The Persistent Impact of Childhood Victimization: Current Mental Health Challenges Faced By Women in Jail

Background and Purpose

Women enter jail with high rates of mental health challenges including childhood and adult victimization (DeHart, Lynch, Belknap, Dass-Brailsford, & Green, 2013). Most studies focus on women’s pre-existing mental health disorders. Very few studies focus on women’s current mental health challenges and how the jail environment can exacerbate women’s mental health, self-efficacy, and feelings of hopelessness. The purpose of the study was to understand the relationship between trauma and current mental health of incarcerated women.

Methods

As part of a larger study of re-entry needs of incarcerated women, women at a County jail facility were asked to participate in a screening for physical health, mental health, and substance use experiences 30 – 45 days before their release.  The final sample consisted of 110 women, 50.9% Black, 32.7% White, and 16.4% Hispanic. The mean age was 33.7, with a median of 31 years. Women were in jail an average of 90.8 days at the time of screening (median = 40 days). The overwhelming majority were mothers (81.8%) with 68.2% of all women having minor children. Measures included the K6 for current mental health functioning, an Adverse Childhood Experiences (ACEs) measure and a measure of Significant Life Events (SLEs). Statistical analyses used Chi-square (χ²), t-tests, and regression to examine relationships among the K6, ACEs and SLEs, and background characteristics (e.g., age, race/ethnicity, criminal history, and forecasts of arrest). Separate hierarchical regression models  examine whether the addition of SLEs and then ACEs explain a statistically significant amount of variance in K6 total scores and having a score above the cutoff of ≥ 13, after accounting for background characteristics.

Results

The women’s mean K6 score was 10.9, with 42.7% having scores ≥ 13, the cutoff indicating serious mental illness. For ACEs, the mean score was 4.56; 59.1% scored ≥ 4 indicating a higher likelihood of severe negative health consequences. For SLEs, the mean score was 4.87, with many women reporting experiences of personal violence. In each analysis including SLE total scores in model 2 a statistically significant additional amount of variance was explained in the K6 measures. Inclusion of ACEs in model 3 explained a statistically significant additional amount of variance in the K6 measures. In model 3, after ACEs were added, the number of SLEs was no longer statistically significant, suggesting that victimization experienced as a child is more strongly related to incarcerated women’s current mental health challenges. In both regression analyses, women’s forecast of a higher likelihood of their arrest after release from jail was statistically significantly related to K6 scores, indicating the level of hopelessness for the future was related to their current mental health challenges.  

Conclusions and Implications

This study’s findings confirm the need for gender-responsive and trauma-informed care to address mental health challenges and childhood and adult victimization among women in jail. Unless these past experiences and current mental health challenges are taken into account, incarcerated women are unlikely to maintain hope for their futures in order to benefit from in-house programming and reentry services.