On Monday, June 29, Piper Kerman, author of the memoir Orange Is the New Black: My Year in a Women’s Prison (and the inspiration for the hit Netflix show), joined the Drug Policy Alliance’s asha bandele for a discussion on mass incarceration, women affected by the failed drug war, and how television and media approach these issues. It was the sixth in a series of telephone townhalls sponsored by the Drug Policy Alliance designed to bring some of the most astute and influential people in the field of drug policy before the general public.

Kerman's experience with the criminal justice system inspired her. Besides writing Orange Is the New Black, she is a staunch advocate for women who are behind bars and for the end of mass incarceration. In the transcript of the townhall call below, Kerman and asha bandele discuss women and a criminal justice system that feeds on the drug war.

asha bandele: Thank you for taking part in today’s important discussion about women, drug policy and mass incarceration. My name is asha bandele, and I direct the grants program here at Drug Policy Alliance, the nation’s leading organization dedicated to ensuring that the harms of drug use and the harms of the drug war are reduced to the maximum extent possible in a way that’s consistent with public safety and health.

This townhall is part of an ongoing series of public discussions we’ve been having not only to provide evidence-based information about drugs and drug laws in our society but also to ensure that we’re hearing and learning from you, who are impacted by both.

Today we are really pleased — really just over the moon — to welcome our friend and colleague Piper Kerman, the author of the best-selling memoir Orange Is the New Black. Piper self-describes as a WASP from a Boston family of lawyers and doctors and educators. As a young woman who graduated from Smith College she seemed to have the world at her feet but for a choice she made not long after that time. She became romantically involved with a woman who dealt heroin for a drug kingpin and she participated in laundering money for the operation. In 1998 she was indicted for money laundering and drug trafficking and subsequently pleaded guilty, and beginning in 2004 began serving 13 months of a 15-month sentence at a federal prison in Connecticut.

Orange Is the New Black, both the memoir and the acclaimed Netflix series, is based on her book Spotlights of Stories of Women Who are Incarcerated, but we wanted to ask Piper, who teaches in prisons now and is a board member of the Women’s Prison Association — I heard her speak recently, beautifully in Washington, D.C., while we were gathered and calling for cutting the prison population — about what it is perhaps that television is less equipped to unpack for us. Despite the headlines and initiatives that seek to address the crisis of male incarceration, little is being done to address the fact that women are incarcerated at nearly twice the rate as men.

Since the 1980s, the female prison population has grown by well over 800 percent while the male population, for example, grew by just about 400 percent. Today some 1 million women are under the supervision of the criminal justice system with more than 200,000 of them incarcerated. It is our drug laws that drive those numbers. So yes, it’s important to underscore that we’re not only incarcerated for primarily drug and other low-level offenses, but that’s not a result of a change in social behaviors but in sentencing laws, and I wonder as a mother myself what that’s meant for all the children who are left behind. I wonder what it says about our nation; our drug policies; this experiment in democracy that we have here; our family values.

And with that as a frame, it is my pleasure to welcome to this call, Piper Kerman. Thank you so much for being with us today.

Piper Kerman: Thanks for inviting me, asha.

asha: Piper, sort of writer to writer, as a woman who has done memoir, I have to ask: You’re a private person. I wonder if you wrestled with putting your life out on a public dais and how that may have even increased so much more so when it became not just a television series, but one over which you had little or no control.

Piper: I had mercifully only been incarcerated for 13 months— I did 13 months out of a 15-month sentence. I think from my very first day in prison it was very clear-cut to me that I had benefited in so many ways from my racial privilege and my class privilege in terms of how I was treated by the criminal justice system. And I came home in 2005 and had this powerful sense that this indelible experience was an experience that more people than just my immediate family — who of course suffered through incarceration just as every single family that’s impacted suffers— I had a wide network of friends and former coworkers and other people who had stayed connected to me. I was very, very fortunate for that and it had a lot to do with my survival in prison and also my successful return home. What I heard from almost every last person that I knew, was that people wanted to hear about the experience in great detail.

