Justice-Involved Women Implications of Physical and Behavioral Health Issues

1. Justice-Involved WomenImplications of Physical and Behavioral Health Issues American Public Health Association October 30, 2012 Maureen Buell National Institute of Corrections

2. Justice-Involved Women Prisons are Challenging Settings for Trauma-Informed Care. Prisons are designed to house perpetrators, not victims. Inmates arrive shackled ……((Owens, Wells, Pollock, Muscat, and Torres, 2008) Evidence based, gender-responsive practices fairly recent in prisons Trauma informed care just starting to emerge in correctional settings However….. “Most successful interventions in prison have goals congruent with duties of correctional staff: public safety and safety of inmates, rehabilitation and staff/institutional security” (Miller, Najavits 2011 “Creating Trauma Informed Correctional Care: A Balance of Goals and Environment”)

3. Justice-Involved Women What Happens in Correctional Settings? Mistrust and lack of confidentiality Highly structured but inconsistent environments Security practices that “trigger” trauma responses Isolation Particularly for women, lack of contact with family and community Staff who bring their own “personal challenges” to the environment negatively impacting the culture Security “trumps” trauma informed practices Lack of appropriate staff training Environments that are under resourced, under valued and overwhelmed

4. Justice-Involved Women Who are the women in correctional settings? 2010 arrest data female arrests up 11.4%, male arrests down 5% (FBI, 20120) and over the …. Same period incarceration for women increased 22% (West, Sabol & Greenman, FBI 2010) Histories of interpersonal violence with estimates as high as 90%. …demonstrated stronger relationship to criminal outcomes in women vs. men (Benda, 2005; Funk, 1999; Kerig & Becker, 2012) ..not considered a relevant factor in the prediction of male offending, there is some evidence to suggest extreme depression, self-harm, and suicidal tendencies are criminogenic for women. (Blanchette & Motiuk, 1995; Loucks, 1995; Rettinger, 1998; Salisbury & VanVoorhis, 2010) Substance abuse primary factor in returns to incarceration for women (Grella & Greenwald, 2007) Mental health symptoms and past trauma and abuse contribute to women’s pathways to incarceration (VanVoorhis, 2008)

5. Justice-Involved Women Some Examples of Research & Theory.. Traditional criminal justice policies and practices have largely been developed through the lens of managing men, not women.. (NRCJIW, 2012) Relational Theory (Miller, 1976) Pathways Perspective (Steffensmeier & Allen(1998) Substance Abuse & Trauma Theory (Herman, 1992; SAMHSA, 2011) Harmed & Harming Women (Brennan, 2007) Adverse Childhood Experiences (ACE) study Race and Ethnicity (Sanders-Phillips, 1999) Economic and Social Marginality (Bloom and Owen, 1995) Homelessness (North and Smith (1993) Relationships (Chesney-Lind 1997)

6. Justice-Involved Women Providing Trauma Informed Care in Corrections Training Correctional Staff Interventions in Correctional Environments

7. Justice-Involved Women Training Correctional Staff Experienced staff rather than research staff Train to What’s In It For Me? Reduce Turnover Reduce costs of mental health beds Reduce use of seclusion and restraint Safer facility and increased job satisfaction What are examples of trauma-related symptoms? Use of verbal de-escalation prompts Use of role-play and demonstration Talking offenders through pat downs and searches Redirecting discussion of trauma to appropriate staff Examples of women offenders who have benefitted from use of trauma informed practice Discuss vicarious trauma and compassion fatigue (correctional fatigue*) *Desert Waters Outreach, Florence,CO

8. Justice-Involved Women Interventions in Criminal Justice Environments Helping Women Recover (Criminal Justice edition, Covington, 2008) Beyond Trauma: A Healing Journey for Women (Covington, 2003) VOICES: A Program of Self-discovery and Empowerment for Girls (Covington, 2004) Seeking Safety: A Model for Trauma and/or Substance Abuse (Najavits, 1992) (2001 (Zlotnick, et. All 2003 study) Engaging Women in Trauma-Informed Peer Support: A Guidebook (Darby, SAMHSA, 2012) Women Offender Case Management Model (NIC, 2008) …supervision plans were guided by a validated risk and need assessment were 26% less likely to be rearrested than non-participants….(Millson, Robinson & Van Dieten, 2010) Trauma Recovery and Empowerment Model (TREM) An intervention program designed for women survivors of trauma (Harris, 1999)

9. Justice-Involved Women RI Dept. of Corrections realized a significant reduction in female inmates assaulting inmates and staff, inmate fights and the use of force as a result of incorporating trauma-informed practices. (SAMHSA, forthcoming) Miami – Dade, Trauma Incident Reduction (Trauma Resolution Center) "We know from the literature, and from our own experience with women in drug court, that as many as 75% of drug and alcohol addicted women have suffered trauma from physical and/or sexual abuse. It is crucial that treatment incorporate counseling relating to those traumatic events so that these women can work through their trauma and feel less of a need to self-medicate with drugs and alcohol. I firmly believe that without processing their trauma, in a supportive and therapeutically controlled environment, women will be less likely to remain abstinent. (Judge Jeri Cohen, Drug Dependency Court Founder) Hawaii Women’s Community Correctional Center …”they need a place to heal” and set out to reinvent the WCCC as a pu’uhonua, a sanctuary where those who break a taboo or rule or are fleeing violent conflict, can go for forgiveness and transformation.(Warden Patterson, 2011)

10. Justice-Involved Women Trauma Informed Care Can Work in Correctional Settings. “ The Truth About Us” (by the women at Hampden County Corrections)