“People can assess me, interview me, incarcerate me, observe me, and think they know what I need,” said Shawn, a person in his early 50s who spent 15 years out and in of prison. “And that may be an educated guess, but at the end of the day, I live inside this body, inside this head. I know what I need.”
Sean is certainly one of 29 formerly incarcerated black men living in Philadelphia that I interviewed as a part of my research. Coping with the mental health effects of incarceration. His name and the names of other people quoted in this text are pseudonyms chosen to guard their privacy.
I study incarceration, mental health and access to health care. I've written before about how incarceration in jails and prisons can have an enduring impact on mental health. But I also wanted to know how the lads I interviewed recognized and addressed their mental health needs—through coping strategies, talking with family and friends, and searching for mental health treatment.
depressed but ‘okay'
each Research And Medical practice often Failed to capture correctly How formerly incarcerated Black men discover their mental health needs. This is partly because implicit bias and Against Black Racism How mental health is assessed and treated in each correctional and community facilities.
Most of the lads I spoke with said that the mental health screenings they received while incarcerated were simply designed to “check boxes” and convey the sensation that nobody really cared.
“They will listen. They will ask relevant questions,” Malcolm, 62, explained. “Then they'll talk to you and then they'll forget all about you.”
Some of the lads received diagnoses they didn't understand or imagine. John, 29, described how a judge ordered him to undergo a mental health evaluation and that he was diagnosed with post-traumatic stress disorder.
“I didn't take it seriously,” he said. “I didn't start to understand and believe in mental health until I was locked up for a long time. I started reading about it and studying it. … That's how I started to see therapy as important.”
Comparing the best way participants described their mental health in their very own words during interviews with standardized screening tools revealed a major pattern. Most described themselves as “good”, “happy”, “peaceful” or “doing well”. Yet just about all reported symptoms of depression, anxiety or PTSD.
More than half reported three or more PTSD symptoms, resembling trauma-related nightmares or constant alertness and being easily startled.
These findings indicate that what appears to be resilience or well-being on the surface may mask underlying mental health needs, and the way these needs are expressed. Shaped by culture And Life experiences.
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Coping procedures
Participants described self-reliance as essential to coping with incarceration and life after release. With physical separation from family and community, strained relationships, and limited resources after release, many felt as in the event that they had to administer their mental problems on their very own.
“When you're in prison, you learn to be self-reliant,” said Kane, 56.
Some said that imprisonment reinforced existing coping strategies that they had, resembling exercise, prayer, journaling, reading and meditation.
“I was always active,” said Ty, 31, who participated in a military-style boot camp while incarcerated. “I learned easy methods to use. [exercise] To deal along with your emotions.”
Others were introduced to recent coping skills. educationalvocational and recreational programs inside their correctional facilities. Men talked about it. Earn a GED, take college courses, Learning the trade And participating in other organized events helped them manage stress and connect with others.
Unfortunately, the Availability of such programs is limited.
Bottled up feelings
Many of the participants in my study described wanting to do things “differently” after incarceration, as a substitute of repressing their emotions.
Some directly linked emotions to the behaviors that led to their incarceration.
“[You’ve] Let many things be made and then [you’ll] Go out and hit the first person you see,” explained David, 30. “I'm getting more comfortable expressing myself, whether it's to my mom or a friend.”
But finding the precise people to trust could be difficult.
“I try to express myself every day. People laugh and make fun of me,” Shakur, 21, said. “If I had someone to sit down with me one-on-one and talk to me about my problems, I would feel better.”
Romantic relationships were also difficult to navigate.
“We come back to them broken. And they're trying to fix us, but they don't know how to fix us. They're broken, too,” Thomas, 44, said.
Mass incarceration doesn't just fracture individuals—it End romantic relationships.as those left behind often navigate their economic pressures, limited resources, and emotional distress.
Participants emphasized that talking with individuals who have shared similar experiences made it easier to precise themselves and help them navigate difficult moments.
Strong mistrust of institutions
Many participants expressed a deep distrust of mental health treatment inside correctional facilities.
“As a black man living to age 62, I do not trust the federal government The Tuskegee Experience What that they had. Running in Holmesburg Prison.Carl said. “How can you trust him?”
Paul J. Richards/AFP via Getty Images
The Tuskegee Study was a research study conducted by the US federal government from 1932 to 1972. It followed black men with syphilis but was withheld from effective treatment even after treatment became widely available within the Nineteen Forties. This led to preventable suffering and deaths.
During the Holmesburg Prison Experiments, conducted at a jail in Philadelphia from the Fifties to the Seventies, University of Pennsylvania researchers tested pharmaceuticals and chemicals on incarcerated men, lots of whom were black, without proper informed consent.
Some of the lads I interviewed also reported experiencing or witnessing abuse after reporting mental health concerns, they usually expressed fear that searching for help while incarcerated would result in punishment reasonably than help.
stigmatization and searching for help
After release, participants expressed concerns that they'd be seen as “weak” by their peers in the event that they spoke about their problems. This mental health stigma acted as a barrier to searching for treatment.
“For people like us, as far as being black, African American, it's not normal to reach out to a therapist,” David said.
Some men, like Antonio, who described feeling like “the walls were closing in on me,” were motivated to hunt treatment for significant mental distress. Others were motivated by a desire to enhance their relationships with their wives or children.
About 70% of participants had used formal mental health services in some unspecified time in the future. Some were ordered into treatment, while others sought help voluntarily – sometimes at local walk-in clinics and behavioral health centers resembling Wedge Recovery Centersa Philadelphia staple that was mentioned by several participants but closed in May 2025 resulting from financial losses.
Communities can work together. Reduce stigma Take expressions of mental distress from formerly incarcerated men seriously, and create spaces where they feel protected, around searching for mental health support and formal treatment.
Participants named visible, neighborhood clinics with walk-in behavioral health services where they felt they may go in moments of need. Increasing the visibility of those services, conducting outreach and integrating formerly incarcerated men Peer navigators Can help construct confidence.