Friends of the Forensic Science Club, this week we present the paper “Women’s experiences of prison-based mental healthcare: a systematic review of qualitative literature”, by Bright, A. M.; Higgins, A. and Grealish, A. (2022), in which authors carry out an investigation on recent and existing literature about women in prison and their experiences regarding mental health to know if the treatments and therapies they follow are effective.
Since 2000, the number of women in prison has increased by around 53% worldwide, with an approximate population of 714,000 inmates.
Internationally, there are increasing trends, although there are some exceptions. For example, in the United States a 700% increase in women in prison since 1980 has been seen, but Australia saw a 10% reduction between 2019 and 202.
On the other hand, in the United Kingdom, an estimated 73% of women serving sentences of 12 months or less are reconvicted for another offense within a year of release.
This is consistent with the position of many experts on short prison sentences: they are less effective in achieving rehabilitation than other sentences, such as community work.
Also in the UK, women experience particular difficulties once they enter prison as there are only 12 women’s facilities, so they are often forced to be a long way from their family and loved ones.
Considering all this, it is not surprising for authors that the percentage of women with mental health problems is so high in the prison context: approximately 80% suffer from them.
Women in prison are 5 times more likely to experience mental health problems than women in the general population. The most prevalent conditions are substance abuse (30-60%), alcohol addiction (10-24%), post-traumatic stress disorder (21.1%) and major depression (3.9-14.1%).
In addition, women in prison are up to 20 times more likely to commit suicide and, within one year of release, 36 times more likely to commit suicide compared to the rest of the population.
In recent years, fortunately, there has been an increased demand for mental health care for women in prisons, calling for the revision of existing policies and services to meet the needs of women in this context.
Authors aimed, in this study, to review existing literature on women serving custodial sentences in prison in order to identify their mental health conditions and to understand their experiences more deeply. They used a total of 7 studies, as recent as possible.
Authors obtained interesting conclusions, such as that women in prison are more likely to participate in mental health treatment programs compared to men in prison; however, they are less likely to be offered this possibility, or, in other words, to have access to treatment programs.
On the other hand, and taking into account that a more or less stable mental health is fundamental for their reintegration, rehabilitation once released from prison is seen as an elusive goal.
Recovery in this context is a concept in which many factors are involved, but, in essence, it refers to people achieving a new meaning, a new purpose for their lives.
In a 2011 study by Leamy and colleagues, 5 essential factors for recovery were identified: connection, hope, identity, meaningful role, and empowerment. It is therefore vital that women are empowered, for example, to be able to manage their own mental health while in prison and, thus, contribute to their recovery and rehabilitation. This can -and should- be supported by strength and skills development activities, and also by increasing self-esteem and self-efficacy.
As a result of being in prison, a person loses the fundamental right to freedom; however, sometimes they also lose the right to privacy. In 5 of the 7 studies in the article, it appears that some prison workers were aware of requests from inmates for psychological treatment, where inmates talked about why they were requesting this care. This, of course, negatively affected the women’s mental well-being.
On the other hand, considering that female inmates are a particularly vulnerable population, it is of concern that in most studies they mentioned having difficulties with prison staff. They reported that these people seemed insensitive to their needs, contributing to the deterioration of the psychological well-being of the women in the center.
Authors believe that providing mental health education to prison staff can help improve their understanding of how mental health problems manifest themselves and their specific vulnerabilities. It would also help them develop their empathy for women prisoners.
In addition, there is a clear need to devote more effort and resources to research in this context, both to improve policy and service delivery, and to enable the voices of women in prison to be heard.
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