Gender, Geography, and Justice: Behavioral Health Needs and Mental Health Service Use Among Women in Rural Jails

Abstract

This multi-jail study examines the behavioral health needs and service use in a sample of 3,787 individuals in jail, to compare women in rural jails to their gender and geography counterparts (that is rural men, urban women, and urban men). Compared to urban women (17.9%, n = 677), rural men (18.2%, n = 690), and urban men (56.1%; n = 2,132), rural women (7.6%, n = 288) had significantly higher odds of serious mental illness and co-occurring mental health and substance use disorders. Rural woman were nearly 30 times more likely to receive jail-based mental health services; however, a discrepancy between screened mental health need (43.1%, n = 124) and jail-identified mental health need (8.4%, n = 24) shows rural women are severely under-identified compared to their gender/geography counterparts. These findings have implications for the changing nature of jail populations and suggests the need to improve behavioral health identification methods.

An exploratory two-part study of behavioral health service needs of women in jails.

“…Results from the instrument were blind to jail staff. (For additional discussions of these data, see Comartin et al, 2021).…”

“…Of those individuals identified by the jail as having a mental health need, the research team assessed who was referred to jail-based services, who received treatment services, and who participated in the jail's intervention program. These mental health outcomes were tracked using jail administrative data, either through the jail information system, electronic medical records, or spreadsheets used by mental health clinicians (e.g., see Comartin et al, 2021).…”

“…This growth has been especially pronounced in rural jurisdictions, where between 1970 and 2014, the number of women jailed in small counties (i.e., with a population below 250,000) increased by a factor of 30 (Swavola et al, 2016). Recent evidence suggests that women are frequently jailed for technical violations rather than for new offenses (Swavola et al, 2016; for additional discussion, see Burgess-Proctor et al, 2020; Comartin et al, 2021).…”

Substance use disorder and rural detention center readmission: Results from a 3-year prospective cohort study.

“…The small amount of research that has contributed to understanding the prevalence of SUD in rural jails has produced a wide variety of results, due in part to the assortment of screening instruments used to identify the condition. Most of these approaches are based on simple reports of recent substance use (Staton et al, 2018), Medicaid records for SUD treatment serving as a proxy for a diagnosis (Victor et al, 2022), or a generic category combining specific SUDs into one group of drug-related conditions (Comartin et al, 2021; Miller & Miller, 2017). While these basic approaches have made important contributions to our knowledge of substance use in rural correctional facilities, more detailed assessments of specific SUDs are needed to better inform which types of services and treatment options might be best suited for the most prevalent conditions within this population.…”

Predicting Co-Occurring Mental Health and Substance Use Disorders in Women: An Automated Machine Learning Approach

“…By leveraging these technological advancements, we aim to bridge the gap between data-driven innovation and clinical practice. SUDs are often inadequately addressed in women [31,32]. The insight of the study holds the potential to develop a tool for early identification of mental health and SUDs in women.…”