Waiting for an Echo

April 20, 2020
In this anguished and impeccably researched account, psychiatrist Montross (Falling into the Fire) examines how the American justice system fails to protect, treat, and rehabilitate incarcerated people with mental health issues. Drawing on her experiences conducting competency evaluations for detainees, and visiting numerous prisons around the country, Montross argues that minorities, the impoverished, and the mentally ill are disproportionately targeted for harsher sentences, and that prisoners are too often left to languish in solitary confinement, where sensory deprivation can worsen, or even cause, mental instability. At a juvenile detention center, she learns that teenagers there can be kept for up to a year in solitary—despite studies showing the importance of human contact for the developing brain. Chicago’s Cook County Jail offers a rare glimpse of hope, as Montross sits in on a cognitive behavioral group therapy session where inmates reflect on their pasts in order to process their traumas. In the book’s final section, she offers practical solutions, including changes to the probation and parole systems that would give the formerly incarcerated better resources for getting their lives back on track, and mandatory periodic mental health evaluations for all inmates. This eye-opening call for reform exposes an overlooked crisis in America’s prisons. Agent: Kris Dahl, ICM Partners. (July)Correction: An earlier version of this review incorrectly stated this was the author's first book. It also misstated that the author met a teenager who had spent a year in solitary confinement at a juvenile detention facility.

May 1, 2020
A searing indictment of a system in which far too many people "languish within prisons and jails because of their poverty, their race, their addiction, or their mental illness." Psychiatrist Montross, who is accustomed to treating mentally ill clients in hospital settings, decided to explore what happened to similar people who landed in the American prison system. What she learned was horrifying--and not just for the inmates. Through her firsthand experiences and diligent research, she concludes that everybody in American society--the imprisoned mentally ill, the rest of the prison population, prison staff, police, attorneys, judges, jurors in criminal trials, loved ones in the free world, residents of neighborhoods into which former inmates have been released, and taxpayers whose money pays for punishment instead of rehabilitation--experiences harm from the status quo. Montross divides the book into three parts--"Our Prisoners," "Our Prisons," and "Our Choice"--each undergirded by copious anecdotes involving real people in distress. In the first section, the author explains why so many obviously mentally ill women and men end up in prison. As she notes, most crimes they commit are caused, at least in part, by their mental illness, and prison staff members are woefully unqualified to deal with psychiatric issues effectively. The second section includes chilling case studies of ineffective incarceration, especially regarding solitary confinement. The final section offers some hope, as Montross chronicles her research in Norway, where prisons have drastically lowered recidivism rates by emphasizing human rehabilitation. So why does the U.S. refuse to learn from such success stories? Montross consistently wrestles with that conundrum, but answers are elusive. In conclusion, the author quotes James Baldwin: "Nothing can be changed until it is faced." In this revelatory book, the author faces the problem head-on. Read this and then turn to Jason Hardy's The Second Chance Club to learn more about what happens after inmates are released. Yet another eye-opening, powerful demonstration of the profound structural problems with mass incarceration in the U.S.

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June 1, 2020
Deinstitutionalization of U.S. mental-health facilities drove the nation's mentally ill into the world with few safety nets. The nation's prison system became and continues to be a significant destination for those left out. Psychiatrist Montross' (Falling into the Fire, 2013) exploration of mental illness and its treatment with incarceration challenges assumptions about rehabilitation, especially in light of the use of mechanisms of revenge and punishment, such as isolation and deprivation. Small infractions can escalate a short sentence into years of solitary confinement, and the mentally ill are especially vulnerable. Comparing the therapeutic environment of the hospital where she treats patients to the methods of control in prisons highlights how prisons are not merely neglecting prisoners' mental-health needs, but exacerbating and sometimes creating mental illness. The three parts of her book explore the prisoners, the environments and treatments to which they're subjected, and possible alternatives. Montross' expertise is complemented by extensive research, including her many visits to facilities. The result is a thoughtful, relatable work that humanizes those who are incarcerated and raises crucial questions.(Reprinted with permission of Booklist, copyright 2020, American Library Association.)

August 7, 2020

Through her work as a psychiatrist, determining whether someone is competent enough to stand trial, Montross (Falling into the Fire) found herself returning to one question: Do they belong in a jail or a mental health hospital? This led her to begin researching the history of the U.S. criminal legal system and realizing that the decision--treatment or punishment--was often an arbitrary one. Interviews with correctional officers and others who work in American jails and prisons show examples of people being incarcerated when they should be hospitalized, and how the decline of psychiatric facilities in the late 20th century, combined with a lack of social services, has led to the criminalization of mental illness. Powerful chapters follow Montross to Chicago's Cook County Jail, as well as Northern in CT, meeting people for whom jail or prison is seen as the lone treatment option. According to the author, we have abandoned the goal of rehabilitation--she explains this as she visits prisons in Norway and Sweden, which focus on rehabilitation and reentry, calls for a more humane system in the United States, and reminds us that we have lost empathy for those who are not at the forefront of our thoughts. VERDICT With consideration and compassion, Montross has written a must-read that asks us to consider who our system is leaving behind.--Stephanie Sendaula, Library Journal

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