Prison life in the U.S. is tough. But when you have an intellectual, developmental or cognitive disability – as hundreds of thousands of Americans behind bars do – it can make you especially vulnerable.

In March, the Bureau of Justice Statistics, the federal agency tasked with gathering data on crime and the criminal justice system, published a report that found roughly two in five – 38% – of the 24,848 incarcerated people they surveyed across 364 prisons reported a disability of some sort. Across the entire incarcerated population, that translates to some 760,000 people with disabilities living behind bars.

Around a quarter of those surveyed reported having a cognitive disability, such as difficulty remembering or making decisions. A similar proportion reported at some point being told they had attention deficit disorder, and 14% were told they had a learning disability.

As a scholar who has researched disability in prison and conducted in-depth interviews with several adults with intellectual and developmental disabilities in the criminal justice system, I’m all too aware of the problems that incarcerated people with disabilities face. Prisoners with these disabilities are at greater risk of serving longer, harder sentences and being exploited and abused by prison staff or other incarcerated people.

Stigma and crimes of survival

The rate of both physical and intellectual disability among the prison population is disproportionately high. According to the Centers for Disease Control and Prevention, 26% of Americans report any kind of disability. Of those, 10.8% reported a cognitive disability.

This is less than half of the proportion of those in prisons. And rates appear to be on the rise – in 2011-2012, 32% of people incarcerated in prisons reported a disability, with 19% stating a cognitive disability.

High as they are, these rates are likely to be an underestimate. They are based on self-reports, and research has shown many people fail to report a disability – particularly an intellectual or cognitive disability – to avoid stigma or because they simply don’t know they have one.

The Bureau of Justice Statistics has also found that people with cognitive, intellectual and developmental disabilities are more prevalent in jails – where people are sent immediately after arrest, to await trial or to serve a sentence of one year or less – than prisons. Jails tend to be associated with what have been called “crimes of survival,” such as shoplifting and loitering. These offenses are linked to unemployed people and people experiencing homelessness – communities in which rates of disabilities are higher.

As a result, a disproportionate amount of people with disabilities enter America’s criminal justice system. I see this in my research on intellectual and developmental disabilities – diagnoses like autism, fetal alcohol syndrome, ADD/ADHD, Down syndrome, and general cognitive impairment are common in our criminal justice system.

In jail, no one listens

Between 2018 and 2019, I interviewed 27 people with these disabilities about their interaction with the criminal justice system. Eighteen reported having been arrested and/or incarcerated.

Many spoke of the harm and difficulties they face throughout the criminal justice system, from courts to being behind bars.

One man I interviewed who had various learning and attention-related disabilities and was in special education as a child told me: “I was in jail one time [because] when I didn’t understand the questions the judge was asking me, and she sentence me to three months in [county jail] because I didn’t understand.” Officially, this was for disorderly conduct.

Confusion in prison and jail can lead to violence or danger. Needing time to process instructions, particularly in high-stress situations, can be interpreted as obstinacy by staff and officers in charge. One middle-aged man who experienced incarceration on a few occasions told me that if you can’t process instructions, sometimes you are physically forced to comply. He provided the example of seeing someone with mental health needs not going to the shower when requested: “In jail, they don’t have time for that. They’ll just throw you in the shower. They’re not supposed to, but I’ve seen that before.”

Further, being seen as obstinate can lead to disciplinary reports in prison or jail, which could result in added time to someone’s sentence or the removal of certain privileges. It could also result in solitary confinement – something known to exacerbate and create mental health concerns and which has been labeled as torture by the United Nations and human rights groups. One study from 2018 found that over 4,000 people with serious mental health concerns were being held in solitary confinement in the U.S. Again, this is likely to be an underestimate.

Incarcerated people with intellectual, developmental and cognitive disabilities risk being exploited by both officers and fellow inmates. One person I interviewed who had experienced incarceration said officers look for those who have a disability by noting who only watches TV and never reads, marking them for exploitation. He went on to say that “some of the corrections officers, they be doing things they ain’t got no business doing. So they’ll slide up onto the disability boy and use him, you know, because he’d making him feel like ‘This is my dog. This is my boy right here. Come and do this for me.’ And they’ll run and do it. So I think people with disabilities are used more by deceptive corrections guards than people that read.”

Rates of these disabilities are even higher among incarcerated women, according to the Bureau of Justice Statistics report. This might be related to the fact that women have much higher histories of abuse and trauma, or because they are more willing to report these disabilities.

One woman with cerebral palsy and unidentified intellectual disabilities I spoke with said that in most jails she’d report her disability, but no one would listen to her.

Hidden behind bars

The disproportionate rates of cognitive, intellectual and developmental disability in U.S. prisons and jails have rarely formed part of the conversation on reforming our police and prison system. When discussing mental health in prison, often the focus is on psychiatric disabilities, like schizophrenia and bipolar disorder. There is good reason for this – people with these kinds of disabilities are also at high risk for incarceration.

But, I believe, it has meant that the needs of incarcerated people with intellectual and developmental disabilities have been neglected. At present, there is little support for people with these disabilities in incarcerated settings. Prisons and jails could ensure staff are better trained to interact with people with intellectual and developmental disabilities.

We could also explore strategies to divert people with intellectual, learning and cognitive disabilities away from the criminal justice system. Cities are increasingly exploring alternatives to police for responding to mental health crises, like the CAHOOTS model in Oregon in which a medic and mental health expert are deployed as first responders. Additionally, there could be more attention to these disabilities in mental health courts, which combine court supervision with community-based services. They have been shown to be somewhat effective at reducing recidivism, but which seem to focus on people with schizophrenia, bipolar, major depression or PTSD.

But before that, awareness about the presence of disability in incarcerated settings needs to be higher. The plight of incarcerated prisoners with intellectual disabilities has long been an issue lost amid America’s sprawling prison network.

Jennifer Sarrett, Lecturer, Center for Study of Human Health, Emory University

This article is republished from The Conversation under a Creative Commons license. Read the original article. The Conversation is a nonprofit news source dedicated to spreading ideas and expertise from academia into the public discourse.