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Women Offender Programs and Issues

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The 2002 Mental Health Strategy For Women Offenders

Jane Laishes
Mental Health, Health Services
2002

RTF

NEED FOR A WOMEN SPECIFIC MENTAL HEALTH STRATEGY FOR WOMEN OFFENDERS

"Women in American society have life experiences that differ from men's in important ways. Many of these - sexual assault, domestic violence, poverty and discrimination - hurt women's mental and physical health" (American Psychological Association).

The findings of the 1989 Mental Health Survey (in Creating Choices, 1990) commissioned by CSC indicate that the types and incidence of mental health problems are different for men and women. Some mental health problems experienced by women offenders can be linked directly to past experiences of sexual abuse, physical abuse, and assault, as well as substance abuse and poverty.

Overall, women outnumber men in all major psychiatric diagnoses with the exception of anti-social personality disorder. Differences also exist in the behavioural manifestations of mental illness between men and women. Women suffer from approximately twice as much depression as men (federally incarcerated women are three times as likely to be moderately to severely depressed compared to incarcerated men). Men tend to be more physically and sexually threatening and assaultive while women are more self-abusive and tend to engage in more self-mutilating behaviours such as slashing (see Appendix D - Gender Differences with respect to Mental Health).

In addition, important mental health differences exist between incarcerated women and women in general. In a study comparing incarcerated women matched by age and ethnicity to those in the community, (Ross, 1988) incarcerated women had a significantly higher incidence of mental disorders including: schizophrenia, major depression, substance use disorders, psychosexual dysfunction, and antisocial personality disorder. A New Zealand study found that when compared to women living in the community, women offenders had a higher current prevalence of several types of disorders including schizophrenia, major depression, and post-traumatic stress (Brinded et al, 2001). In the United Kingdom, women offenders were also found to have a higher prevalence of schizophrenia and neuroses than non-incarcerated women (UK Department of Health, 1997). While less than male offenders, women offenders also had a high prevalence of personality disorders and alcohol/drug dependence. In addition, studies have shown that incarcerated women have a much higher incidence of a history of childhood sexual abuse and a history of severe physical abuse than women in the general population (see Appendix E - Mental Health Problems of Incarcerated Women Compared to Community Samples).

The above findings are consistent with the results of CSC prevalence studies of mental disorders in women offenders. The Creating Choices report includes the results of a survey of 170 of the 203 women serving federal sentences in 1989. The survey found that two thirds of the women had children and more than 70% had been single parents part or all of their children's lives; 80% had been abused, 68% reported physical abuse, and 54% reported sexual abuse; and 69% reported that substance abuse had played a major role in their offense or their offending history. Among incarcerated Aboriginal women 90% had been physically abused, and 61% reported sexual abuse (Shaw, 1990).

A 1989 study, which achieved a 58.5% response rate, assessed the prevalence of mental disorders in 76 inmates at the Prison for Women (Blanchette, 1989). Table 1 provides a summary of the proportion of inmates that met stringent criteria for DSM disorders.

Table 1: Prevalence of DSM Disorders, Stringent Criteria, Prison for Women, 1988.

Disorder Percentage (%)
Major depression 32.9%
Generalized anxiety disorder 19.7%
Psychosexual dysfunction 34.2%
Antisocial personality 36.8%
Alcohol use/ dependence 63.2%
Drug use/ dependence 50.0%

In 1992, the following findings were obtained from assessing the mental health needs of 75 women at the Burnaby Correctional Centre for Women (19% of the population was comprised of federal inmates):

  • 49% were found to have personality disorders;
  • 67% reported current substance abuse problems and 87% reported that substance abuse had been a problem at some point in their lives;
  • 36% reported childhood physical abuse, 47% reported childhood sexual abuse, 19% reported adult sexual abuse, and 69% reported adult partner physical abuse;
  • 29% reported engaging in self-destructive behaviours such as slashing;
  • 20% reported current depression, while 32% reported that depression had been a problem at some point in their lives; and
  • 24% reported that they experienced current problems with anxiety, while 29% reported that anxiety had been a problem at some point in their lives.

The authors reported that many of the inmates had multiple problems with many having suffered abuse and experienced violence as children and adults (Tien, 1993).

As a result of the research that has been done with women offenders, the Creating Choices report notes that there is a strong need for improved access to physical and mental health services. Three main reasons for providing mental health treatment within correctional facilities are to: (Metzner, 1997)

  • reduce the disabling effects of serious mental illness to maximize each inmate's ability to electively participate in correctional programs;
  • decrease the needless extremes of human suffering caused by mental illness; and
  • help keep the prison safe for staff, inmates, volunteers, and visitors.

The research noted above supports the need to provide appropriate mental health services oriented to the specific needs of women offenders. In light of the CCRA and resultant policy (see Appendix F and Appendix G), mental health services for women offenders must be developed and implemented in recognition of gender differences. These differences can be found in the etiology and classification of mental health problems, the prevalence of specific categories of mental disorders, and with regard for the context in which these problems developed.

Many women offenders are from marginalized backgrounds and situations that may include poverty, discrimination, abuse, and chemical dependency. Programs and services must be holistic insofar as they need to address the social context of women's lives and target those areas that have contributed to their criminal behaviour. Therefore, gender appropriate mental health services must respond to the experiences and related mental health needs of incarcerated women.

Effective correctional programs for all women offenders should also be based on a model of empowerment whereby women gain insight into their situation, identify their strengths, and are supported and challenged to take positive action to gain control of their lives. This process acknowledges and holds women offenders accountable for their actions while recognizing that actions occur within a social context (Kendall, 1993).