How ‘post-incarceration syndrome’ could affect Kentuckians released from prison

After years of being in and out of prison, Savvy Shabazz became a college graduate who now runs a nonprofit and another business.

But there’s one thing he doesn’t have: a microwave.

The sound of the machine reminds him of 2004, when he was housed in a packed open dormitory at the McCracken County Regional jail. Shabazz said he served 67 months total for two nonviolent drug trafficking offenses, which were pardoned by Gov. Andy Beshear in 2020.

“You're constantly hearing the clicking of a microwave, the buttons, the beats, the smell that gives off the roar when it's being used,” he said.

It’s one of many triggers that exacerbate his post-traumatic stress disorder, years after leaving prison.

Now, researchers are trying to formalize a diagnosis related to post-traumatic stress on people who were incarcerated. It’s called post-incarceration syndrome, or PICS.

The term was coined by Terence T. Gorski, a specialist in relapse prevention and addiction, in 2001 to describe something experienced by people who’ve left prison and are reentering society. It’s caused by a combination of PTSD, institutionalization, antisocial personality traits, social sensory deprivation and substance use.

PICS can have different effects on a person, ranging from depression and anxiety to difficulty adjusting to life outside of prison and struggling to maintain relationships.

Shabazz, who is the founder and executive director of the nonprofit Life Coach Each One Teach One Reentry Fellowship, said people in prison may already have previous trauma stemming from their childhood. Prison, he said, “is like a cherry on top.”

“A lot of people are already dealing with a lot of issues before they even get in prison. So now you're packing it,” he said.

Shabazz also runs Savvy Shabazz Solutions, which provides reentry coaching and consulting for businesses that want to hire and work with formerly incarcerated people. Part of that work involves educating people and organizations about PICS.

He said he’s spoken with formerly incarcerated people going through symptoms of the syndrome. He feels they recognized themselves in the symptoms, which helped them understand their behaviors.

“Once you realize why you do something, you're more interested in, ‘How can I change this?’ Or, ‘How can I fix this?’ But if people don't know, we're just going to be a whole demographic of people walking around the nation dealing with PICS, but never finding the solutions or treatment for it,” he said.

The state of PICS in psychiatry

“Post-incarceration syndrome” hasn’t been formally recognized by the American Psychological Association, but lawmakers on the federal level want further research into the condition.

In May 2023, Democratic Reps. Ayanna Pressley of Massachusetts and Grace Napolitano of California sent a letter to the National Institute of Mental Health, asking them to research post-incarceration syndrome to tailor prevention and treatment strategies.

Nicole Wiesen, who was previously incarcerated, is a regional coordinator at the Atlanta-based Multifaith Initiative to End Mass Incarceration. The initiative is part of the Ebenezer Baptist Church and aims to engage faith communities and groups to end mass incarceration.

Wiesen said reentry is difficult, especially with recovering from the loss of autonomy and suspended identity in prison.

“You go from having maybe 125 choices a day to the average person has and makes roughly 35,000 decisions a day. And on top of that, you are then dealing with potential enhanced traumas that could have surfaced as a child,” she said.

She said she hasn’t found many mental health professionals who specialize in treating formerly incarcerated individuals, especially any with lived experience.

And that lack of mental health services, Wiesen noted, makes it harder for people reentering society to find a job, pay restitution and make other changes after being released.

“You might have seen some of the most horrific things that have happened to a person … and then you're trying to get back to ‘Okay, well who am I now?,” Wiesen said.

Researchers at the University of Cincinnati College of Medicine are conducting a study into PICS.

Wiesen said it’s important to let people do their time humanely.

“Let's prepare them for coming home when they reenter society to make sure that they've got their mental health, they've got everything that they need to thrive so that they don't go back,” she said.

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