People in prison are more likely than the general United States population to have received a

mental disorder A mental disorder, also referred to as a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitti ...

diagnosis, and women in prison have higher rates of mental illness and mental health treatment than do men in prison. Furthermore, women in prisons are three times more likely than the general population to report poor physical and

mental health Mental health encompasses emotional, psychological, and social well-being, influencing cognition, perception, and behavior. It likewise determines how an individual handles stress, interpersonal relationships, and decision-making. Mental health ...

.Starr-Sered, Susan and Maureen Norton-Hawk. 2014. ''Can't Catch a Break: Gender, Jail, Drugs and the Limits of Personal Responsibility''. Berkeley: University of California Press. Women are the fastest growing demographic of the United States prison population.Hall, Martin T., Seana Golder, Cynthia L. Conley, and Susan Sawning. 2012. "Designing Programming and Interventions for Women in the Criminal Justice System." ''American Journal of Criminal Justice'' 38(1):27–50. As of 2019, there are about 222,500 women incarcerated in

state State may refer to: Arts, entertainment, and media Literature * ''State Magazine'', a monthly magazine published by the U.S. Department of State * ''The State'' (newspaper), a daily newspaper in Columbia, South Carolina, United States * ''Our S ...

and

federal prisons A federal prison is operated under the jurisdiction of a federal government as opposed to a state or provincial body. Federal prisons are used for convicts who violated federal law (U.S., Mexico), inmates considered dangerous (Brazil), or those se ...

in the United States. Women comprise roughly 8% of all inmates in the United States. In 2011, 11% of male inmates had an overnight hospital stay due to psychiatric problems, while the proportion of women who did was roughly twice that of men. In 2010, 73% of incarcerated women and 55% of incarcerated men self-reported mental health problems. This statistic accounts for the reporting of at least one of two criteria, as a self-reported mental or emotional problem, or a reported overnight hospital stay. The most common mental health problems among incarcerated women are

substance abuse Substance abuse, also known as drug abuse, is the use of a drug in amounts or by methods which are harmful to the individual or others. It is a form of substance-related disorder. Differing definitions of drug abuse are used in public health, ...

/ dependence,

post-traumatic stress disorder Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that can develop because of exposure to a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on ...

, and depression. Other common disorders include

schizophrenia Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social withdra ...

bipolar disorder Bipolar disorder, previously known as manic depression, is a mental disorder characterized by periods of depression and periods of abnormally elevated mood that last from days to weeks each. If the elevated mood is severe or associated with ...

, and

dysthymia Dysthymia ( ), also known as persistent depressive disorder (PDD), is a mental and behavioral disorder, specifically a disorder primarily of mood, consisting of similar cognitive and physical problems as major depressive disorder, but with lon ...

.Visher, Christy A., and Nicholas W. Bakken. 2014. "Reentry Challenges facing Women with Mental Health Problems." ''Women and Health'' 54(8): 768-780.

Before crime

Early experiences of victimization

Criminality In ordinary language, a crime is an unlawful act punishable by a state or other authority. The term ''crime'' does not, in modern criminal law, have any simple and universally accepted definition,Farmer, Lindsay: "Crime, definitions of", in Can ...

among females is intimately associated with experiences of

trauma Trauma most often refers to: * Major trauma, in physical medicine, severe physical injury caused by an external source * Psychological trauma, a type of damage to the psyche that occurs as a result of a severely distressing event *Traumatic i ...

and victimization occurring early in life.Dehart, D., S. Lynch, J. Belknap, P. Dass-Brailsford, and B. Green. 2013. "Life History Models of Female Offending: The Roles of Serious Mental Illness and Trauma in Women's Pathways to Jail." ''Psychology of Women Quarterly'' 38(1):138–51. The majority of incarcerated females have experienced some kind of

victimization Victimisation ( or victimization) is the process of being victimised or becoming a victim. The field that studies the process, rates, incidence, effects, and prevalence of victimisation is called victimology. Peer victimisation Peer victimisati ...

