Spectrum: Autism Research News
Autism behind bars
Prisons are often ill-equipped to handle autistic inmates, who are at risk for mental health problems and abuse.
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Andrew Beasley was quickly losing his cool. It was October 2015, and he was about two years into his sentence at the Federal Correctional Institution, Fort Dix in New Jersey.
Beasley, then 32, had left his MP3 player on a charging station in the facility’s computer room, but when he went to retrieve it, it was gone. He thought he knew who had it and frantically started to look for the man.
“I’m forgetting politics. I’m forgetting everything. I’m just looking for my MP3 player,” says Beasley, who had been diagnosed with autism two years earlier.
In the heat of the moment, he had also forgotten the man’s name. When Beasley spotted him, he shouted, “Yo, yo!” and when the man ignored him, he grabbed the shoulder of the man’s jacket. The man spun around and snatched Beasley up by his coat collar. A screaming match ensued.
“Did you see my MP3 player?” Beasley demanded.
The other man denied any knowledge of the device’s whereabouts, shoved Beasley away and stormed off. Beasley found a quiet place to cool down — but it was not long before the man found Beasley again. “He walks up to me,” Beasley recalls. “I’m sitting on the floor; he crouches down. He just starts, you know, speed-bag punching my ribs. I think it was about 14 hits.”
Two months later, another inmate attacked Beasley after he refused to switch beds — the man did not want to sleep near Beasley and wanted him to move farther away.
Violence is hardly rare in prison: About one in five men in the U.S. prison population is assaulted by another inmate or by prison staff every six months, according to a 2009 study. But prison holds particular dangers for people with autism, who are prone to anxiety, inflexible thinking and sudden outbursts — traits likely to provoke the ire of others. For those with sensory sensitivities, the crowded, noisy spaces and bright lights of prison can exacerbate their anxiety and other traits. And many autistic inmates are oblivious to social cues that are critical to peacefully navigating the prison environment.
As a result, they are apt to get into fights or become the target of bullies who see them as reactive or gullible. “People with autism don’t get unwritten rules,” says Glynis Murphy, a clinical psychologist at the University of Kent in Canterbury, England. “They don’t get them when they’re out in the community, and they don’t get them when they’re in prison.”
Compounding the problems autistic people face behind bars is the fact that prisons tend to be ill-equipped to accommodate inmates on the spectrum. Most facilities are chronically short of mental health professionals, who tend to prioritize schizophrenia and other conditions that present a greater security risk than autism does. And corrections staff are rarely trained to recognize and appropriately interact with autistic people. Prison officials sometimes see them as troublemakers and mistakenly blame them for altercations, Murphy says.
“There’s a really basic issue of whether prison works for people with autism.” Glynis Murphy
Two weeks after the second attack on Beasley, for example, the prison lieutenant called Beasley into his office — for the 26th time since his arrival at Fort Dix. “You know what?” Beasley recalls the lieutenant saying. “There’s something wrong with you.” The lieutenant placed Beasley in a special housing unit popularly referred to as ‘the hole.’ For 96 days, he was confined to a 6-by-8-foot cell with two other inmates. As the third man in a two-bunk cell, Beasley had to sleep on a razor-thin mattress on the floor, his head 2 feet from a shared toilet. “I’d be up at night staring at the brick walls,” he says. “It was really disturbing, psychologically.”
Spectrum contacted two prisons where Beasley was held. Fort Dix declined to comment. The second facility, the Federal Correctional Institution, Danbury in Connecticut, redirected Spectrum to the Northeast Regional Office of the Federal Bureau of Prisons, which did not respond to requests for comment.
There is no official count of autistic prisoners in the United States or any other country, but studies suggest they are plentiful. Survey data from the U.S. Bureau of Justice Statistics show that in 2011 and 2012, 30 percent of women and 19 percent of men in U.S. state and federal prisons had a ‘cognitive disability,’ a category that includes autism. A 2012 study of 431 male prisoners in the U.S. found an autism prevalence of 4.4 percent, about double the prevalence in the general population. Many other prisoners on the spectrum may go undiagnosed.
