Chris Uggen's Blog: January 2013

Tuesday, January 22, 2013

mental health and second chances

Today's post is coauthored with Jason Schnittker for the Robert Wood Johnson Foundation Human Capital blog

More than 650,000 inmates are released from prison every year.[i]  Although their debt to society may be paid, their struggles have just begun.  Reentry is not easy.  Former inmates need to find a place to live.  They need to find a job.  And many need to support families.  All told, 4 million people in the U.S. are dealing with the “mark” of a prison record and its consequences for their work and personal lives.[ii]  Most will struggle for years following their release.

Given all these difficulties, it’s hard to imagine health being a major part of their struggle.  After all, many former inmates are still quite young and, for that reason, unlikely to suffer from major health problems.  Mental health is part of the picture, but usually considered through a different lens:  policy-makers ask how mental illness affects criminal offending—that is, what leads to prison in the first place—but rarely consider the pivotal role of mental health in making a successful return to the community.

Yet the role of mental illness is just as relevant after release as before.[iii]

Many former inmates suffer from poor mental health.  And these problems often get worse following release, given the many disadvantages they face.  Former inmates suffer from many of the same disorders as other people, including depression and anxiety, albeit at higher rates. We know that substance disorders and psychosis are related to criminal offending, but former inmates suffer from mood and anxiety disorders too, and these conditions have received far less attention.  Our own research suggests that depression plays an especially powerful role in shaping the reentry prospects of former inmates.[iv]

Insofar as we demand that former inmates become productive and responsible members of society, we may need to provide them with a little more help.  Reintegration requires persistence, motivation, and a strong social network, all of which are undermined by mental health problems.  Mood and anxiety disorders, in particular, can rob individuals of motivation and initiative and undermine their relationships.  Psychosis and substance abuse are, of course, important as well, especially in preventing new offending.  But good health is more than the absence of these particular conditions, just as reintegration is more than the absence of particular criminal behaviors. Reintegration also implies successful adjustment to challenging work and family situations -- and good overall health fortifies us all in meeting such challenges.

To date, enthusiasm for better mental health treatment among former inmates has been limited.  From a cost-benefit perspective, the role of treatment in reducing crime is inconclusive.[v]  But evidence on the effectiveness of mental health treatment for other outcomes, including employment, is more favorable.[vi]  The Affordable Care Act will help.[vii]  A robust safety net of low cost service providers will help too.  But true reform requires something more ambitious:  the recognition that good health is a precondition to getting back on your feet.

i. http://www.justice.gov/archive/fbci/progmenu_reentry.html
ii. http://www.soc.umn.edu/~uggen/Uggen_Manza_Thompson_ANNALS_06.pdf
iii. http://www.urban.org/publications/411617.html
iv. http://hsb.sagepub.com/content/53/4/448.full
v. http://www.nber.org/papers/w15858
vi. http://www.jstor.org/stable/3768328?seq=1
vii. http://content.healthaffairs.org/content/31/5/931

Jason Schnittker, PhD, and Chris Uggen, PhD, both recipients of Robert Wood Johnson Foundation (RWJF) Investigator Awards in Health Policy Research, recently published a study in the Journal of Health and Social Behavior on incarceration and psychiatric disorders. They found that incarceration increases the risk of mood disorders after release and that these disorders increase disability. Schnittker is an associate professor in the Department of Sociology at the University of Pennsylvania. Uggen is the Distinguished McKnight Professor in the Department of Sociology at the University of Minnesota.

Tuesday, January 08, 2013

somewhere between jedi and jackhole

People have varying reactions to my research presentations, only some of which involve projectiles hurtling toward the lectern. The most memorable positive response came more than a decade ago. As soon as I finished speaking, a woman stepped quickly to the podium and looked me right in the eye, saying, “You’re like a Jedi!” Now, maybe her reaction had something to do with my tunic and belt pouch (I kid, I kid…), but it just so happens that I was feeling clear and good and true about the work I was presenting. If only for this one presentation of a single research study, I felt like I was firing on all cylinders as a social scientist, taking apart a problem and putting it back together in a smart and useful way.

No one has called me a Jedi since (or, if you prefer, “called me a Jedi since, no one has, hmm?”). Though I did not realize it at the time, that sort of clarity and focus does not come along every day – at least not in my career. As we start a brand new year and a fresh semester down at the brain mill, I’d like to challenge myself to do more of this kind of teaching and research and less of the other kind of teaching and research. The trick is that good and true science (and art) simultaneously demands both the self-confidence to think differently and the selflessness to set aside one’s personal interests and prejudices, however temporarily, in pursuit of some higher ideal. I say “temporarily” because eventually the world outside our labs, offices, or studios always creeps back in -- and with it, our vanity and insecurity.


Undue praise, for example, seems to upend the delicate balance of confidence and selflessness, such that being called a Jedi is likely to turn one into a complete Jackhole instead – arrogant, self-serving, and unmoored from all manner of higher ideals. I witnessed a few Jackholes while hanging backstage as a music writer and, truth be told, hanging at professional meetings as an academic. Left unchecked, or perhaps stoked by undue criticism, the Jackhole can quickly degenerate into the more destructive narcissism of the Common Bully, whose envy or resentment is manifest in cruelty. A fourth possibility is the absence of both confidence and selfishness, which I’d characterize (and recognize) as the sad state of Weeniedom. The weenie is neither beating up on anybody nor making any of the sorts of waves one must make to do good work. 

I know that the world is much more complicated than a two-by-two table would suggest, much less a graphic that is loaded with such loaded terms. But sometimes such images can be helpful in personal mojo reclamation projects and some of us have indeed visited all four of its quadrants. Just as Jamey Johnson wants to be filed somewhere between Jennings and Jones, I'd happily reside somewhere between Jedi and Jackhole.