From the first day I walked into prison at the Texas Department of Criminal Justice (TDCJ) in 2021, I knew mental health struggles were slowly creeping up on me, like a looming shadow.
I had given birth to my only child in jail just over a year prior, in 2020, and I had festering feelings of anger and hopelessness. What I did not know was that I was in the full swing of postpartum depression. I was fighting an opponent completely invisible to me.
It would take seven months after my initial request for mental health support to receive an appointment and be evaluated. I received a swift diagnosis of postpartum depression as well as bipolar depression and was prescribed two psychotropic medications. The appointment concluded with a dismissal to be seen again in six weeks.
As I rose from my seat, dumbfounded, I thought of asking if I should be looking for any telltale signs that the meds weren't right for me. The provider said, "Drop a sick call if you feel funny," but to take the medication continuously for three weeks. Then, I was asked to leave the office.
Adjusting to the foreign medication came with its difficulties. As an unpaid prison worker, the drowsy side effects from both medications left me struggling through my days. Receiving disciplinary infractions due to medication-induced lethargy and deep, deep sleep made working almost impossible.
My experience is not unique. While free people can personally research medications online, people incarcerated by the TDCJ do not have this privilege. Instead, we are purposefully left uninformed of prescription risks. With a $13.55 fee for each medical visit, it's easy to understand why thorough care and information are so regularly withheld, especially since people in Texas prisons are forced to work for no pay and many depend solely on family support to pay the fees. It wouldn't be a far reach to believe that money is more valuable to the state than incarcerated people's health. Their treatment of us all but screams it. The only way we can protect ourselves is by getting informed through outside support, if possible. Otherwise, we suffer because of the ignorance we're forced into.
Mental health needs are prevalent across all prisons. According to 2016 data analysis by the Prison Policy Initiative, 56 percent have "recent or prior history of mental health problems." The problem is most acute for women who are incarcerated, as a 2017 report by the Bureau of Justice Statistics found that in 2011 and 2012, 20 percent of women in jail and 30 percent in prisons had experienced "serious psychological distress" in the month before the survey, compared to only 14 percent of jailed men and 26 percent of men in prison.
Outside of prison, mental health diagnoses, medications, and treatments have received growing attention throughout recent years. The ability to find ideal treatment plans based on the uniqueness of each individual has advanced. Yet, Texas prisons remain uninvolved and impersonal; these institutions set out not to help, but to harm. The proof lies within the walls of TDCJ's women's unit.
In my dorm, I listened attentively to a middle-aged woman named Jenny. Like myself, she is one of many women who did not come into TDCJ with a mental health diagnosis, but was prescribed medications to cope, without being advised of the risks.
"I noticed the [medication's side effects] in the first week, but I just brushed them off. I thought they would eventually fade after the three-week mark," said Jenny, who was prescribed the psych medication Ziprasidone (also called Geodon), one of the two I was also prescribed. Jenny now suffers from many physical impairments—including muscle tightening, locking, and spasming, all of which have affected her lower extremities, disrupting her mobility and making speaking and eating increasingly difficult. "The providers don't give a damn, and I'm walking proof," said Jenny.
Contrary to the provider's advice, Jenny demanded that I "discontinue [taking the pill] immediately if anything is off with my body." I took heed of her warning. Relying on other incarcerated people who freely offer medical advice from personal experience has been greatly favored, rather than asking medical staff, who have unhelpful advice to offer for a $13.55 fee.
Ironically, when I was a child, my mother would tell me to always listen to the doctor's advice and no one else's. Now, as an adult in prison, I find the doctors both unreliable and unhelpful. Many health concerns are passed off as manipulation tactics, and when they are addressed, it is not with effective or thorough care. TDCJ's informal, yet daily practice of medical care follows these lines: visible afflictions get treated, non-visible concerns get dismissed. Sacrificing diligence for quick treatment, dismissals, or false diagnoses is a dangerous game to play. Still, providers in TDCJ regularly tread the thin line.
The lax, almost nonexistent concern of mental health provisions in TDCJ has also led to high rates of thoughtless self-medication. This can contribute to substance abuse disorders with psych meds.
As staff ridicule incarcerated people by saying things like "Bitches getting high on crazy meds," it is evident they have no concern for our mental health. Most of those incarcerated are unaware of what they're battling internally and have a major disadvantage in seeking proper guidance. The lack of support, combined with the prison's oppressive environment and officers' behavior, prevents suffering people from getting the help they need.
It wouldn't be a far reach to believe that money is more valuable to the state than incarcerated people's health. Their treatment of us all but screams it.
My second prescribed medication, Carbamazepine (also called Tegretol), is quite popular in TDCJ. Given its drunken-like effects when taken in large amounts, this mood stabilizer has been the cause of many overdoses. It is frequently traded and sold among those incarcerated, but what is unknown to consumers are the life-threatening side effects, commonly ignored by those who are driven by the disease of substance dependency.
At my six-week follow-up, the provider asked if my mood had improved. After stating that there was no change and the Carbamazepine made me itchy, I was told to "monitor it" because it could result in a much worse syndrome, which in turn could cause a burning sensation across the skin and progress to visual or internal burns, peeling, and falling off of the skin.
"Why aren't you telling people that upfront?" I demanded, only to be told that they can't help unless we tell them. Yet, the provider still deemed it best to up my dosage since there was no change in my mood. He also prescribed Benadryl to counteract the itch.
Walking around my prison, I have seen many people dragging along in a numb or unsteady trance, contrasted by the crazed eyes of people riding the peaks of other medications. All seeking different reliefs, hardly any of us aware of the possible consequences. When psychiatrists leave consumers ignorant of the risks, it only enables the normalization of usage with unmonitored dosages. This band-aid treatment offers temporary fixes, exacerbating existing problems by the negligent care offered.
About a year after my initial prescription, I was being scheduled for an electrocardiogram. Confused, since I never had heart problems, I asked the nurse for the reason behind the test. She informed me that the psych doctor ordered it because my combined medications could cause slow heart rates and other heart issues.
I was left in the dark about what I battled internally, from the diagnoses to the medication I consumed. I sat down and weighed the benefits, eventually deciding that I needed to find a route that didn't have so many negative side effects.
With the help of outside support—who supplied exercises from the Internet, passed through my e-message platform—I combined my medications with self-therapy and journaling. I learned that medication alone did not work for me; it only blanketed very serious problems I needed to confront head-on. After officially denouncing the meds, it is still a struggle, but the pain is easier managed, thanks to countless reading materials on postpartum depression and self-healing—which TDCJ did not offer.
The best thing anyone seeking help for mental health can do is to get educated on what they are struggling with. Turn to caring support systems and people who can help locate common symptoms, find accessible coping techniques, and educate on non-medicinal routes.
Psych medication can only help with proper dosages, knowledge, and pairing based on the individual. This due care is not offered by TDCJ. Instead, incarcerated people are treated more like lab rats than patients, as if we have no futures. We're given half-hearted care, as if we are lost causes.
An incarcerated woman's family will always see them as a mother, daughter, or sister. That unbiasedness should also be reflected in all medical staff, who have taken oaths to treat all of their patients—despite their location, race, or sickness—with the same concern and care. Sadly, that treatment does not make an appearance in Texas prison medical facilities.
Yes, we may be incarcerated, but we are still humans, and that should be reason enough for fair medical care.