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Prison Madness, by Terry Kupers, MD (Book Review)

Jossey-Bass, 1999

Reviewed by Dan Pens

Ted Kaczynski is clearly mentally ill. So said six psychiatrists who told the court that the infamous Unabomber is an acutely psychotic paranoid schizophrenic.

In addition to being quite mad, Kaczynski possesses a brilliant intellect; he was a professor of mathematics at UCal Berkeley before withdrawing from society, at age 27, to a 10' x 12' wooden shack in Montana where he constructed elaborate handcrafted bombs.

He was convinced the nightmarish storms raging through his brain were brought about by forces outside of himself. He blamed technology for his mental turmoil. And in desperation he bombed technologists.

But in the United States, in the 1990s, Ted Kaczynski is above all a "criminal".

The publicity surrounding his arrest was intense. However, when it became clear to the press that Ted was mentally ill (rather than diabolically evil), the media circus packed up its tent and left town. Little attention was given to the court proceedings where Kaczynski was duly convicted and sentenced for his "criminal" behavior.

Kaczynski now lives a solitary existence in a 10' x 12' concrete box in the bowels of the federal maximum security prison in Florence, Colorado a.k.a. "The Alcatraz of the Rockies". Like legions of mentally ill persons in the U.S., Kaczynski has been "disappeared".

On any given day some 300,000 mentally ill are warehoused in U.S. jails and prisons. Nine of ten mental hospital beds in the U.S. have been eliminated since 1960. But 90 percent of the mentally ill haven't been "cured". A shocking number of them have been tossed into the human wastebin of the U.S. criminal justice system. Swept off the streets and disposed of.

And what happens to the mentally ill after they arrive in prison? Few people are better qualified to answer that question than Dr. Terry Kupers.

In the late 1960s, Kupers helped run a free clinic in South Central L.A., part of a community service program administered by the Black Panther Party (BPP). In December, 1969, police raided the South Central L.A. office of the BPP with heavy artillery and a tank. Some of the wounded were chained to county hospital beds and brutalized.

"I was asked by the Panthers to report abuses to the press," Kupers writes in the book's introduction. "There were headlines."

A few years later the Los Angeles ACLU filed suit against the L.A. County Sheriff's Department for shoddy medical and psychiatric care. The lead attorney remembered Kupers from press accounts of the treatment of Panthers in the L.A. County Jail and asked him to be an expert witness in the case ( Rutherford v. Pitchess , 1977). Thus began a lifelong tour of the seven circles of hell.

Kupers has since served as a psychiatric expert in more than a dozen class action lawsuits concerning the conditions of confinement and (in)adequacy of mental health services in U.S. jails and prisons, and as consultant to the Civil Rights Division of the U.S. Department of Justice and to Human Rights Watch.

In clear, convincing language, Dr. Kupers describes not only the madness within prisons, but the madness of prisons the madness of classifying the bizarre behavior of-mentally ill persons as "criminal" and relegating them to concrete tombs.

But this insane public policy does not end with imprisonment. There the madness really begins.

Dr. Kupers clearly describes the cruel (and often vicious) slope that mentally ill prisoners slide down once they are imprisoned. At the bottom of that slope lay a growing number of control unit cells (commonly called "Special Housing Units" or SHUs) where the so-called worst of the worst prisoners end up.

After nearly 20 years of imprisonment I thought I'd seen and heard it all. But Dr. Kupers has been places and seen things that I've never dreamed of. In the middle third of the book, aptly titled "What Goes on Behind Bars", Kupers describes a how custody staff short-circuit the time-consuming process of going through constitutionally- mandated motions before they can involuntarily medicate a prisoner.

"I have seen prisoners placed in four-and five-point restraints in their cells and told they will not be released, not even to use the toilet, until they agree to take the medications."

In the final section of the book Dr. Kupers discusses the possibilities and limitations of litigation, and makes some specific recommendations for treatment and rehabilitation. One thing he makes clear, however, is that rather than merely a "mental health" crisis, the plight of mentally ill in U.S. prisons is a political and public policy nightmare. Few who read this book will not be convinced that it s time to wake up.

Prison Madness, can be ordered by calling 1-800-956-7739 or by mailing a check for $25 plus $7 shipping to: Jossey-Bass Inc.; 350 Sansome Street, 5th Floor; San Francisco, CA 94104-1342

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