Hierarchy of Needs


While my family and I hunkered down during the recent snowstorm, I thought about the many things that most readers of this blog likely take for granted. We were comfortable, warm, and well fed. We had entertainment, work that provides meaning to our lives, and the benefit of each other's company and support.

Many of the people in our criminal justice system are there, at least in part, because they lack these things.

In a recent article, Dr. Amy Wilson, a professor in the school of applied social sciences at Case Western Reserve University, spells out the importance of these important pieces of our lives for which we often take as given.

In my years working with individuals and with systems on assisting individuals with mental illness in transitioning successfully from jail or prison to their home communities, I have focused on being sure that these people had their medications, that they had providers in the community who could care for their medical and mental health needs, that they had benefits to pay for that care.

Often, I overlooked these people's more basic needs, such as housing, or transportation, or childcare that would permit them to obtain their treatment or get to the pharmacy to pick up their medications. Naively, I took it for granted that “someone” would take care of this, or that people would naturally have places to go and the ability to get there.

This is not new. Over 70 years ago, the psychologist Abraham Maslow put forth the postulate that there is a “hierarchy of needs“. The most basic needs are physiological – obtaining food, shelter, and safety so that an organism could safely reproduce and pass on his or her genes. These needs are basic to all life.

The remaining needs are generally specific to humanity only. And it is only when these most basic needs are met can people move up the ladder to higher level needs. These needs are demonstrated via a pyramid, with the most basic needs at the bottom, demonstrating that they are foundational to higher level needs. This diagram is adapted from McLeod, at http://www.simplypsychology.org/maslow.html.

What Professor Wilson reminded me of, and what my reaction to the snowstorm reminded me of, is that without housing, without food, without the most basic safety needs being met, it is impossible for people to concern themselves with therapy or treatment, no matter how important those are to the person's ultimate success in the community. It behooves us all to pay attention to this important lesson. While we may not control access to these basic services, we must own the responsibility to advocate for access to them on behalf of our clients and to advocate for systems change so that these important and most basic services are available when our clients return to their communities.

Erik Roskes, a regular blogger for The Crime Report, is a forensic psychiatrist and serves on the teaching faculty in the Psychiatry Department at the University of Maryland School of Medicine. The opinions expressed are those of the author only, and do not represent those of any of Dr. Roskes' employers or consultees, including the Maryland Department of Health and Mental Hygiene. He welcomes readers' comments. Dr. Roskes' website is http://www.erikroskesmd.com/.

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