Holding Smoke, by Elle Cosimano

Holding Smoke, by Elle Cosimano
I received a copy of this book from Disney Press via NetGalley
in exchange for a fair and honest review

John Conlan is in juvie for double murder, but the bars can’t hold him like they hold the other inmates. John is able to leave his body behind and travel around as a “ghost.”

I read Holding Smoke for two reasons: 1) I like teen fantasy, and 2) I like realism about teens in difficult situations. The second one is a bit of a stretch, since fantasy and realism are generally considered opposites, but I had high hopes for the realistic setting of this book because the author was the daughter of a prison warden.

As far as realistic settings go, Cosimano did a fantastic job. She managed to show the type of anger and violence that occur in a prison, without making it unsuitable for teens. She also wrote likable main characters with flaws. I’m always interested in reading what teen books say about prison, since I think it is important for teens to realize that “this could be you under different circumstances.” No, I don’t think of every teen as a potential prisoner so much as every prisoner as a human being with a story. This book did a good job of showing that John was a human being first, and a prisoner second.

Of course, the realism had to stop somewhere – it is, above all, a fantasy novel. I enjoyed the fantasy/romance side of the story, too. In fact, it’s the unique prison setting that makes this such a good fantasy story. Also unlike most teen fantasies these days, it’s about a male character – making it appeal to kids of both genders.

Recommended for teens 12 and up.

Unfair, by Adam Benforado

Unfair: The New Science of Criminal Injustice
Written by Adam Benforado
Narrated by Joe Barrett

In Unfair, Adam Benforado discusses the injustices of the American justice system with historical, current, and scientific evidence. In his historical musings, he discusses the idea of justice as it evolved with time. For instance, he brought up witch trials (including the ridiculous ones where they throw the unlucky defendant in a lake and to see if she floats) and trials of animals that had killed humans. He pointed out that our concept of justice will continue evolving so that in 100 years our own criminal system will seem as preposterous and horrific as a witch hunt.

His current information included a lot of discussion of people who had been wrongly convicted due to misapplication of “justice.” Personally, although I think wrongful convictions are horrible, I believe they are so rare that he should have spent more time focusing on other injustices – like the fact that a drug kingpin, once caught, can provide names of everyone beneath him so that those people have no one to snitch on. Such miscarriages of justice mean that the kingpin gets a greatly reduced sentence and the people below him get regular-to-maximum sentence. That’s the type of thing I wanted to hear about, so I could complain about the justice system in a more informed manner. 🙂 Benforado also spent a lot of time discussing natural human bias – such as the fact that a person’s appearance, history, socioeconomic background, etc. affects the jury’s perception of guilt.

In his scientific discussion, he told the reader about current breakthroughs in lie detection (such as brain scans), which, although promising, need a lot of work. The author pointed out that jurors are much too likely to accept this “scientific evidence” as truth just because brain scans seem to be indisputable.

Overall, Unfair was interesting, despite focusing too much on the rare cases of wrongful convictions. The book was well-paced, interesting, and intelligent. It leaves the reader plenty to think about.

The Serpent King, by Jeff Zentner

Dill is no stranger to hardship. He’s dirt poor, financially supporting his mother, and seems to have zero future prospects. His father, a snake-handling preacher, is in prison; many of his former parishioners blame Dill. Yet Dill has two things that keep him getting up in the morning – his friends Travis and Lydia. The three are strikingly different but are pushed together by their mutual status as social outcasts.

This is a story about friendship, futures, and fighting. It’s the first book in a long time that’s made me just start bawling – I generally avoid crying if I can, but this book deserved a good cry. It was that moving. I didn’t just feel for Dill and his friends, I felt with them – which is saying a lot since I personally have not experienced most of the hardships that Dill and his friends were going through.

The characterization and mood of this book were what made it amazing. The characters were real. They were flawed. They got angry for stupid reasons or were sometimes bossy and blind to the needs of others. Yet they were perfect. They were just what good friends should be. They knew how to love, how to inspire, how to live. The mood of the book was remarkably well-kept. It somehow mixed the darkness of hardship with the light of an amazing friendship.

Overall, I would recommend this book to anybody who likes gritty teen realism. Personally, I volunteer for a texting crisis hotline for teenagers, and I find reading books like these helps me to better relate to the teens that text in. I am currently collecting books that I think would either be good to recommend to troubled teens, or help others in the crisis center to empathize with teens in crisis. I consider this an important collection, and carefully think about each book that I include. This one is a definite yes. Issues that I consider important in this book – religious extremism (and how it impacts youths), family members in prison, bullying, grief, mental illness, and coping mechanisms.

