Post Incarceration Syndrome (PICS)

What is post incarceration syndrome?

Post-incarceration syndrome (PICS) is a psychiatric disorder that affects individuals who have been incarcerated and then are released back into society. It is characterized by a range of psychological, emotional, and social difficulties that can arise as a result of being imprisoned. These difficulties can include depression, anxiety, post-traumatic stress disorder (PTSD), difficulty adjusting to life outside of prison, and difficulty forming and maintaining relationships. 

PICS is not currently a recognized psychiatric disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases (ICD). However, the term is used by some researchers and practitioners to describe the very real psychological challenges that people who have been imprisoned may face upon reentry.

Post Traumatic Prison Disorder (PTPD) vs. Post Incarceration Syndrome (PICS) vs Post Carceral Syndrome (PCS) – What is the difference?

In short these terms are all referring to the same phenomena of a person struggling to reenter society after being incarcerated - Mostly highlighted by the lack of mental health support during and post incarceration.

Since the advent of focusing on mental health in relation to recidivism, new terminology has begun to spring up at a higher rate – further emphasizing the lack of standards and awareness around the subject matter.

At this time, there are no distinctions in the use of these words as they are considered synonyms in 2023. However, we prefer the term “Post Incarceration Syndrome” since it has the most prevalent notoriety and traction.

Is post incarceration syndrome bad for society?

Post-incarceration syndrome (PICS) can have negative consequences for both the individual who has been affected by it and society as a whole. For the individual, PICS can lead to social isolation, difficulty finding and maintaining employment, and difficulty forming and maintaining relationships, which can contribute to a cycle of poverty and social marginalization. These difficulties can also increase the risk of recidivism, or returning to criminal behavior.

For society, PICS can also have negative consequences. If individuals with PICS are unable to successfully reenter society and become productive members of the community, this can lead to increased costs for social services, healthcare, and law enforcement. In addition, if individuals with PICS are more likely to engage in criminal behavior, this can have negative impacts on public safety and overall quality of life in the community. These issues are often compounding and systemic in the manner in which they lead to negative societal externalities.

Additionally, beyond the mere direct cost which may arise, the families of previously incarcerated individuals tend to suffer economically, emotionally, and mentally. For example, the estranged relationships between children, spouses, and immediate family members tend to be stressed considerably. 

It is important for society to address the psychological challenges that individuals who have been incarcerated may face upon reentry into society in order to promote successful reintegration and reduce the negative consequences of PICS on a community.

What are ways to mitigate the effects of post incarceration syndrome?

There are several strategies that can be used to mitigate the effects of post-incarceration syndrome (PICS). These strategies may include:

1. Providing access to mental health treatment: Individuals with PICS may benefit from mental health treatment such as therapy and medication. Treatment can help individuals manage their symptoms and improve their overall well-being.
2. Providing support and resources during the transition back into society: This can include helping individuals find housing, employment, and connecting them with social and support services.
3. Providing education and job training: This can help individuals acquire the skills and knowledge they need to succeed in the workforce and become more self-sufficient.
4. Providing peer support and mentorship: Connecting individuals with others who have successfully navigated the challenges of re-entry can be very helpful.
5. Reducing the stigma surrounding incarceration: It can be difficult for individuals with a criminal record to overcome the negative stigma associated with incarceration. Reducing this stigma can help individuals feel more accepted and supported as they reenter society.

With that said, Post Incarceration Syndrome will likely require a varied and comprehensive approach that icludes a range of interventions at the individual, community, and societal levels.

How long does post incarceration syndrome last? 

It is difficult to determine how long post-incarceration syndrome (PICS) may last, as there is limited research on the topic. However, factors that may influence the duration of PICS include the individual's pre-incarceration mental health status, the duration of their incarceration, the conditions of their imprisonment, and the level of support and resources available to them upon reentry.

Individuals who had been incarcerated are at increased risk for mental health problems, including depression and anxiety lasting up to 5 year or more based on other factor. 

It is difficult to determine how long PICS may last, as it likely varies from person to person. It is important for individuals who have been affected by PICS to have access to mental health treatment and support to help manage their symptoms and improve their overall well-being.

What are the causes of Post Incarceration Syndrome?