Because for many of the people that I knew, the criminal justice system was just this sort of distant system that had no real perceptible impact on their lives, and their understanding was very much driven by mass media and stories that they hear primarily by either the news media or the entertainment media. So I was encouraged by my husband, I was encouraged by other people to write about my experience and I took that step not really consciously seeking a really personal sense of catharsis, although of course I think I’m sure, asha, that you will agree that any memoir writer goes through a process of unpacking their life which is very revealing and sometimes painful. But what I’d hoped was that someone who read the story of my own incarceration and the way that my life intersected with other women’s that I was incarcerated with, that people would really come away with a really different sense of who's incarcerated and why, and what really happens to people when they are incarcerated.

Because my own experience was so different than what I anticipated and it was clearly a very different story than all the people around me expected as well. And I thought that was important because I think that question of who and why and what is very fundamentally important when we have so many people in this country who are incarcerated for drug offenses, and many of those drug offenses are nonviolent and incredibly low-level. And that just doesn’t sync up with many people’s expectations of who fills up our prisons and jails, which is based, again, on mass media.

asha: I think that’s right and I think if anything, Orange Is the New Black, together with the advocacy that’s been happening on the ground, certainly makes us think about what’s an appropriate punishment and why are we so reliant on punishment. I’m very interested in talking about ending mass incarceration, but also about ending a mentality around criminalizing and how we punish people who’ve done something that we consider an offense; you can essentially make anything a crime.

Piper: asha, you articulated so clearly the change in female incarceration, and what has driven that up completely is not that we’ve had this female crime wave, but rather that we have developed a different social response to behaviors which include the use of legal or illegal drugs, and also includes an incredible lack of response to mental health crises. When we look at women and girls in the system, we know that what drives women’s involvement in what would be labeled crimes — and certainly their incarceration — are primarily substance abuse, mental health issues, full-blown mental illness and an overwhelming experience of trauma: sexual abuse or other kinds of physical abuse as part of people’s histories before they get locked up.

So when we think about those three things driving behaviors that are harmful to individuals who are sometimes harmful to the community, and when we think about incarceration as a response to those problems, suddenly things really start to fail any kind of a logic test, because taking people that have experienced a ton of trauma or are suffering from mental illness or are struggling with addiction, and thinking that putting them in a cage is going to solve those problems is very wrongheaded.

asha: Yeah, I think that’s exactly right and let me come back to that incarceration rate, with women being incarcerated at twice the rate of men. I want to break that out a little bit because black women really are the most vulnerable. One in 19 black women will be incarcerated during her lifetime as opposed to 1 in 45 Latinas and 1 in 118 white women. And yet we don’t see the centrality of a black woman’s story on the landscape yet. And I wonder if you’d talk about the impact of not only race, Piper, but class, and getting your story out, and if indeed in getting it out it did spark the full conversation that you wanted it to or if there’s more work we have to do.

Piper: Well, there’s always more work, and part of the reason there’s more work to be done particularly around this question of personal narrative — the sort of chicken’s eye view, I sometimes say, as opposed to the eagle eye’s view — is that we have the biggest prison population in human history in this country. And the idea that any individual narrative can explain this sort of huge maze of prisons and jails that we’ve created here, clearly no story can do that.

We need the stories; certainly we need the stories from African American women, Latino women, native women, different people who come from different walks of life and different class hierarchies, but we also need the stories of old people and obviously we need the stories of children and very young people. A narrative like Dwayne Betts’ A Question of Freedom, a memoir of learning survival and coming of age in prison, which was published the same year my book was published.

One of the things I think the response to my book and its adaptation raises is this question of whose story gets valued and when are stories considered surprising or unsurprising. I always say that every prison story is a survival story. I think that’s inherent in every single prison narrative that I’ve read— and I’ve read a lot of them — and the broader thing is that genres start to apply to different stories, in other words every story we hear or read fits into a broader knowledge base that we have and all the stories we’ve already heard. We always start thinking like, well, what kind of story is this? Oh, well it’s a coming-of-age story, oh, it’s a fish-out-of-water story, which is the way that people often describe my memoir. Well, they think it’s a fish-out-of-water story because on some very fundamental level there’s an assumption that an upper-middle-class white woman isn’t going to be in prison, which is very problematic. Right?

asha: Because she doesn’t deserve to be in prison. What I think is, right, she doesn’t deserve to be in prison, Piper, right?

