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Information Needs of Women in Prison with Mental Health Needs

by Judith Ford (2009). Information Needs of Women in Prison with Mental Health Needs. London: NACRO.

In a recent note, a London-based coalition of mental health direct care (Center for Mental Health), practitioner (Royal College of Psychiatrists), and lobby (RETHINK) groups in the United Kingdom observed, "Many people in the criminal justice system have complex mental health needs which are poorly recognized and inadequately managed. Large numbers end up in prison: a high cost intervention which is inappropriate as a setting for mental health care and ineffective in reducing subsequent offending."

The foundation for this statement was a push toward greater use of diversion options. Of importance, the groups defined diversion in this manner: "Diversion seeks to ensure people with mental health problems who come into contact with the police and courts are identified and directed towards appropriate mental health care, particularly as an alternative to imprisonment." As for the latter option, the groups described "alternatives to incarceration" as non-custodial sanctions or community-based support services that are used instead of pretrial or postconviction confinement.

Statements such as these, as helpful as they are, are often frustrating because they tend to falter in terms of how jurisdictions can actually achieve these much-merited objectives. In this context, it is interesting to read through this brief - but engaging - report from the National Association for the Care and Rehabilitation of Offenders (NACRO).

The aim of this 18-page document is simply to describe the mental health needs of incarcerated women. Actually, this may not be so simple after all as many jurisdictions fail to adequately survey the needs of mentally ill men or women in local jails or state prisons.  Still, such surveys can be done easily enough and they are routinely helpful.

British prisons have "prison in-reach teams who liaise with services in the community" and "disability liaison officers whose responsibility is to assess and support prisoners."  Nonetheless, in this report, NACRO notes that "the mental health needs of women in prison are very complex: they are often linked with histories of abuse, manifest themselves in high levels of drug misuse, and are compounded by the effects of imprisonment. In many cases, prison regimes can exacerbate mental distress."

The purpose of the research done for this report was "to establish what information was available for women in prison with mental health problems and what more could be made available."  For this purpose, focus groups were convened at a series of British prisons for women.  In these facilities, women prisoners were asked about their experiences and need in relationship to the following areas:

  • Information they receive on reception into prison;
  • Access to listeners (prisoners who are trained to work with other prisoners experiencing stress);
  • Effects of prison on emotional well-being;
  • Healthcare referrals;
  • Mental health support prior to incarceration;
  • Access to mental health care in prison;
  • Methods of relieving stress and relaxation;
  • Awareness and availability of alternative therapies in prison;
  • Contact with outside agencies;
  • Referrals to prison-based counselors;
  • Group membership while incarcerated;
  • Contact with disability liaison officers; and
  • Other information that may be useful.

Of particular interest, "information requirements" were categorized into five stages or criteria: first night and induction; during sentence; healthcare and medication; approaching release; and equality and diversity. Three of these suggest possible activities at different stages of a woman's incarceration - on entering prison, during incarceration, or as release from prison comes near. Two suggest activities for different contexts: healthcare and medication, and equity and diversity (referring to the physical and mental states - dyslexia, illiteracy, disabilities - of particular prisoners).

NACRO concludes that important information is regularly absent for women prisoners, including those with mental health problems. Leaflets are though useful, but the needs of reading-impaired women are important to note. Different formats, including cartoons and pictorial images, for providing information are thus necessary. The delivery of information is especially useful at the start of a women's confinement. This information should address not only what certain medications, for example, can do for them, but also what they cannot do for them. Once settled, information can helpfully lead women toward thinking about their release. Such information might address the provision of community-based mental health care.

As this report notes, "One of the hardest aspects for a women prisoner with mental health issues is making a successful transition from prison to the community and the more that can be done to link the two the greater the chance of successful reintegration and a reduction in future offending. Any information that can be provided which enables women to make contact with support providers while in prison and advises what assistance is available on release will help to ease this transition."

Overall, this report assists practitioners and others to identify not where information is useful, but also what information is of importance.

See the full report here.




Posted Fri, Aug 26 2011 2:15 PM by Tracey Vessels

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