, defined as experiences of physical, sexual, or emotional trauma. Among female offenders 78% of have reported prior sexual or physical abuse, compared to only 30% of male offenders. Furthermore, "research consistently links histories of violence with negative mental health outcomes, such as depression, substance abuse, and intimate partner violence among incarcerated women at higher rates than those in the general female population".Liebman, R. E. et al. 2013. "Piloting a Psycho-Social Intervention for Incarcerated Women With Trauma Histories: Lessons Learned and Future Recommendations." ''International Journal of Offender Therapy and Comparative Criminology'' 58(8):894–913. Early experiences of victimization predispose women to be more likely to suffer from certain psychiatric disorders, particularly post-traumatic stress disorder (PTSD), depression, and dysthymia. A study conducted in 2017, found that 60% of participating female inmates had been diagnosed with a mental illness. Following PTSD and substance abuse/dependence, depression is the third most common psychiatric disorder among incarcerated women. Depression and substance abuse, too, are closely linked with experiences of victimization or PTSD, and more so for women than for men. In fact, according to the

National Comorbidity Survey The National Comorbidity Survey: Baseline (NCS-1) was the first large-scale field survey of mental health in the United States. Conducted from 1990–1992, disorders were assessed based on the diagnostic criteria of the then-most current DSM manual ...

, women are twice as likely as men to experience co-occurring PTSD and depression. The prevalence of depression among incarcerated females links to trends within the general population as well. A study found that of the 54% of incarcerated women diagnosed with lifetime PTSD, 63% reported experiencing three or more traumatic events. While women are more likely than men to suffer internalized problems, such as

anxiety Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different than fear in that the former is defined as the anticipation of a future threat wh ...

and depression, men are more likely to be treated for externalized problems such as

delinquency Delinquent or delinquents may refer to: * A person who commits a felony * A juvenile delinquent, often shortened as delinquent is a young person (under 18) who fails to do that which is required by law; see juvenile delinquency * A person who fa ...

aggression Aggression is overt or covert, often harmful, social interaction with the intention of inflicting damage or other harm upon another individual; although it can be channeled into creative and practical outlets for some. It may occur either reacti ...

, and substance abuse.Thompson, Melissa. 2010. "Race, Gender, and the Social Construction of Mental Illness in the Criminal Justice System." ''Sociological Perspectives'' 53(1):99–126. This difference coincides with a gendered discrepancy in the experiences of mentally ill offenders once they enter the criminal justice system.

Victimization and criminal offending

In both males and females,

sexual abuse Sexual abuse or sex abuse, also referred to as molestation, is abusive sexual behavior by one person upon another. It is often perpetrated using force or by taking advantage of another. Molestation often refers to an instance of sexual assa ...

physical abuse Physical abuse is any intentional act causing injury or trauma to another person or animal by way of bodily contact. In most cases, children are the victims of physical abuse, but adults can also be victims, as in cases of domestic violence or wo ...

, and

neglect In the context of caregiving, neglect is a form of abuse where the perpetrator, who is responsible for caring for someone who is unable to care for themselves, fails to do so. It can be a result of carelessness, indifference, or unwillingness and ...

increase the likelihood of arrest for a juvenile by 59% and as an adult by 28%. Although sociologists do not point to a single explanation for the association between victimization, trauma, and incarceration, researchers have found that trauma frequently cause women to abuse drugs and alcohol as a coping mechanism. Sociologists also point out that early victimization increases the likelihood of women's continued or exacerbated involvement in harmful settings.Steffensmeier, Darrell and Emilie Allan. 1996. "Gender and Crime: Toward a Gendered Theory of Female Offending." ''Annual Review of Sociology'' 22(1):459–87. According to one

ethnography Ethnography (from Greek ''ethnos'' "folk, people, nation" and ''grapho'' "I write") is a branch of anthropology and the systematic study of individual cultures. Ethnography explores cultural phenomena from the point of view of the subject o ...

of female offenders in Boston, "In fact, running away from home—often to escape abuse in households dominated by violent men—is the charge in the first arrest for nearly a quarter of girls in the

juvenile justice system A juvenile court, also known as young offender's court or children's court, is a tribunal having special authority to pass judgements for crimes that are committed by children who have not attained the age of majority. In most modern legal s ...

… On the streets, women are vulnerable to

harassment Harassment covers a wide range of behaviors of offensive nature. It is commonly understood as behavior that demeans, humiliates or embarrasses a person, and it is characteristically identified by its unlikelihood in terms of social and moral ...

