Not talking about the caucus winner here. Talking about a pair of grass-roots Iowans, my friends Leslie and Scott Carpenter, mental-health advocates who fit every definition of “everyday heroes.”
The parents of a schizophrenia-afflicted son brutalized by our broken treatment systems, Leslie and Scott have carried on a tireless crusade for reform that has extended more than ten years. Often they struggled in obscurity, and against indifference, until the Iowa caucuses brought the Democratic presidential candidates to their doorstep.
Their work in spreading the reform messages directly to the candidates has placed them at the center of a widening national movement to end the many atrocities of our treatment and criminal-justice systems, and the candidates are listening. I will let Leslie pick up the story here, and close by saying that these two luminous people embody the concept of “hope.”
The leading Democratic candidates for president in 2020 have at long last agreed that abolishing this atrocity is an essential part of criminal-justice reform. It is up to us to hold them to their words.
When you hear or read the words “solitary confinement,” what images form in your mind?
A naughty inmate spending some time in a kind of “time out” space wearing a hang-dog expression?
A lonely prisoner in a tiny dark cell gazing at light from the slit of a window, with maybe half a bowl of dirty drinking water at his feet?
A mentally ill man who, after 112 consecutive days of solitary, has just severed his penis with a razor and flushed it down his cell’s toilet?
One of these things is not like the others.
All three images are rooted in the dark dominion of solitary confinement. Only one of them burns through the fog of euphemism and forces a reckoning with a terrible truth—in this case, one of the most perverse, destructive, and unnecessary varieties of soul-murder yet devised by man.
The topic “solitary confinement” has been raised lately (and gingerly, and fleetingly) by several candidates for the 2020 Democratic presidential nomination: raised as an agenda item in their calls for repairing the fissures in America’s criminal-justice system. (Criminal-justice reform is tightly intertwined with reform of our negligent systems of mental healthcare in America.)
The candidates have in turn been influenced—inspired—by the efforts of a bright new coalition of mental-health reform advocates: parents, mostly, spurred to action by the death or deep psychosis of a beloved child. Polite yet unyielding, ferociously informed, they amount to a neo-Dorothea Dix approach to getting justice for the dispossessed.
Iowa is their perfectly chosen beachhead. Not only does the state offer an early concentration of corndog-chewing candidates for them to buttonhole. Iowa City is the home of the turbo-charged advocacy team of Scott and Leslie Carpenter. Armed with an exhaustive five-point bill of particulars for mental healthcare reform compiled by the California advocate DeDe Moon Ranahan, the Carpenters essentially have brought the grass roots onto equal footing with the political elite—on this issue, at least.
But why shine the spotlight on solitary confinement when the justice reform agendas are crowded with so many other “big-ticket” demands? Cutting the U.S. prison population in half comes to mind, as do ending the notorious “cash bail” system that keeps poor young inmates locked up only because they can’t afford otherwise; or tightening up on police oversight; or legalizing marijuana; or abolishing private prisons.
Here is the reason: I sense that of all these important, difficult-to-achieve goals, the abolishing of solitary is among the easiest to bring up and then dismiss: the one most vulnerable to lip service.
And that would be a colossal shame. Stuffing sentient human beings into small, dark, fetid enclosures and leaving them there is about the worst thing it is possible to do to one’s fellow man. The American record for duration in solitary was held by a triple murderer named Thomas Silverstein, who died just last May at age 67. He’d spent more than half his life in isolation.
It borders on the impossible to find shared humanity with a monster like Silverstein. Yet traces of his humanity struggle to declare themselves like green shoots through cracked pavement. “It’s almost more humane to kill someone immediately than it is to intentionally bury a man alive,” he wrote. For one superb writer’s searching attempt, read Pete Earley’s masterful 1992 book, The Hot House: Life Inside Leavenworth Prison.
