Aiming to bring a diverse group of educators and community leaders together in conversation, CARE, the Carceral Awareness, Reform and Education club at Brandeis, hosted “Health in Prison: A Panel Discussion,” which took place at the Heller School for Policy and Management on Monday, April 1. The panel included Sashi James, the director of Re-Imagining Communities at the National Council for Incarcerated and Formerly Incarcerated Women and Girls, which is an organization working towards the abolition of the American carceral system. Also contributing her voice and experience was Angelina Jefferson, who provides education services and support to formerly incarcerated people through the Partakers Empowerment Program and the Brandeis Educational Justice Initiative. Rounding out the profuse assembly of perspectives was Stuart Grassian, M.D., who advocates for solitary confinement reform, and Brandeis Prof. Sanaullah Khan (ANTH). 

In addressing the focus of the panel, Kabrhel acknowledged that “the title of this talk is health in prison, but [we have] to start … with health before prison.” In addressing systemic healthcare injustice inside the prison system, it is necessary to first address the root of the problem in outside communities, which involves layers of systemic social and political injustice. As Grassian put it, “the sicker [people] are, the harsher they are treated,” and it is “indisputable” that unequal and sometimes impossible access to healthcare outside of prison contributes to healthcare injustices inside. Khan added that “people entering prison coming from low income neighborhoods … [which] have been engulfed in violence for a long time” has obvious impacts on mental health as well as physical. 

James supported this assessment of the problematic inadequacy of American healthcare with her own personal experience. She said that “as a daughter of formerly incarcerated parents, and a member of the most incarcerated neighborhood in the Commonwealth of Massachusetts,” she knows that having access to healthcare is important through witnessing and experiencing its shortcomings. James sees suffering in her community and believes that leaving this unaddressed creates a generational cycle. She referenced her own financially motivated decisions that have meant foregoing health insurance, and fears how this will impact her daughter, who she does not want viewing healthcare as a financial sacrifice. 

If the healthcare system is troubled outside of prison, Jefferson testified to the fact that it is disastrous inside. Jefferson is a cancer survivor and was formerly incarcerated for 31 years before having her conviction overturned 21 months ago. She said that “behind the wall all [she] was saying was … please God don’t let me die in here.” When she returned home, all she wanted to do was to see a doctor. Jefferson described her first visit to the doctor outside of prison, saying that “when [she] got there, [she] broke down and cried [to her doctor] ... and had every test you could name.” She said that “it made [her] emotional … and made [her] think: this is what I have been missing.” 

Diving deeper into the health crisis hidden within the walls of American prisons, Jefferson explained more about the alarming lack of accountability that allows people to go without the treatment and care they need. She remembered that she had to pay three dollars, which was a whole week of work in prison, for a “sick slip” when “she felt something was wrong.” The “sick slip,” which promised a checkup in 24 hours, did not actually guarantee treatment and it was normal for people to not be seen for weeks. She said that she was lucky she had family advocating for her, remembering that “they knew when my grandmother was calling … I would hear my name over the loudspeaker saying ‘[that] the head of medical need[ed] to see me.’” 

James also touched on the issue of accountability. Prisons are supposedly the social and legal symbol for accountability, yet as James articulated, they ironically demonstrate a profound lack of this value. She described a friend dying from stage four cancer after she got out of prison, having been ignored in prison despite having meticulously documented her symptoms, as well as a friend with lupus who died while serving an 18 month drug charge because his underlying condition was not taken seriously. 

The discussion made apparent the litany of dangers incarcerated people face in not receiving proper health care because of the removal of “their liberty, … their autonomy and control over their bodies.” As an example, Jefferson described the chronic prescription of pain medication to mask more serious problems, which is especially dangerous for people with substance abuse, and James chimed in to affirm that  “we’re responding to people that are dealing with substance abuse issues [ect.]... and we’re packing them down with more trauma.” Kabrhel added that “when you receive healthcare in prison it’s reactive not preventive, [and] when you come from a background where you don’t know what preventive care is like, you don’t know what to ask for.” This creates an environment that sets people up for inadequate care. James also touched on the incarceration of intoxicated people in general and how dangerous this forced detox can be. She highlighted the necessity for wellness checks and pointed out that “these people should be in the hospital [instead of behind bars]. … Before you do anything, get their health straight first.” 