, exploitation, and drug use, all of which drag them into the correctional circuit". In addition to symptoms of trauma, other mental health problems such as major depression, schizophrenia, and mania are linked with patterns of violent offending and

homelessness Homelessness or houselessness – also known as a state of being unhoused or unsheltered – is the condition of lacking stable, safe, and adequate housing. People can be categorized as homeless if they are: * living on the streets, also kn ...

prior to arrest.

Substance abuse

Substance abuse and dependence are the most common mental health problems among incarcerated females, and drug use is the most common reason for women's incarceration. At the end of 2018, 26% of female state prisoners were serving time for drug related offenses. This percentage is double than that of male state prisoners who are serving time for drug related charges. Seventy percent of incarcerated females suffer from drug abuse or dependence, and incarcerated females are nine times more likely than the general population to experience substance abuse and dependence. Social researchers have linked substance abuse to experiences of trauma and victimization. Sociologists have conducted extensive research in favor of a

self-medication Self-medication is a human behavior in which an individual uses a substance or any exogenous influence to self-administer treatment for physical or psychological conditions: for example headaches or fatigue. The substances most widely used in se ...

hypothesis in relation to women's drug use and abuse, positing that women use drugs as a way to cope with experiences of sexual or physical trauma. Past research suggests that consequences of childhood sexual abuse increase a woman's risk for self-medicating with alcohol and drugs. Incarcerated women with a history of substance abuse are more likely have had prior mental health and criminal justice experiences than incarcerated women with no history of drug abuse.

In the courts

Within the United States justice system, women's criminal activity is more likely than men's to be medicalized, in connection with a tendency to perceive female offenders as "mad, rather than bad." Female offenders are more likely than men to receive psychiatric evaluations, even when they have not self-reported a mental illness. Sociologists have noted that gendered stereotypes among men and women contribute to this discrepancy in mental health evaluations. While criminal behavior and aggression are more associated with

masculinity Masculinity (also called manhood or manliness) is a set of attributes, behaviors, and roles associated with men and boys. Masculinity can be theoretically understood as socially constructed, and there is also evidence that some behaviors con ...

, traits such as passivity and submission are more associated with

feminine Femininity (also called womanliness) is a set of attributes, behaviors, and roles generally associated with women and girls. Femininity can be understood as socially constructed, and there is also some evidence that some behaviors considered fe ...

roles. Female offenders are more likely to be identified as having engaged in role-incongruent or deviant behavior that is explained, diagnosed, and treated psychiatrically. Receiving a psychiatric evaluation reduces the chances that a defendant will have charges dropped against her or him, and also increases the likelihood of conviction, incarceration, and lengthier prison sentences. Because women who have engaged in crime are thought to have violated

gender norms A gender role, also known as a sex role, is a social role encompassing a range of behaviors and attitudes that are generally considered acceptable, appropriate, or desirable for a person based on that person's sex. Gender roles are usually cent ...

, some sociologists posit that female offenders may receive harsher sentences than men. However, among men and women in the general population, sociologists have not reached a consensus on the differences in sentencing, treatment, and leniency among males and females in general. For instance, among juveniles, males are more likely to be arrested, petitioned, and adjudicated than females. Among juvenile females who are sentenced, studies vary on whether these women receive lighter or harsher sentences. Some studies find that women are treated more leniently by courts. Other studies show that juvenile women may be sentenced more harshly than their male counterparts

During incarceration

Prevalence of mental illness

Several studies have found that rates of

mental illness A mental disorder, also referred to as a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitti ...

in prisons are higher than those in the general population and that rates of mental illness in women's prisons are higher than those in men's prisons.Magaletta, Philip R., Pamela M. Diamond, Erik Faust, Dawn M. Daggett, and Scott D. Camp. 2009. "Estimating the Mental Illness Component of Service Need in Corrections." ''Criminal Justice and Behaviour'' 36(3): 229-244. In 1999 a report for the Department of Justice estimated16% of the prison population had some form of mental disorder. However, much research in this area "lack specificity regarding important subpopulations, such as female offenders." That work which has looked at female offenders as an "important subpopulation" has found that they experience mental health problems at greater rates than their male counterparts. According to a report through the Bureau of Justice Statistics, female prisoners are about twice as likely than male prisoners to have a history of mental health problems. A study through the Mental Health Prevalence Project which used "three major indicators of mental illness: diagnosis of a serious mental illness, history of inpatient psychiatric care, and

psychotropic medication A psychoactive drug, psychopharmaceutical, psychoactive agent or psychotropic drug is a chemical substance, that changes functions of the nervous system, and results in alterations in perception, mood, consciousness, cognition or behavior. T ...

