Presence of Trauma in Carceral Settings: Adult Experiences throughout Criminal Legal Involvement

Background: Experiences of trauma disproportionately impact individuals involved in the criminal legal system compared to the general population. Presence of trauma is high for people who are incarcerated as well as under community supervision. Despite high rates of trauma, the criminal legal system is often underequipped to address the symptoms and impacts of it for clients. Experiences of trauma can result in substance use, anxiety, impulsivity, and isolation, all of which can contribute to criminalized behaviors and once in the system, individuals with traumatic pasts are likely to experience additional traumas. This creates a challenging cycle in which individuals can become perpetually involved in the system due in part to untreated trauma.

Methods: This study explores the trauma and its relationship to substance use as well as engagement in treatment for 461 individuals who are incarcerated in a medium security prison in a Midwest state. For the purposes of our study, trauma was defined as an experience involving assault, abuse, maltreatment, or violation between two or more people. Surveys inquired about their experiences of trauma (as a child, in the juvenile corrections system, as an adult, and in the adult corrections system) and substance use. The sample was majority White (61%) and heterosexual (83%) and aged 43 years on average (19-86 years).

Results: Overall, about half the sample had experienced childhood trauma (59%) and/or adulthood trauma (45%). Within the correctional system, 30% of the sample experienced trauma within the juvenile system and 38% reported it within the adult system. 81% of respondents who experienced trauma in the adult system had also experienced it during childhood (p<.001, x²=43.9). Respondents who had been diagnosed with a substance use disorder were more likely to have experienced trauma within the adult system (p<.001, x²=17.0) and during childhood (p<.001, x²=28.0). Individuals who had experienced trauma within the adult corrections system were significantly less likely to be engaged in mental or behavioral health services (p<.05, x²=4.8), though this finding did not hold in regression models. Older (p<.001, OR=1.0) participants, those who had been previously diagnosed with substance use disorder (p<.05, OR=2.0), and participants with childhood trauma experiences (p=.001, OR=3.1) were more likely to participate in substance use treatment when also controlling for BIPOC status (p=.10), mental health diagnosis (p=.09), and adult corrections traumatic experience (p=.22) in a logistic regression model (p<.001, pseudo-R²=.10).

Implications: Our study supports prior research findings that trauma is overrepresented among criminal legal samples. Unsurprisingly, history of trauma was associated with substance use disorder diagnosis, however, it was also associated with lower engagement in services. This leaves room for additional policies and practices to get people into services who have compounding experiences of trauma and substance use. Departments of corrections should consider screening and identification procedures early in someone’s incarceration to identify those who would be appropriate to receive additional support and treatment.