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.

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.

I’ve been reluctant to write about the terrible events at Sandy Hook Elementary School because the wounds are still too fresh for any kind of dispassionate analysis. As a social scientist, however, I’m disappointed by the fear-mongering and selective presentations of the research evidence I’ve read in reports and op-eds about Friday’s awful killing.

Such events could help move us toward constructive actions that will result in a safer and more just world — or they could push us toward counter-productive and costly actions that simply respond to the particulars of the last horrific event. I will make the case that a narrow focus on stopping mass shootings is less likely to produce beneficial changes than a broader-based effort to reduce homicide and other violence. We can and should take steps to prevent mass shootings, of course, but these rare and terrible crimes are like rare and terrible diseases — and a strategy to address them is best considered within the context of more common and deadlier threats to population health. Five points:

1. The focus on mass shootings obscures over 99 percent of homicide victims and offenders in the United States. The numbers should not matter to parents who must bury their children, but they are important if policy makers are truly committed to reducing violent deaths. There are typically about 25 mass shootings and 100 victims each year in the United States (and, despite headlines to the contrary, mass shootings have not increased over the past twenty years). These are high numbers by international standards, but they pale relative to the total number of killings – about 14,612 victims and 14,548 offenders in 2011. In recent years, the mass shooters have represented less than two-tenths of 1 percent of the total offenders, while the victims have represented less than one percent of the total homicide victims in any given year. We are understandably moved by the innocence of the Sandy Hook children, but we should also be moved by scores of other victims who are no less innocent. There were 646 murder victims aged 12 or younger  in the United States in 2011 alone — far more than all the adults and children that died as a result of mass shootings.

2. The focus on mass shootings leads to unproductive arguments about whether imposing sensible gun controls would have deterred the undeterrable. As gun advocates are quick to point out, many of the perpetrators in mass shootings had no “disqualifying” history of crime or mental disorder that would have prevented them from obtaining weapons. And, the most highly motivated offenders are often able to secure weapons illegally. Even if such actions do little to stop mass shootings, however, implementing common-sense controls such as “turning off the faucet” on high capacity assault weapons, tightening up background checks, and closely monitoring sales at gun shows are prudent public policy. But the vast majority of firearms used in murders are simple handguns. I would expect the no-brainer controls mentioned above to have a modest but meaningful effect, but we will need to go farther to have anything more than an incremental effect on mass shootings and gun violence more generally.

3. The focus on mass shootings obscures the real progress made in reducing the high rates of violence in the United States. I heard one commentator suggest that America had finally “hit bottom” regarding violence. Well, this is true in a sense — we actually hit bottom twenty years ago. The United States remains a violent nation, but we are far less violent today than we were in the early 1990s. Homicide rates have dropped by 60 percent and the percentage of children annually exposed to violence in their households has fallen by 69 percent since 1993. We can and should do better, of course, but these are not the worst of times.

4. The focus on mass shootings exaggerates the relatively modest correlation between mental illness and violence. Those who plan and execute mass shootings may indeed have severe mental health problems, though it is difficult to say much more with certainty or specificity because of the small number of cases in which a shooter survives to be examined. We do know, however, that the correlation between severe mental illness and more common forms of violence is much lower — and that many types of mental health problems are not associated with violence at all.

5. The focus on mass shootings leads to high-security solutions of questionable efficacy. Any parent who has attempted to drop off a kid’s backpack knows that security measures are well in place in many schools. Rates of school crime continue to fall, such that schools are today among the safest places for children to spend so many of their waking hours. In 2008-2009, for example, only 17 of the 1,579 homicides of youth ages 5-18 occurred when students were at school, on the way to school, or at school-associated events. Of course we want to eliminate any possibility of children being hurt or killed at school, but even a 2 percent reduction in child homicide victimization outside of schools would save more lives than a 90 percent reduction in school-associated child homicide victimization. While every school must plan for terrible disasters in hopes that such plans will never be implemented, outsized investments in security personnel and technology are unlikely to serve our schools or our kids.

In the aftermath of so many deaths I am neither so cynical as to suggest that nothing will change nor so idealistic as to suggest that radical reform is imminent. I’m just hoping that the policy moves we make will address our all-too-common horrors as well as the rare and terrible events of the past week.

from CNN (take 3 minutes to watch the video if you have a chance):

Robbie Parker has a message for the family of the gunman who killed his 6-year-old daughter and 19 of her school mates.

“I can’t imagine how hard this experience must be for you, and I want you to know that our family and our love and our support goes out to you as well,” Parker said, as he remembered his oldest girl, Emilie Alice.

Emilie died Friday at the hands of a gunman who opened fire at her elementary school in Newtown, Connecticut, in the second deadliest school shooting in U.S. history…

Fighting back tears with his voice cracking, Parker asked Saturday night that the tragedy “not turn into something that defines us, but something that inspires us to be better, to be more compassionate and more humble people.”