Among Murderers, by Sabine Heinlein

Among Murderers: Life After Prison
written by Sabine Heinlein
narrated by Cassandra Campbell

In Among Murderers, Heinlein follows three convicted murders in the years immediately after their release. The blurb describes it as:

What is it like for a convicted murderer who has spent decades behind bars to suddenly find himself released into a world he barely recognizes? What is it like to start over from nothing? To answer these questions Sabine Heinlein followed the everyday lives and emotional struggles of Angel Ramos and his friends Bruce and Adam – three men convicted of some of society’s most heinous crimes – as they return to the free world.

However, this isn’t only a book about the difficulties of reintegrating – like finding a job, finding a home, dating, and figuring out how to live in a world that has matured 30 years while you were locked away – it is mainly comprised of doing research into the murderers’ backgrounds in order to give an adequate description of their crimes, who they were, who they have become, and what factors have influenced their lives. This gives the book a personal flavor – it encourages compassion and understanding for the three men and their troubles, without totally discouraging your caution in dealing with such men.

I’m going to soon be volunteering with people recently paroled, helping them to reintegrate and to reduce their chance of recidivism. I thought this book would be helpful and interesting. Although it spent a little less time focusing on current troubles of the three men, this book was incredibly helpful.

Psychopath Whisperer, by Kent A Kiehl

The Psychopath Whisperer: The Science of Those without Conscience
by Kent A Kiehl, narrated by Kevin Pariseau

In this fascinating scientific exploration into the biological differences between psychopaths and non-psychopathic people, Kiehl discusses his own dealings with psycopaths in prisons. Kiehl is known as the first person to use an MRI in a prison to study the differences between psychopaths and non-psychopathic prisoners.

Kiehl would determine psycopathy by interviewing prisoners and then rating them 1-3 on a list of 20 attributes. A score of 30 indicates a psychopath. Approximately 20% of inmates were psychopaths. A balanced number of people who rate high and low on the psychopathy scale would be chosen for the experiments.

Once the study subjects were put in the MRI, they would be shown pictures of three types: a morally neutral photo (perhaps an ice cream cone), a morally ambiguous photo (perhaps a wrestling match), and a immoral act (perhaps someone placing a bomb in a car). The prisoners would then rate one a 1-5 scale how immoral the picture was. When a person who scores low on the psychopathy scale sees an immoral picture, his limbic system lights up; but a psychopath’s limbic system remains eerily dark.

In his book, Kiehl also discusses findings other people have made about psychopaths – like the fact that they have no startle reflex. This mixture of scientific, psychological, and personal narrative make for a fantastic book.

I enjoyed this book quite a bit – especially the ethical implications of whether a psychopath deserves an insanity plea because their brains function differently than “normal” people and they are unable to physiologically respond the “right” way to the thought of immoral activity. Kiehl himself longs for a day when psychopathy will be caught earlier in childhood, so that they can receive treatment rather than incarceration. But the issue is quite an ethical dilemma. Where do you draw the line on the insanity plea?

I have previously discussed another ethical dilemma of the insanity plea: whether, in a patient with dissociative identity disorder, it is ethical to punish one personality for what another personality has done. Again, where’s the line? And then I wonder about what the neurodiversity movement would say about the whole thing? Things that make you go hmmmm.

Crazy: A Father’s Search Through America’s Mental Health Madness, by Pete Earley

Crazy: A Father’s Search Through America’s Mental Health Madness,
by Pete Earley, Narrated by Michael Prichard

When Pete Earley’s son was diagnosed with schizophrenia Earley was devestated. His son’s potential career was on the line, he wasn’t willing to accept treatment, and he was generally unpredictable and very unsafe. When Earley tried to get his son into the hospital, his son was turned away because he didn’t want to be treated – and laws say that unless someone is an immediate threat to himself or others, he can not be treated involuntarily. Earley had to pretend his son was a threat to Earley’s well-being to get his son hospitalized. Then Earley went to a commitment hearing to make sure his son stayed in the hospital until he was better. Early was appalled by his son’s defense lawyer who did her best to defend Earley’s son despite his son’s clear mental illness. In her own defense, the lawyer said it was her job to defend the rights of someone who did not want to be committed. Earley’s son won the case and was released.

After this incident, Earley’s son broke into a house, peed on the carpet, turned over the all the photographs, and took a bubble bath. He was arrested and charges were filed against him by the family. Despite Earley’s pleading with the family that his son was not targeting them specifically, that he was sick, the mother felt threatened and continued to press felony charges. Earley knew that the charges would be an irremovable bar from his son’s career choice.

