Mental Health Awareness Month should not stop at awareness.
If the past several years—through COVID-19 and beyond taught us anything, it is that mental health matters just as much as physical health. We hear influencers and celebrities talking openly about anxiety, depression, trauma, and burnout. The conversation has shifted. But the system has not kept pace.
While we watch these cameos and believe we can now diagnose our friends and family, the reality remains that we treat mental health needs differently than we treat any other illness. A disease of the brain is still met with stigma, silence, and fear—fear of being judged, labeled, or exposed. No one hesitates to seek care for heart disease or diabetes. Yet many hesitate to pursue treatment for psychosis, depression, or substance use because they fear what others might think.
And nowhere is this gap more visible than in our correctional system. Correctional staff have little problem labeling someone in their care as needing mental health help while failing to recognize their own needs. The conversations may stem from a lack of resources, clear medication needs, or concern for safety, but the way we react, talk about, and care for those with serious brain disease and neurological disorders in jails and prisons around the country is the talk that is informing our colleagues what we think about these needs. “Dude needs some meds” or “call mental health, we have a crazy one” informs those around us that we do NOT think these needs are the same as the insulin required by a person with diabetes, or the need for a physician when someone is having chest pain.
This article could take two different directions, but I will argue that staying connected to both ends is the truest need.
On one hand, jails and prisons have become the largest mental health facilities in the United States. We do not say this with pride—but we should acknowledge it with urgency. More than 40% of individuals in U.S. jails and prisons have a diagnosed mental health condition—more than double the rate in the general population. [samhsa.gov]
A person should not have to become violent, suicidal, incarcerated, homeless, or severely deteriorated before help is available. And yet, our systems around the country are structured so that “dangerousness” becomes the gateway to treatment.
Today, we wait until someone is in crisis—until their illness disrupts public safety—before we can intervene. We call this a right to …. But what about the right to be well? By time someone is in crisis and a danger to themselves or others, the consequences are far more complex, far more costly, and far more damaging to individuals, families, and communities.
If we are serious about reducing incarceration and improving public safety, we must stop using crisis as the entry point for care.
But the story does not end there.
On the other side of the cell door are the men and women who work in these environments every day—correctional staff whose behavioral health needs are often overlooked, under-discussed, and under-resourced.
The toll is profound.
Correctional professionals experience significantly higher rates of trauma, depression, and suicide than the general population. In fact, research shows correctional officers have a suicide rate approximately 40% higher than other working-age adults and an average life expectancy of just 59 years—more than a decade shorter than the general U.S. population. [news.siu.edu]
These are not incidental outcomes; they are the result of chronic exposure to stress, trauma, and human suffering in environments few outside the profession truly understand.
As we come off Correctional Officers’ Week, it is worth asking: when was the last time we truly considered what this work requires?
It is not simply locking doors or ensuring order.
- It is holding someone steady while they receive involuntary medication for their acute psychosis.
- It is calmly responding to accusations fueled by delusion and hallucinations —being told you have harmed someone when you are simply trying to help.
- It is guiding a person with dementia who no longer knows where they are, helping them navigate fear and confusion in an already disorienting environment.
- It is ensuring basic hygiene for individuals whose brain disorders prevent them from understanding their own basic needs.
- It is making split-second decisions—sometimes using force against someone with serious mental illness —because you fear what may happen next.
- It is witnessing severe violence.
- It is responding to an overdose and administering Narcan to save a life.
- It is cutting someone down after a suicide attempt.
This is the reality of correctional work. And we ask people to carry these experiences, day after day, often without adequate support in an environment built to punish those who live inside.
So yes—Mental Health Awareness Month matters. But awareness alone is insufficient.
Green ribbons and slogans do not expand access to care. Green ribbons do not fund early intervention. Green ribbons do not support families. Green Ribbons do not change outcomes.
If we want meaningful change, we must focus on four priorities:
- Expanding access to treatment earlier—before crisis becomes the entry point. We must advocate for the right to be well.
- Reduce stigma so individuals feel safe seeking care. Acknowledge that someone needing mental health help is no different than someone needing physical health help.
- Support families and communities who are often the first line of response.
- Invest in behavioral health services across systems, not only after someone enters the justice system.
Corrections is not separate from the community—it is a reflection of it. And because of that, it has the potential to lead.
Correctional facilities sit at a critical intersection of public health and public safety. They see the consequences of untreated mental illness every day. They also have the opportunity to model a different approach—one rooted in early intervention, coordinated care, and trauma-informed practice.
We can—and should—do both: improve care for those who are incarcerated and invest in the well-being of the staff who serve them.
We can partner with organizations like the National Alliance on Mental Illness (NAMI), Mental Health America (MHA), and the National Shattering Silence Coalition (NSSC) to build stronger, more responsive systems.
We can invite our communities into the conversation—help them understand the realities of correctional work and the shared responsibility for change.
We can shift from reacting to crisis to preventing it.
Mental Health Awareness Month should not be the end point of the conversation. It should be the catalyst.
Because awareness without action does not save lives.
But action can.
Dr. Deanna Dwenger, PsyD, HSPP, is Chief Behavioral Health Advisor for Elevatus Architecture.
References
Substance Abuse and Mental Health Services Administration. (2024). About criminal and juvenile justice & behavioral health. U.S. Department of Health and Human Services. https://www.samhsa.gov/communities/criminal-juvenile-justice/about
Jayawardene, W., Kumbalatara, C., Jones, A., & McDaniel, J. (2024). Work stress and psychoactive substance use among correctional officers in the USA. Psychoactives, 3(1), 65–77. https://doi.org/10.3390/psychoactives3010005
Southern Illinois University. (2024, June 26). SIU researchers find prison guards suffer PTSD and other issues but get little help. https://news.siu.edu/2024/06/062624-siu-researchers-find-prison-guards-suffer-ptsd-and-other-issues-but-get-little-help.php
Bureau of Justice Statistics. (2021). Indicators of mental health problems reported by prisoners (NCJ 252643). U.S. Department of Justice. https://bjs.ojp.gov
