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COVID-19 Is Harming Mental Health in Prisons

A new study shows COVID-19 worsens mental health for prisoners and workers.

by Alexandra Brewis and Amber Wutich

A new paper in Medicine, Science, and the Law finds that the mental health of people detained and working in prisons has been worsened by the COVID-19 pandemic. Drawing from past literature and recent reports in the UK, the authors advocate for increased attention to mental health for prisoners and prison workers facing COVID-19 risks.

Underfunding and overcrowding in prisons put prisoners at greater risk of contracting COVID-19, the authors note. Inadequate equipment, weak social distancing, and poor infection control causes fear and anxiety. Early evidence indicates that stigma and fear may lead prisoners to hide symptoms of COVID-19 and mental ill-health, worsening health outcomes. Mental health workers report that the COVID-19 pandemic has triggered an across-the-board deterioration in prisoners’ mental health. With the suspension of non-essential services, the authors argue, prisoners may be denied pastoral, educational, and therapeutic services.

Prison workers, too, are at elevated risk of mental ill-health, the authors argue. In addition to the stresses of overwork, disease risk, and poor working conditions, the paper notes, prison workers are reportedly suffering moral injuries. Moral injury happens when people commit or witness acts that deeply violate their own moral and ethical beliefs. People who experience moral injury are more likely to develop anxiety, depression, substance abuse, PTSD, and suicidality. The authors indicate that Black prison workers, and prison workers from other minoritized groups, may be particularly affected by COVID-19 risks and related mental health harms.

An emerging literature on COVID-19 is documenting widespread moral injuries among doctors and other healthcare providers who see patients die needlessly due to a lack of equipment, personnel, or inequitable care. Prior studies of moral injuries have largely focused on military combatants or others who have seen civilians injured or killed in war (like journalists).

This study is the first to highlight prison workers’ risks of incurring moral injuries while doing work that violates their morals and ethics. As such, it makes an important contribution to our growing understanding of the ways in which people are harmed by doing work that sustains unjust, immoral, unethical, or structurally violent systems.


Kothari, R., Forrester, A., Greenberg, N., Sarkissian, N., & Tracy, D. K. (2020). COVID-19 and prisons: Providing mental health care for people in prison, minimising moral injury and psychological distress in mental health staff. Medicine, Science and the Law
0(0) 1–3. DOI: 10.1177/0025802420929799

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