use" found that female offenders have "on average, twice the rate of various indicators as males." The study found (using a weighted sample) that 17.8% of male offenders and 35.1% of female offenders have a mental health problem upon being committed. This study did not treat

as a mental health disorder. Other studies report much higher rates of mental illness among prisoners. One

Bureau of Justice Statistics The Bureau of Justice Statistics (BJS) of the U.S. Department of Justice is the principal federal agency responsible for measuring crime, criminal victimization, criminal offenders, victims of crime, correlates of crime, and the operation of crim ...

survey in 2004 found that 55% of male inmates and 73% of female inmates self-reported a mental health problem.

The Sentencing Project The Sentencing Project is a Washington, D.C.-based research and advocacy center working for decarceration in the United States and seeking to address racial disparities in the criminal justice system. The organization produces nonpartisan repor ...

, in their 2007 Briefing Sheets, also report that 73.1% of women in prisons have a mental health problem. Female inmates who experience co-occurring disorders are four times more likely than other female inmates to receive severe disciplinary punishment. No significant relationship has been found between severe punishment and a singular mental health disorder or substance use disorder. Female inmates are more likely than male inmates to be diagnosed with depression, substance abuse, developmental disabilities, bipolar disorder, PTSD, and eating disorders.

Mental health treatment and services

For many offenders, incarceration provides a rare opportunity to access mental health services not available to offenders within their communities. Despite the growing prison population in the United States and the prevalence of mental health problems "In-prison services have not expanded sufficiently to meet treatment needs. In fact, between 1988 and 2000, prison mental health services declined, and those services that are available are concentrated only in the most secure facilities." One study found that 41% of female inmates report use of mental health services while incarcerated, while 73% report mental health problems. According to the Bureau of Justice Statistics "All Federal prisons and most State prisons and jail jurisdictions, as a matter of policy, provide mental health services to inmates, including screening inmates at intake for mental health problems, providing therapy or counseling by trained

mental health professional A mental health professional is a health care practitioner or social and human services provider who offers services for the purpose of improving an individual's mental health or to treat mental disorders. This broad category was developed as a ...

s, and distributing psychotropic medication."James, Doris and Lauren Glaze. 2006. "Mental Health Problems of Prison and Jail Inmates." ''Bureau of Justice Statistics Special Report''. Researchers working with the Mental Health Prevalence Project note that "legal mandates and humanitarian concerns alone require that ental healthservices be provided. In addition, the effective, safe, and orderly management of

correctional facilities A prison, also known as a jail, gaol (dated, standard English, Australian, and historically in Canada), penitentiary (American English and Canadian English), detention center (or detention centre outside the US), correction center, correcti ...

require that these needs be met." While sociologists have recommended trauma-focused treatments for offenders, these services are still lacking. Researchers have also noted that "there is strong

empirical Empirical evidence for a proposition is evidence, i.e. what supports or counters this proposition, that is constituted by or accessible to sense experience or experimental procedure. Empirical evidence is of central importance to the sciences and ...

support for gender-specific, trauma-focused treatments". In one study, researchers offered 25 therapeutic group sessions to female inmates with mental health problems. It was found that the sessions were "successful at significantly decreasing post-traumatic stress disorder (PTSD) and

substance use disorder Substance use disorder (SUD) is the persistent use of drugs (including alcohol) despite substantial harm and adverse consequences as a result of their use. Substance use disorders are characterized by an array of mental/emotional, physical, and ...

