Even as neglect inside correctional institutions during the COVID-19 pandemic effectively sentences those inside to illness and potential death, there were already more than 2,700 people in the United States who have been awaiting death in prison because their offenses were deemed abhorrent enough for the state to end their lives.

Last Tuesday, 64-year-old Walter Barton became the first person on death row to be executed in the United States since the COVID-19 pandemic was declared a national emergency in March. Barton’s execution during this public health crisis exemplifies how at the same time correctional facilities are rapidly attempting to quell the spread of the disease, they’re continuing to operate the official processes of state-mandated death.

While the ills of the criminal justice system are increasingly acknowledged, as evidenced by presidential campaign platforms and the election of reform-minded local officials, this bipartisan, mainstream empathy for those entangled in the system rarely stretches beyond those who have committed nonviolent offenses. Even more infrequently does it reach those on death row, though a notable exception can be made for cases where there is widespread consensus that the individual is actually innocent.

However, a group of people who cannot help but think of those on death row are those intimately connected to them⁠—people like Tara Barton, Walter Barton’s niece. Tara, along with her sister, began researching Barton’s case in February and believes that he was wrongly convicted. “We didn’t realize he was innocent,” she told The Appeal in an interview a week before his execution.

Family members like Tara are left to reassemble their lives long after an execution takes place. With little support, they must privately tend to their own mental health as they mourn the deaths of their loved ones, all while recognizing that those deaths were intentionally coordinated by the criminal legal system and may even have been celebrated by the broader public.

Nobody To Talk To, a report released last fall by the Texas After Violence Project, highlights the unique trauma experienced by families who have a loved one on death row, the barriers that keep them from receiving mental health care, the mechanisms by which they attempt to cope in the absence of that care, and recommendations for how the medical community can better address their needs.

‘I used to cry every day’

Texas After Violence Project (TAVP), a community-based documentary project, has been collecting oral histories that illustrate the impact of both interpersonal and state violence on the lives of Texans. Since its founding in 2007, TAVP has conducted 116 oral histories with people who have had some experience or contact with Texas death penalty cases. Of those, 12 histories were with family members of people who had been executed. Those discussions as well as subsequent follow-up interviews served as the basis of the report. Footage of the conversations are available for public viewing through the TAVP archive housed at the University of Texas library.  

Among those conversations was a 2009 interview with Tammy Anderson. Anderson’s son, Anthony, was executed by the state of Texas in 2004 at the age of 30 after being arrested for a robbery and murder 10 years prior. In the video, which looks a bit like a home movie, Anderson is seated at the dining room table in the home where she grew up and where she later raised her own children. She speaks vividly and candidly about Anthony’s childhood and his conviction, how she maintained her relationship with him while he was on death row, and the final day of his life.

“The thing that sets in my head is that when we were leaving out of there,” said Anderson, “I turned to look at him as he was walking away and he was crying and that was horrible for me to see. [It was the] first time he had cried and I dream about it too. He cried and then I started crying. It was just like, ‘Mom, help me,’ and I couldn’t do nothing.”

Intense grief became a feature of her everyday life and remained so long after Anthony’s death.

“Recently it’s gotten better but I used to cry every day, every day for the longest—for years, I cried every day,” she said. “And I’ll be driving sometimes and I think about him and I cry, I’ll be in the shower and I think about him and I’ll cry. I guess it’s just the way it is, it’s a kid, your son, it’s harder.” 

Anderson’s experience is one shared by other death row families who must process the loss of their loved one while also navigating the complex, unique experience of the death penalty. Depression and suicidal ideation are common within these families, according to Nobody to Talk To.

This depression can be rooted in the severe stress caused by managing the demands of supporting a loved one in prison like paying for phone calls, coordinating visits, and contesting their case, all while also supporting the needs of the larger family unit. While families with incarcerated loved ones are familiar with those stressors, those with loved ones on death row also face additional challenges like anticipatory grief, or the prolonged trauma of knowing their family member will be executed but not knowing exactly when.

Report authors say that another concept manifesting in death row families is that of the “family ghost.” The report draws upon the work of Walter Long, a capital defense attorney who describes the family ghost as a missing family member with whom the other family members have a complicated emotional relationship. According to Long, this ghost can create a feeling of “ambiguous loss” and haunt a family member’s mind, occupying their attention and taking them away from the present moment and the pressing needs of those immediately around them.  