Autism itself is not associated with crime, but it is linked to factors, such as unemployment and homelessness, that research shows increase a person’s chances of entering the criminal justice system, often repeatedly. The result is a large population of people at high risk of abuse behind bars. “There’s a really basic issue of whether prison works for people with autism,” Murphy says. “I’m not a great believer in prisons anyway, but I think they’re even less appropriate for people with autism.”
Beasley was arrested on 3 October 2012 while coming home from the grocery store with two boxes of Nutty Buddy snack bars and two bags of pierogies. A police car followed him back to his mother’s house; as soon as he opened the door, he felt a hand on his wrist, he says. He did not deny the offense: 26,492 photographs of child pornography on his computer. He remembers the exact number because he had obsessively organized the illicit files on his computer. “I always hated myself for it,” he says of his compulsion. “I felt entirely helpless against it.”
The public defender listened to Beasley’s history of depression, addiction and anxiety and recommended he see a clinician, who tied all those troubles to a common source: autism. The diagnosis had no apparent impact on Beasley’s sentence — nine years and seven months in prison — but it had a huge effect on his safety behind bars.
Other prisoners often see autistic inmates as vulnerable and target them for extortion and abuse, says Clare Allely, a forensic psychologist at the University of Salford in Manchester, England. After his arrest, Beasley was detained in Brooklyn, New York, where almost immediately an inmate tried to badger him into lying to medical staff to get sleeping medication. “How are you sleeping?” he asked Beasley as a drill for an exchange with the clinicians, Beasley recalls. “I’m … sleeping fine?” Beasley responded, confused. “Nah, you’re sleepin’ like shit,” said the other inmate, who wanted to obtain the drugs to sell them. “You need medication to help with that.”
In another ruse, non-autistic inmates cheat autistic prisoners in card games, says Will Attwood, an autistic man from Australia who wrote the book “Asperger’s Syndrome and Jail: A Survival Guide” after serving two years of a three-year sentence for robbery. “You agree to start gambling and then it’s like — what’s going on?” he says. “They got you.” Attwood once saw a bloody fight over an unpaid $7 gambling debt.
The bullying can take less subtle forms, too: Attwood says his fellow inmates would sometimes poke him in the ribs to make him jump, just for their own amusement. Attwood understood what was happening, but autistic people do not always know when they are the butt of a joke. “[They] think that because people are talking to them, they’re their friends, and don’t realize they’re getting abused for comedy,” Allely says.
Even when nobody is targeting them, autistic prisoners can unwittingly court trouble. Prison staff once yelled at Beasley for standing on a small rug outside the medical office. Other inmates knew the guards considered the rug off-limits, something Beasley had not picked up on. The prison dress code also puzzled him. He noticed that his fellow prisoners only sometimes obeyed the stipulation to tuck in their shirt. They had figured out that only certain guards cared about the rule, but Beasley had not and was continuously on edge. “I’d be scared that I was going to get in trouble because I simply wasn’t getting what someone meant,” he says.
Beasley was also unable to parse the inmates’ unspoken codes of conduct. He reported the drug dealer trying to dupe him at the detention center in Brooklyn and helped the guards to identify the inmate — a betrayal that would ordinarily put a prisoner in danger. Nobody retaliated against Beasley, but he was transferred to another unit for his own protection.
“In prison, what happens is you have official prison rules, and then you have unofficial prison rules where if you tell on someone, you get in a lot of trouble,” says Brian Kelmar, co-founder of the nonprofit Legal Reform for People Intellectually and Developmentally Disabled. “This is why [autistic people] get in trouble in the prisons.”
Once when Attwood was in the prison yard, a known ‘tough guy’ was shouting over a wall to conduct a drug deal, he says. For no apparent reason, the inmate accused Attwood of spying. Attwood snapped and told him to pipe down — a situation that he describes in his book as his Asperger syndrome getting the best of him. The inmate assaulted him. Other inmates helped Attwood clean up his bloodied face and wash the blood from the pavement to be sure he didn’t then attract unwanted attention from the guards as well.
