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.