In Oregon, an 11-year-old boy is being arraigned on allegations of first- and second-degree robbery and unlawful use of a firearm.  His accomplice was a 7-year-old boy.

The Oregonian reports:

Police said the 11-year-old was armed with a loaded .22-caliber derringer and threatened Amy Garrett, 22, in her pickup while she was parked at Freedom Foursquare Church about noon Saturday. Garrett said the 11-year-old and a 7-year-old boy, carrying a backpack with bullets, demanded her pickup, then money and her phone.

The boy’s father was charged with a relatively new law that makes it a crime to leave a gun unsecured and within reach of a child.  The father is a convicted felon, and he has had two child neglect and abuse complaints filed against him in the last year.  The 11-year-old boy and his two younger siblings were taken into protective custody.

A neighbor claimed to have called police several times over the past 18 months with complaints about vandalism and trespassing involving the then 10-year-old boy.  The young age of the attempted carjacker and his relatively long history of contact with police brings to mind the case of Nathaniel Abraham; Abraham was given a real opportunity when he was sentenced as a juvenile; unfortunately, he seems to be struggling in prison as an adult.

But back to the current situation with an 11-year-old boy facing first- and second-degree robbery and weapons charges.   What a strange and sad case!  What in the world would an 11-year-old do if his victim had surrendered her vehicle?  Would he have attempted to drive it off?  To where and to what end? And, what are the circumstances of his 7-year-old accomplice?  The boys are not related and police have not take action against the 7-year-old.

What do you think should be done in this case?  What would be an appropriate response?

Edit, Dec. 13: here is a follow up to this story.

When you take a course of antibiotics to zap a bacterial infection, you can also lay waste to a lot of healthy bacteria that your body really needs. And once you’ve wiped out the healthy flora in your gut, you’re vulnerable to nasty bacteria such as Clostridium Difficile, which brings symptoms ranging from severe diarrhea to life-threatening colon problems. Though I’m skeptical-bordering-on-terrified of organicist arguments in sociology, hearing a talk by Minnversity colleague Mike Sadowsky on “C. diff.” brought some parallels in social research to mind. Before proceeding, I should acknowledge the obvious “ick factor” in this post, but bear with me a moment.

As Dr. Sadowsky explained, one successful treatment for recurrent C. diff infections involves fecal transplantation – essentially implanting a donor’s stool sample in a recipient to repopulate the healthy colonic flora and restore bacterial balance. Within a very short time, the donor’s gut flora is typically brought back to healthy equilibrium. Now that might sound icky (even when said sample is freeze-dried), but it is way less icky than surgical treatments like colectomy. What really got me thinking was my colleague’s big-picture conclusion that much of the past century of U.S. research in this area had been devoted to isolating and zapping the bacterial delinquents, while much of the next century seems devoted to restoring the whole to healthy balance. And, if I understand things correctly, it turns out that the latter approach is actually a lot simpler than specifying, modeling, and manipulating the complex interactions among myriad bacteria that may be “good” or “bad” depending on the particular combination and circumstance.

Of course, certain Ghosts of Sociology Past, Present, and Future think about societies in quite similar ways. No, people aren’t bacteria and communities aren’t intestines, but you don’t have to be a functionalist or an organicist to draw some basic analogies. For example, as William Julius Wilson points out, it is the social isolation of the urban poor that exacerbates the challenge of redressing imbalances and (re)building the institutions needed for basic community functioning. More generally, social interventions, like medical interventions, sometimes bring their own pathologies or iatrogenic effects. Like the overprescription of antibiotics behind the apparent C. diff epidemic, the grand American experiment with racialized mass incarceration, has had untold effects on individuals, families, and communities that are only now coming into focus.

I won’t speculate here about how to restore social systems to healthy balance, but some of us try to at least consider such questions in our research. In some cases, this involves calling out the problems associated with attempts to isolate and zap our more delinquent members. In others, it involves identifying and assessing viable alternative approaches to reducing harm — regardless of any potential “ick factors” that might be associated with our research.

The word cloud above represents how my 2012 Inside-Out students from Oregon State University and the Oregon State Penitentiary felt about their experience in my class.   As you may know, the larger the word is in the cloud, the more times it was mentioned by participants.  I had each student try to capture the essence of the experience in three words and this is what they came up with.  “Inspiring” was by far the most-used word to describe our class.  Wouldn’t it be great if all college classes earned such a positive response?

This quarter’s students also added more posts to our We Are the 1 in 100 tumblr site, offering perspectives on incarceration and communities from both inside and outside of prison.  For the first time, we’ve got photos taken inside the prison on the site; while no individuals are identified in these posts, I think it adds a little something.  Check it out and feel free to add you own submissions.

Here’s a case that brings up some intriguing questions: as a condition of a youth’s probation for a driving-related manslaughter conviction, an Oklahoma judge sentenced him to attend church regularly for 10 years.   The New York Times reports on the details of the case:

The 17-year-old defendant, Tyler Alred, was prosecuted as a youthful offender, giving the judge more discretion than in an adult case. Mr. Alred pleaded guilty to manslaughter for an accident last year, when he ran his car into a tree and a 16-year-old passenger was killed.