Or return for a moment to the lost soul who severed his penis with a razor. That would be the mentally ill inmate identified by his initials, J.I., a solitary inmate at Broward County Jail in Fort Lauderdale, Florida. On the night of September 2018, jail guards, alerted by prisoners’ shouting in a lockdown unit, rushed to the scene, where they beheld J.I., his hands and forearms bloody, who told them: “I have a real medical emergency. I just cut my penis off and flushed it down the toilet. I have no need for it anymore.”
J.I., who survived, had sat in solitary for 112 consecutive days. He’d been sent there for yelling at staff members. Records showed that guards had been negligent in monitoring his therapeutic needs. 1
Solitary is patently barbaric; bereft of any use (other than convenience and a lust for inflicting psychic pain). It is a legalized yet likely unconstitutional torture which, I have come to believe, is slightly more heinous even than the death penalty: its victims, while not dead, experience death as their own observers, existing in claustrophobic isolation and silence and darkness and decay, with no definable release awaiting them.
And so in order to tolerate it as public policy or even as a thought, some self-anesthetizing helps. (Those charged with actually imposing it on human beings presumably develop tougher psychic scar tissue.) “Solitary confinement” is a term useful for the necessary numbing: an abstraction, one of those “Orwellian” constructions that serve more to camouflage than to evoke their full, and usually terrifying implications.
That very abstraction is dangerous. It can too easily lead to evaporation.
This blog, then, is a plea to those presidential candidates who have made the abolition of solitary confinement a part of their criminal-justice reform demands: Do not let this happen. Honor the constituency that has materialized in Iowa and exists throughout the nation. Keep this issue alive.
In subsequent blogs I will trace the peculiar origins of solitary confinement in America, and will look into some of the lesser-known forms of its use—for example, as an instrument of control for juvenile inmates and even schoolchildren.
I will close this blog with a soaring testimony of hope, resilience, faith, and self-reclamation written by a former criminal and solitary inmate named Thomas Tarrants, and published in the August 19 edition of Christianity Today.2 It was sent to me by my friend, the literary scholar Harold K. Bush of St. Louis University. Thank you, amigo.
Two mobilizations of historic enlightened reform are abruptly converging in American politics and policy. Their aims are intertwined: to bulldoze and rebuild our blighted structures of criminal justice, and to reclaim our dispossessed mentally ill brothers and sisters from the hellscape of danger, pain, and early death that the blight of justice confers on them. And the economic drain that it exacts from all of us.
The symbiotic forces are (1) the elite tier of progressive candidates for the 2020 presidential election, and (2) the sleeves-up cadre of activists working at Ground Zero who toil because they daily confront serious mental illness up close, and witness its effects for what they are: cancers upon our societal health and sense of decency.
(The first of two parts)
At first glance, justice and mental-healthcare reform may seem but a marginal sliver of all the issues pressing in on America in the 2020 elections. (The physical salvation of the planet comes to mind, and abolishing the immigrant gulags at our southern border.)
This is a distorted, damaging perception, made more dangerous because the crisis is so easily concealed. It can sometimes seem as though insanity and incarceration are like two undersea predators, their tentacles wrapped around each other in a death-struggle of futility. The quality of courts, jails, and prisons has been weakened by years of tending people who should be under psychiatric care. The essentially helpless 11.2 million seriously mentally ill population in turn is vulnerable to suffocation in the folds of feckless court rulings and inhumane treatment behind bars, including deprivation of essential meds and the beckoning maw of solitary confinement (about which more—much more—later.) The one in five adults with less chronic afflictions—nearly 47 million—are within range of the tentacles as well.
Yet that perception, or lack of perception, prevails. It prevails because to open our eyes to the full truth of these abominations is to risk scorching the soul. “I’ll do what little I can in writing,” lamented the great James Agee in another, and again oddly similar context some 75 years ago. “Only it will be very little. I’m not capable of it; and if I were, you would not go near it at all. For if you did, you would hardly bear to live.”
Thus we banish the ghastly effects from our attention as “normal” Americans, until it is too late. The entwined crises strike quickly, and from nowhere, and spread ruin: in households and communities (black and poor ones especially), in the workplace, in public places, in our economic state, and in the less tangible spheres of our collective optimism, hope, and peace of mind.