Piper: The question of deserving is an interesting one. We know that people from all walks of life commit crimes, right? And we also know that the data shows us very clearly that the criminal justice system is utilized as not equally across the board, but as a tool of control over certain communities, and most of all, poor communities of color. And so that’s reflected — when we look at a narrative of a story that comes from a person who has been raised in a poor community of color and it involves the criminal justice system, some people feel like oh, that confirms all the things that we already expect. And that’s a real story because those stories are really, really important if we want to understand the world.

asha: I think that’s true, certainly the television show takes its lead from you in ensuring that the broader landscape of people’s stories gets heard. And you know, and I know that there’s some people on this call who may not have read the memoir yet which is quite different from the television show. One place I found it particularly different, the show doesn’t focus as much on motive — I know that there’s a couple of narratives woven throughout— but I wanted to turn to the question of mothers in prison.

Fully 75 percent of the women who are in prison were not just mothers but their child’s sole caretaker at the point of the arrest. Putting on your hat as an advocate, Piper, what would you share with us about what you’d want us to know about the impact of incarceration on mothers and children and families?

Piper: The impact of female incarceration on mothers and children and families is seismic. It is a devastating tragedy for a family when they lose a father into prison or jail, but we know, the data shows, that when the mom gets locked up, her kids are five times more likely to go into foster care. And obviously not all foster care situations are bad, but some of them are very bad. And the dissolution of those families is a tragedy for each and every one of those individuals involved.

We also know that because women are still — we have been the fastest growing segment of the prison population, but we are still a smaller percentage of the overall population of any system. And what that means is that there are fewer places where female prisoners are housed, and the result is that women are more likely to be sent far away from their families, very often, and New York state is a great example. Many women in New York State who are incarcerated are from New York City or the area around it. And yet, at this point, they’re getting sent way, way, way, far upstate.

You see very similar things transpire in the federal system. If a woman is locked up for a federal offense and goes through the federal system of prisons, there’s West Virginia, there’s Aliceville, Alabama, there’s all of these prisons that are basically in very remote, rural areas that are very, very far away from where most prisoners are from. So you know if you are a poor family in the Bronx, or in Philly, or in Oakland, California, those distances can be vast. So what happens is that we see that these women very rarely get the opportunity to see their children, and that has a devastating effect on those women, but has an even more devastating effect on those kids.

asha: I think that’s right, and keeping it along this advocacy lens, I wanted to say that you know what’s probably the most surprising to me is that despite the extraordinary success of Orange Is the New Black, many continue to argue that our advocacy lens hasn’t been adjusted to see the particular challenges faced by women in prison, the vast majority of whom are there for drug and addiction-related offenses, including mental health challenges, as you’ve noted.

I’m thinking specifically about a recent article on AlterNet by Teresa Castillo in which one of her sources speculated that when it came to supporting women who are vulnerable to our drug laws, funders are often white men and they just don’t see us. So if that’s true and I don’t know that it is, certainly that’s been argued, and if you were right now talking to a panel of caring funders who were concerned about the intersection of drug and criminal justice policy, what reforms — maybe your top three or top five— would you implore them to support in the name of reducing the harm specifically visited upon women?

Piper: Reforming our drug sentencing laws is the absolute linchpin of a solution to being less reliant on incarceration for people who clearly don’t need to be confined. And that really covers a huge swath of women who are currently locked up or who cycle in and out of prisons and jails via a probation or parole system. And it would be hard to overstate that if you walked through the federal units where I did time or if you walk through the women’s state prison where I now teach writing, the vast majority of women who fill up those facilities, most people would really debate powerfully just what value their incarceration offers.

