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

by @marisahtaylor July 31, 2015 7:00AM ET

A program in California state prisons helps women convicted of violent offenses face trauma from their pasts

Mental Illness
Psychologist Stephanie Covington (center), an expert on mental health among incarcerated women, leads a discussion at the Custody to Community Transitional Reentry Program, a transitional facility for female offenders, in San Diego.
Jessica Chou for Al Jazeera America

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.”

Linda Lentini and Robin Cullen, who were both incarcerated in their youth, were inspired by their experiences to help other women. They now lead sessions of Healing Trauma, a trauma recovery program in Hartford, Connecticut, offered to incarcerated women during and after their prison term. "This group should be in every women’s prison in America," Lentini said. "Because trauma is the reason a lot of women go into prison."
Yana Paskova for Al Jazeera America

Women, trauma and crime

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.

Prisoners lead the Beyond Violence sessions. “If you can pick the lifers that have really turned their lives around, they’re passionate about helping other women," Covington says. "These women, they make it their own.”
Jessica Chou for Al Jazeera America

“If you start to listen to their stories, it’s just shockingly common that they were physically, sexually, emotionally, psychologically abused, often at very young ages and continuing through their young adulthood,” says Jacobs.

“They tend to get involved in criminal justice because of those relationships,” says Becki Ney at the Center for Effective Public Policy in Silver Spring, Maryland, who helps train corrections departments on women in the criminal justice system. That was the case, for example, for Antoinette Yancey, 49, a woman at the Chowchilla prison who is serving a life term for helping her jailed boyfriend carry out the murder of a witness in his case.

Biological research has also shown that traumatic stress rewires the brain, pumping up levels of the stress hormone cortisol and lowering levels of mood enhancing serotonin, pushing abuse survivors into a state of constant hyper-arousal. The stressful prison environment, in which women are subject to regular bed checks and body searches, can re-traumatize them. Covington and other experts say that any mental-health program for incarcerated women should take past trauma into account.

The Michigan Department of Corrections approached her in 2010 to create a program specifically for violent female offenders. She hesitated, since violent offenders were not her area of expertise, but changed her mind when she learned that there was already a similar program for violent male offenders in the state, which allowed them to come before the parole board early. She spent months conducting focus groups at the Women’s Huron Valley Correctional Facility in Ypsilanti, Michigan, and launched Beyond Violence at the prison in September of that year.

The lasting effects

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 studysaid 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.”

Inmates at the Central California Women's Prison in Chowchilla, California, hold a group session of Beyond Violence, a treatment program for violent offenders, on July 20, 2015. The pilot program aims to help prisoners serving long term sentences address the trauma from their pasts and learn mindfulness and visualization techniques to deal with their anger.
Courtesy CDCR

Kubiak’s team followed up with the women a year after they had been released on parole, and, according to research that has not yet been published, they found that those who participated in Beyond Violence had less recidivism and drug use than the women who did the standard program. Women in the Beyond Violence group also reported that they were still using the tools they had learned. “The effects seemed to last at a year after their release,” Kubiak said. “I do not think that’s common.”

Based on the promising results in Michigan, the California Department of Corrections and Rehabilitation commissioned a pilot program of Beyond Violence at two facilities in 2014. Early evaluations by a UCLA criminologist have found that the women’s PTSD, anxiety, anger, aggression and symptoms of mental illness had declined significantly after completing the program.

But because women tend to be such a small portion of prison populations — there are only 5,381 female prisoners in California state prisons, versus 109,605 men — trauma-informed programs designed for incarcerated women are rarely a priority in an era of strained state budgets, says Ney, of the Center for Effective Public Policy. 

The Chowchilla prisoners say the program has already made a difference. Christina Martinez, 34, who is serving a life sentence for first-degree murder for helping her boyfriend kill a man during a burglary, says that she and her sister were molested as toddlers and witnessed physical abuse in her family throughout her childhood. “I became a bully,” she said. “And then I isolated myself, which is what my mother did.” Martinez says being part of Beyond Violence has helped bring their community together. We laugh together, we cry together, we learn together, and we also heal,” she said. “We don’t have to sit in silence no more.”