America has needed an “intervention” for more than two centuries. Intervention seems, at last, to be on its way.
The most ambitious manifestos, in my unscientific reckoning, were issued within the last ten days by Senators Bernie Sanders and Elizabeth Warren and South Bend, Indiana Mayor Peter Buttigieg. Nearly as powerful were the earlier justice reform announcements of Cory Booker, Amy Klobuchar, and Julian Castro. Joe Biden and Kamala Harris submitted strong, if not notably comprehensive, reform ideas.
This ranking hierarchy is not as fixed as the tiers might imply. The eight plans are far more significant for their overlapping reform goals they stress than for their differences.
Slashing into federal prison glut is high on most lists. Sanders, Warren and Buttigieg unveiled proposals that would cut into mass-incarceration, each by roughly 50 percent: by reducing long sentences, ending the “cash bail” system that pauperizes poor families of those arrested, tightening up on police oversight, legalizing marijuana, and abolishing private prisons. Sanders’s document, at 6000 words, is by far the most minutely detailed. Warren would go after policies that “criminalize” homelessness, poverty, and mental health problems (critically, she has not elaborated on this last). Booker would scale back inmate numbers via a clemency program that would free many elderly inmates under the theory that criminals “age out” of their impulses to commit violent crimes. Klobuchar also embraces clemency via a restructured reform plan and would modify the “tough-on-crime” stances she held as a prosecutor in Minnesota.
Castro’s vision is likewise far-ranging, but he places special emphasis upon overhauling violent and clueless behavior of policemen. He wants to curb the use of force, end stop-and-frisk, holding police more accountable for misconduct, and restoring trust among police and the communities they are sworn to protect.
As for Biden and Harris, their reform plans are similarly comprehensive and replicate the bold ideas of their rivals as listed above. Both candidates—and to some extent Klobuchar as well—are preoccupied with freeing themselves from the taint of the “tough-on-crime” stances that they adopted in the mid-1990s.
That is my personal survey, unfairly truncated perhaps, of the generally ground-breaking flurry of criminal-justice reform ideas released by eight of the leading progressive presidential candidates.
An obvious but important caveat: none of these audacious ideas will tap-dance its way into law or policy should its sponsor get elected. (The proto-autocrat decrees of our current incumbent might lull some into that assumption.) A new chief executive will need to inspire the House and Senate to a pitch of pro-active fervor not seen since the First Hundred Days of Franklin D. Roosevelt’s presidency when the New Deal took form in a blizzard of “relief, recovery, and reform.” For our present stumbling and divided Congress to suddenly sprout capes, masks, and flippers and get busy cleaning out the present rot may seem a stretch. Yet things can happen quickly, as the last midterms showed, and a whiff of activism does linger in the air.
With all this in mind, let us turn to the symbiotic manifesto that has arisen from those ordinary heroes at Ground Zero: “Grassroots 2020: A 5-Part Plan for Mental Illness SMI.”
Grassroots: 2020 has been personally distributed to visiting Democratic candidates or mailed to their offices by Leslie and Scott Carpenter of Council Bluffs, Iowa. The Carpenters’ tireless work has helped join the reformist trajectories of these politicians and the people.
I lay it out below with minimal editing, in summary form. You will note that each part of the plan delineates action that a president can undertake, sometimes independently of Congress. And unlike the candidates’ ideas above, Grassroots: 2020 addresses justice-reform issues (incarceration-trimming, for example) only incidentally. It focuses on existing rules, many of them arcane to the non-specialist, that nonetheless have caused decades of frustration and despair for those struggling to reclaim their afflicted loved ones from a decayed system:
A FIVE-PART PLAN TO ADDRESS SERIOUS MENTAL ILLNESS (SMI) 2020 PRESIDENTIAL CANDIDATES. PLEASE ADDRESS THESE TOPICS IN YOUR CAMPAIGN APPEARANCES AND DEBATES:
1. RECLASSIFY SERIOUS MENTAL ILLNESS (SMI) FROM A BEHAVIORAL CONDITION TO WHAT IT IS – A NEUROLOGICAL MEDICAL CONDITION
WHY RECLASSIFICATION IS IMPORTANT:
Re-classification will unlock more research funding and help eliminate discrimination in treatment, insurance reimbursement, and the perception of SMI as a “behavioral” condition. SMI is a human rights issue. The National Institutes of Mental Health ranks SMI among the top 15 causes of disability worldwide with an average lifespan reduction of 28 years.
