle other systems of oppression that perpetuate that violence.
As someone who is critical of the institution of psychiatry in the United States, I also had an issue with some of her conceptualizations of mental illness, effective treatments, and behavior. So it goes. Still, got something out of this, even if I don't fully agree with some of Montross' conclusions.
(NOTE: This review as of 10/27 is literally just a couple key takeaways upon finishing, but does not address all core aspects of the book, including Montross' explanation of the intersection between mental illness and mass incarceration, with roots in the deinstitutionalization movement (I'm a some-pros, some-cons on that myself) and what may very well be considered a criminalization of mental illness. May edit later.)
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