Women with Mental Illness and the Growth of the U.S. Prison Population
In the United States, there are two distinct groups that constitute the fastest growing element of the incarcerated population: women and persons with mental illness. The U.S. Bureau of Justice Statistics (BJS) reported that in 2005, 95,096 women were incarcerated in state prisons, compared to 82,058 in 2001 and 57,263 in 1994 . Recent years have seen a similar rise in number of persons with mental illness incarcerated in U.S. state prisons. At present, more than 700,000 people with mental health problems live in state prisons, or 56% of the entire U.S. state prison population . Women in State prisons have higher rates of mental health issues compared with male prisoners, with 73% of the female state prisoner population expressing symptoms of mental disorder, compared to 55% of the male population .
Further, in 1999 the BJS reported the highest frequency of mental illness among white women in State prison. In State facilities, approximately, 29% of white women, 22% of Hispanic women, and 20% of African American women were categorized as mentally ill . This brief report highlights this intersection by describing the mental health, offense and recidivism status of incarcerated women with serious mental illness (SMI) in the UT State prison system. In addition to citing statistics published at the national and state levels, we also report on pilot data and preliminary findings of our ongoing study of recidivism, serious mental illness and prison and community-based treatment in Utah State prisoners released from prison 1998-2002 .
Women in Utah Prisons: Rates of Incarceration and Demographics
In 2004, Utah ranked 35th in its female incarceration rate, with 42 female inmates per 100,000 female residents . In 2006, 570 women were housed in Utah State Prison compared with 30 women in 1977 . Women now comprise 9% of the Utah prison population, a higher ratio than the U.S. average of 7% . As of May 2006, women of minority status represented slightly over 2% of the overall Utah prison population, with the following distribution by racial and ethnic category: Asian/Pacific Islander, 0.18%; African American, 0.48%; Native American/Alaskan Native, 0.27%. White women currently represent 7% of the total prisoner population in the Utah State system .
Women with Mental Illness in Utah State Prison 1998-2002. Descriptive Statistics Related to Demographics and Incarceration Patterns 1998-1999
The descriptive statistics reported in this and the next section were generated from a sub-sample of women identified as seriously mentally ill (SMI) 6 who were released from Utah State Prison 1998-1999 (N = 246).
Of these women, 226 were identified as White (92%), 11 as African American (4.5 %), 1 as Asian (0.4%), 1 as Pacific Islander (0.4%), and 5 as Alaskan Native (3.3 %). Fourteen percent of this sub-sample was identified as Hispanic, while 86% were not. The average and median age of first incarceration in state prison for women with SMI was 30 years of age, with a range from 17 to 61. However, the most frequent age of first incarceration in our sample was 24 (20 women or 8.2%) and the next most frequent was 31 (6.9%) with 33 (6.5%) and 34 (6.1%) close behind. This highlights the interesting point that the frequency distribution for age of first incarceration had a distinct bimodal pattern, with age of first admission clustering in the mid-twenties and the early to mid-thirties (Figure 1). The average and most frequent number of total prison admissions through 12/31/2002 for this sample was 3 (26%) with a range of 1 (18%) to 9 (0.4%) admissions.
Psychiatric Diagnoses and Symptoms
In addition to collecting data related to demographics, incarceration patterns and recidivism, we also collected data related to psychiatric diagnoses, symptoms and treatment for women with SMI in our 1998-1999 sub-sample. Sixty percent of women prisoners with SMI were screened for mental illness as part of the prison admission process while 40% were not. Of those screened, 9% were flagged as positive for mental illness requiring follow-up evaluation. Further, 98% of those who received follow-up clinical evaluation were diagnosed as mentally ill. By far, the most common DSM-IV psychiatric diagnosis of these women is Major Depressive Disorder, with 144 or 59% of women in our sample having this diagnosis recorded in their prison medical charts. The second most common psychiatric diagnosis in this sample was Bipolar Disorder (55 women or 22%). Finally, individual chart reviews for all women with SMI showed that in 44% of charts, staff had recorded significant symptoms of serious mental illness such as mania, hallucinations, delusions, disorganization, self-isolation, poor hygiene and compulsive behaviors.
