an ambulance parked at the entrance of an emergency department

Psychiatric Care in Crisis

By Zainab Ahmed

Psychiatric care in the Emergency Department is all-or-nothing and never enough. Often, legal holds are the only intervention available, and they rarely are therapeutic. Upon discharge, our patients are, once again, on their own.

The ED acts as a safety-net for a failing health system, one that places little value on mental health services, either preventative or follow-up. The demand for acute psychiatric care is high; however, EDs have little physical capacity for psychiatric patients.

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Barbed wire in front of blue sky.

The Struggle to Survive in the Pandemic Prison

By Jamal Spencer and Monik C. Jiménez

Prisons, jails, and other carceral facilities have been core sites of the COVID-19 pandemic, from initial outbreaks in Chinese prisons to some of the largest outbreaks in the U.S. The uniquely dangerous physical conditions within carceral facilities (i.e., overcrowding, poor ventilation, and lack of sanitation); a high prevalence of chronic diseases among incarcerated people; and high levels of physical movement through facilities, resulted in environmental conditions ripe for uncontrolled SARS-CoV-2 transmission.

As early as June 2020, the mortality rate from COVID-19 among incarcerated people was three times higher than the general population and the infection rate five times higher. Yet, despite these inequities, the human toll of COVID-19 among incarcerated people has remained behind the walls and in the shadows. Without intentionally centering the voices of those who have lived in the most extreme conditions of social and physical marginalization, we fail to understand the full toll of the pandemic and impair our ability to respond humanely to future crises. 

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Austin, Tx/USA - May 23, 2020: Family members of prisoners held in the state prison system demonstrate at the Governor's Mansion for their release on parole due to the danger of Covid-19 in prisons.

Federal Failures to Protect Incarcerated People During Public Health Crises

By Rachel Kincaid

As the COVID-19 pandemic persists, and as we face the reality that future pandemics are coming (or have already begun), it’s a fitting time for the United States to take stock of how the carceral system has exacerbated the harms of COVID-19, and for policymakers to seriously consider what can and should be done differently going forward.

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Empty hospital bed.

Do No Harm: A Call for Decarceration in Hospitals

By Zainab Ahmed

In an era of mass suffering, some still suffer more than others. What’s worse, there is nothing natural about it. It is human made.

As an emergency medicine resident at a large academic hospital in Los Angeles, I see how incarcerated patients’ suffering is sanctioned by hospitals and medical professionals, despite their pledge to do no harm.

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Drug test strips.

Synthetic Cannabinoids and the Lack of Substance Use Disorder Treatment in Carceral Settings

By Aaron Steinberg, Ada Lin, Alice Bukhman, LaToya Whiteside, and Elizabeth Matos

The inability of prisons and jails to address the drivers of and treat substance use disorders, especially during the pandemic, is leading to underexplored health ramifications for prisoners, and particularly for prisoners who identify as Black, Indigenous, or other people of color (BIPOC), who already had comparatively poorer health outcomes.

This article focuses on one substance of growing popularity in carceral settings: synthetic cannabinoids (SC), which are frequently referred to as K2 or spice.

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scoreboard with home and guests written on it at sunset time.

A Mind Is A Terrible _____ To Waste

By Vincent “Tank” Sherrill

You fill in the blank! I’ve often referred to the mind as a womb, or a laboratory of life, not a “thing,” but rather a place where thoughts and ideas are conceived. However, since COVID-19 has been introduced on the scene, I’ve watched a cold game being played inside two Washington State prisons: the game between “The Progression of the Mind versus The Regression of the Mind.”

I didn’t have a front row seat in the Colosseum to this American tragedy; I was one of the 2.3 million sacrificial bodies. (Some of these bodies were released, back into a society not prepared to receive, due to their own post-COVID health needs.)

Supposedly, under the watchful eye of Lady Justice, prisoners are afforded certain inalienable rights and privileges, like religious and education services, for the redemptive qualities they both provide. However, due to this plague of epic proportion within these walls (some ancient, and some modern), which have made my domicile for 28 years, these basic services that provide the space for the Mind to grow, develop, and reconcile ceased.

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cells with the doors closed at a historic Idaho prison.

The Pandemic Prison

By Dan Berger

The pandemic prison has utilized several of the worst features of incarceration as a foundational part of how the institution governs “public health” for its captives. And because prisons are never as removed from society as proponents like to think, these protocols redound far beyond the prison system itself.

The scale of COVID-19 in jails, prisons, and detention centers was expected. These institutions are defined by close quarters, poor health care, and, at least initially, little or no personal protective equipment. From the earliest days of the pandemic, anyone paying attention to jails, prisons, and detention centers knew that they would be vectors of community spread.

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Medical Hospital: Neurologist and Neurosurgeon Talk, Use Computer, Analyse Patient MRI Scan, Diagnose Brain. Brain Surgery Health Clinic Lab: Two Professional Physicians Look at CT Scan. Close-up.

Creating Brain-Forward Policies Amid a ‘Mass Deterioration Event’

By Emily R.D. Murphy

COVID-19 will be with us — in our society and in our brains — for the foreseeable future. Especially as death and severe illness rates have dropped since the introduction of vaccines and therapeutics, widespread and potentially lasting brain effects of COVID have become a significant source of discussion, fear, and even pernicious rumors about the privileged deliberately seeking competitive economic advantages by avoiding COVID (by continuing to work from home and use other peoples’ labor to avoid exposures) and its consequent brain damage.

This symposium contribution focuses specifically on COVID’s lasting effects in our brains, about which much is still unknown. It is critical to focus on this — notwithstanding the uncertainty about what happens, to how many, and for how long — for two reasons. First, brain problems (and mental health) are largely invisible and thus overlooked and deprioritized. And second, our current disability laws and policies that might be thought to deal with the problem are not up to the looming task. Instead, we should affirmatively consider what brain-forward policies and governance could look like, building on lessons from past pandemics and towards a future of more universal support and structural accommodation of diminishment as well as disability.

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