“Mass incarceration is an illness. Most people who are incarcerated have ended up in prison because our community health systems have failed them.” Dr. Brie Williams ’90 is a Professor of Medicine in the UCSF Department of Medicine, Director of the Criminal Justice & Health Program at UCSF, and Director of Amend: Changing Correctional Culture. Dr. Williams’ work focuses on bringing a medical and public health lens to transforming the culture in US prison systems, improving them for people who are incarcerated, for officers, and the community as a whole. This comprehensive approach connects law with public health, human rights with medical care and requires deep partnerships with community activists, policymakers, and government officials in the effort to make change.
Dr. Williams first took care of an incarcerated patient as a medical student at the Mount Sinai School of Medicine in New York City. Her work has evolved over the years as she learned about the profound healthcare needs that exist among people who are incarcerated, eventually building a career as a clinician-researcher to understand and improve the healthcare needs of this population. As a physician with knowledge and experience in correctional healthcare, she has been frequently called to serve as an expert witness in legal cases related to improving conditions of confinement in prison. “We would go to court for egregious cases and, time after time, the courts would rule in our favor, not because it was a particularly strong lawsuit, but because the situation was so dire, the living conditions or medical care in the prisons were so poor, that there was no other option. We would achieve hard-won victories and return a week, a month, a year later to find that nothing had actually changed. In fact, oftentimes, things had just gotten worse. So instead of focusing my time on helping attorneys change the devastating conditions that exist in our nation’s prisons through litigation, I decided instead to apply the tenets of public health and medicine and build a program that brings policymakers and correctional staff the motivation, knowledge, and tools they need to make a change.”
Brie’s view of the injustices in prison systems is holistic, focusing not only on incarcerated people but on correctional officers as well. “Correctional officers have one of the worse occupational health profiles. Many work their entire careers, attend their retirement party, and soon after, they die. Correctional staff have sky-high rates of suicide and the same chronic medical conditions that many incarcerated people have. As a result, their average age of mortality is in the late 50s. According to Brie, many correctional officers say ‘I knew I was going to end up in a prison for my life, the only question was which side of the bars I was going to be on.’ With both officers and incarcerated people suffering tremendous violence, chronic disease and early mortality, the key to change is recognizing and communicating that every single person who steps foot in a prison is being harmed—residents and staff alike. Something has to change. They aren’t safe for anyone.” To solve the public health crisis of toxic, violent cultures in US prisons, Brie envisions transforming prisons to focus on dignity, humanity, and health. Her goal is to create a new system that has almost no resemblance at all to what exists today, to replace places of punishment with places of rehabilitation and health.
Through her research, Brie sought models of prison that were, at their heart, centers of health and rehabilitation; she found such a prison system in Norway. “When people in Norway—from correctional staff, to prison residents, from policymakers to taxi drivers—are asked ‘what is the purpose of prisons?’ They will all reply with the same answer: ‘People go to court to be punished; they go to prison to become better neighbors.’ At its heart, this is fundamentally a human rights driven, public health-focused sentiment. It means that every policy, every program and every interaction with a staff member is scrutinized for its ability to help people in prison change their lives for the better. To reenter the community healthier than when they left it.” Her work studying and collaborating with Norwegian colleagues has informed her view of what is possible in the U.S. “From the moment that a person arrives in prison, their entire stay should be laser focused on the ultimate goal—to return them to the community, to their family, to being a healthy, productive member of society. That’s an approach that places healthcare first, not punishment first. That’s what we do at Amend, we collaborate with the Norwegian correctional service to adapt the policies, programs and correctional officer training in Norway for use in US prisons.”
Brie’s work has been informed by the Quaker testimonies of peace and equity that she learned during her years at Friends Seminary. “What I learned at Friends was how both history and present day life are profoundly interconnected. In the case of Friends Seminary this deep connection is literally reflected in the bones of the School’s building itself, and the importance of placing people, humanity and dignity first has always been the core of the Friends’ approach. I am very grateful that my early education was informed by the Quaker tradition and that I have had the good fortune to dedicate my career to the Quaker testimony of nonviolence.”
Dr. Williams believes that we all have a role to play in bringing about a world that ought to be.
“I hope the work that I do throughout my career challenges even just a few people to engage in what we need so desperately now—a national reckoning with mass incarceration, with the warehousing millions of Americans, a disproportionate number of who are people of color. For too many Americans, incarcerated people are out of sight and for far, far too many people they are also out of mind. If we want to live in a society that is safer and healthier, we must contend with—and change—the violence and poor health that are festering in our nation’s prisons, massively decarcerate prisons and infuse education and healthcare inside the walls for staff and residents alike.”