Confronting the Disabling Effects of Imprisonment: Toward Prehabilitation.

• Author: Johns, Diana
• Position: Report

Harm is embedded in every aspect of the prison: from its inception as an institution of punishment and correction to the deprivations of prison and post-prison life. Recognizing that penal harms militate against prisons' rehabilitative aim and capacity, this article applies a therapeutic justice lens to argue for ^rehabilitation as a means of strengthening communities, protecting against criminogenic conditions and the disabling effects of imprisonment, and ultimately reducing the reliance on imprisonment as a supposed crime-reduction strategy.

This article explores two conceptualizations of the prison: in terms of violence and of health. These different conceptualizations illustrate the various ways in which penal harms may be understood as disabling, and they locate the prison on a continuum of which violence and health are intertwined components.

**********

Your average offender, your stereotypical crim, is a person who is dysfunctional, who is disadvantaged ... He's young, he lives in a certain postcode where if he were to return there would get into trouble invariably, regardless of how much they don't want to, they will. So for a person like that, you've got to habilitate them, you've got to create a pro-social community. (Sam)

disable, verb: to deprive of legal right, qualification, or capacity; to make incapable or ineffective, especially to deprive of physical, moral, or intellectual strength, (www.merriam-webster.com)

IN THE OPENING QUOTE, SAM (SW22), (1) A FORMERLY IMPRISONED POST-release support worker, is describing the typical prisoner: "disabled" (2) initially by life experiences of violence, marginalization, and exclusion in the community, and further by the experience of the violence, marginalization, and exclusion of incarceration. (3) Harm is embedded in every aspect of the prison: from its inception as an institution of punishment and correction, to the deprivations of prison and post-prison life (Clear 1994, Irwin & Owen 2005). On the inside, these include the suffering of "empty time" (Medlicott 1999, 220) and its links to self-harm and suicide; the fear and threat of physical violence and intimidation; the psychological violence of stigma and shame; and the emotional damage to individuals, families, and relationships. On the outside, the effects of institutionalization bring forth men (4) ill-equipped to deal with life in the community and facing homelessness, unemployment, and exclusion. On a broader scale, the racialized, gendered, epistemic, and structured harms of incarceration (Pollack 2012, Scott 2015) manifest in the overrepresentation of formerly enslaved and colonized peoples (Cunneen 2006; see Drake 2013), the "dispossessed and dishonored" (Wacquant 2001, 95), "the destitute, the disreputable and the dangerous, and all those who chafe in the lower regions of social space" (ibid., 382). How then can the prison--shaped and characterized by violence (Brown 2009)--possibly achieve the positive transformation (5) ("rehabilitation") of its inhabitants amid such conditions of abject negativity?

Recognizing that penal harms militate against prisons' rehabilitative aim and capacity, this article applies a therapeutic justice lens to argue for prehabilitation as a means of strengthening communities, protecting against criminogenic conditions and the disabling effects of imprisonment, and ultimately reducing the reliance on imprisonment as a supposed crime reduction strategy. From this perspective, stemming the tide of incarceration is a matter of not only addressing "criminogenic needs" or reducing individual reoffending risk, but also inoculating places and communities to withstand its undertow. This starts with examining the factors that make populations and places susceptible to poor health and, consequently, to penal harms (De Viggiani 2007). Penal harms may be characterized in different ways. This article explores two conceptualizations of the prison: in terms of violence--its physical, emotional, psychological, and relational forms, as well as the symbolic, institutional, structural, and epistemic violence it perpetrates and represents--and of health--prisons as sites of supposed rehabilitation or cure and as "sick places" (De Viggiani 2007,115) of disadvantage, deprivation, disability, and despair, whose iatrogenic conditions bring forth populations further damaged and disabled by the experience of imprisonment. These different conceptualizations illustrate the various ways in which penal harms may be understood as disabling, but they also, importantly, locate the prison on a continuum of which violence and health are intertwined components.

