COVID-19 has rapidly upended the normal state of affairs in the United States and around the world. While the virus may not discriminate when choosing a host, the United States certainly does discriminate when rolling out protections and services. Attention has repeatedly been called to how this crisis adversely affects inmates in US jails and prisons. Riker’s Island in New York currently has the highest rate of infection in the country—3.91% compared to New York City’s 0.5%—and its inmates are being paid $6 an hour to dig their own mass graves.
This is the nightmare scenario. The coronavirus pandemic has occasioned a crisis in American mass incarceration, revealing its flaws and inhumanity. Jails and prisons are so rife with the virus because they force masses of people to live in small, confined, and often filthy spaces. The virus only reveals that brutal reality.
But wherever a crisis forces open a rift, possibility also dwells: as we begin to recognize the flaws inherent to our penal system, we also have the opportunity to make changes. Things deemed impossible just a month ago have become a reality in short order: jails are releasing non-violent offenders, others are setting $0 bails, while others are forgiving petty probation violations like drinking alcohol or leaving a state.
The speed and breadth of these adaptations reveal above all that the criminal justice system’s claims of inflexibility and overwhelming rigidity have been overstated. Unnecessary suffering could be lifted; the world won’t end because the judge let the poor person who can’t afford a $200 bail walk instead of sent him to jail.
In comparison, other nation-wide networks of coercive confinement connected with health administration, like psychiatric commitments and group homes, have received little attention. How has COVID-19 forced psychiatric hospitals and treatment centers to change? While private psychiatric practice has largely moved to tele-health options and some inpatient facilities have been converted into extra beds for the coming surge in virus patients, psychiatric commitments continue in many states.
Just like jails, psychiatric hospitals and treatment centers in Washington, Michigan, New Jersey, New York, and Louisiana have seen major outbreaks of the virus, revealing, in similar fashion, the health dangers inherent to forcing large groups of strangers to sleep and eat in close quarters. The risk of exposure for staff is likewise not negligible, but they ultimately have the choice—at the risk of losing work in some cases—to not work in unsafe conditions or to go on strike. Patients do not share this luxury.
Additionally, while it is generally staff who contract the virus and introduce it into such facilities (since the patients can’t leave), it’s the patients who must deal with the fallout. Michigan psychiatric hospitals have rescinded visitation rights and sent patients to isolation. Authorities in Vermont have seized the Woodside Juvenile Rehabilitation Center and intend to use it as a separate holding site for psychiatric patients with COVID-19, despite concerns that the space is too small and confined.
In the Trenton Psychiatric Hospital in New Jersey, four patients died as a result of COVID-19. In an article for the Trentonian, the staff would have you believe this is basically their fault: one former staffer said of a man who died that “If anyone would be killed by virus I would think he would be a prime candidate” because “he was a heavy smoker for years.” There’s something wrong with this picture. We all know smoking is damaging to your health, but this man did not choose be exposed to dozens of others with a deadly virus, which in this case was something entirely outside of his control. The attitude expressed here (and implied in the other cases) blames involuntary inmates for their own deaths, while the policies above ultimately punish the suffering for a problem brought about by conditions they did not choose.
The situation only gets worse at the for-profit institutions. In Detroit, a staff member at the 162-bed private, for-profit psychiatric facility StoneCrest Center said in his interview that “unfortunately, we’re for-profit. So we need to keep these beds filled. Otherwise, we can’t stay open as a facility.” If they insist on staying open, the administration is faced with the cruel alternative of either exposing 162 patients and their staff to a deadly virus, or locking down patients and closing group spaces. Death or misery.
A for-profit psychiatric facility cannot structurally be invested in changing the conditions that led to patients ending up on their doorstep. They wouldn’t make money if these things change. In a crisis like this pandemic, their drive to make money by any means necessary appears in its true form: as a fatal and flippant self-serving impulse, content on letting others suffer and die in the name of profit.
Psychiatrists, on their part, are doing their best to disseminate the message that the fear and worry caused by a global pandemic are expressions of medical conditions like depression and anxiety and are currently gearing up to welcome a new influx of patients once the first wave dies down. The smart ones are quickly adapting to tele-therapeutic options and new biometric distance surveillance options like apps that feed them information on patients’ heart rates and sleeping patterns. This is perhaps the most dangerous development of all.
I, like many others, am struggling day-by-day to comprehend the intensity of the information coming in, the news of widespread deaths, the further entrenchment of America’s racial and class disparities in health care. The stress caused by COVID-19 is very real, but medicalizing the issue suggests that the United States will settle on handling this stress as a symptom of a medical problem solvable with therapy or profitable drugs, rather than as a political problem that demands political action here and now.
In the wake of COVID-19, it ought to be more clear than ever that no amount of drugs will lift people out of poverty; tele-therapy for a prisoner in a solitary cell only creates the possibility he will bear a miserable existence long enough to die of old age rather than suicide.
The terror of COVID-19 lies first in its capacity to kill the elderly and sick, but a second terror appears in its ability to reveal the cruelties and disparities that persist around us. If the jails opened tomorrow and every poor person was relieved of the stress of how to pay for rent or figuring out where they would sleep tonight, I can all but guarantee that the worryingly increasing rates of suicide in this country would drop rapidly. This crisis has revealed that such actions are not the impossible pipe dreams of a handful of utopians, but real possibilities.
At every turn, it is imperative we point out the fault lines the novel coronavirus is revealing in American society. If we fail to do this, we will return to the world that made it many degrees more deadly and frightening for the inmates, the sick, and the vulnerable.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.