Given that very few people who are incarcerated get substantive help on things like substance abuse and addiction, and given that the process of incarceration is so very destructive to the social fiber of people who are in vulnerable situations out in the free world. Their removal from the free world ultimately makes them even more vulnerable when they return home now bearing a felony conviction and all of the collateral consequences that go along with that. So I would say that sentencing reform and making sure that we keep people out of the system or at minimum out of confinement as much as possible is incredibly important and that question of diversion out of the criminal justice system when there are mental illness or substance abuse problems that are primary drivers of low-level offenses especially is just a huge no-brainer.

Which is not to say that legislative reform is easy; it’s very difficult. However, one of the reasons that I thought it was important to write the book is because I think that women and girls in the system offer us these crystalizing examples of where we’ve gone wrong and where we can very easily make better steps because women are so disinclined to commit violent offense, and when women get the help they need, they flourish. And this is something we see when women get chances to do things differently— they take it and they run with it.

I’ll offer one very straightforward example: In New York state, the cost of incarcerating a woman or a person is very high — it can run as high as $60,000 a year. If a woman has two children who are going to go into the foster care system, suddenly the cost to taxpayers climbs up to around $130,000 for one year.

So the Women’s Prison Association launched a program called Just at Home about almost two years ago and that is an instance where women who are facing at least a year of prison or jail if not more are given an opportunity by their district attorney and by their judge to remain in their home to be held accountable for whatever their conviction is, but also to get the help they need. And the help that these women need is individualized. It might be mental health problems. It might be substance abuse problems. It might be parenting classes or a whole host of different things that people need. And when women complete that program successfully, they also get an opportunity to get an expungement so they do not have that felony conviction weighing them down for the rest of their lives. That program costs under $20,000 a year. It’s like a complete no-brainer to me.

asha: That’s certainly true. I’m going to ask my final question here and then turn to the audience. As someone who was married to a man for more than 20 years who was incarcerated — and I’ve testified about this, I’ve written about it — what I know for sure is the importance of family support when somebody is locked up. It’s true that we do better when we have strong family support and ties, and so there’s a lot that’s happening out here that’s sort of disrupting that, whether it’s from people not transforming like the actual real-world visiting situations between many private prisons, where there’s video-conferencing, or people are just so far away from home or in the federal systems across state lines.

So before I turn to the audience I need to shout out your husband Larry Smith, who just resides in all of our hearts. I remember when I read his piece in Modern Love and I was like, what? Because as far as I know, we’re the only two people who have written in Modern Love about loving someone who is in prison, and you know, it’s not so much a question. Let’s just talk about what his love, your family’s love, his family’s love and enduring patience, kindness and all the things that we know love needs to be meant, and what it would mean if more women were supported with love, because we know that women are supported far less than men are when they live behind razor wire and Plexiglas and 20-foot walls.

Piper: Anecdotally, people ask all the time about the women who are depicted in my book and who I’m in touch with and how much I’m in touch with them. I’m in touch with a lot of the women I did time with, and they have faced a whole array of different challenges as they have come home. And many of them have come home very successfully and done all kinds of amazing things.

And the thing that in all of those individual personal cases made all the difference was their family situation. And of course that’s family broadly considered. There are all different kinds of families. But being able to stay in contact with the people who love you and need you and the people that you love that you need is how you survive with your sanity and some clarity about your future in place and it is absolutely how you transition home successfully — how you make the journey home a safe one and a successful one.

I was lucky to have Larry in my life. I was lucky he didn’t walk away from me when this very complicated past was revealed to him. And I remember so vividly a good friend of mine who was also fortunate enough to have a lot of contact with her people on the outside, and she had a boyfriend who visited her often, she said, "They do the time with us."