The exact causes of PICS are not fully understood, but it is believed that a variety of factors may contribute to the development of the condition. These factors may include:

1. Trauma: Incarceration can be a traumatic experience, and individuals who have been imprisoned may be at risk for developing post-traumatic stress disorder (PTSD). PTSD can cause a range of psychological and emotional symptoms, including anxiety, depression, and difficulty adjusting to life outside of prison.
2. Loss of social support: Incarceration may lead to a loss of social support, as individuals  lose contact with friends and family members during their imprisonment. This leads to social isolation and difficulty forming or maintaining relationships.
3. Loss of skills and knowledge: Incarceration disrupts an individual's education and employment, potentially leading to a loss of skills and knowledge. This makes it more difficult for previously incarcerated individuals to find or maintain employment.
4. Stigma: Incarceration is stigmatized in society, which make sit difficult for individuals with a criminal record to find employment and housing or to form new relationships. This haunting stigma contributes to a myriad of deleterious mental states, isolation, and shame.
5. Lack of resources: Individuals face barriers to accessing resources such as housing, employment, education, and healthcare. These barriers make it more difficult for individuals to successfully reenter society.

References:

Lykes, M. B., & Topper, M. (2007). Incarceration and re-entry: A qualitative study of the process of reintegration. Qualitative Health Research, 17(1), 92-104.

Visher, C., & Travis, J. (2003). The social context of reentry: A review of the literature on prisoners returning to the community. In R. L. T. Hotchkiss (Ed.), From prison to home: The effect of incarceration and reentry on children, families, and communities (pp. 67-115). Washington, DC: National Academy Press.

How Many People Suffer from PICS?

It is estimated that 40% of the 600,000 people released annually will have PICS.

However, it is difficult to determine how many people suffer from post-incarceration syndrome (PICS) since there are no widely accepted standards in medical publications. However, based on generally accessible data we can make some inferences. 

Likewise, according to the Bureau of Justice Statistics, there were approximately 2.3 million people incarcerated in the United States in 2019 (Bureau of Justice Statistics, 2019). It is likely that a significant number of these individuals will experience some level of PICS, although the extent and severity of these difficulties may vary.

A significant number of individuals who have been incarcerated experience difficulties adjusting to life outside of prison.

References:

Bureau of Justice Statistics. (2019). Correctional populations in the United States, 2019. Retrieved from https://www.bjs.gov/content/pub/pdf/cpus19.pdf

What are ways to help someone with PICS?

There are several strategies that can be used to help someone with post-incarceration syndrome (PICS) which include:

1. Access to mental health treatment: Individuals significantly benefit from mental health treatment such as therapy and medication. Treatment help individuals manage their symptoms and improve their overall well-being.
2. Support & resources during reentry: This includes housing, employment, and connecting them with social and support services.
3. Education & job training: This helps individuals acquire the skills and knowledge they need to succeed in the workforce and become more self-sufficient. Additionally, studies have shown access to education and training while incarcerated greatly reduces the likelihood of recidivism. 
4. Peer support & mentorship: Connecting individuals with others who have successfully navigated the challenges of re-entry can be very helpful. Firsthand knowledge passed to newly reentering individuals is paramount to outlining proper paths to follow and the pitfalls reentry proposes. 
5. Reducing the Stigma: It can be difficult for individuals with a criminal record to overcome the negative stigma associated with incarceration. Reducing this stigma can help individuals feel more accepted and supported as they reenter society.

References:

Hagan, J., & Dinovitzer, R. (1999). Collateral consequences of imprisonment for children, communities, and prisoners. Crime and Justice, 26, 115-169.

Hirschi, T., & Gottfredson, M. R. (1983). Age and the explanation of crime. American Journal of Sociology, 89(3), 552-584.

Warren, J. I., & Travis, J. (2001). The social costs of incarceration: Implications for race and ethnicity. Du Bois Review: Social Science Research on Race, 8(1), 51-70.

Are Others impacted by PICS?

Yes, others may be impacted by post-incarceration syndrome (PICS), which can contribute to a cycle of poverty and social marginalization. These difficulties can also increase the risk of recidivism, or returning to criminal behavior.

Families, friends, governmental institutions, communities, and society as a whole all the bear the cost of previously incarcerated persons who are struggling to reenter society. 

