The Prison Environment
The four main types of offenses that can lead someone to jail or prison are crimes of violence, property, drug, and public order. Jails are county run institutions; individuals in jails have committed minor crimes, are on trial, or are serving short sentences. Prisons are federal or state run institutions; offenders committed to prisons have been convicted of state or federal crimes and sentenced to serve anywhere from a few years to a lifetime.
Criminal behavior is closely linked to sociological, social psychological and psychopathological factors. Sociological factors such as social stratification, culture, and social interactions have been found to be correlated with criminal behavior. A 2002 study by the U.S. Census Bureau showed that criminal behavior may be influenced by recent homelessness and a history of foster home care (James & Glaze, 2006). Sex and race are sociological factors correlated with criminal behavior that are well documented in U.S. prisons. Black and Hispanic men have incarceration rates 6.6 and 2.5 times higher, respectively, than White men (Kruger & Hill De Loney, 2008). African American females have incarceration rates 10.5 times higher than Hispanic females, and 20.5 times higher than white females (Hatton, Kleffel, & Fisher, 2006). Men, regardless of race, have dramatically higher incarceration rates than women. In 1983, women composed only 7% of the nation’s jail population. By 2003, women composed 12% or 1/8 of the total prison population Elias, 2007).
Social psychological issues (individuals’ thoughts, feelings, and behaviors as they affect, and are affected by others) are also relevant. There are common variables among the family member of inmates. In 2002, self-reports by inmates indicated that 56% grew up in a single-parent household, 31% had grown up with a parent or guardian who abused drugs and 46% had an incarcerated family member (U.S. Department of Justice).
Psychopathological issues (mental illness, mental distress or the manifestation of abnormal behaviors due to mental illness) also contribute to criminal behavior. Studies of state prisoners have found that approximately 15% have serious mental illness, which is three to four times more prevalent than in the general population (Jemelka, Rahman, & Trupin, 1993; Ditton, 1999). Estimates suggest that at least 50% of prisoners with a mental illness also have co-occurring psychiatric and substance abuse disorders (PBS, 2006). Typically, inmates with mental illness have lengthier criminal histories than non-mentally ill inmates (Lurgio & Snowden, 2008).
A 2002 study by the U.S. Census Bureau showed that the current percentage of inmates with substance abuse problems ranges from 58.4% to 70.6% (Kerridge, 2009). It is difficult to determine if crime leads to drug use or vice versa but it is important to be able to treat both problems to prevent recidivism (re-incarceration). When inmates have co-occurring disorders of crime and addiction they need to be assessed for dependence issues and learned behavioral patterns of crime. Positive results have been obtained from cognitive-behavioral treatment programs such as academic, vocational, and social skills training classes. In one study of individuals released from prison, the group of academically trained individuals had recidivate rates of 18%, while individuals from the non-academically trained group had reincarceration rates of 70% (Deitch, Koutsennok, & Ruzi, 2000).
Life in prison is based on deprivation of liberty, which is markedly different than the freedom of action and choice enjoyed by members of the outside community (Castellano, 1997). This complete change of lifestyle impacts prisoners physically, mentally, and emotionally. The mental health of prisoners is affected by the stress of incarceration, formal restrictions, and/or unspoken rules of conduct. A common unspoken rule is for inmates to explicitly disregard the problems of other inmates. For example, inmates will choose not to inform the prison staff if a fellow inmate demonstrates deteriorating mental health (Lurgio, 2008).
Prisoners may be deeply affected by many emotions including distress, concern for their children, concern about the consequences of drinking, concern for their personal future, humiliation, vulnerability, powerlessness, and fear of guards along with other feelings (Lurgio, 2008; Taylor, Williams & Eliason, 2002; Castellano, 1997). These issues suggest the importance of including psychologists on the prison staff. However, it is appropriate to consider what level of treatment is acceptable when inmates require mental health services (Lurgio). The dual role as the mental health evaluator and therapist Palermo, 2009) may undermine psychologists’ therapeutic effectiveness (Decaire, 2009). It can be difficult to gain prisoners’ trust due to fears that their confidentiality may be breached.
Women in Prison
Female crime offenders tend to be young, poor, minority group member, single, and imprisoned for nonviolent drug-related crime(s) Taylor, 2002). Prior to incarceration, women are often susceptible to health problems due to a history of sexually transmitted diseases, suicide attempts, exchanging sex for money or drugs, and lack of healthcare (Conklin, Lincoln, & Tuthill, 2000). While in prison, women often need health services for pregnancy, STDs, mental health issues, cancer, HIV and TB. Treatment for HIV is especially needed because it is ten times more prevalent in female prisoners than in individuals in the general population Taylor, 2002).
Incarcerated women face healthcare barriers due to long waiting times for treatment as well as their concerns regarding privacy, dignity, co-payments, and attempts to conceal health problems in order to obtain work opportunities (Hatton, 2006). Health care services specific to imprisoned women suffer when funding is short and gynecological services are often the first to be cut (Thayer, 2004). A 1994 study by the National Institute of Corrections found that only half of state prison systems offered female-specific services such as mammograms and Pap smears (U.S.A. Amnesty International, 2009).
It is estimated that 67% of female inmates have a history of sexual abuse, 79% have a history of physical abuse, and 43% have a history of trading sex for drugs (Fickenscher, 2001). Many of these women cannot escape such situations in prison. They may face physical and sexual assaults by other inmates and prison employees. Male employees have been known to routinely abuse their authority by exchanging “privileges”—such as food, basic hygiene products, or time with visiting family—for sex (Thayer, 2004). According to the U.S.A. Amnesty International, female inmates develop feelings of powerlessness, humiliation, and fear of retaliation because of the imbalance of power between inmates and guards (U.S.A. Amnesty International, 2009). These feelings often exacerbate previous medical and mental health problems. More information on improving correctional institutions to meet the needs of female inmates is available at: Facility Planning to Meet the Needs of Female Inmates.pdf