• Create a cabinet position exclusively focused on SMI. • Push for Congressional appropriations to include schizophrenia in a CDC2 program that collects data on the prevalence and risk factors of neurological conditions in the U.S. population.
2. REFORM THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)3
WHY HIPAA REFORM IS IMPORTANT
Overly strict HIPAA laws make it extremely difficult for families and caregivers to partner in the treatment of their loved ones, resulting in important life-saving medical information gaps. By eliminating this barrier, family support will be strengthened, reducing the chance of relapse, homelessness, imprisonment, and death.
Work with legislators to change HIPAA law to ensure mental health professionals are legally permitted to share and receive critical diagnostic criteria and treatment information with/from parents or caregivers of SMI.
3. REPEAL MEDICAID’S INSTITUTES FOR MENTAL DISEASE EXCLUSION (IMD).
WHY IMD REPEAL IS IMPORTANT:
The Medicaid IMD Exclusion prohibits Medicaid payments to states for those receiving psychiatric care in facilities with more than 16 beds for those in the 21-65 age group. This demographic represents the majority of SMI cases. Repeal of the IMD Exclusion will increase the availability of acute care, inpatient psychiatric beds. The IMD exclusion not only discriminates against those suffering from neurological brain disorders, it’s a leading cause of our national psychiatric hospital bed shortage.
• Work with legislators to repeal the IMD exclusion.
4. PROVIDE A FULL CONTINUUM OF CARE FOR THOSE WITH SMI
WHY A FULL CONTINUUM OF CARE IS IMPORTANT:
A continuum of care insures that SMI patients receive early intervention at all stages of their illnesses, long-term care when needed, and follow-up treatment (medications and therapies) when they’re released. Providing a continuum of care reduces: incarcerations, emergency rooms visits, homelessness, and death. A continuum of care provides life-time management that permits a patient to move without penalty from one level of care to another as needed.
• Create federal incentives to states which are addressing a full array of inpatient, outpatient, and supportive housing care.
5. DECRIMINALIZE SERIOUS MENTAL ILLNESS (SMI)
WHY DECRIMINALIZATION OF SMI IS IMPORTANT:
People suffering with other neurological conditions like Alzheimer’s and dementia can get treatment promptly without being kicked out of their homes to wander the streets until they are arrested and put in jail or prison rather than a hospital. Serious mental illness is the only disease where the doors to treatment are shut unless a crime is committed. This is pure and simple discrimination with the disastrous results we see in our country today — homelessness, incarceration, the disintegration of families, and death.
• Work with legislators to change “must be a danger to self or others” criteria. • Work with legislators to change involuntary commitment criteria, alleviating the subjective nature of “gravely disabled” and redefining it in objective terms based on scientific medical need for treatment. Psychosis, like a stroke, is a traumatic brain injury and needs immediate treatment for the best outcome.
Returning to the candidates’ manifestos, I have omitted two demands that show up in most of them, yet are given no more than lip-service by none except Bernie Sanders: abolishing capital punishment and solitary confinement. Both are urgent. Deciding which is the most urgent depends, I guess, upon the morbid calculation of whether continued existence in the “hole,” with its barbaric history of destroying human personality, is worth the torture. I have felt my way to an agonizing decision. In my next blog I will urge the candidates to meditate on solitary confinement for exactly what it is, and to treat it as primary target for abolishment.