And something to consider very seriously and very heavily, is that each and every person that we send away to prison, it is a punishment that is borne by many, many other people in very profound ways. And children and spouses and those kind of loved ones, and of course, parents bear the heaviest brunt, but entire communities bear the brunt. Yeah, Larry’s a good man. It's true. And my parents are also just these incredibly loving and generous and patient people. So it would be impossible to overstate how important those lifelines in and out of prison are for people’s survival and also just a question of public safety. We know that people who are able to maintain those lifelines are more likely to come home and stay home.

asha: Thank you so much for that, and just to harken back to what you were saying in the question before, about people being moved all over the country and being separated from their families and loved ones and friends. If you kept people together what impact might that have on what happens when people come home? And their ability to reintegrate? You know, even if you can’t approach it from a moral point of view, which I think everybody should, ultimately this is a moral question, then you can at least approach it from a fiscal point of view, because when people come home completely disaffected, what impact is that going to have on our society?

[The format now switches to direct questions from the physical and virtual audience.]

Bobbi Pughs-Milman: There are so many questions I have and so it was difficult to narrow it down to just one. But I think that one thing that is a little bit different from what you’re talking about today, but I have this curiosity and so did my husband: What do you think about the Supreme Court decision on being able to use the cocktails for the death penalty right now? Now it’s become okay to continue killing people in the country — how do you feel about this?

Piper: Well, I oppose the death penalty, so I think anything that makes it possible for us to allow state-sanctioned murder is a big mistake.

Gretchen Berg-Berman: I just wanted to make a comment as a mom who visits my son behind bars every week on a constant basis and had to sort of fend off the comments of, oh, you’re an enabler and co-dependent. I’ve felt so strongly that I have to stay involved as they come out and as they struggle to reassimilate into society, so I want to say, Piper, I love your comment that it’s a lifeline. It so affirms the way I believe about this issue.

Piper: Absolutely. They are lifelines. They’re really, really powerful and important, and of course, family broadly considered is important, but some people who are incarcerated lack family or their family is truly disconnected, so being able to forge lifelines really with any concerned person who is going to be engaged, who’s going to value someone’s life who’s currently incarcerated is also important. So those sort of broad-stroke things like pen-pal programs and other ways that people stay connected to the outside world are also important. Those connections to family and immediate friends are total lifesavers.

Ifatayo Harvey: I’m a Smith alum as well, and I’m also someone who has a family member behind bars, and recently Columbia divested from prisons, and some Smith alums were discussing how can we get Smith to do the same and people brought up your name. Like, where’s Piper Kerman and how can we get in touch with her? So my question is, coming from a place of privilege (we’re both Smithies), what’s our role in supporting women who are incarcerated or their families?

Piper: Yes, I was extremely excited to see that Columbia news and I think we can get Smith to do the same. And what I really hope is that many institutions of higher learning will follow that lead of divesting themselves from prison profiteering because it's particularly incompatible for them to be invested or profiting from institutions that do exactly the opposite. So that’s an important thing in sort of looking at all of the different ways that individuals and certainly people or groups in our current society draw benefit out of the current system, whether you’re talking about private prison populations, private healthcare corporations, Aramark, all of the different ways people make money off of having the biggest prison population in human history.

To your second point, I think that the current advocacy environment really relies on several different sort of forms of communication or advocacy. One of the things that’s most important is that people most directly affected by mass incarceration have voice in reform strategies and that means people who are incarcerated, people who have been incarcerated, the families that are the most affected and communities that are most affected.

We know that the communities that are most affected by mass incarceration are poor communities of color, and one of the problematic things in terms of fast-action or getting action around reform as quickly as possible is that we also need powerful and privileged people to join the fight, because if we simply rely on the communities that have been most devastated by mass incarceration, those communities have to be a very central part of the solution, but we also need people who are more privileged to get in and to say we’re going to support these efforts and we’re going to make sure that everyone has voice but we’re certainly going to lend our voice.

I think this is particularly important when we’re talking about elected officials because the blunt truth is that we know that elected officials don’t listen to all people equally. We need to ask them to do that but we also need to chime in and lend our voices in powerful ways.

Elijah Clemente: I was just wondering, what your relationship was with Alex at all? If you still talk to her?

