A new way to treat women's mental health in prison

CHOWCHILLA, California — Flanked by fig groves and vineyards and surrounded by electrified fences and thick coils of barbed wire, the Central California Women’s Facility is the largest women-only prison in the state. Inside the low-slung cinderblock buildings, in a trailer that doubles as a classroom, a dozen prisoners have gathered around a conference table. They are black, white and Latina; former gang members, preschool teachers, musicians and veterans. 

They have one thing in common. All these women are serving long-term sentences for committing violent offenses. Many of them are LWoPs—life in prison, without the possibility for parole. They’ve come to this classroom to talk about the beginning of their journeys to prison — which almost invariably began with childhood trauma.

Fauzia Fields, 31, remembers being so independent growing up that she never turned to her family for help. As a result, she became isolated in an abusive relationship as a young woman. Fields had the same mindset when she came to prison, where she is serving 22 years for voluntary manslaughter and first-degree robbery. “When I first stepped in here, I was like, ‘I’m not going to talk about my past, it’s nobody’s business,’” she said, adding that she felt it would be an expression of weakness to “sit up there and cry about being molested at 3 years old and use it to justify something I did at 26.”

As Fields talks, the others women murmur words of support. “Yeah, that’s real good,” one says.

These prisoners are part of a pilot program called Beyond Violence, launched in 2014 by the California Department of Corrections and Rehabilitation at two of its women-only prisons. In 20 group sessions, Beyond Violence is part seminar on the sociology of violence, part group therapy session. The women discuss their family histories and learn mindfulness and visualization techniques to help them deal with their anger. At its core, the program tries to help the women deal with the trauma they have experienced and everything that comes with it: depression, post-traumatic stress-disorder, self-harming behavior and other mental illnesses.

Most state and federal prisons offer anger management classes as well as addiction programs like Alcoholics Anonymous. But few mental health programs are geared specifically toward women. Mental health treatment for women behind bars tends to be pharmaceutical-based, and more about controlling problematic behavior than about treatment or getting better, says Ann Jacobs, director of the Prisoner Reentry Institute at John Jay College of Criminal Justice in New York, who spent nearly 20 years as the executive director of the Women’s Prison Association. 

Word about the program has spread around the yard, among the 3,089 prisoners. About 475 have completed Beyond Violence, and 500 more are on the waiting list. Prisoners also lead the sessions. Kaieesha Franklin, 20, serves as a peer facilitator. She says her journey to prison began when she was 5, when the state of California removed her from her mother’s home. She says she was beaten by the woman who was supposed to be taking care of her, and was repeatedly sexually abused by relatives. “I didn’t have no one to talk to and no one to protect me, and they thought I was the crazy one,” says Franklin. “That’s when I started acting out.” At age 16, according to court documents, (PDF) Franklin was tried as an adult and convicted of attempted murder for repeatedly stabbing a 13-year-old girl during a neighborhood brawl.

As she serves her 13-year sentence, Franklin says Beyond Violence has helped her put a name on the horrors she experienced growing up. “I didn’t know what trauma was,” Franklin said. “At home, there’s no such thing as self-help groups, or figuring out what’s going on, or why your family’s sick and why they’re doing the things they’re doing. I just know I’m hurting inside this house.” She says she wished this kind of help had been available to her before she was sent to prison. “We need to figure out why we are so broken and destroying each other.”

While women are a small proportion of the total U.S. prison population, the rates of mental health disorders among incarcerated women is much higher than that of incarcerated men. Nationwide, 73 percent of women in state prisons had a mental health problem (PDF) in 2006, the latest year for which data are available, compared with 55 percent of men. In federal prisons, 61 percent of women suffer from mental health problems, compared to 44 percent of men.

Stephanie Covington, a psychologist based in La Jolla, California, and an expert in treating women who are addicted to drugs and alcohol, first began working with incarcerated women in the 1980s, after she met a warden from a women’s prison in North Carolina. She talked the warden into letting her live inside the prison for a few days. “I realized that most addictive women have trauma histories,” she said. “Then I realized I really wanted to help women with trauma histories.”

Covington and other criminal justice experts say that past trauma stemming from abuse, mental illness and criminal behavior tend to coalesce among incarcerated women, far more so than with men. A 2006 Bureau of Justice Statistics report found that 57 percent of incarcerated women in state prisons had reported sexual or physical abuse before they were admitted, (PDF) and a landmark 2001 study sponsored by the U.S. Department of Justice found that child abuse and neglect increases the likelihood of being arrested for a violent crime by 30 percent.

In 2012, a research team from Michigan State University ran a randomized controlled study of the Beyond Violence program and found that levels of anxiety, depression, PTSD and other mental illnesses declined significantly among women who participated, as did their levels of anger and aggression. These effects were stronger than in the control group, who were enrolled in the prison’s existing program, a course designed for men. Sheryl Kubiak, a professor of social work at MSU who led the study, said that Beyond Violence was unusual in focusing on women’s past experiences, rather than how to avoid committing crimes in the future. “Beyond Violence actually went the other way first, to help them understand how they got there in the first place,” she said. “And that was a real breakthrough for them.”