Because of the horrors of being unable to treat his son, and the unfairness of the charges, Earley decided to research the state of the mentally ill in the Miami jail system. There are, according to the staff psychiatrist, “a lot of people who think mentally ill people are going to get help if they are in jail. But the truth is, we don’t help many people here with their psychosis. We can’t. The first priority is making sure no one kills himself.” The psychiatrist said that the point of the prison was to dehumanize and humiliate a person. Such treatment is counter to improving anyone’s health.

The psychiatrist’s task was to try to convince the inmates to take antipsychotic medication so that they could be deemed stable enough to stand trial. Earley was shocked at the state of the prisoners. Most of them refused the medication, and were clearly psychotic. Some huddled down into corners, covered in their own body matter. Some stood motionless and unresponsive. Some harassed the guards as they walked by with strange and crude accusations. The prisoners who were on suicide watch were stuck alone in a cell with no blanket, mattress, or clothes.

Miami has high numbers of mentally ill homeless people because of the nice weather and the immigration from Cuba. It is rumored that when a law was passed allowing Cuban refugees to enter America, Fidel Castro released his mentally ill inmates and deported them all to America – they ended up in Miami.

Earley picked mentally ill inmates at “random” and decided to follow them throughout the next couple of years to watch their recidivism rate. Most people who were released were not given proper care after release. They were given some pills and sent away; not being given proper social services to help keep themselves off the streets and stable. Thus, these people ended up back in prison within months. Others were held indefinitely because they cycled from jail to a hospital, where they were stabilized and deemed ready for trial; back to the jail, where they destabilized; and then back to the hospital again.

Earely wasn’t only out to castigate the Miami prison system, he also focused on what the system was trying to do to make the situation better for the prisoners. He discussed the CIT program, which is meant to train officers to respond with compassion to mentally ill people in crisis so that they are less likely to be shot or arrested. (This program is discussed in a previous post.) Earley also researched institutions that tried to keep the mentally ill off the streets by housing them.

The end of the book returns to his son. Luckily, after too many postponements, the family that was pressing felony charges against Earley’s son were unable to make it to the trial. Therefore, the sympathetic prosecutor and judge found him guilty of a misdemeanor and was he mandated to stay on his medications. His career was no longer at stake.

Earley encouraged society to end stigma about mental illness, and to change laws that inhibited proper treatment of unwilling mentally ill patients. Of course, this is easier said than done.

If you are interested, I also have a post discussing the state of the mentally ill in Ohio state prisons, with a Frontline documentary.

4.5 stars for excellent research, well- written narrative, and a fantastic, revealing topic

Brave New Films: This is Crazy

In a previous post, I discussed my thoughts on Frontline’s New Asylums documentary, about the overcriminalization of the mentally ill. Millions of taxpayer dollars are being spent on housing the mentally ill in prisons, when they could be treated more affordably (and more humanely) by the community. Because that video (filmed in 2005) left me with a lot of questions, I looked up some more recent resources. Of the videos I watched, my favorite was a series created by Brave New Films.

Brave New Films: Why are we using prisons to treat mental illness?

The video begins by dramatically pointing out a problem: police and correctional officers are not trained to deal with mentally ill “offenders,” which results in unnecessary deaths. This is an issue that I’ve already been seething about in my home suburb here in Minnesota. There have been a few times in recent years when our police have killed mentally ill people that they have been called to help. For instance, an officer shot a knife-wielding suicidal teen after his family called the police for help. Because the police are untrained to deal with mentally ill, families are left in a quandary: they sometimes don’t feel safe around their mentally ill loved one, but they don’t want to call the police for fear that their loved one will either be killed or get tied up indefinitely in a revolving-door judicial system.

The video continues by describing the Crisis Intervention Training (CIT) program. In CIT, officers are trained to drop the authoritative attitude that they are supposed to use in non-crisis occasions. They are trained to use soothing and empathetic tones of voice to disarm the mentally ill. The video included a heartwarming interview with a mother of a schizophrenic man who is grateful for the CIT officers’ treatment of her son during a crisis – how the officers managed to defuse the situation without anyone getting hurt or being sent to jail.

CIT officers in San Antonio can now bring mentally ill people to treatment centers instead of emergency rooms. This change keeps ER and officer overtime costs down. (Officers must be paid overtime because they spend hours in the ER waiting for the “offenders” to get psych evaluations.) An officer on the video claims that in the past 5 years they’ve saved about $50 million of taxpayer money by utilizing CIT and treatment centers.

