Lifetime Trauma for Individuals with Mental Illnesses on Probation: Race and Gender Analyses

Background and purpose: Individuals with mental illnesses and BIPOC are overrepresented in the criminal legal system. Justice-involved individuals and individuals with mental illnesses experience traumatic events at greater rates compared to the general population, which has implications for interventions at the interface of mental health and criminal justice, especially for social workers. However, little research examines how PTSD and traumatic exposure varies by gender and race among individuals with mental illnesses on probation. To address this gap in the literature, we use self-report data from individuals with severe mental illnesses to identify the rates of PTSD, traumatic event experience, and which types of events are most prevalent among this understudied group.

Methods: We analyze cross-sectional, baseline data from the Life Events Checklist (LEC) for 204 individuals with severe mental illnesses on probation to identify the extent to which this subpopulation has experienced trauma. Mental illness diagnosis was confirmed via the Mini International Neuropsychiatric Interview (MINI). During a research interview, participants self-reported their lifetime direct exposure to the 17 items on the LEC. We examine bivariate relationships between rates of trauma for men (n=122, 58.94%), women (n=85, 41.06%), Black participants (n=106, 51.71%), and white participants (n=84, 40.98%). We use multivariate analyses to examine the extent to which traumatic event histories are present for each of these subgroups within the sample.

Results: Half of the participants met diagnostic criteria for PTSD (n=104, 50.24%). Participants experienced an average of 5.27 (SD=2.85) traumatic events over their lifetimes and 94.1% of participants had experienced at least one event in their lifetime. On average, participants had experienced 3.44 (2.06) interpersonal events, such as physical assault, and 1.85 (1.23) non-interpersonal events, such as a car accident. Women were more likely than men to experience physical assault (x²=4.99, p<.05), sexual assault (x²=59.98, p<.001), and any other unwanted or uncomfortable sexual experience (x²=35.66, p<.01). Additionally, women experienced greater numbers of interpersonal traumatic events (3.99, SD=1.98) than the men in the sample (3.05, SD=2.02; t=-3.26, p<.01). Black men were most likely to experience assault with a weapon (p=.05, x²=7.68) and white women were most likely to experience sexual assault (x²=52.82, p<.001) or other unwanted sexual experience (x²=34.66, p<.001). When controlling for all covariates, women (b=0.62, p<.05), having PTSD (b=1.23, p<.001), and having higher educational attainment (b=0.77, p<.05) were associated with higher rates of interpersonal event experience.

Implications: This is one of the first studies to explore the rates of exposure to trauma by gender and race among a sample of individuals with confirmed severe mental illnesses on probation. Our findings demonstrate the need for increased attention to trauma within criminal legal settings for individuals with severe mental illnesses. Rates of trauma among this subsample of the population are substantially higher than general U.S. and incarcerated populations. Though the findings support prior research that women experience more interpersonal trauma than men, our findings provide additional nuance and support for the need to consider the role trauma plays in continued criminal legal system involvement for those individuals also experiencing severe mental illnesses.