Waiting for an Echo: The Madness of American Incarceration

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.