Bridging the Restorative Gap
The United States population makes up only five percent of the world’s total population, yet accounts for 25 percent of the world’s incarcerated population at just over 11 million inmates. We incarcerate at a higher rate per capita than any other developed country. This statistic, coupled with a report from the National Association of Counties that estimates 64 percent of inmates deal with mental health issues, inspired me to explore how we, as architects, could help lower those figures. With funding from DLR Group’s Professional Development Grant program, I studied how the environment of a detention facility influences perceptions of both the staff and inmate populations, and how design can influence these conditions.
Providing adequate care to people with mental health disorders has been an uphill battle in U.S. history. It wasn’t until the 1840s when activists convinced the U.S. government to build facilities dedicated to helping those suffering from mental illness. Eventually, as funding and staffing decreased, the inpatient care model led to poor treatment of patients. By 1955, most of these facilities were decommissioned and asylum-based mental healthcare shifted to community-based care. Unfortunately, a continued lack of funding for these programs led to more individuals with mental illness living on the streets, or unable to function in society, resulting in increased mental health disorders within our jails and prisons. In essence, they became the de facto mental health provider. Studies have identified that inmates with mental health disorders are more likely to have a lengthier stay, more solitary confinement, and more injuries compared to inmates with no mental health disorders.
I began the study with a survey to garner perceptions of working with inmates diagnosed with mental health disorders in the detention environment. Respondents included custody officers currently working in jail facilities across counties in Washington and California whose years of experience ranged from one year or less to 16 years or more, with the majority in the 16 years or more category. In addition to the survey, command staff and clinicians were interviewed with the same questions that addressed primary issues facing the incarcerated mental health population, adequacy of services, defining quality care, challenges to providing quality care, and identification of elements within a facility that contribute to quality care.
The majority of all interviewees identified three main issues affecting inmates with mental health disorders.
- The criminalization of mental-illness behaviors (i.e., addiction, homelessness);
- The stigma surrounding mental health disorders impacting safety of the inmate with mental health issues;
- Keeping mentally ill inmates from harming themselves or others.
Knowing that these inmates are more likely to suffer injury and experience a longer length of stay than inmates without disorders, respondents indicated the following areas as priorities for improving physical space:
- Non-institutionalized colors;
- Single level spaces for housing and all services;
- Opportunities for family visitation;
- Access to natural light and outdoor space.
Opinions of custody officers, compared to command staff, indicated a vast difference in perspective about providing adequate services to inmates with mental health disorders. Custody officers who interact more directly with inmates indicated they are providing adequate mental health services. However, command staff generally believed that services for mental health issues were inadequate. Participants noted a lack of funding and lack of specialized staff wanting to work in this environment as the biggest hurdles to providing adequate care. They ranked access to community resources as the most beneficial form of programming to reduce recidivism.
Participants believe that the following changes to the system would be helpful to inmates with mental health disorders:
- Better training for staff on how to work with inmates suffering with a mental health issues;
- Programs and treatment to stabilize and monitor medications;
- Assistance with finding housing options after inmates are released.
Changing Jail Environments
A jail environment often exacerbates mental health disorders and stress-related symptoms in both staff and inmates alike. Designing normative spaces can help reduce behaviors that commonly keep inmates with mental health disorders incarcerated longer, and counties and states across the U.S. are beginning to address this challenge more directly. Sonoma County, California is currently completing a new behavioral-health housing unit designed with access to nature, daylighting, and programming space. All individual cells also have views to courtyards and the natural environment. Other counties are converting existing units into more open, light-filled spaces that resemble a healing environment.
The opportunities to provide safety and security to mental health populations, as well as the staff and officers that serve them, are endless. Implementing spaces that allow people to more effectively do their jobs can positively influence the populations they serve. Providing improved spaces alongside improved training and programs can bridge the gap of services available to this vulnerable population.