Although his alcohol level tested below the legal limit, because he was under age he was legally considered to be under the influence of alcohol. Mr. Alred told the court that he was happy to agree to church attendance and other mandates — including that he finish high school and train as a welder, and shun alcohol, drugs and tobacco for a year. By doing so, he is avoiding a 10-year prison sentence and has a chance to make a fresh start.

This sentence certainly seems to challenge the separation of church and state, and the ACLU is seeking sanctions against the judge…but is it a bad idea?

The judge believed that both the offender’s and victim’s families were satisfied with the sentence; the article reports his view of the outcome: “‘I am satisfied that both the families in this case think we’ve made the right decision,’ and noted that the dead boy’s father had tearfully hugged Mr. Alred in the courtroom. If Mr. Alred stops attending church or violates any other terms of his probation, Judge Norman said, he will send him to prison.”

Given the few details we have on this case, I think it’s fair to speculate that Mr. Alred – the young offender – was friends with the 16-year-old victim who was riding in his car with him.  Being responsible for a friend’s death is a heavy, heavy burden to carry regardless of the state-imposed punishment.  I’ve known a couple of young men serving prison sentences for similar crimes, and the guilt seems to be a separate entity that they will carry for a lifetime.  I wish we could hear from the victim’s family to better understand their thoughts on the situation and the sentence, but it may be that these unusual conditions of parole may actually “save” a second family’s son.

What do you think?  Is sentencing an offender to church all that much different than requiring parole/probationers to attend 12-step programs like AA?  If the young man fulfills the conditions of his probation and stays out of prison, should it be considered a success?  Why or why not?

Thanksgiving offers an annual opportunity to stop, take stock of one’s life, and to simply be grateful.  As a sociologist, I can appreciate the many continuums in the social world, and it is a useful exercise to think about where my one wild and precious life fits into the grander scheme.  I’m grateful for parents who loved me (and love me still) and supported me through every aspect of my life.  As someone who studies and teaches about delinquency, I truly understand the importance of parents and families in shaping our understanding of the world, in building and nurturing our emotional bonds, and in guiding us into adulthood.  I was more than fortunate to have kind, caring, compassionate, and hard-working parents.  I was and am lucky to have older sisters who watched out for me when I was younger and are now my beautiful friends as well as my family.  School was another place that largely worked in my favor: I grew up with peers who took school seriously and helped me stay out of trouble, and I had teachers who took notice of my particular skill set and ambitions and encouraged me.

I am fortunate today to have a career that I love and that I believe matters.  I have great colleagues and friends that I get to share ideas with and engage in thought-provoking and fun discussions.  My students – both inside and outside – inspire me on a daily basis.  They make me strive to work harder and do better.  The resilience of the men that I know in our state prisons and their passion for doing good in the world – despite their confinement and limited resources – reminds me of the luxuries in my own life and the many, many opportunities that I have to make a positive difference in my own communities.  I’m grateful to know them and to be able to consider them my teachers as well as my students.

I’m still learning and growing, but I’m grateful for these many blessings and happy to be another year into this journey.

Here’s an election image from the smart and creative folks at the Prison Policy Initiative, adapting some data from our recent Sentencing Project report on felon disenfranchisement.

This post is in response to a comment on my earlier post The Irony is Killing US: When to Treat Juveniles as Adults.  It was written by an inside student after I shared that blog post – and the comments – with a couple of men in my Inside-Out class at the state penitentiary who were convicted as juveniles (they do not have internet access, so I shared a paper printout and was given a handwritten response).  These are his words:

“People are versatile.”  I pulled this from what was written in the previous comment.  Absolutely, I agree.  Beyond that, and in support of that very idea is that “everyone is different,” as no two people or situations are the same.  Do I believe that there are some juveniles who once imprisoned should at no point thereafter be released?  Yes, I do believe that, however, not based solely on that act which first put them in prison.  To say that any choice made as a juvenile discounts one’s ability to grow, learn, change, and become a productive member of society…for the rest of their life!  No, not now and not ever.  One can change at any stage in life, for better or worse, we as humans are continually going through changes from the moment we are conceived to the moment we pass from life to death, this is simply in our nature.  I don’t believe it is just in any way, shape or form to label a juvenile as “scum” that cannot ever change and therefore be sentenced to “Life in Prison” when at that age there remains such an incredible amount of potential for both growth and change.  It does no harm to allow someone hope; condemning an individual, especially a juvenile, closes doors we as a society have no right to close.  Can anyone know the future?  No matter what position of authority is held, I’ll not be convinced that the act of a minor guarantee the outcome of their future based on decisions made as a juvenile.

the photo is from OSU’s Inside-Out tumblr page: We Are the 1 in 100