‘We really don’t talk about it’

In Anderson’s interview with TAVP, she’s asked how the rest of her family handled Anthony’s death. She says that his youngest sister took it the worst and that her grief almost derailed her life before she got back on track. But then again, Anderson considers, his sister Amy also took it hard.

“Well, they all took it hard,” she said. “Everybody took it hard, his brother took it hard. But nobody really talks about it. Sometimes we’ll say stuff and joke around about Anthony—things that he used to do—but we really don’t talk about it.”  

The overwhelming grief that has clouded Anderson’s family and other death row families should make them prime candidates for receiving therapy that could help them cope with an unimaginable and complicated loss. However, as Nobody To Talk To notes, there are high barriers to treatment. While some barriers—like finances or fears about medication—might be shared by other communities, others are wholly unique to the experience of those connected to people on death row.

Among those barriers is an ambivalence and guilt towards seeking help for oneself, recognizing that when someone’s loved one is about to die, the family member’s own feelings of sadness may appear small in comparison. For children, they may not want to impose an additional burden on their parents by talking about their depression.

However, perhaps one of the key barriers to care for death row families arises from the nature of their loved ones’ death and the deep stigma that the death penalty carries. Seeking care can turn an intensely private and personal experience into a political one, and that fear of judgment or dismissiveness can discourage individuals from even reaching out to a therapist, the report notes.

While there has been a gradual shift in support for life imprisonment over the death penalty, a 2019 Gallup poll still revealed that 56% of Americans are in favor of capital punishment for a person convicted of murder in the absence of any alternative options for retribution. This wide support for the death penalty can make it difficult for families of those on death row to feel entirely safe and welcome in a therapist’s office.

Even in situations where clinicians are not judgmental, a lack of familiarity with the capital punishment process can create unease within a patient, causing them to have to teach their therapist about what they are experiencing. The report also notes instances of interviewees who met with therapists who were so unaware of the death penalty that they themselves became overwhelmed with sadness by the patient’s stories.

Susannah Sheffer, one of the authors of the report, says this “creates the barrier of will I be judged? Or will I have to educate?” Neither of which are burdens that a grief-stricken patient wants to bear.

Breaking barriers

While Nobody To Talk To lays bare the roadblocks that death row families may meet as they seek care, it does not present these roadblocks as insurmountable. The report includes recommendations for the mental health community on how they can restructure their practices to be more welcoming and amenable to the needs of death row families. Those suggestions include openly communicating a willingness to work with death row families by, for example, having a clinician mention to prospective clients that death row family members are a specific population that they work with. The report also notes the need for more training for clinicians on the nuances of death row and the unique needs of people impacted by it. Last November, TAVP hosted their own in-person training in Austin, Texas, and have made that course available online for clinicians.  

Among the most pressing needs the report argues for is that medical organizations and practitioners need to recognize death row families as their own uniquely affected group, including children.

The report says one organization that could take the lead on recognizing and building tools for children impacted by death row is the federally funded National Childhood Traumatic Stress Network (NCTSN), one of the most widely respected groups focusing on the mental health needs of youth. Sheffer told Prism that children can have a particularly difficult time articulating how they feel. For NCTSN to acknowledge children with family members on death row as a special group in need of care could legitimize their experiences.

NCTSN already has a wide array of specific resources for traumatic grief among children, and they are constantly building new resources as they see patterns emerging within their direct service centers across the country. While NCTSN has resources for children of incarcerated parents, they do not yet have any for children with parents or siblings who are on death row. However, according to DeAnna Griffin, product development coordinator at NCTSN, this is a population that they have included in a running list of groups that they would like to build resources for.

At the heart of Nobody To Talk To’s recommendations is the assertion that “clinicians cannot respond optimally to a population whose existence they have not even considered.” That process will require more engagement with death row families to understand their varying needs, a deeper familiarity with what death row looks like, and an interrogation of how public attitudes about who deserves punishment can undermine one’s ability to process and heal from their own private pain. In doing so, the mental health community will have to consider how the death penalty takes a toll far beyond the individual being executed.

“It’s not a small problem with one person,” said Long. “It does damage to everyone.”