'I Couldn't Stop Crying': The Lasting Mental Health Impact of Prison on Black Men

The Lasting Impact of Incarceration on Mental Health

Mike returned home to Philadelphia after serving a 15-year prison sentence and experienced a severe emotional breakdown. “I just couldn’t stop crying… I don’t know. It was the anxiety. It was just a lot,” he shared. “I was under a lot of pressure, and it just came crashing down.” Mike, who was in his late 40s when we spoke, recounted a childhood marked by abuse, his first arrest at age 14, and over two decades spent behind bars.

As a registered nurse and nurse scientist who studies how incarceration affects mental health, I have seen many stories like Mike’s. Research shows that Black men who have been incarcerated face higher rates of PTSD, depression, and psychological distress compared to those who have never been incarcerated. Working in psychiatric hospitals in Philadelphia, I met numerous patients in crisis who had once been incarcerated. As part of my doctoral research, funded by the National Institute of Nursing Research, I interviewed 29 formerly incarcerated Black men to understand how incarceration has affected their mental health. My peer-reviewed findings were published in the journal Social Science & Medicine, with all quotes using pseudonyms to protect the men’s privacy.

The Trauma of Incarceration

Mass incarceration in the U.S. has serious health consequences for individuals, families, and communities. In Philadelphia alone, over 20,000 people return home from incarceration each year. While incarceration rates are declining in the city, the needs of those returning remain significant.

Many formerly incarcerated men described experiencing or witnessing violence, including being beaten by correctional officers and seeing friends assaulted or killed. “You know you are not regular because you come from a traumatic situation, right?” said Thomas, 44, who spent 18 years incarcerated. Participants also mentioned racism as a common experience, especially in facilities located in rural central and northern Pennsylvania.

“I ain’t gonna sugar coat it – Black people going up into them white people mountains, they call you [n-word] all day long and you basically there to accept it,” Antonio told me. Incarceration was particularly challenging for those held for months pretrial without conviction and those incarcerated during the pandemic, who spent more than 23 hours a day in their cells.

'Even Though I'm Free, I Ain't Free'

Participants described life on parole or probation, or in transitional housing, as another form of confinement. Ken, 56, has been out of prison for over a decade but said, “I’m still locked up, even though I’m free, I ain’t free. You just get a whole new set of rules and regulations.”

Men expressed significant anxiety related to community supervision requirements, including difficulty sleeping before a probation appointment. They also described distress caused by “no association” restrictions, which prohibit interaction with others who have criminal records or are under supervision. Violating these rules can lead to reincarceration.

While these requirements aim to reduce reoffending, they often isolate individuals from supportive relationships and resources, including housing and employment. “There are a lot of smart brothers in there. And it hurts my heart. And that’s where the depression coming in too,” said Reese, who spent six years incarcerated. “I can’t contact them in jail. … That’s just how it is in the system.”

Philadelphia has the highest rate of community supervision among large U.S. cities. At the time of a 2019 analysis, 1 in 23 adults in Philadelphia were under community supervision, and 1 in 14 Black adults were under supervision. The men I interviewed felt parts of them never left jail or prison, while others felt they brought prison or jail home with them.

Tyrese, 34, said he stays home as often as he can. “I’ve been out of the joint for seven years now and feel like I’m still institutionalized, I guess,” he said. “I know people that don’t even come outside,” referring to other formerly incarcerated men. Others had dreams of being back in a cell or wearing jail clothing. Long after release, many described constant hypervigilance and anxiety.

Finding Work

People who have been incarcerated often struggle to find employment after release, as many employers are unwilling to hire someone with a criminal record. This leaves about 35% of formerly incarcerated Black men unemployed. At the time of our interview, Tay, 31, was working part-time in carpentry. “Because I had felonies on my record, a lot of places won’t hire me,” he said. “And a couple of places that I was working with, they ended up firing me once they did the background check.”

These frustrations can spill over into family life. Mark, 30, who works part-time, found himself frequently becoming agitated and snapping at his kids, other family members, and his girlfriend. “I can’t get the job I want or the job that I need to do what I need to do for my family and I’ll be frustrated,” he shared. Participants struggled with having to depend on others for basic needs upon release. Kenny, who is now self-employed as a caterer, recalled his experience a few years earlier. “I was crying. I was a grown man, almost 40 years old, and my mother had to buy me underwear, socks,” he said.

The Importance of Fatherhood

Despite their hardships, some of the men spoke with joy about reconnecting with their children. “The most positive thing that happened since I’ve been out of prison is I got custody of my sons,” said Ken, a father of two. “Them kids saved me.” Like many of the other participants with children, however, he was frustrated about being unable to provide for them and worried about repeating harmful cycles.

“You want to do good, but it makes you think bad stuff when you don’t have the right resources,” he continued. “You don’t want [your kids] to do the same things you did.” Others struggled to bond with their children after years of separation. John, 29, explained, “The bonding is kind of awkward, because you weren’t there, especially during the pandemic when there was no visits allowed.”

Returning to Disadvantaged Neighborhoods

Most people released from incarceration return to neighborhoods with high rates of poverty, violence, and other disadvantages. Shawn, who lives in public housing, showed me abandoned buildings and boarded storefronts in his neighborhood and described how the environment made rebuilding his life harder. For many participants, returning to divested communities brought stress. They experienced frequent exposure to substance use, violence, and negative police encounters, and had limited access to basic resources and job opportunities needed to support recovery and stability.

“This is my real life. It’s not fake. It’s not no, ‘Well, why did he go back and do this or that?’” he said. “I live in an underserved, impoverished, danger zone – period.”

Moving Forward

The experiences these men shared demonstrate how traumatic incarceration is, even many years after release. Supporting the mental health of formerly incarcerated Black men requires trauma-informed services, such as culturally responsive counseling, peer support, and care that acknowledges the lasting effects of incarceration. It also means helping them build or rebuild their financial resources, reconnect with their children and loved ones, and supporting the broader communities they return to through investment in housing, employment, and accessible health and social services.