Piper: Elijah is asking, I think, about my ex-lover, whose name is not Alex. She’s called Nora in the book. My ex-lover is home from prison, I’m happy to say. She served a significantly longer sentence than I did. Her sister was also my codefendant and is also home and I’m happy about that. Her sister is doing incredibly well…is doing all kinds of amazing work around substance abuse and addiction and does incredible work with people who are struggling with that. My ex published her own book recently about her own life and her own incarceration and I support her in that effort. I think it’s important for everybody to have a voice about defining the parameters of their own life and their own story.

Pamela Clifton Vine: I had a question about — actually I had two questions. One, how do we strengthen the conversation about keeping women home instead of sending them to prison and getting them the services they need on a national level. And on a state level as well?

Piper: In some other parts of the world, including places in Europe, they’re beginning to debate whether they even need to have women’s prisons, whether that’s even a necessary or useful thing. I think making sure that when we talk about prisons and jails and whatever utility that people think they have, that we remind people that women are part of the equation because it is frequent that the discussion simply does not include women at all. My observation having been through the system is that prisons are built largely or almost exclusively by men and they are built for men. And women are just a complete afterthought in the system.

I think that the lynchpin or the critical point of advocating to keep women and girls out of confinement, that focus is really around the court system. And thinking about public defense reform, and thinking about judges and educating the bench, and frankly, educating prosecutors as well, is the practical question in terms of getting better outcomes for women and girls in the system, and more broadly as well. And that’s a hard thing to do, that’s not an easy undertaking. It’s interesting to watch the discussion and debates around police reform that are finally happening in this country in a more substantive way, in a very, very much needed and long-overdue way. Policing issues happen out in the street, and so many people, when they get their eyes opened, see.

Things that happen in places like the court system are in some ways much less obvious and apparent to people who don’t have to go through those experiences, and so looking long and hard at public defense reform, the vast majority of people who are accused of a crime are too poor to afford a lawyer. And they will be reliant on an indigent defense system. And what that means is that often people don’t get access to counsel until they’ve been locked up in jail or had some other way into the system for a while — like, far too late.

Looking at those things and making sure that public defenders and other court-appointed council, prosecutors and judges are well informed about what might be in play with a woman or a girl who comes before them and goes through that system is probably, in practical terms, the lynchpin moment for making sure that people don’t end up in confinement who don’t belong there.

asha: This raises the question — it’s been a lot of conversations, probably for at least 20 years at this point beginning with Angela Davis, about the question of prison abolition— and have you had time to think about the question of prison abolition at all and Angela’s argument that you’re actually made less safe by the presence of prisons and if you released everyone from prison now we would still have a more safe society than we have with prisons and she had some data to back that up … I don’t know if you’ve been in any of those discussions or if you have any reactions to that.

Piper: Dr. Davis is one of the most brilliant minds that we have out there right now, isn’t she? I think it’s very telling that the states that have reduced their prison populations the most, which are states like New York and New Jersey and even California with all of the craziness around that state correctional system, those are the states that have also enjoyed the biggest decline in violent crime. So the idea that our prisons are actually not making us safer; the idea that they are in many ways making us less safe , because they are creating cycles which individuals are really, really compelled by these external cycles or these cycles of conviction and re-entry which is incredibly challenging and then ending up back in the system — it just says a lot.

I think it says that we have to really seriously reconsider what we expect of a prison. Like, what is the real result that we expect and when we do recognize that a huge number of people that we choose to incarcerate are people who have experienced an incredible amount of trauma and sometimes incredible victimization themselves and whether we have just perpetuated a cycle of victimization is a question well worth trying to answer.

asha: We have so many hands still up, I want to acknowledge now that we may not be able to get to every question. I’m doing my best today, but let me encourage you to please continue the conversation on Twitter. Piper, can I give out your Twitter address?

Piper: Sure, it's @Piper.

asha: @Piper. The hashtag is #realdrugtalk. We’re going to try to get to as many questions as possible, but if we don’t, continue the conversation online.