From a therapeutic justice perspective, improving health and reducing violence are inextricably linked. Health is seen as the antidote to crime and violence as well as the violence of incarceration--a way to interrupt rather than entrench and exacerbate harms. Confronting the inherent harms of incarceration means focusing on the physical, emotional, mental, and social health needs and well-being of those imprisoned and their communities. This perspective decenters the prison as the point of intervention, locating it instead on a continuum of violence/health. Here, "violence" is shorthand for the range of harms and dysfunction produced, contained, and emanating in/from prison settings, whereas "health" describes social, emotional, and psychological well-being, capacity, and dignity. (6) To start to build a picture of this continuum, I begin by canvassing the extent and nature of the disadvantage characterizing prisoner populations. After exploring the violence of the prison, I draw on data gathered through interviews with ex-prisoners and post-release support workers about men's experience of release from prison in Victoria, Australia, to illustrate the disabling effects of imprisonment and how they entrench and amplify damage and dysfunction, which then leaks out into the community. Finally, I show how a prehabilitation approach might inoculate against and thus mitigate the disabling effects of imprisonment. First, though, I briefly explain the therapeutic justice approach.

A Therapeutic Justice Lens

The principle of therapeutic justice draws on the field of therapeutic jurisprudence, which grew out of mental health law in the 1980s and has begun to inflect legal practices around the world (Wexler 2008, Wexler & Winick 1996). Therapeutic principles are discernible in localized penal practices (e.g., HMP Grendon in England; see Shuker & Sullivan 2010) and particular cultural carceral settings (e.g., Halden Prison in Norway; see Benko 2015), but overall, they have scarcely troubled the dominant penal paradigm and the violence it embodies. The related concept of justice reinvestment has had greater traction, particularly in the United States, perhaps because its fiscal rationale affords broad political appeal (Allen 2011). Therapeutic justice, "a philosophy of reorienting the jail experience from being mostly punitive to being mostly rehabilitative" (Clear et al. 2016,185), similarly recognizes the harms and costs of incarceration but not solely in economic terms. Rather, a therapeutic justice lens highlights how and why prisons reconfigured as places that support growth and development--"anti-prisons" (Gilligan & Lee 2004)--have a greater capacity to reduce crime and violence than those emphasizing control through coercion. The key principle here is that prisons do cause harm (in fulfilling their punitive function of the deprivation of liberty), but they can operate in a way that is less harmful and more effective. That is, penal intervention can become therapeutic and abling, rather than destructive and disabling. The notion of prehabilitation, through this lens, takes in the wider social context of reoffending-reimprisonment cycles and highlights the need to work "upstream" of the prison to effect such changes.

What Does Prison Do?

As an arguably universal criminal justice goal, reducing reoffending offers a reasonable measure of whether prison "works" or not. Recidivism rates across the United States and beyond, however, indicate that imprisonment does not reduce reoffending and can actually have the opposite effect (Chen & Shapiro 2007; Ritchie 2011, 2012). Return-to-prison rates attest to the limited rehabilitative capacity of the prison: In Australia, for example, 44 percent of prisoners return to custody within two years of their release (Productivity Commission 2016), and 56 percent of prisoners have been previously imprisoned under sentence (ABS 2016). In the United States, 55 percent of inmates return to prison within five years (Durose et al. 2014, 15). Bhati (2006, 40) found incarceration to have "merely incapacitative" effects for 56 percent and criminogenic effects for 4 percent of his US prisoner sample. Earlier research showed that, among 56 percent of prisoners who were first-timers, two-thirds were rearrested post-release, whereas a higher proportion--nearly three-quarters--were rearrested among the group who had been previously imprisoned (Langan & Levin 2002,10). The effects of imprisonment are multiple, recursive, and cumulative, which explains in part why so many prisoners return and why an individual's likelihood of reincarceration increases each time they are released. The cycle of imprisonment adds to and exacerbates the cycle of disadvantage and dysfunction through the serial depletion of resources (Baldry et al. 2003, Grunseit et al. 2008), the whittling away of the personal, social, and economic capacity of individuals and of the families and communities to which they return, each time they return. For these reasons, as Sam hints, confronting the disabling effects of imprisonment requires looking beyond the prison to the communities and neighborhoods that feed into prison populations, the places where "trouble" is endemic and embedded. It means applying restorative and preventive strategies that build...