(SUD) symptoms, with almost 50% of participants no longer meeting criteria for the disorder and 65% reporting no substance use at the 3-month follow up". Reasons for the lack of gender-specific treatment in women's prisons despite their proven use may be the difficulties of setting up such programs, including navigation of "legal and logistical barriers." It has been found that female inmates are medicated at higher rates than their male counterparts. Women are also treated differently than men in prisons in regard to mental illness. Studies suggest "that female inmates' behaviour is more likely than males' to be 'psychiatrized' by correctional staff".Baskin, Deborah R., Ira Sommers, Richard Tessler, and Henry J. Steadman. 1989. "Role Incongruence and Gender Variation in the Provision of Prison Mental Health Services." ''Journal of Health and Social Behavior'' 30(3):305. One study shows that "role incongruence" effects how female and male inmates are treated. According to the study "female inmates who perpetrated acts of violence against others and/or property, or who demonstrated

aggressiveness Aggression is overt or covert, often harmful, social interaction with the intention of inflicting damage or other harm upon another individual; although it can be channeled into creative and practical outlets for some. It may occur either reacti ...

or agitation, were significantly more likely than men exhibiting similar behaviors to be placed in mental health units". Furthermore, the researchers found that men exhibiting "female psychiatric disorders (e.g., depression)" were more likely to receive mental health care than females exhibiting the same disorders. The study suggests that differential treatment of male and female inmates may be based on the inmates adherence to

, and that a breaking of these norms is likely to be treated psychiatrically. Therapeutic or rehabilitation programs in prisons also differ for men and women, with male prisons providing more access to programs for

anger management Anger management is a psycho-therapeutic program for anger prevention and control. It has been described as deploying anger successfully.Schwarts, Gil. July 2006. Anger Management', July 2006 The Office Politic. Men's Health magazine. Emmaus, PA: ...

, and female prisons providing more access to programs addressing trauma or loss.Adshead, Gwen. 2011. "Same but Different: Constructions of Female Violence in Forensic Mental Health." ''International Journal of Feminist Approaches to Bioethics'' 4(1):41–68.

After prison

In many instances, living in prison obligates individuals to adapt socially and psychologically, making it difficult to reintegrate into daily life outside of prison and to develop healthy relationships.Massoglia, Michael and William Alex Pridemore. 2015. "Incarceration and Health." ''Annual Review of Sociology'' 41(1):291–310. Furthermore, due to the prevalence of chronic diseases within jails, offenders returning to low-income communities may be inadvertently contributing to health inequities in low-income areas. The difficulties facing women upon their release from prison range from "finding housing, getting a job, earning enough money to support themselves, reconnecting with children and family." Failure to find work and a stable home may lead women back to committing crime and back to prison. The

recidivism Recidivism (; from ''recidive'' and ''ism'', from Latin ''recidīvus'' "recurring", from ''re-'' "back" and ''cadō'' "I fall") is the act of a person repeating an undesirable behavior after they have experienced negative consequences of th ...

rates among prisoners is so high that it has been termed the " revolving door phenomenon." Studies have found that among women released from prison in 1994 "58% were arrested" within three and a half years of release, and "39% were returned to prison". A 2011 study by Pew Center of the States find similar recidivism rates. The release and reentry difficulties that female prisoners face are often exacerbated by mental health challenges. The high rates of mental health problems among female offenders follows them past prison and into reentry. A study published in 2010 by the Reentry Planning for Offenders with Mental Disorders: Policy and Practice found that "of 357 women released from prison in six states, 44% reported they had been diagnosed with bipolar disorder, depression,

obsessive compulsive disorder Obsession may refer to: Psychology * Celebrity worship syndrome, obsessive addictive disorder to a celebrity's personal and professional life * Fixation (psychology), a persistent attachment to an object or idea * Idée fixe (psychology), a preo ...

, post traumatic stress disorder, phobia, or

."Broner, M., P. K. Lattimore, and D. Steffey. 2010. "Mental Health Needs and Services Receipt of Reentering Offenders: A Multi-site Study of Men, Women and Male Youth."Reentry Planning for Offenders with Mental Disorders: Policy and Practice, edited by H. A. Dlugacz. New Jersey: Civic Research Institute. A majority, 56%, of these women, felt they were currently in need of treatment. However, studies find that mental health and substance abuse treatment is not readily available to women returning to their communities from prison. Furthermore, upon release many women often have trouble keeping up with medication they had access to in prison. These mental health problems may hinder offenders as they try to find a job and housing. Their health problems may be so severe they cannot work, they face the additional job of managing their health problem and mental illness increases the likelihood of engaging in "inappropriate behavior that provokes a law enforcement response." These challenges may increase recidivism rates. An individual's chance of recidivism decreases if significant change occurs to their in-prison mental health.

References

{{reflist, 30em Penal system in the United States Imprisonment and detention in the United States Forensic psychology Mental health in the United States