Mental health becomes a major issue as well, which Grassian sees especially in regards to solitary confinement as a punishment. Solitary confinement is sometimes even the solution for imprisoning people with serious mobility issues or disabilities. Jefferson said that in her experience, addressing mental health in prison meant being locked up “in a room in a turtle suit … [where] you’re just lying on the floor … and an officer sits there writing down every single move.” Grassian added that because “[inmates] know that this is how they deal with mental health issues, … [with] those suicide cells, [with] nothing to distract yourself … of course you won’t reveal that you have mental health problems because they’ll threaten you with that.” According to Jefferson, what is really necessary is “someone who’s going to listen and [help you] deal with the issues that you [are facing].” Simply put, according to James, “if you’re my doctor we should be a team,” but instead, healthcare in prison results in more disenfranchisement and more trauma.

Jefferson said that instead of receiving support for mental health from the state, help came from building community within prison. She helped create a peer support and restorative justice program inside the prison and explained that “a lot of women trusted us more than they trusted the system.” Further highlighting the fact that community groups and grassroots organizations offer the support needed when the state does not, Jefferson gave a shout out to New Beginning Reentry Home and Families for New Beginnings — “two major organizations that had [her] back” when she eventually got out of prison. She added that if she hadn’t gotten mental health treatment she “wouldn’t be sitting here right now.” She went on to describe that even living in her own home with the freedom and autonomy that represents for her does not allow her to fully escape the trauma she has from prison. She “never closes the door … [because] it takes her back to a place [she] doesn’t want to be.” 

Grassian concluded that the failure of American justice and its intersection with the healthcare system is due to “the emphasis is on control and power” and “control for control’s sake.” Kabrhel stated that “some [people in government] like to stand on the platform of prison as a retributive place for people that have harmed others … without addressing the fact that prison is a place where we harm people [too].” To Grassian, this proves that society is “set up for disaster” because the “system is not geared toward rehabilitation … you’re not getting tough on the prisoner — you’re getting tough on the community.” Even with his “tremendous amount of work on solitary confinement reform,” Grassian explained that although some of these reforms have made a change on paper, the “culture doesn’t want to change.” James agreed, saying that she feels as though “we’re at war everyday with the state, with the DOC … [and] they just got billions of dollars to build a new prison while we’re addressing real harm.” 

However, James described her own work for Reimaging Communities as a light in the darkness. She said that the organization “covers so much work, from policy and litigation to [literally] reimaging communities.” She said this approach “is the answer for how we abolish the system … we are not flexible in abolition — [we are] organizing for seven generations in the future and seven generations behind.” This emphasis on supporting the community, especially by focusing on building up women and girls and getting them out of prison, was a point of pride as James gestured to Jefferson saying, “she’s not a lifer anymore — she’s Angie Jefferson.” 

Concluding the discussion, James encouraged attendees to spread awareness and get involved: “it’s about the power and the people.” At the current moment, CARE is aiming to support the work of organizations such as James’ Re-Imagining Communities by campaigning for the passage of a Prison Moratorium in Massachusetts so alternatives to incarceration can be implemented. BEJI, of which Jefferson is involved in, works “alongside Brandeis to build a program that centers on vital supportive mentorships that provide access to critical resources and understanding that returning citizens need to rebuild their lives.” More information on how to get involved with BEJI can be found at 

— Editor’s Notes: Justice Editor Nemma Kalra ’26 is employed by Brandeis Educational Justice Initiative and did not contribute to this article. Justice Associate Editor Julia Hardy ’26 is a part of CARE and did not contribute to this article.