Incarceration & mental health

Housing, work, parole, triggers and the first weeks after release are covered in the “Coming home after prison or jail” guide in Resources.

Partners, children, caregivers and parents inside are covered in the “When a loved one is incarcerated” guide in Resources, including visits, calls and talking with kids.

People often describe

• Anger that builds with no outlet
• Constant worry about family, court dates or safety
• Feeling hopeless or stuck
• Feeling numb as a way to survive
• Memories of past trauma coming back
• Trouble sleeping in noise and bright light

Most jails and prisons have a way to request health or mental health care, often through a written request (sometimes called a “sick call” or “kite”). Services vary a lot from place to place.

Tips

• Ask a family member or lawyer to help advocate if you are not getting a response
• Ask for mental health staff by name if you can
• If you feel unsafe or have thoughts of hurting yourself, tell staff right away
• Keep a copy or note of each request and the date you sent it
• Write down what you are feeling and for how long

The first hours and days can bring fear, confusion and shame all at once. You may not know what will happen with your case, your job, your home or your children. Feeling overwhelmed in this moment is a very human reaction.

What can help

• Ask how to contact family and a lawyer
• Focus on the next few hours, not the whole future
• Tell staff about any health needs, including mental health care you were getting before
• Tell staff right away if you feel unsafe or have thoughts of hurting yourself

A 2024 review of research from around the world found that people in prison have higher rates of depression (about 11.4%) and PTSD (about 9.8%) than the general public.

In Europe, the World Health Organization found that mental health conditions were the most common health problem in prisons, and that suicide was the most common cause of death in prisons.

Humans are wired for connection. Missing birthdays, funerals and everyday moments with loved ones can bring deep grief and loneliness. Expensive calls and long travel for visits can make it even harder to stay close.

What can help

• Connecting with others through programs, faith or study groups
• Keeping a list of questions or news to share
• Letters, cards and drawings, which can be read again and again
• Regular call times, so everyone knows what to expect

Solitary confinement (also called “restrictive housing”) means being kept alone in a cell for most of the day. Research shows it can be very harmful to mental health.

In New York City jails, only 7.3% of admissions included time in solitary, but those stays accounted for 53.3% of acts of self-harm. In North Carolina, people who spent time in restrictive housing were 24% more likely to die in the first year after release, including a higher risk of suicide and overdose, than people who did not.

These studies show a strong link, not proof that solitary is the only cause. But researchers say they point to the need for alternatives.

If you are in solitary

• Ask for mental health staff if you feel your mind slipping, or have thoughts of hurting yourself
• Keep a simple daily routine: wake, stretch, read, write, rest
• Move your body every day, even in a small space
• Write letters, a journal or plans for the future

To stay safe, many people learn to hide feelings, trust no one, and react fast to any threat. These habits are smart inside. Around family, they can look like being cold, jumpy, quick to anger or hard to reach.

What can help

• Counseling with someone who understands incarceration
• Naming the habit: “This is my guard up, not the real me.”
• Slow breathing when your body feels on alert
• Telling loved ones what you are working on

Many people grieve the time they lost: children growing up, parents aging, chances that passed by. This grief is real and worth naming, even if others don’t understand it.

Ideas

• Set small goals you can control each day
• Talk with others who have been through it
• Write about what you lost and what you still hope for

Losing a loved one while incarcerated can be especially painful. You may not be able to say goodbye, attend the funeral or grieve with family. Some people feel they have to hide their sadness to stay safe.

What can help

• Ask a chaplain or mental health staff for support
• Ask whether your facility allows a call or a special visit
• Hold your own small ritual: a letter to the person, a prayer, a moment of silence
• Talk with others inside who have lost someone

A personal routine gives your brain something steady to hold on to. It can be as simple as stretching when you wake, reading after count and writing before lights out.

Try this

• A short “wind down” habit before sleep
• One thing each day just for you, like a puzzle, drawing or a chapter of a book
• Stretching or exercise at the same time each day
• Writing tomorrow’s small goal on a scrap of paper

Try this

• Name 5 things you can see, 4 you can hear, 3 you can touch
• Press your feet into the floor and notice the ground holding you
• Slow breathing: in for 4, out for 6
• Tense and release your hands, shoulders and legs, one at a time

Learning gives the mind something hopeful to work on and builds skills for the future. Many facilities offer education, job training or a library, though what is available varies a lot.

Ask about

• Art, music or writing programs
• Classes toward a high school diploma or college credit
• Job training and work programs
• The library, including books you can request

Groups can be a rare place to be seen as a whole person. Faith services, recovery groups, peer support and other programs can bring connection, purpose and a sense of belonging.