Watching this video made me feel optimistic about the future of mental health. There’s a lot of work to be done – a lot of training to do, a lot of lobbying to resistant politicians (and an unsympathetic public), a lot of treatment centers to be built – but there is a solution. New Asylums was a fantastic documentary, but it left me feeling hopeless. I’m happy I found the Brave New Films’ snippet.

I also watched this Brave New Films documentary:

Brave New Films: This is Crazy: Criminalizing Mental Health

This video begins in much the same way as Why are we using prisons to treat mental illness, providing different examples. It continues by discussing brutality within prisons, and the over-use of solitary confinement for mentally ill inmates. One mentally ill woman claims that of the 18 years she spent in prison, 4 of them were in solitary confinement. Each person in solitary confinement costs taxpayers $75,000 a year; compared to the $16,000 a year per person in supportive housing.

Finally, This is Crazy discusses the fate of prisoners once they are released from prison. As discussed in New Asylums, prison is like a revolving door for the mentally ill. Most of the homeless population are mentally ill. They break laws either because they are delusional or because they have basic needs. When they are arrested, they spend 3 to 4 times more jail time than “normal” inmates. They often get shuttled back and forth between stabilization hospitals and jail (where their psychiatric treatment, and their mental state, degenerates). When released, they are given 2 weeks’ worth of medication and are left out on the streets again – with nowhere to look for treatment. Despite the fact that community treatment would save taxpayer money, the first item on the political finance chopping block are treatment centers and institutions for mental illness.

The take-home point of these documentaries is that because police are not trained to deal with mentally ill people in crisis, many mentally ill people end up being abused, killed, or put in a revolving door prison system. Once a mentally ill person has a bad experience with cops, he is likely to be fearful and uncooperative in the future. I have seen this myself. I have a mentally ill friend who suffers from PTSD after being brutalized by police for a case of mistaken identity. Now whenever he sees a cop, even if the cop is completely uninterested in him, my friend goes into a blind panic. I strongly suspect that my friend wouldn’t have been brutalized by the cops if he hadn’t been mentally ill. Another important point is that outrageous amounts of taxpayer money would be saved, and deserving human beings would be treated with compassion, if only cities around the US would develop CIT programs and fund more treatment centers. If only the taxpayers and politicians would listen to reason.

This is a series of posts summarizing what I’m learning in my Abnormal Psychology course. Much of the information provided comes from reading my James N. Butcher’s textbook Abnormal Psychology. To read the other posts, follow these links:

The Definition of Abnormal
A History of Abnormal Psychology
Abnormal Psychology in Contemporary Society
Contemporary Viewpoints on Treating Mental Illness – Biology
Contemporary Viewpoints on Treating Mental Illness – Psychology
Frontline: New Asylums
Brave New Films: This is Crazy
Clinical Mental Health Diagnosis: Biological Assessment
Clinical Mental Health Diagnosis: Psychological Assessment
Does the DSM Encourage Overmedication?
Post Traumatic Stress Syndrome – The Basics
Panic Disorder
Obsessive Compulsive Disorder
Hoarding and Body Dysmorphic Disorders
Depression – an Overview
Personality Disorders – Clusters and Dimensions
Personality Disorders – Cluster A
Personality Disorders – Cluster B
Personality Disorders – Cluster C
Biological Effects of Stress on Your Body
Somatic Symptom and Related Disorders
Dissociative Disorders
Borderline Personality Disorder
Dialectical Behavioral Therapy
Paraphilic Disorders
Gender Dysphoria – Homosexuality and Transgender
Anxiety Disorders
Bipolar Disorder – The Basics
Suicide – An Overview

Frontline: New Asylums

New Asylums (2005) is a Frontline documentary that delves into the problem of housing the mentally ill in prison systems. Believe it or not, the world’s three largest asylums for mentally ill are the Cook County Jail in Chicago, the Twin Towers of the Los Angeles County Jail, and Riker’s Island in New York. This problem has been escalating ever since the mid 1900’s when deinstitutionalization of mentally ill and intellectually challenged became a popular movement to encourage “humane” treatment of mentally ill and to reduce state expenditures on medical care.

The original plan, as described by the Community Mental Health Act of 1963, was to fund community mental health centers in which the mentally ill could be treated while working and living at home. However, most of the proposed centers were never built, and few of those built were fully funded. As deinstitutionalization accelerated, hundreds of thousands of mentally ill patients were released without a place to go and without adequate access to mental health care. A lot of them ended up on the streets. And on the streets, their mental illnesses flared up, leading to law-breaking. Many of the laws broken were for basic living purposes – theft of food, break-ins to get a place to sleep, stealing blankets out of a car – and many were violent crimes fueled by a desperate situation combined with psychosis. And this is how jails and prisons became the new asylums.

