Sexual Victimization and Mental Illness Prevalence Rates Among Incarcerated Women: A Literature Review

Abstract

Incarcerated women evidence high rates of both interpersonal trauma and mental illness. In particular, the rates of sexual violence victimization are so high that some researchers have suggested that sexual abuse may be a pathway to prison for women, likely through the development of mental illness, including substance abuse. This review article summarizes the literature on sexual victimization ( n = 32 articles; 28 independent studies) and mental illness ( n = 11 articles; 8 independent studies) prevalence among samples of incarcerated women ( Ns ≥ 100) in context of methodological choices within included articles. Best estimates for sexual victimization from studies using established survey methods were as follows: 50-66% for child sexual abuse, 28-68% for adult sexual abuse, and 56-82% for lifetime sexual assault. Although data directly comparing prevalence of sexual victimization among incarcerated women to prevalence for other groups are limited, the existing data indicate that incarcerated women have significantly greater exposure than incarcerated men and community samples of women. Moreover, compared to findings from the National Comorbidity Survey-Replication, incarcerated women evidence greater prevalence of most lifetime and current mental illnesses, especially depressive disorders, post-traumatic stress disorder, and substance use disorders. Surprisingly, only two independent studies have investigated the overlap between sexual victimization and mental illness in samples of incarcerated women. Both studies found disproportionally high rates of mental illness among victims of sexual violence. Suggestions and implications for research, policy, and practice are discussed.

How Does Timing Affect Trauma Treatment for Women Who Are Incarcerated? An Empirical Analysis

“…Adjusting to being incarcerated can be stressful, possibly even traumatic, and women with histories of sexual assault struggle with adjustment more so than do women without sexual assault histories (Islam-Zwart & Vik, 2004 ; Yardley & Wilson, 2013), although the concern that prisons are necessarily chronically stressful is likely overstated (Bonta & Gendreau, 1990). Because most women who are incarcerated have a history of prior trauma exposure (Karlsson & Zielinski, 2018), incorporating trauma treatments into therapeutic programming in prison settings is a priority (Hall et al, 2013). However, there are questions about whether it is appropriate to offer such treatment to women at all, especially when the treatments use exposure techniques which necessitate the retelling of traumatic, intrusive memories at a time and in a place where women may be feeling especially vulnerable (Miller & Najavits, 2012).…”

“…Because many survivors of sexual assault, who are most often women, commonly use drugs and/or alcohol to cope with posttraumatic symptoms (Ullman et al, 2013), greater enforcement of drug laws disproportionately increases women's justice involvement. Indeed, a recent review found that 56% to 82% of incarcerated women have experienced lifetime sexual victimization, with 50% to 66% having experienced sexual abuse in childhood (karlsson & Zielinski, 2018).…”

Making change happen in criminal justice settings: leveraging implementation science to improve mental health care

“…Over half of people who are incarcerated meet criteria for at least one mental illness (Fazel & Danesh, 2002 ; Fazel, Yoon, & Hayes, 2017 ). Substance use disorders and other mental illnesses that are associated with trauma (e.g., posttraumatic stress disorder, major depressive disorder, personality disorders) are particularly common (Fazel & Danesh, 2002 ; Fazel et al, 2017 ; Karlsson & Zielinski, 2020 ). Beyond the obvious personal health implications of mental illness, it can also contribute directly to the outcomes that incarceration is supposed to deter.…”

Healthcare challenges of incarcerated women in Australia: An integrative review

“…[3] Incarcerated women are also a highly traumatized population resulting in the need for increased specialised health needs. [5] It is crucial that all women within the prison sys-tem and wider communities have access to health services to assist in their overall health and wellbeing.…”