Ask about

• Anger or stress management groups
• Faith services and chaplains
• Parenting classes
• Peer support or mentoring
• Recovery groups

Contact with people who care about you can be a lifeline. Letters can be read again and again, and regular call times give everyone something to look forward to.

Ideas

• Keep a list of news and questions to share on your next call
• Send drawings, poems or stories to children
• Write even when you have little to say: “thinking of you” matters
• Ask a chaplain or program about pen-pal or mentoring programs if family contact is hard

Days can blur together, and it is easy to start seeing yourself only through a number or a charge. Keeping your values, faith, goals and loved ones in view helps protect your sense of self.

Ideas

• Keep photos or letters where you can see them
• Make a list of your strengths and add to it
• Plan for the future, even in small ways
• Write a letter to your future self

A mental health court is a special court docket for people with mental illness who have been charged with a crime. Instead of the usual back-and-forth of a trial, a team works together to solve problems. People choose to take part, and they follow a treatment plan made with court staff and mental health professionals.

A judge checks in on progress regularly. The goals are to reduce repeat contact with the justice system and improve daily life, including work, housing and treatment.

“Diversion” is a broader word for programs that steer people away from jail and toward community treatment, either before charges are filed or later in the court process.

If you or a loved one is facing charges

• Ask the defense lawyer or public defender whether a mental health court or diversion program exists locally
• Ask what the program expects, and what happens if you leave it
• Share any history of mental health care with the lawyer

The CIT model began in Memphis, Tennessee. It brings police and mental health services together so that officers are better trained to respond when someone is in a mental health crisis, and to connect them with care.

If you call for help in a crisis

• Share that the person is in a mental health crisis
• Tell the call-taker about any weapons, so responders can plan for safety
• You can ask whether a CIT-trained officer or a mobile crisis team is available

Being arrested, losing your freedom, seeing or experiencing violence, and long stays in solitary can all be traumatic. Many people also had trauma before they were ever incarcerated. Reactions can include nightmares, being easily startled, avoiding reminders and feeling numb.

A worldwide review found that about 9.8% of people in prison had PTSD in the past six months, higher than in the general public.

Many people in the justice system have lived through trauma, and many have struggled with alcohol or drugs, often as a way to numb pain. The National Institute on Drug Abuse estimates that about 65% of the U.S. prison population has an active substance use disorder.

NIDA notes that treatment works best when it starts inside and continues after release without a gap.

In a study of 55 exonerees, researchers found that many were living with serious anxiety, depression, PTSD, or a mix of these at the time they were interviewed. They called for better support for exonerees’ social, emotional and mental health needs.

Exonerees often come home with no parole officer or re-entry program to help them, because technically they were never “guilty.” They may face the same struggles with housing, work and records as other returning citizens, with even less support.

Thirty-eight states and Washington, D.C. have laws to compensate people who were wrongfully convicted, but the rules and amounts vary widely. Innocence organizations and legal aid can help you understand what you may be owed.

The Legal Services Corporation’s website has a tool to find the free civil legal aid office that serves your area.

Ideas

• Connecting with other exonerees who understand
• Innocence organizations and legal aid for help with compensation and records
• Patience from family as trust is rebuilt
• Trauma-informed counseling

Families may have spent years fighting for the truth, and may feel anger, relief and exhaustion all at once. A homecoming after a wrongful conviction can be joyful and very hard at the same time.

What can help

• Expect ups and downs, even after good news
• Get support for yourself, not just your loved one
• Let your loved one set the pace for talking about what happened

CBT helps you notice thoughts like “I’ll never get out of this” or “Everyone is against me,” and test whether they are true and helpful. NIDA notes CBT can help people manage triggers and stress during recovery.

Therapies such as cognitive processing therapy, prolonged exposure and EMDR help hard memories lose their grip. A trauma-informed therapist will go at your pace.

Peer specialists and mentors with lived experience of incarceration can offer hope, practical tips and understanding that no textbook can. Many re-entry programs include peer mentors.

Many facilities offer groups on topics like recovery, anger, stress or parenting. Hearing others share can make your own struggles feel less lonely, and practicing new skills with others can build confidence.

Questions to ask

• Can I join while I wait for a counselor?
• Is there a waiting list?
• What groups are available here?

Many returning citizens go on to raise families, build careers, mentor young people and lead their communities. Support, opportunity and belief from others make change more likely.

Linking mental illness with danger adds to stigma and keeps people from seeking help. What people in distress usually need is care, connection and stability.

Many people inside learn to hide every feeling to stay safe. But talking to mental health staff, a chaplain or a trusted peer is a smart way to protect yourself. Getting support now can make the rest of your time, and your return home, easier.

Studies have linked time in solitary with higher rates of self-harm inside and a higher risk of death after release. If you spent time in solitary, your reactions are understandable, and support can help.