Recidivism Rates for Women Parolees with a Mental Illness
Overall, recidivism rates for both women and men are higher in Utah than the national average, due in part to stricter and more intensive monitoring of parolees than might be practicable in states with larger offender populations. Our larger study sample includes all persons released from Utah State Prison 1998-2002, and identifies those who meet study criteria for SMI . In our sample of Utah State prisoners, 87% of women with SMI and 84% of men with SMI are released to parole, so our initial analyses of recidivism have focused on parolees. For 1998-2002, the average percentage of men and women with SMI who returned to prison within 36 months of release was 77%, compared with 62% for non-SMI men and women. Analyzing the women’s data separately, we found that 72% of women with SMI released from Utah State Prison between 1998 and 2002 returned within 36 months, nearly one and a half times the percentage for women without SMI (49%).
Primary Offense of Conviction: Alcohol and/or Drug Related and Violent Offenses
Across the U.S., the crimes for which women are primarily incarcerated are alcohol and drug-related offenses. BJS states that in 2000, 1 in 3 women were imprisoned for a drug-related crime and roughly 50% of women imprisoned in State prisons were under the influence of drugs or alcohol at the time of their offense . A Utah Commission on Criminal and Juvenile Justice Study (CCJJ) reported in 2006 found that 62.5% of Utah women are incarcerated for a drug- related offense, and 77.6% of women committed their crime while under the influence of alcohol or drugs .
When examining the data related to primary offense for our sample of women prisoners with SMI released from Utah State prison, we found the following: For the five year period 1998-2002, the average percentage of women parolees with both SMI and an alcohol and drug related primary offense was 56%, compared with 63% for women parolees without SMI, 29% for men parolees with SMI, and 38% for men parolees without SMI. Thus percentages of alcohol and/or drug related primary offenses are high for both SMI and non-SMI women when compared with the male population. During 1998-2002, the average percentage of women parolees with SMI and violent offenses  was 11%, compared with 8% for women without SMI. The difference in percentages of women parolees both with and without SMI who committed violent offenses is notable, when compared with male parolees, with average percentages of 32% (SMI) and 28% (non-SMI), respectively. Data related to primary offense are summarized in Table 1.
- Bureau of Justice Statistics Bulletin: Prisoners in 2005. Available online at http://www.ojp.usdoj.gov/bjs/pub/pdf/p05.pdf. Accessed January 25, 2007.
- Bureau of Justice Statistics Special Report: Mental Health Problems of Prison and Jail Inmates 2006. Available online at http://www.ojp.usdoj.gov/bjs/pub/pdf/mhppji.pdf. Accessed December 27, 2006.
- Bureau of Justice Statistics Special Report: Mental Health and Treatment of Inmates and Probationers 1999. Available online at http://www.ojp.usdoj.gov/bjs/pub/pdf/mhtip.pdf. Accessed January 2, 2007.
- The research study described here is supported by funding from the Utah Commission on Criminal and Juvenile Justice, the University of Utah Research Committee (Faculty Research Seed Grant) and the University of Utah College of Nursing Research Committee.
- Institute on Women and Criminal Justice: Hard Hit: The Growth in the Imprisonment of Women, 1977-2004. Available online at http://www.saferfoundation.org/docs/HardHitReport4.pdf. Accessed December 31, 2006.
- Cloyes et al. Assessment of Psychosocial Impairment in a Supermaximum Security Unit Sample. Crim Just and Behav 2006: 33(6): 760- 81. For details on how the published algorithm for SMI was adapted and applied in this study, contact Dr. Cloyes.
- Utah Commission on Criminal and Juvenile Justice: A Survey of Women Inmates in Utah. Available online at http://www.justice.utah.gov/Research/Adult/ExCell%20Survey.pdf. Accessed December 20, 2006.
- In calculating the percentages of women and men with and without SMI with violent primary offense, we included the offense categories of murder, person and first and second degree felony, registerable sex offenses.