Self-care problems can also spark disputes. Like many people with autism, Beasley has a mixed record of caring for himself. He has had more than 20 cavities from not brushing his teeth. While in prison, he rarely changed his socks, an oversight that Beasley suspects contributed to the tension with his bunkmate. “I understand that I wasn’t a good bunkie,” he says.
Prison systems in the U.S., the United Kingdom and other countries do little to ease the distress and violence these problems create — and they often make matters worse.
The environment itself presents challenges. At Danbury, where Beasley was held from April 2016 until October 2019, many inmates smoked, setting off fire alarms at all hours. And when inmates staged a hunger strike to protest a decision to remove their personal storage footlockers, staff retaliated by leaving the lights on all night, he says. This would bother anyone, but for someone with sensory sensitivities, it can be unbearable. Beasley slept only a few hours at a time for “many, many nights” while the lights were on.
Most prisons also lack proper mental health care for autistic inmates. Psychologists or psychiatrists, often in conjunction with supervised predoctoral interns, usually evaluate and provide supportive services, including individual and group therapy, to prisoners. But staff shortages abound because it is often difficult to recruit qualified mental health professionals to work in prisons and to retain those who do.
The U.S. Federal Bureau of Prisons mandates that federal prisons employ one psychologist for every 500 inmates, but it is not uncommon for prison psychologists to have a much higher load of inmates under their care, sometimes 1,000 or more. State prisons are similarly understaffed. For example, the number of psychologists in the Oklahoma Department of Corrections prison system decreased by 64 percent from 2006 to 2019.
Within this strained system, many inmates with autism go undiagnosed, and fewer still get proper attention and care. “A lot of studies show that people with autism are undiagnosed or misdiagnosed in the prison environment,” Allely says. Autism is not included in the mental health screens in U.S. and U.K. prisons, where professional staff tend to focus on conditions, such as schizophrenia or antisocial personality disorder, that present security risks.
Even if prison administrators decided to screen for autism, they would have trouble doing so. “As far as I am aware, there is no screening tool with evidence of effectiveness in prisons,” says Louise Robinson, consultant forensic psychiatrist at the University of Manchester in England, who helped test one autism screen for inmates and found it ineffective.
Inmates who come in with a diagnosis, as Beasley did, are likely to find prison staff ignorant of autism and their needs. A significant number of correctional staff say they do not know what autism is and are not confident they know which inmates have it, according to a review Allely conducted in 2015. As a result, prison officials may misinterpret certain actions from a person with autism as recalcitrance rather than, say, distress or anxiety.
“I’d be scared that I was going to get in trouble because I simply wasn’t getting what someone meant.” Andrew Beasley
For example, Beasley received disciplinary write-ups for refusing to submit urine specimens to test for drugs. He has a condition called ‘shy bladder’ that makes him too anxious to use the bathroom when other people are nearby. But instead of giving him the option to collect his urine in private or drink more water beforehand, prison officials punished him: They pushed his release date back by 45 days and docked his pay for his prison job for a year.
A lack of knowledge about autism can also shape the outcome of parole board hearings. An autistic person who presents with a flat demeanor or does not make eye contact may signal a lack of remorse to parole board members, Allely says. And as a result, autistic people may be denied parole and serve much longer terms than their typical peers do.
In this climate of ignorance, an inmate with autism may be punished unfairly because a prison official mistakes him for a repeat offender rather than a recurrent victim, as happened when Beasley was put in the hole. Most guards are not trained in crisis intervention or de-escalation when responding to prisoners with mental health conditions, and they frequently use excessive force against these inmates, including the use of chemical agents, physical restraints and violence that results in serious injuries, according to a 2015 report by Human Rights Watch.
Beasley’s experience in prison only exacerbated his depression, a condition that often accompanies autism. And in early October of 2015, at Fort Dix, he attempted suicide: While watching television with other inmates one night, he downed 70 of the antidepressant pills a psychiatrist had prescribed for him. Beasley recovered, but his follow-up care involved only one visit to a psychiatrist.