Scott Sieseldorn: I’m really glad someone’s honest about the issue of divestment. I’m calling you today from the SSDP office in Washington, D.C. and I know a lot of our chapters are interested in pursuing campaigns to get their schools to divest in the prison industry. My question is about correctional officers. Piper, is there any way possible that we can be engaging with the people who work in prisons and jails to end the mass incarceration or is that completely off the table? I know as a nonprofit worker my end goal is to put myself out of a job by ending the drug war and mass incarceration, but I doubt that correctional officers feel the same way. Am I correct in that and how can we be engaging those folks at all?

Piper: There’s a huge variety of law enforcement employees. There’s obviously cops out in the street, there are correctional officers, there are probation and parole officers, and my observation is that there is actually a fascinating diversity of opinion and experience between some of those different roles within the system, and also I think that when you get inside and you have an opportunity to talk to people in a substantive way you get sometimes very nuanced perspectives. Not always, but sometimes.

Right now I’m working in a medium-security prison in a women’s state prison and so I come into a great deal of contact with correctional employees, and sometimes, when correctional employees have their eyes open and their hearts open, they spend time day in and day out with people who are struggling to survive incarceration. And sometimes they have a lot of insight around the things that drive mass incarceration and the problems with the existing system.

And I think that while law enforcement has in many ways had a lot of license to define public debates around how we accomplish public safety and the idea of relying so heavily on prisons to accomplish that aim, which we know is a wrongheaded goal, I think this: having been through the system it cannot be reformed solely from the outside in. I think we have to engage people within the system to change it, we have to give a lot of oxygen to people who are doing good things within law enforcement systems if we want other people to do the same. And so that’s really, really important.

There are many rules and regulations that govern people who work in law enforcement in terms of their ability to interface with other folks, but I think that especially if you’re talking about prisons and jails, the thing I always say is that I wish that the walls of every prison and jail were transparent and permeable, and the more that a facility allows the outside world to come in and again, to sort of establish and maintain lifelines, the better those facilities are run. So I think that creating those connections with people who work in law enforcement is really, really important if we want folks to do things differently and we want these systems run differently.

Jack Mack: Decades ago mental hospitals were closed, but the people released were not well served. How will we avoid that if we’re lucky enough to change the rate of incarceration?

Piper: That’s a good question. We’re spending all this money on mass incarceration when at least a huge chunk of that money should be spent on public health. And that’s true whether you’re talking about mental illness, whether you’re talking about substance abuse, because obviously things overlap sometimes. You know I was pretty young at the time that state mental hospitals and other terrible places were shut down. There was a promise at that time that community health centers and community health care would be established to replace the sort of horrific centralized institutions — that of course never materialized. That went by the wayside during the Reagan years despite the promise that there would be community health.

If we look at the numbers — it's estimated we spend at least $80 billion on incarceration alone, not including all of the other criminal justice functions— it’s a clear demand that we should be shifting those resources into the public health system and away from the criminal justice system. However, that’s politically not an insignificant challenge, so it’s going to take a lot of focus on people who care about how these issues overlap. I think the good news is that there is increasing recognition and clarity around the fact that the way we treat people who have mental health problems is not only illogical but also extremely cruel sometimes and really ineffective. So I think hopefully there is more steam building — I know that there is a federal law that’s been introduced, proposed to address this very question of mental health and the criminal justice system. And we’ll see how successful it is up on Capitol Hill.

asha: I spent a good part of the '90s in Cuba during a time they called the Special Period. It was when ties with the Soviet Union or the former Soviet Union had been severed and so Cuba was essentially subsisting on 15 percent of its GNP. Now try to think about that, having only 15 cents for every dollar that I need to live, but let me tell you what they did; you could almost not pass a street corner where they didn’t have clinics.

Because they understood the pressure that was going to be revisited upon people who were living with so few resources— it was going to kind of drive people crazy, and they provided all ways for people to engage with mental health professionals and other wellness experts so that they would not just lose their minds. They stayed strong and I wonder again if it's exactly what you’re saying, that if we really address the trauma that exists when you have 40 percent of black children being born into poverty, when you have mass incarceration at the rates that we do, when you’ve got children in Atlanta presenting PTSD at the same rates as people coming home from war, what it would mean if we had the investments in public health. I just wanted to really underscore that important point.

