Insane = unhealthy. Only an unhealthy person would commit violent crimes. By definition, a healthy person wouldn’t do these things. So why should we treat unhealthy social behavior differently from unhealthy physiologic behavior? When someone gets sick, they go to the clinic or hospital. When someone is in dire social straits (poverty, hunger, product of violence themselves), where do they go? Mental health clinic: 60 day wait list to see an overworked, undersupported therapist? Social Services: don’t meet specific disability criteria? The list (or lack thereof?) goes on.
Most of society is locked in a paradigm of body-mind duality, and that behaviors are the result of intrinsic faults of a person, or that they SHOULD have chosen otherwise. However, my experience as a primary care physician, and my research into the physiology of behavior, and how developmental and environmental influences will drive what people do begs a more nuanced consideration of how to address people when they socially transgress. Also, what if we frame the issue as how to get the best future society for an investment today? Incarceration costs ~ $ 20,000-50,000 / year. This also removes that person from employment, where they might make money and pay taxes, so there’s an opportunity cost there as well. Let alone that same amount of money might be spent on educating the person so they could be more productive and pay EVEN MORE TAXES!
Do people who socially transgress “deserve” this treatment? I feel that EVERYONE is entitled to this treatment. Shouldn’t people who socially transgress be “punished”? I think that we should pursue the most effective strategies and not get hung up on notions of desert and punishment. We are creatures that respond to incentives, first and foremost. If we want to promote certain behaviors and inhibit others, then we need to set the environment and incentives to match.
Again, what is the INVESTMENT that will lead to fewer future problems and MORE future benefits? Restorative Justice speaks to this at length and with great evidence. Defy Ventures and the Anti Recidivism Coalition have shown that educating inmates reduces recidivism.
Punishment is a heuristic that comes from a time prior to quality cognitive science and interventional psychology. Why would we adhere to thinking that is not based on the realities of the human condition and have reliably been shown to generate worse outcomes? Coming back to the opening line of this article, only unhealthy people commit violence. I propose that we advocate that socially unhealthy people have access (and be placed if needed for their or anyone else’s safety) to institutions that are indistinguishable from our best hospitals. In all the ways that matter: location, geography, architecture, staffing, goal to discharge as quickly as is safe, etc. Provide them with comprehensive services, therapies, and if needed medical treatments that will allow them to integrate safely into the larger society.
There are multiple entry points and exit strategies along the school to prison pipeline. Obviously blocking entry is the most effective, hence why I’m motivated in this project. But all of these institutions are interpenetrating and are best addressed simultaneously.