When Prison and Mental Illness ‘Are a Death Sentence’

May 7, 2024

By Courtney Wise

Plus, one Iowa-based grocery store chain launches a mental health campaign with the potential for far reach. And another reason pets can be good for your mental health.

---

For Markus Johnson and other mentally ill inmates, prison can be deadly

Markus Johnson was just 21 years old when he died in the custody of the Illinois state prison system. Rather than adequately treat his diagnoses of schizophrenia and bipolar disorder, officials with Wexford Health Sources, a for-profit health care contractor in Illinois prisons, “documented [Johnson] to death,” his lawyers told The New York Times. They kept a record of his progress, or lack of it, but failed to give him the care he needed for his mental illness.

In a story called “When Prison and Mental Illness Can Be a Death Sentence,” the Times recounts Johnson’s untimely demise. Johnson appeared stable the day he arrived for prison intake in 2018 for gun possession. He’d made some bad choices to get himself there, motivated by the desire to belong. But he hoped to learn some new work skills while incarcerated. And his public defender was able to get him a sentence that would see him home by January 2020. 

The Times reports that prisons and jails are severely short on clinical staff to treat the serious mental health conditions many incarcerated people face. In this case, Johnson’s family says that after the loss of his grandmother in early 2019, he spiraled. He stopped taking his medications, stopped eating, and eventually stopped drinking water. Staff barely took action, even up until the day he died. A concerned staff member asked for medical tests, but Johnson, severely dehydrated and too weak to stand or follow instructions, was pepper-sprayed by guards when he could hardly move. After trying unsuccessfully to get his vitals, the staff called for medical help as he fell unconscious; Johnson died shortly afterward. The cause of death, the prison said, was cardiac arrest.

His mother has since filed a wrongful-death lawsuit, arguing Wexford and correctional staff not only repeatedly failed to transfer Johnson to a facility better equipped to treat his mental health needs, the people responsible for his care juggled a handful of “missteps, missed opportunities, potential breaches of protocol and, at times, lapses in common sense.”

Johnson’s experience underscores the systemic nature of the problem with prisons being the largest providers of mental health care: They’re simply not equipped to serve the needs of people with mental illness. Making matters worse, it’s a perpetual problem, exacerbated by high staff turnover, stressful working conditions, and insufficient resources.

---

Grieving the death of a loved one while continents away

At just 19 years old, Amrita Chavan traveled across continents to pursue higher education. The opportunity was a source of pride for the whole family. Many of her relatives even visited the airport to lovingly send her off, but “with no idea what it meant to leave home,” she told Yes! Magazine. While away, she missed her family but could have never prepared for the loss of her grandmother 12 years later in early 2020. Worse yet, she couldn’t rush to her family’s side. The plane ticket from Canada to Australia was just too expensive. Weeks later, we’d all be driven inside by the pandemic. Chavan emotionally shut down. “I felt very frozen for a very long time,” she said. 

Chavan’s experience is shared by many immigrants in their homes away from home, with experts calling it “transnational grief.” It differs from traditional grief by adding layers of guilt, denial, and suffering as one is unable to attend the typical shared rituals associated with loss. “I did not feel like I had permission to grieve, because I had not been there,” Chavan said. Not seeing the deceased loved one further complicates closure with the loss. COVID-19 deepened this reality for many immigrants, while forced isolation made it real for relatives in the same town. “It’s a chapter with no ending, and it remains unfinished,” one immigrant man said, highlighting the challenge and burden of carrying grief alone. It also speaks to the need to create policy that would help people, immigrants especially, who grieve from afar. 

In the meantime, researchers and sociologists stress the need for supportive communities and the creation of personal rituals to help process grief from a distance. Some comforting actions include journaling, creative writing, eating a loved one’s favorite meal, or even participating in their favorite activity. But place reasonable expectations on yourself, said psychologist Gabriela Encina. It takes time to not only make peace with a loved one’s death, but also to indulge in their favorite things. 

The article points to the need for a shift in how our culture thinks about immigration and loss. Considering that it can take years for an undocumented immigrant to become a legal, permanent resident of the US, even traveling back home once to be with family feels like a waiting game, said Kristina Fullerton Rico, a sociologist at the University of Michigan’s Center of Racial Justice. “If we pass laws that prioritize a fast path to citizenship, we could avoid having people go through these experiences,” she said. In addition, paid bereavement leave would support grievers by providing them much needed time off without the worry of severe income loss, or worse, losing their job. 

---

A year after the launch of Chicago’s ‘Treatment Not Trauma’ plan, critics call for more progress

With nearly one year as mayor under his belt, Mayor Johnson has been peppered for updates on his ambitious plan for mental health treatment. Called ‘Treatment Not Trauma,’ the initiative is intended to overhaul a system in which shuttered clinics and difficulty accessing treatment were a hallmark. Johnson has even pointed to his own brother’s struggles with mental illness to emphasize his commitment to systemic change in the treatment of the city’s mentally ill. But, having seen little in the way of change so far, some critics told the Chicago Tribute they’d like to see more. 

“I think it’s quite disappointing to all of us that a year into this administration, that even on the campaign stage held up Treatment Not Trauma as one of its core priorities, we still haven’t made any steps forward,”  said Eric Reinhart, a public health, law and psychiatry anthropologist and physician who co-wrote a white paper that pushed for the policy. “Everybody’s getting a working group, but where are we seeing implementation?” But Reinhart’s co-author, Arturo Carrillo, disagrees. A social worker by trade, Carrillo said, “It’s almost like we are playing catch up. This should have been started four years ago—under the last administration. We were constantly being told no, we were constantly seeing barriers put up. [There was] complete resistance to any input. Now we absolutely see the wheels of government moving.” 

Johnson’s 2024 budget does include funding to improve non-police emergency responses and plans to reopen some previously closed mental health clinics. However, the broader implementation, including the deployment of non-professional community care workers and the expansion of non-clinical support services, remains uncertain.

---

In other news…

Credit: Shutterstock

Pets can make us feel better when we’re down.  Scientists who spoke to the Seattle Times couldn’t exactly explain why pets make us feel so much better, although many studies suggest that pets can help improve one’s mental health. The Times found that dogs not only offer companionship to those struggling with loneliness, they also provide an easy pathway to community with other dog lovers. Becky Farwell said her dog, Bodhi, helped her get out of the house after a series of foot surgeries. “I discovered I’m nobody without Bodhi,” she said. Bodhi calms her nerves, so she sometimes brings him on first dates. “You can talk about the dog right away, and that’s a good icebreaker.” (See also MindSite News’ newsletter and story on how dogs (and cats) can improve your mental health.)

Hy-Vee, a grocery chain in Iowa, launches a video series to raise awareness about mental health. The four-part series, A Holistic Approach to Improving Mental Health is hosted by Hy-Vee’s  chief medical officer Daniel Fick and offers viewers patients on methods of managing their mental health. The landing page where the videos sit also includes information about other resources to support mental wellness, including at-home workouts for adults and children. 

---

If you or someone you know is in crisis or experiencing suicidal thoughts, call or text 988 to reach the 988 Suicide & Crisis Lifeline and connect in English or Spanish. If you’re a veteran press 1. If you’re deaf or hard of hearing dial 711, then 988. Services are free and available 24/7.

---