Event Reflection – Public Health Student Association-organized talk, The Epidemic and Pandemic in our Prisons with Aakash Shah, MD, MBA, MSc. on 10/14/20 at 7:00pm
The Epidemic and Pandemic in our Prisons was a thought-provoking talk about the intersectionality of public health and prison reform, especially in light of the current pandemic. This talk was presented by Aakash Shah, an ER doctor and Medical Directors for Substance Use Disorder Program Development, the Hospital-Based Violence Intervention Program at Hackensack Meridian Health, and New Jersey Reentry Corporation. His approach to prison reform is that the “ultimate manifestation of justice is treatment, not punishment”.
Fundamentally, the prison system needs to be reimagined. In place of a Department of Corrections, we need to have a Department of Rehabilitation. Instead of letting people experience further trauma and rot away in prison, Dr. Shah suggests the creation of therapeutic communities and the practice of rehabilitative release. In short, we need a public health approach to the criminal justice system. It just makes more sense: financially, older people need more healthcare; morally and logically, prison inherently changes people. But take a look at Covid-19. In the current crisis, the incarcerated have a higher risk of contracting the virus, and yet also a greater chance of being overlooked in terms of treatment and eventually, vaccine distribution. This just doesn’t make sense. At the end of the day, the prison system needs massive reform.
But this begs the question: how do we differentiate between criminals and individuals with mental health disorders? In order to answer this question, we must first become — as Dr. Shah calls them — “students of history”, to understand why conditions and circumstances are the way they are. A brief history of prison reform includes a push to de-institutionalize treatment of mental health disorders. This actually led to a reduced number of available “beds”, but a lack of good alternatives and robust resources. As a result, a good number of individuals ended up in prison instead of mental institutions. The current situation can be encapsulated by this story: a trauma surgeon managed to save the life of a patient with a severe mental health disorder, but this is what he said afterwards to Dr. Shah: “You know how this ends.” What did he mean? Ending up in prison. And statistics support this expectation: the overwhelming response to mental illness to calling the police. In fact, ¼ -½ of police orders are mental health calls. But the police have their obvious limits in terms of training and options that they can offer. So what would be the ideal situation? According to Dr. Shah, we should re-route emergency calls to mental health specialists. In trials, the line should be drawn between criminals and individuals with mental health disorders by mental health professionals rather than law enforcement / judges.
Reform is never a quick, easy process, especially when it comes to historically undervalued members of society. However, as Martin Luther King Jr. said, “the arc of the moral universe is long, but it bends toward justice.” It takes time and effort to make change, but as humanity tends toward righteousness, it is inevitable.
