The purpose of this article was to conduct a review of experimental, quasi-experimental, and pre-test/post-test studies using manualized, trauma-informed interventions with incarcerated women. A systematic search of electronic databases, reference harvesting, and communication with experts were used to identify relevant primary studies. Nine studies meeting the specified inclusion/exclusion criteria were identified. Three studies used random assignment and five used a comparison or waitlist group. Interventions identified included Seeking Safety, Helping Women Recover/Beyond Trauma, Esuba, and Beyond Violence. Results of the studies indicate a decrease in post-traumatic stress disorder (PTSD) symptomatology and an additive effect to treatment as usual. Initial evidence for trauma-informed interventions for incarcerated women appears positive; however, replication using more rigorous research designs and inclusion of effect sizes are recommended. Limitations of this review include exclusion of the gray literature and lack of meta-analysis.
Women are one of the fastest growing sectors of the prison population, and have different pathways into prison and differing needs during the reentry process when compared to men (Cloyes et al. J Forensic Nurs; 6:3-14, 2010b; Herrschaft et al. J Offender Rehabil; 48:463-482, 2009). Women report higher levels of mental health problems overall, and report more severe symptomatology (Cloyes et al. J Forensic Nurs; 6:3-14, 2010a; Hyde 2012; Lynch et al. 2014). The current study focuses on the role of severe mental disorders for women released from prison. Data collected from the North Carolina Division of Adult Correction and Juvenile Justice were used to analyze the specific role of severe mental disorders in women's recidivism at eight years post-release (n = 2311). Approximately 20% of women in this sample met the criteria for diagnosis with a severe mental disorder (SMD). Logistic regression analysis indicated that there was an association between SMDs and recidivism for this sample only (p = .11). Cox regression analyses indicated that women diagnosed with SMDs were 16% more likely to have recidivated at eight years post-release compared with women who were not diagnosed with an SMD (p < .05). Implications for the recognition, role, and treatment of SMDs during reentry are discussed.
The field of child welfare continues to be plagued by high rates of worker turnover that further complicate the challenging work of protecting and enhancing child welfare in the United States. The child welfare workforce plays a crucial role in promoting child well-being and preventing abuse and neglect, but safety, permanence, and well-being outcomes of children are negatively impacted by high rates of workers leaving their jobs. Numerous organizational and individual factors have been studied in relation to worker turnover, and while there is a foundation of research related to direct and indirect trauma separately, different typologies of trauma have rarely been studied together. This study examined child welfare workers' exposure to work-related trauma from a stress-response framework. A statewide sample of child welfare workers (n = 657) responded to items relating to their experiences of client perpetrated violence, deaths or injuries on their caseloads, and secondary trauma. They completed scales measuring their current levels of depression, anxiety, posttraumatic stress disorder, and overall commitment to the field of child welfare. Three typologies of trauma emerged: primary trauma, caseload trauma, and secondary trauma. Structural equation modeling analysis indicated that primary trauma had a small, but positive relationship with commitment to the field (B = .17, p , .05). Caseload trauma predicted workers' levels of secondary trauma (B = .14, p , .05), and secondary trauma had a strong, predictive relationship with worker mental health (B = .77, p , .001). Creating typologies to distinguish different kinds of trauma allowed for a nuanced look at workers' experiences and how they influence outcomes related to the mental health of workers and commitment to the field.
In 2019, the viral pandemic known as COVID-19 touched and indelibly impacted the global community, including the United States. The impact of COVID-19 was particularly onerous for the US’s incarcerated. Not only is the United States the leading incarcerator in the world, but the the carceral system represents the nation’s largest de facto mental health treatment setting. The carceral system is overrepresented by people of color, people with disabilities, and people of lower socioeconomic status—with great overlap between these populations. In combination with tough-on-crime policies, the US prison population also now finds itself aging, a process accelerated by confinement. The present systematic literature review describes the current state of peer-reviewed scholarship addressing the impact of COVID-19 on mental illness, incarceration, and their intersection in the United States. To be considered for inclusion, articles (1) were based in the United States or, if a global study, explicitly inclusive of the United States; (2) addressed COVID-19 and mental illness, COVID-19 and US incarceration, or COVID-19 and mental illness and US incarceration; and (3) were published or in-press between December 2019 and October 2021, as either a peer-reviewed commentary or research article in an academic journal. The final literature sample yielded 34 peer-reviewed articles. Ten themes and accompanying figures were developed within each of the three intersections: Intersection #1, COVID-19 and mental illness; Intersection #2, COVID-19 and US incarceration; and Intersection #3, COVID-19 and mental illness and US incarceration. Implications for respective US policies, programs, and systems are discussed.
Introduction Firefighters are trained to respond to an array of acute emergencies that culminate in repeated exposure to trauma subsequently impacting their mental health. Yet, they often fail to seek services that could mitigate those adverse effects due to stigma, as well as a dearth of systematized resources and first responder proficient trained mental health professionals. This study explored work-related traumatic event exposure, PTSD symptomatology, levels of depression, anxiety, and suicide risk, and barriers to care for firefighters in a designated catchment area of a southeastern state. Results were used to inform local departments interested in culture change and intervention, as well as providing the basis for successfully obtaining federal grant monies. Methods Using Qualtrics, a web-based survey platform, researchers administered a cross-sectional survey to firefighters between Fall 2020 and Spring 2021. The survey included the PCL-5, PHQ-9, GAD-7, SBQ-R, and BACE. Descriptive statistics, correlations, and independent t-tests were run to determine the level of trauma exposure and clinically significant mental health symptomatology, associations between different types of trauma and mental health symptoms, and barriers to accessing care. The sample (N=511) primarily identified as Caucasian (n=421) and male (n=477). Mean age and time in fire service were 39.1 and 14.5 years, respectively. Results In this sample, 18.7% met the criteria for a provisional diagnosis of PTSD based on the PCL-5; 24.4% met the criteria for moderate to severe depression based on the PHQ-9; 14.5% met the criteria for moderate to severe anxiety based on the GAD-7; and 13.7% reported a significant risk of suicidal behavior as measured by the SBQR. Firefighters also indicated the following as the most common barriers to accessing care: 1) being unsure of where to get care (47.3%); 2) thinking the problem would get better itself (41.8%), 3) feeling embarrassed or ashamed (39%), 4) concern that they might be seen as weak for having a mental health problem (36.2%), and 5) thinking they did not have a problem (34.3%). Conclusions Due to the high levels of work-related trauma exposure, firefighters in this study were at an increased risk of developing mental health symptomatology including PTSD, depression, anxiety, and risk of suicidal behavior when compared to the general population. Additionally, perceived and actual barriers to care provided implications for the grant program application.
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