Report Addresses Death-Row Family Members’ Barriers to Mental Health Care

Families who have a loved one on death row, or who have experienced the execution of a loved one, suffer a variety of adverse mental health effects, including depression, anxiety, and Post-Traumatic Stress Disorder (PTSD), according to a new report by the Texas After Violence Project (TAVP). The report, Nobody to Talk to, describes the mental health challenges faced by family members of death row prisoners and the special difficulties those family members experience in seeking mental health care that addresses their situation.

TAVP found that death row families faced unique hardships in obtaining mental health treatment resulting from the stigma of being connected to a death-row prisoner and a lack of understanding of their experiences. The report summarizes the current state of research on the psychological effects of having a family member sentenced to death. Not surprisingly, that research documented high rates of depression and symptoms of PTSD among family members of capital defendants, death-row prisoners, and people who had been executed.

TAVP reported that families affected by the death penalty face many of the same challenges experienced by other distinctive groups who have been traumatized by their exposure to violence, but also face the social stigma and guilt-by-association from having a loved one charged with or convicted of capital murder. “Researchers and advocates look both at how the experience of these families is like the experience of other victims of violent loss (particularly family members of murder victims) and how it is distinct from other experiences of loss because of the particular characteristics of the death penalty,” the report explains.

Quoting a 1983 study by Michael Radelet, the report notes that, “in contrast to others facing loss, these families must know that the death of their loved one is actively desired by others.” Death-row families also share many characteristics with other family members of prisoners, including family separation, navigating the criminal justice system, and dealing with prison visits and phone calls, but with the added difficulty of the looming death of their loved one. Because of the “combination of knowledge and uncertainty inherent in the often-repeated cycle of death sentence, litigation, and temporary reprieve means that the family members experience ‘anticipatory grief’ over an extended period of time… and the emotional whiplash of hopes raised and dashed and then raised again, sometimes several times in succession.”

Family members of death row prisoners face the same common obstacles to obtaining mental health care faced by the general population, including financial barriers and negative views of psychological medication. However, death-row family members also reported hesitation or ambivalence about seeking help for themselves when their relative on death row was in greater need of help, and also worried that providers would not understand their situation, would not be familiar with the death-penalty system, or would judge them or their family.

To address these special needs, the report recommends that providers of mental health services recognize “families of persons sentenced to death or executed” as a distinct trauma-affected group and offers suggestions to help clinicians better understand the challenges these families face. “Clinicians cannot respond optimally to a population whose existence they have not even considered, and death row family members are understandably wary of seeking help from mental health professionals who are wholly unfamiliar with their situation and whom they have good reason (based on their experiences with others outside their families) to fear might be judgmental or dismissive or at least too overwhelmed by the families’ stories to be of help,” the report states.

TAVP also recommended that clinicians be provided specialized training in working with death row families, just as current trainings focus on the needs of domestic violence survivors or other groups in need of specialized care. Clinicians who undergo such training or are interested in working with the population of death row family members can identify themselves to groups that work with that population. TAVP notes that it plans to develop training materials and create a referral list of providers who welcome family members of death row prisoners.