What are common signs of Post Incarceration Syndrome?

Post incarceration syndrome can be a widely varied disorder that manifests itself in numerous ways. Some commonly accepted signs of PICS may include:

1. Depression: People with post incarceration syndrome can experience feelings of sadness, hopelessness, and a lack of interest in activities that they previously enjoyed.
2. Anxiety: Individuals suffering from PICS may experience feelings of worry, nervousness, and fear that are not proportionate to the situation.
3. Post-traumatic stress disorder (PTSD): Experiencing symptoms of PTSD such as flashbacks, nightmares, and avoidance of triggers related to their incarceration is commonly noted with for previously incarcerated individuals. 
4. Difficulty adjusting to life: Reentry can be difficult, and persons with PICs may strugle to adapt to the demands and expectations of life outside of prison, including finding and maintaining employment, establishing and maintaining relationships, and navigating the criminal justice system.
5. Social isolation: Individuals with PICS may have difficulty forming and maintaining relationships, which can lead to social isolation.

It is important to note that these signs may vary from person to person and that not everyone who has been incarcerated will experience PICS. It is also important to seek help from a qualified mental health professional if you or someone you know is experiencing these or other mental health concerns.

Does PICS lead to higher recidivism rates?

Post-incarceration syndrome (PICS) is assumed to be associated with higher rates of recidivism, and returning to criminal behavior. PICS is characterized by a range of psychological, emotional, and social difficulties that can arise as a result of being imprisoned, and these difficulties can make it more challenging for individuals to successfully reenter society and become productive members of the community.

It has been noted that individuals with mental health problems, including depression and anxiety, were more likely to reoffend after being released from prison. One study found that individuals who had a history of mental health problems prior to incarceration were at increased risk for recidivism (Fazel et al., 2012).

It is important to note that the relationship between PICS and recidivism is complex and may be influenced by a variety of factors.

References:

Fazel, S., & Danesh, J. (2002). Serious mental disorder in 23000 prisoners: A systematic review of 62 surveys. The Lancet, 359(9306), 545-550.

It’s been years since I was formerly incarcerated, and I still have symptoms of PICS – what do I Do?

If you have been experiencing symptoms of post-incarceration syndrome (PICS) for an extended period of time and these symptoms are causing significant distress or impairment in your daily life, it is important to seek help from a qualified mental health professional. A mental health professional can assess your symptoms and develop a treatment plan to help you manage your symptoms and improve your overall well-being.

Treatment options for PICS may include therapy, medication, or a combination of both. Therapy can help you identify and address the underlying causes of your symptoms and learn coping skills to manage your symptoms. Medications can help to manage specific symptoms such as anxiety or depression.

It is important to be open and honest with your mental health professional about your symptoms and concerns. They will work with you to develop a treatment plan that is tailored to your specific needs and goals.

What is it like living with post incarceration Syndrome?

PICS is suffocating. Like not knowing what is wrong with you or the world - the puzzle pieces just don’t seem to line up. Paralyzing depression, fear, anger, and anxiety are just words that epitomize the revolving door I seem to be stuck in. I did my time, but the lasting vestiges of a draconian punishment system never cease to torment. 

Regardless of the offense, sympathy is unheard of. Nay, discouraged. The stigma that is rampant within society for previously incarcerated individuals is akin to the high school football coach telling you to “man up” and “walk it off,” despite the horrific injury you may have endured. 

Imagine all the doors in your life being closed - on top of that you're blind, def, and dumb. Post incarceration syndrome leads me down a path of bad choices, but to me they seem good. I don’t know I’m a snowball gathering momentum down a hill. I don’t know that I’m just another failed statistic. I’m just a broken version of my former self trying to reenter a world that no longer tolerates me. 

My friend/spouse/family member has PICS – what do I do? 

