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Book Review   |    
Aaron Moore
Psychiatric Services 2010; doi: 10.1176/appi.ps.61.5.535

by Kathleen A. Cairns; Albuquerque, University of New Mexico Press, 2009, 224 pages, $27.95

Dr. Moore is with the Department of Psychiatry, UMass Memorial Health Care, Worcester, Massachusetts.

We live in a country where over 2.3 million people are incarcerated, according to the U.S. Department of Justice. Evidence indicates there may be more people with mental illness in prisons and jails than in all U.S. psychiatric hospitals combined (1). In the words of Angela Davis, "Democratic rights and liberties are defined in relation to what is denied to people in prison. So we might ask, what kind of democracy do we currently inhabit?"

Despite $200 billion in annual local, state, and federal expenditures, most correctional facilities remain overcrowded and abusive and provide minimal, if not unconstitutional, health care. Although men constitute the majority of prisoners, there has been a stunning rise in the number of female prisoners over the past quarter-century. Between 1977 and 2004, the female prisoner population grew by 757%, far exceeding the 388% increase in the male prisoner population, with over 96,000 women in U.S. prisons in 2004 (www.ojp.usdoj.gov/bjs). Currently 40% of women in prison are incarcerated on drug or fraud charges. Half are African American. The vast majority were earning less than $10,000 annually before incarceration. Seventy percent of women in prison have children, and half of these mothers have no visits with their children while incarcerated (www.ojp.usdoj.gov/bjs).

The enormous proliferation of prison beds in the past 40 years is mirrored by a decrease in nonforensic psychiatric inpatient beds. It is easy to imagine a different utilization of public resources to address intersections between substance abuse, mental health, and criminal behavior. But can mental health advocates and prison reformers move their hopes toward political and social change? With prisons and jails a common way station for many with mental illness, how can advocates shape penal or rehabilitation policy in the Obama era?

Hard Time at Tehachapi examines the conditions and actors that created a brief but radical prison reform in the early half of the 20th century. The book explores the attempt at implementing more humane treatment within an institutional setting. The California Institution for Women at Tehachapi offers a case study of a group of women who, excluded from most realms of political power, enacted a remarkable model of state-run rehabilitation for female prisoners in California from 1933 to 1952.

The majority of this book traces the effort to establish a female reformatory and the struggle to maintain the rehabilitative goals that set Tehachapi apart from earlier prisons, such as the one at San Quentin. The women's groups and educated professional women who created the Tehachapi facility shared the Progressive Era philosophy of reengineering society. The founders believed that fresh air, hard work, and education were preferable to the brutal conditions women faced while sharing space with men in prison.

Tehachapi wasn't the first exclusively female prison, but it differed from ones founded earlier. It was racially integrated and actively sought to house felons. On 1,600 acres in a rural farming area, with gardens and cottage-style residences, Tehachapi was home to 426 prisoners at its peak. Many inmates had individual rooms and could wear their own clothes. Women performed agricultural tasks on a working farm, produced theater performances, and held county fairs with parades. Inmates had their own newspaper, and attending vocational and educational classes was a mainstay of prison life. In the 1940s the recidivism rate at Tehachapi hovered around 10%.

Tehachapi's model for reform was generally based on white middle-class "family" values. Soon after its start, Tehachapi reformers recognized that implementing a rehabilitative agenda was more complicated than anticipated. The women they aimed to rehabilitate turned out to be complex individuals, and not all were thrilled about partaking in a rehabilitation agenda aimed at turning them into paragons of middle-class domesticity.

This book explores how the coalitions and political climate that created Tehachapi soon fell apart. Power struggles and in-fighting among Tehachapi superintendents, warders, and state women's groups—with arguments often based on class and lack of political power—contributed to Tehachapi's demise. The fading of the Progressive Era, new Cold War fears, and an increasingly punitive power structure ultimately forced Tehachapi's closure.

Cairns questions how changing gender politics have affected the evolution of women's prisons. For a brief period, Tehachapi changed the view of prisons as "male places." The pursuit of gender equality may have created more inhumane prisons for women; that is, equality came to mean that female prison conditions resembled those of male prisons. The idea of female prisoners having different needs than men was abandoned. The idea of male prison guards for a women's prison would not have been accepted in Tehachapi's time. Although Tehachapi's essentialist notions of "maternal domesticity" were problematic, Tehachapi administrators dedicated themselves to creating a safe space for women of all classes and ethnicities. Tehachapi tangibly cared for female prisoners and their futures. Cairns argues that this sensibility has been all but lost.

To end the book, Cairns soberly describes the current state of California women's prisons. The coddling and maternal approach has been pushed out, and there are no inmate publications. The rolling hills and cottages of Tehachapi have been replaced by the bleak cinderblocks and warehouses that house 4,000 prisoners, the largest female-only prisons in the world, with seven or eight women to a cell. Current prisoners have a severely deeper distrust of staff and fellow inmates; less than one-third of inmates are enrolled in academic, vocational, or job-training classes. There is minimal drug counseling. Over half of female inmates reoffend, over half have drug and alcohol disorders, and over three-quarters have traumatic abuse histories. Inmates today are often "stunned at the notion that politicians, journalists and society at large ever cared much about inmates."

Despite its impermanence, Tehachapi remains a lesson in prison rehabilitation policy. The facility was a two-decade experiment in a radically different form of incarceration and a "near miracle [to have] existed at all." Tehachapi happened when committed advocates used political savvy to take advantage of an opportune opening. The result was idealistic and imperfect but was an example of more humane and transformative treatment for a vulnerable and neglected population.

This is an easily accessible book, written in a journalistic tone fitting the author's previous career as a reporter. Currently a women's studies and history professor, Cairns offers in her book a well-researched story of an important time in the history of American penology. It will appeal to those interested in rehabilitation, forensics, women's and social movements, and of course those working with the incarcerated. The book personalizes the policy and social movements that formed this history. Cairns takes an interdisciplinary approach to understand the politics and culture of the eras, threading individual narratives of inmates, inmate advocates, superintendents, and prison reformers into the larger political fabric.

The reviewer reports no competing interests.

Lamb RH, Weinberger LE: Persons with severe mental illness in jails and prisons: a review. Psychiatric Services 49:483–492, 1998


Lamb RH, Weinberger LE: Persons with severe mental illness in jails and prisons: a review. Psychiatric Services 49:483–492, 1998

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