The documentary New Asylums focuses on the Ohio state prison system, which has a relatively well-developed system for dealing with the mentally ill. In 2005, when the documentary was filmed, there were nearly 500,000 mentally ill people housed in America’s prison systems – 10 times more than the 50,000 housed in mental institutions.

The documentary begins with a disturbing scene of “group therapy” in which inmates are locked inside tiny cages, with just enough room to sit in a chair. In this warm, inviting environment, the inmates are encouraged to share their problems with their fellow inmates. I think it is fantastic that group therapy is provided for inmates, but how helpful is it really, in this environment? Can an inmate really share his fears and heartbreaking secrets with other inmates? Wouldn’t rumors get around quickly among the inmates and less sympathetic officers in prison? How much help can group therapy really do these inmates, especially since they are locked in a tiny cage; which probably doesn’t encourage openness?

A while back, I told my therapist that I thought Dialectic Behavioral Therapy (DBT), which I was currently undergoing, would be a world of help to many people in prison. She agreed. But now that I see this video, I realize the limitations of such therapy. Prison does not provide a safe environment to let those feelings out. But what to do? Do we just not provide the inmates with therapy because of these limitations? Clearly, the problem needs to be solved before the mentally ill people are imprisoned, but I don’t know how to solve that problem, other than reinstitutionalization.

The documentary only became more horrifying after that. There were scenes in which a naked, frightened, screaming man was resisting being handcuffed. Eventually, a group of 5 men who were dressed like a SWAT team and carrying a riot shield burst into the cell, pinned the man down, and carried him kicking and screaming away. One officer tells the camera “A lot of the mentally ill inmates in here, you gotta use more…I mean, you do have to use force on them.”

Having seen the footage, I understand why the officers feel that they need to use a lot of force. I mean, how else would they get the naked, psychotic, screaming man down to solitary? But don’t you think that the strict and unforgiving culture of prisons is part of the reason these inmates are acting out? Isn’t the fear of solitary, which would certainly exacerbate psychotic symptoms, part of why they’re acting out? Most of them would certainly be better behaved in a healthier, more caring environment. And then force wouldn’t have to be used.

I can see two solutions (both of which I think should be implemented): the number of mentally ill patients housed in mental institutions should be increased, thus decreasing the prison population. And people in prison should be treated with more kindness – providing a rehabilitative instead of punitive justice system.

The documentary continued by describing Oakwood Correctional Facility, which is a temporary housing unit for mentally ill inmates who need to be stabilized. The culture and environment seems so much more caring and open – it appears that inmates who were dangerously psychotic in the general prison are stable and well-behaved at Oakwood. There’s a heartbreaking scene in which one of the inmates is being told by a panel of mental health workers that he’s stabilized and ready to go back to the general prison population. The inmate practically begs to stay at Oakwood. The panel is at first kind, but they become more and more firm. They show a depressing lack of empathy. The tragedy is that they have to. They have to send the inmate back to the general population, because they don’t have enough beds to house all the thousands of mentally ill inmates in the Ohio state prison system.

At this point I got into a discussion with a classmate about why these inmates aren’t all housed in such therapeutic environments as Oakwood. But where would Ohio state get the money to pay for those units to be built? How would they decide who is mentally ill enough to end up in such a facility? And is it ethical to treat some 16% of their inmate population so humanely and ignore the inhumane treatment of all the other prisoners? Do the “healthy” prisoners not matter just because they don’t have a serious mental illness? Once we start creating this humane prison system, where do we stop?

During most of the documentary, I was applauding Ohio state for at least trying to create a therapeutic environment for its mentally ill inmates. But there were a couple of comments which made me rethink. Reginald Wilkinson, the Director of the Ohio Department of Corrections said that he once had a judge mention to him: “Well, I hate to do this, but you know the person will get treated if we send the person to prison.” So judges are more likely to give a prison sentence because they feel there’s better mental health care there? My question was confirmed later in the documentary when it pointed out: “We shouldn’t devote ourselves to continually raising the level of mental health care in prisons because the better you make an institution that shouldn’t be used for the purpose you’re improving, the more you’re ensuring its use.”

It’s a catch-22. If you don’t work to take care of the mentally ill in prisons, they’ll get worse and you’ll have to stash them away in solitary or other “general population” punishment areas. If you do develop a system to care for the mentally ill, then you end up with even more mentally ill people dumped into your system, where they don’t belong. So tragic. I wish enough people cared about this highly stigmatized group so that money could be raised to properly care for both the imprisoned and the unimprisoned mentally ill.

4 snowflakes for interest level, research, approachableness, and subject