Attwood, too, found prison’s psychiatric care wanting. He was often without his anxiety medication because the medical staff would order refills only after he ran out. In one instance, after waiting four days for a refill, Attwood submitted a repeat request and the head nurse berated him for harassing her. She softened after Attwood explained his situation. But a guard at his housing unit was less sympathetic, telling Attwood that had he continued to press the issue, the officers would have “belted the f— out of you for carrying on like a brat.”
To try to prevent insensitivity, the U.K.’s National Autistic Society has worked with government officials to create autism accreditation standards for prisons. The first U.K. prison received accreditation in 2016. There are no such standards in the U.S. so far.
The U.K. standards include training staff on how to interact with autistic prisoners and making environmental changes, such as creating dedicated ‘quiet’ times or spaces for recreation. The society also offers a voluntary course on autism for anyone who works in the criminal justice system, including police officers and prison guards. In theory, people with autism in U.K. prisons can be moved into secure psychiatric hospitals, but in practice, few prisoners make the move because of limited capacity and a reluctance of facility staff to admit prisoners, Murphy says.
The U.K. Ministry of Justice, which sets law enforcement policy, is also developing a ‘neurodiversity care pathway’ that would provide autistic prisoners, among others, with communication accommodations to ensure they understand the requirements of community sentencing, an alternative form of sentencing that can include house arrest, suspended sentencing and mental health treatment. The program would also expand access to programs in prisons that are designed to address the specific needs of neurodivergent offenders, says Jenny Talbot, director of the Care Not Custody program at the U.K. nonprofit Prison Reform Trust.
Some prisons in the U.K., Australia and the U.S., among other countries, have worked to improve care for autistic inmates by way of ‘special-needs units,’ which shelter these inmates from the general prison environment. Inmates in these units tend to be less aggressive than other prisoners, says Attwood, who chose to move into one for the last 10 months of his sentence after he was diagnosed with autism. Creating a special-needs unit at an Oregon jail improved inmates’ access to medical care, decreased the number on suicide watch and lowered violence and victimization in the general prison population, according to one 2009 report.
“As far as I am aware, there is no [autism] screening tool with evidence of effectiveness in prisons.” Louise Robinson
These units are not always respites, however. Inmates in a special-needs unit in a Pennsylvania state prison were often confined to their cells 22 to 23 hours a day and offered “very little mental health treatment,” according to a 2012 investigation by the U.S. Department of Justice and the Western District of Pennsylvania.
Sometimes even simpler solutions can have a big impact. One U.K. prison, for example, found that distributing earplugs helped inmates get a better night’s sleep and halved violent incidents, many of which occurred first thing in the morning in response to nighttime noise. U.S. prisons also typically offer limited opportunities for employment and living-skills training, which can be of particular benefit to autistic inmates. In Connecticut, Beasley participated in a program in which he learned about budgeting, taking responsibility for his actions, communicating effectively and other skills meant to help him stay out of prison upon release.
Over time, Beasley came to understand how to avoid provoking staff and other inmates. He realized he needed to clean up evidence of altercations so as not to alert corrections officers. He learned to turn a blind eye to nonviolent inmate violations, such as possessing a mobile phone — an offense that carries penalties in line with an attempted escape. “If it’s not affecting me, I don’t see any reason that I should go blabbering,” he says. And he found solace working in the prison library: He liked organizing the stacks and talking to other inmates about the books he had read.
After more than seven years inside, Beasley was moved to a halfway house in October 2019 and then released in February this year. Now 37, he lives with his mother in Long Island, New York, in a home they share with his uncle and grandparents. He helps around the house, caring for his grandparents, preparing their meals and feeding the cats. He wants to move on with his life, but his parole conditions limit his use of electronic devices, leaving him feeling cut off from the world. And his time in prison hangs over him like a thick fog. Beasley knows what he did was wrong, but his experience with the criminal justice system has left him feeling bitter and powerless. “It’s not justice,” he says.
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