Women Prisoners with Mental Illnesses Experiences of Social Support

Background:  Women comprise the fastest growing population in US prisons with nearly 200,000 women incarcerated in jail or prison on any given day. Approximately three-quarters of women prisoners have a history of mental health problems; many with comorbid substance addictions.  Almost all women prisoners will be released from prison and return to communities.

Research indicates that positive social support from family or friends plays a beneficial role for former prisoners – reducing mental health symptomatology, decreasing substance misuse, and disrupting criminal behaviors. Although prior studies have largely been conducted with male former prisoners, the results suggest that protective factors of social support may be enhanced with targeted interventions for women prisoners with mental illnesses. However, little is known about the availability of postrelease social support and predictors of social support for women prisoners with mental illnesses. This study provides a critical first step in filling that gap in knowledge.

Methods:  Data are presented from a stratified random sample of women prisoners with lifetime histories of mental illnesses (n=108). Stratification was based on planned release to urban and rural communities. Participants were recruited from two state prisons representing all security levels. The study response rate was 87%. Participants completed standardized assessments of social support, victimization, mental health, and substance use. Bivariate and descriptive statistics assessed availability and quality of pre and postrelease support. Regression models assessed predictive factors of postrelease social support.

Results:  Participants were Caucasian (64%), African American (33%), and Hispanic (3%). The mean age of participants was 34 (SD=9.85) and the average length of incarceration was 18 months (SD=17.5). Most participants had a substance use disorder (81%).

Participants reported social relationships primarily comprised of negative or limited social support. Nearly 20% of women reported no pre-incarceration positive support. Most participants (62%) indicated limited amounts of positive support, 13% said they had moderate positive support, and 5% indicated high amounts of pre-incarceration positive support.  Women anticipated more positive social support upon release than they reported having prior to incarceration (p<.01): 13% perceived no postrelease support; 38% anticipated limited support; 27% expected moderate support, and 21% anticipated high levels of support.  Regression analysis indicated that age, race, perceived need for addiction treatment, and experiences of adult victimization did not significantly predict outcomes.  Significant predictors of postrelease positive social support (p<.01) were amount of pre-release social support (b =.28), length of incarceration (b =.02), presence of a substance use disorder (b =.81), and victimized as a child (b = -.15).

Conclusion:  Women prisoners had low levels of pre and postrelease positive social support. The protective role of social support on mental and physical health outcomes in the general population has been empirically validated for decades. Similarly, research indicates positive support contributes to reduced problematic behaviors for former prisoners. A dearth of information exists on the availability and predictors of postrelease positive support for women prisoners with mental illnesses. Establishing a better understanding of support is necessary for developing targeted social support interventions aimed at enhancing postrelease outcomes of this vulnerable population.