Risk Profile and Treatment Needs of Women in Jail with Co-Occurring Serious Mental Illness and Substance Use Disorders

Abstract

Recent research has documented the unusually high rates of incarcerated women’s serious mental illness (SMI) and substance use disorders (SUD). Complicating these high rates is the high comorbidity of SMI with SUD and trauma histories. Yet, incarcerated women have significantly less access to treatment and health services while incarcerated than men. We used data from a multi-site, multi-method project funded by the Bureau of Justice Assistance (2011–2012) to determine the risk profile of women in jail (n=491) with a current co-occurring SMI (i.e., major depressive disorder, bipolar disorder, schizophrenia spectrum disorder)and SUD (i.e., abuse, dependence). The study spanned multiple geographic regions, and structured diagnostic interviews were used to understand better the women that comprised this vulnerable population. One-in-five of the women had a current co-occurring disorder (CCOD). The findings revealed that significantly more women with a CCOD had been exposed to violence and were exposed to drugs at a younger age. Further, about one-third of women with a CCOD had received no treatment from a health care professional in the past year, demonstrating a substantial unmet need. We conclude that investing in mental and behavioral health care in jails is critical to the health and safety of women as well as the communities to which they return.

Hazardously Drinking Jailed Women: Post-Release Perceived Needs and Risk of Reincarceration

“…It is clear that hazardously drinking women perceive their own needs for treatment, and that this needs perception links to poorer outcomes. These associations are consistent with prior research (Lynch et al, 2014; McPhail, Falvo, & Burker, 2012; Nowotny, Belknap, Lynch, & DeHart, 2014; Scott & Dennis, 2012) and suggest that women who are unable to access relevant treatment services early after release are less likely than those without such needs to successfully remain in their communities. It may also be that women who identify a need for treatment may be more likely to partake and respond to treatment, though this question needs to be explored in future investigations.…”

Psychosocial Determinants of Health among Incarcerated Black Women: A Systematic Literature Review

“…37 Another study by Nowotny and colleagues examined the risk profiles of 491 female detainees (37.4% Black) that were diagnosed with a co-occurring disorder (CCOD), a serious mental illness and any substance use disorder in the past year, and found that these women had a high prevalence of physical abuse (86.5%), sexual assault or rape (79.8%), and intimate partner violence (76.9%). 24 Hebert and colleagues conducted a study to examine the differences in the psychosocial profile and risk behaviors of 147 female inmates at the Women's Facility of the Rhode Island Department of Corrections. The women were divided into two groups based on the types and level of trauma experienced.…”

“…43 Nowotny and colleagues described that women with CCOD were most likely exposed to drugs by family members who used (62%) or were given drugs (14%) or alcohol (31%) by their parents during childhood. 24 A study by Messina and Grella, examining childhood traumatic experiences (CTE) impact on adult physical and mental health issues and behaviors of 491 female California prisoners (40% Black), found that family violence was the most reported type of CTE (47.6%) and the odds of prostituting, taking psychotropic medication, receiving treatment for mental health, having a gynecological problem, STI, or alcohol problem, and reporting a fair or poor health status increase significantly with the occurrence of each CTE. 44 In contrast, Staton-Tindall and colleagues’ study of N=366 female, substance using inmates (27% Black) found that positive parental influence was associated with less HIV risk behavior and drug use and positive influence from peers was associated with less drug use only, despite the presence of any additional negative influences or relationships.…”

Health Services Use Among Jailed Women with Alcohol Use Disorders

“…26 Of women in nine county jails in four US regions, 53% had a current substance use disorder, and 32% had serious mental illness. 27 Of women with co-occurring substance use disorder and serious mental illness (20% of the sample), 29% had received treatment for both mental illness and substance use, and one third had not received any health care in the past year. 27 Despite knowledge gained by studies on the breadth and severity of health problems among incarcerated women, there is still a need to examine associations of problems with health services utilization, which steered the present study.…”