If you have a friend, spouse, or family member who has been affected by post-incarceration syndrome (PICS), it is important to provide them with support and understanding. Here are some things you can do to support someone with PICS:

1. Listen and offer emotional support: It can be helpful for individuals with PICS to have someone they can talk to about their experiences and feelings. Encourage your friend or family member to share their thoughts and feelings with you and let them know that you are there to listen and support them.
2. Encourage them to seek help: If your friend or family member is experiencing significant distress or impairment as a result of PICS, encourage them to seek help from a qualified mental health professional. A mental health professional can assess their symptoms and develop a treatment plan to help them manage their symptoms and improve their overall well-being.
3. Help them connect with resources: There are many resources available to help individuals with PICS manage their symptoms and reenter society. These may include therapy, medication, peer support groups, and community resources such as housing and employment assistance. Help your friend or family member connect with these resources as needed.
4. Be understanding and patient: Adjusting to life outside of prison and managing PICS can be a long and challenging process. It is important to be patient and understanding with your friend or family member as they navigate these challenges.

We encourage you to be supportive, but at the same time not rely solely on your own intuition to address these issues. There are experts, peer support groups, and accredited professionals with years of experience in handling these issues. Make sure to be self-aware of your own capacity to help and seek outside help as soon as possible. 

Does Post Incarceration Syndrome Last forever? 

It is difficult to determine how long post-incarceration syndrome (PICS) may last, as PICS is a proposed psychiatric disorder and there is limited research on the topic. PICS is characterized by a range of psychological, emotional, and social difficulties that can arise as a result of being incarcerated, and these difficulties can persist for an extended period of time.

However, it is important to note that with proper treatment and support, individuals with PICS can learn to manage their symptoms and improve their overall well-being. Treatment options for PICS may include therapy, medication, or a combination of both.

It is difficult to determine how long PICS may last, as it can vary from person to person. However, with proper treatment and support, individuals with PICS can significantly reduce the severity of their symptoms.

Is Post Incarceration Syndrome PTSD – what are the differences?

While PICS may include symptoms of PTSD, it is important to note that PICS is not the same as PTSD. PICS is a proposed disorder that is used by some researchers and practitioners to describe the psychological challenges that individuals who have been incarcerated may face upon reentry into society. PTSD, on the other hand, is a recognized psychiatric disorder that is characterized by specific symptoms that occur after a traumatic event.

In conclusion, PICS may include symptoms of PTSD, but it is important to note that PICS is not the same as PTSD.

Should Lawmakers be concerned about PICS?

Lawmakers need to be concerned about post-incarceration syndrome (PICS) due to the  negative consequences of PICS for individuals who have been affected by it and for society as a whole. 

For instance, if individuals with PICS are more likely to reoffend, this can have negative impacts on public safety and overall quality of life in the community. Additionally, if individuals with PICS are unable to find and maintain employment and become self-sufficient, this can place a burden on social welfare systems.

Lawmakers who are concerned about PICS may consider implementing policies and programs to address the psychological challenges that individuals who have been incarcerated may face upon reentry. For example, lawmakers may support initiatives to provide access to mental health treatment, education and job training, and peer support and mentorship for individuals with PICS.

What are the Stages of Post Incarceration Syndrome? 

It can possibly be indefinite if resources are not readily available upon release. 

People with PICS tend to have a 6 stage post-release symptom progression that leads to recidivism:

1. Stage 1 of this Post Release Syndrome is marked by Helplessness and hopelessness due to the inability to develop a plan for community reentry, often complicated by the inability to secure funding for treatment or job training;
2. Stage 2 is marked by an intense immobilizing fear;
3. Stage 3 is marked by the emergence of intense free-floating anger and rage and the emergence of flashbacks and other symptoms of PTSD;
4. Stage 4 is marked by a tendency toward impulse violence upon minimal provocation; Stage 5 is marked by an effort to avoid violence by severe isolation to avoid the triggers of violence;
5. Stage 6 is marked by the intensification of flashbacks, nightmares, sleep impairments, and impulse control problems caused by self-imposed isolation. This leads to acting out behaviors, aggression, violence, and crime, which in turn sets the stages for arrest and incarceration.

Is Post Incarceration Syndrome Associated with mental health?

People with PICS are at high risk for developing substance dependence, relapsing to substance use if they were previously addicted, relapsing to active mental illness if they were previously mentally ill, and returning to a life of aggression, violence, and crime. They are also at high risk of chronic unemployment and homelessness.

It's incited towards disintegration of one's mental capacity. Not a natural mental health disorder occurring by chemical imbalances. 

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