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Women, Serious Mental Illness and Recidivism: A Gender-based Analysis of Recidivism Risk for Women with SMI Released from Prison

Kristin G. Cloyes, Bob Wong, Seth Latimer, and Jose Abarca (March 2010).. Journal of Forensic Nursing, 6(1), 3-14.

Serious mental illness may not affect the way we perceive those suffering this disorder, but it influences the way people with this condition act in the world, and the way the world, particularly the criminal justice system, reacts to them. In this article, Kristin Cloyes, Bob Wong, Seth Latimer, and Jose Abarca, all affiliated with the University of Utah School of Nursing, compare the recidivism rates, severity of mental illness, and clinical history of men and women released from the Utah State Prison between 1998 and 2002. 

 Twenty-three percent (2,112) of those released from the Utah State Prison over this five-year period were seriously mentally ill. The average age of this group was 40 years of age. Most had been incarcerated previously, usually at least three times. One-half of the sample (1.065) were incarcerated on misdemeanor offenses; 26% (556) for felonies; 6% had violent histories and 71% were in prison for non-violent offenses. Women comprised 23.5% (498) of the sample (and 9% of the prison’s population). For the women in the sample, Major Depressive Disorder was the major mental health problem, followed by Bipolar I and II Mood Disorders. Women, compared with men, were overrepresented with mood disorders and underrepresented with thought disorders such as schizophrenia and schizoaffective disorders. Twenty percent of the women had previously lived in acute care or residential mental health care housing. On average, men with serious mental illness were first incarcerated at age 28 while women were first confined at age 31.

In the study, Cloyes et al. find that “women with serious mental illness seem to be at risk of repeated incarceration due to factors specifically related to the intersection of gender and mental disorders. This difference is striking despite the fact that women in our sample had lower overall risk of recidivism than men, because the impact of serious mental illness on recidivism was greater for women than for men.” Also, the researchers found that “people with serious mental illness are not a homogenous group. There are critical differences that have tremendous influence on a wide array of outcomes, each associated with numerous economic, political, social, cultural, and clinical factors.”

 Several implications of this study stand out:

  • Correctional and mental health service providers face a serious challenge stemming from the rising number of women being incarcerated;
  • SMI women who could benefit from targeted mental health services either in the community or while incarcerated are probably undercounted in this article because of its rigorous standard for inclusion in the study; and
  • SMI women are likely at elevated risk of repeat incarceration because SMI-related factors may have greater impact on the length of time they stay in the community or are at risk of recidivism, SMI incarcerated women may be more disordered than generally believed.

 According to the authors, two gender-specific issues are worthy of note:

  • SMI women are generally older when they first appear in prison, more likely to be mothers, and more susceptible to substance abuse as a co-occurring disorder; and
  • SMI and co-occurring disorders may sap the particular strengths and resources that women possess.

Cloyes et al. conclude, “The focus of healthcare providers and policymakers should be on funding, designing, and delivering sustainable interventions and comprehensive models of acre that are sensitive to both gender and mental illness, and tailored to the specific histories, situations, and needs of women with SMI. Such targeted interventions would need to identify and capitalize on those aspects unique to women’s situations that promote longer community tenure, and mitigate those that are most negatively affected by factors related to mental illness. Furthermore, such support services would have exponential effects, considering the potential breath of impact on the health of families and communities.”

 For further information, contact Kristin G. Cloyes, PhD, RN, University of Utah, College of Nursing, 10 South 2000 East, Salt Lake City, UT 84112,  (email)



Posted Fri, Mar 11 2011 4:46 PM by Tracey Vessels


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