Meeting the Mental Health Needs of Incarcerated Women
Pomeroy, Elizabeth C., Kiam, Risa, Abel, Eileen, Health and Social Work
Since 1980 the population of women inmates has increased by more than 200 percent (Gabel & Johnston, 1995). Women inmates currently account for 9 percent of the entire prison population and of this group, 57 percent are women of color. The majority of women are arrested for nonviolent crimes. Typical offenses include fraud, use of illegal drugs, and prostitution (Singer, Bussey, Song, & Lunghofer, 1995).
Many women inmates also contend with mental health issues. As many as two-thirds of women inmates require mental health services at or soon after their initial incarceration (James, Gregory, Jones, & Rundell, 1985). One in five women inmates report that they were physically or sexually abused as children (U.S. Department of Justice, 1991). In a recent study of women inmates in New York, 64 percent of the sample fell within the clinical range for mental health problems, 83 percent were in the substance abuse range, and 81 percent had been victimized at some point in their lives (Singer et al., 1995). Twenty-five percent of all women inmates are HIV positive (Stephan & Jankowski, 1991).
Despite the mental health problems facing the ever-increasing population of women inmates, only minimal research has been conducted regarding interventions developed and implemented by social workers with women in the prison system (Harris, 1993). This article describes a pilot study of a psychoeducational group conducted with women inmates and the effectiveness of this program.
DESCRIPTION OF PROGRAM
The goal of this psychoeducational group intervention was to reduce perceived stress, anxiety, depression, and trauma experienced by women inmates with the long-term goal of reducing the recidivism rate of women reentering the jail system. To test the effectiveness of this intervention, a pilot study was conducted with women drawn from the population of women incarcerated at a large jail facility in Orange County, Florida. The project included a treatment group and a comparison group. Participants in the project were recruited by announcements of the group in the day areas of the units where the women were allowed to congregate outside their cells. The first 12 women to volunteer were placed in the treatment group and the remaining volunteers were placed in the comparison group. Women in the comparison group were allowed to participate in the second treatment group, which consisted of 10 inmates. Because of transfers or releases, nine of the 22 women in the two treatment groups did not complete the program. In sum, the experimental group comprised 13 women and the comparison group seven women.
Because random assignment was not possible as a result of agency constraints, the study used a quasi-experimental, nonequivalent control group design. Ninety-minute group sessions were held three times per week for five weeks for a total of 15 sessions.
The groups were conducted by a licensed master's level social worker experienced in group facilitation, with assistance from two second-year clinical MSW students. The authors developed a training manual that included information on the educational and emotional support sections of each group session. The students received training in group processes before the group began.
Each group member was contacted by one of the group facilitators who explained the confidential nature of the research as well as the voluntary participation agreement. Each woman who understood and agreed signed an informed consent form. Before the group began, women inmates in both the experimental and comparison groups completed pretest scales that examined depression, anxiety, trauma, and stress. Posttests using the same measures were given at the end of the last group session to the women in experimental group. Comparison group members completed the same scales after the last group session was completed. At the end of the five-week group, the women were given referral sources and encouraged to contact these sources following discharge from jail. …