Piper: I would only say in response that we can all be very grateful for the federal health care reforms being upheld mercifully because I do believe that we are going to see some of the benefits of greater access to health care, including mental health care and including substance abuse. I think that we’re going to see at least some steps in that direction as more and more people and particularly very poor people have health care that they need.

Romy DeFay: My question is, I spent 28 months and I went to West Virginia Hazelton and I’ve been through Allendale [Correctional Institute] and then Caldwell. When is the question going to be shifted on health care, because I have been personally pressured to have a hysterectomy for a simple procedure that could have been treated easily. When is this going to be talked about, because that is a big problem that’s happening, because people are dying out here right now and no one is saying anything.

asha: You mean access to health care when people are locked up?

Piper: Yeah, I saw immediately when I got to prison that the most dangerous thing I faced is if I got ill. There’s always these assertions around "Cadillac health care," when in fact nothing could be further from the truth in terms of people who become ill while they are incarcerated or the huge number of people who come into confinement with chronic disease problems whether that’s HIV, whether that’s heart disease, whether that’s diabetes, you know there’s a whole range of chronic disease things that you see being particularly prevalent among poor people and therefore in prisons because we overwhelmingly incarcerate people from the poorest communities.

We know the reason California has made strides in reducing its prison population is because they went into federal receivership because the health care they were delivering was so inadequate that the Supreme Court deemed it cruel and unusual punishment. And we know that health care costs are one of the biggest costs of incarceration and are climbing as our prison population grays. And every single time I walk into the men’s medium-security prison where I teach writing, there are so many very elderly men there who are lined up by the medical unit which is right by the front door where I come in.

We have an estimated 250,000 senior citizens incarcerated in this country. That is largely because of the incredible harshness of our sentences. I think we all know that senior citizens are not out there madly committing these heinous crimes; rather we locked people up while they were young and we have kept them in prison for deranged sentencing ranges.

And we also know that some of the harshest sentences have been around drug offenses, not crimes of violence. So there is increasing attention being paid to some of these questions around medical care, but it is often couched around this question of caring for senior citizens or how do we get senior citizens out of prison finally. The issue that we see, Romy, in every women’s facilities and I think at many men’s facilities are these questions of conditions and whether those conditions are lawful. And I think often they are not. Almost always the only way that things get addressed is by litigation, by suing correctional systems to correct the things that they have done wrong. And unfortunately, I think that still remains true.

asha: The relationship between your husband and yourself, has it gotten any stronger?

Piper: One of the things that happens when someone is incarcerated is that everybody on both sides of the wire is working really hard just to survive that experience. And so you have these fleeting moments of happiness with the people who you love, and the people who love you in the visiting room or on the phone, and at least my tendency, our tendency, was to just try and focus on the positive and have those be good times. Happy times. Times that we really valued.

But what that means is that a lot of times you’re sort of putting a lot of problems aside or you’re not focusing on some of the things that are most challenging and difficult. This is a reality I think not just for people who are in romantic relationships, but also for family relationships etc. People put aside resentments or obviously everyone who is incarcerated always feels that they’re this huge burden to their family. But you come home and on some level those things are waiting for you and you have to go through that reconciliation process, both the wonderful reuniting, but also dealing with the fact that your incarceration has put people you love through hell and you have to make amends for that.

That’s an important part of the process, but it's also a really difficult part of the process. I often get a lot of questions from people who have loved ones who are locked up who are going to come home. They ask how to make it a successful process. And it takes everyone having a lot of patience with each other, because to be reunited and to have survived that kind of an ordeal together is something that can really strengthen those bonds to an incredible level, but also, you know, life goes on and then you have to get adjusted and it's like, oh, we’re no longer in crisis mode. Now we’re going to be living hopefully a more ordinary life and that’s an adjustment as well. And so everyone having a lot of patience with each other and being able to really draw down on that love is really, really important.

Any time that I ever get into an argument with my husband, all I have to do is remember that he was waiting at the gate for me that day I was released from prison, and I’m like, all right.