Mental Disorders Among Mothers in Contact with the Criminal Justice System: A Scoping Review and Meta-analysis

This scoping review critically assessed evidence regarding mental disorders among mothers involved with the criminal justice system (CJS) and provided pooled prevalence rates of mental disorders. In total, 27 studies were included in the review, with 23 studies from the United States of America and 26 focused on incarcerated mothers. The findings supported the evidence on substantial burden of mental disorders, among CJS-involved mothers. Several factors contributing to mental disorders were identified, including history of abuse/incarceration/mental illness, a greater number of pregnancies, child-rearing responsibilities, less contact with children, and poor social support, which were organised using a socioecological model. However, significant gaps in the current evidence base were apparent, including inconsistencies in methodologies and outcomes assessed and a lack of large, longitudinal studies. The study highlights the importance of high-quality longitudinal research to extend knowledge around causal pathways between different risk or protective factors and mental disorders among CJS-involved mothers.

Community relationship quality and reincarceration following rural drug-using women's reentry from jail

Interpersonal relationships and social support are important factors in women's successful reentry from incarceration, but limited research has explored the role of women's relationships to their communities during the reentry process. In the current study, women were recruited from three rural Appalachian jails, screened for high-risk behaviors (including drug use and unprotected sex), and interviewed at 12 months postrelease (N = 339). Interviews included the Relational Health Indices-Community scale, a validated measure of women's relationships in community contexts, with subscales for empowerment/zest, engagement, and authenticity. Women who were reincarcerated during the 12-month postrelease period (43.4%) were younger, less employed, more likely to have used illicit drugs, and reported lower-quality community relationships at 12-month follow-up. Multivariate logistic regression models indicated that the effect of community relationships may be driven by the engagement and empowerment/zest constructs. Results suggest that community connectedness may relate to more successful reentry outcomes for rural women.

Families post-release: Barriers and pathways to family therapy

Family therapy has helped repair relational ruptures and restore stability within families for decades. However, service can be inaccessible and underutilized among many minoritized and stigmatized groups, including families post-release. Harmful sociocultural and relational experiences pose considerable risks to families before, during, and after incarceration. While not exhaustive, this article highlights potential attitudinal, relational, and logistical obstacles to family therapy engendered by therapists, clients, or both. Feasible and accessible clinically oriented conceptual and practical pathways of support to combat such obstacles are outlined to help therapists attract and retain families post-release.

Service Needs for Corrections-Involved Parents With a History of Problematic Opioid Use: A Community Needs Assessment

The incarceration of a parent is often a continuation of a challenging family situation marked by poverty, unstable housing, trauma, and abuse. These challenges make it difficult for incarcerated parents reentering their communities to raise their children effectively and, thus, increase the likelihood of poor outcomes for their children. Children whose parents are also battling opioid misuse have an even higher risk for long-term problems. This study uses survey data from 48 community service providers to better understand the service needs of parents with histories of problematic opioid use who are reentering their communities after incarceration. Community service providers recommended implementing intervention programs that cover critical information related to basic needs, supportive community resources, drug treatment programs, and parenting to help individuals thrive in their communities and meet their children's needs. The services most frequently identified by providers as important for reentering parents included housing, mentors or peer counselors, mental health support, group therapy and other support programs. Key topics to address in parenting programs included problem-solving techniques, the effect of parent's addiction on children, and strategies for connecting with and meeting children's needs. Suggestions are made for future research and intervention development.

An Assessment of Prisoner Reentry, Legal Financial Obligations and Family Financial Support: A Focus on Fathers

Scholars have found that family support is an important facilitator of successful reentry from prison to the community. At the same time, they have argued that owing court-ordered fines or fees, also called legal financial obligations (LFOs), can act as an additional barrier to reentry, especially for parents. There remains a need to test how LFOs impact the financial support formerly incarcerated parents receive from their families. The current study responds to this gap by employing logistic regression analyses of the Serious and Violent Offender Reentry Initiative (SVORI) data to test whether owing court fees is associated with formerly incarcerated fathers’ (1) perceptions of available financial support from family and (2) receipt of financial support from family. We find that owing court fees is not associated with perceptions of available financial support. However, owing court fees has a positive, statistically significant association with receiving financial support from family during the first three months after prison release. This relationship remains after accounting for whether the person owes child support or sees their children monthly. Our results suggest that LFOs may create a greater need for financial support among formerly incarcerated fathers, making the financial challenges of reentry a consequence not just for those who were incarcerated but for their loved ones as well.

They Are Coming Home: The Effect of Trauma-Related Cognitions on Vocational Readiness of Incarcerated Women

The prevalence of trauma in the lives of incarcerated women has been well-documented. Yet, few studies have included trauma-related cognitions, a common response to interpersonal trauma, in their analyses. The purpose of this study was to examine the relationship between trauma (pre-incarceration trauma [PIT] and incarceration-based trauma [IBT]), trauma-related cognitions [TRC] (i.e., Total; Self, Blame, and World), posttraumatic stress disorder (PTSD) severity, and vocational readiness-motivation (VR-M) in a random sample of incarcerated women in three prison facilities. A cross-sectional research design was employed using a stratified random sampling procedure. The stratum was housing security levels 1 to 4. The study was conducted in three prisons located in the midwestern region of the United States. Self-administered questionnaires measured PIT, IBT, TRC, PTSD, and VR-M. The study sample included (N = 250) female inmates: 152 White (60.8%), 50 Black (20.4%), 18 Biracial (7.3%), 13 Native American/Pacific Islander (5.3%), and 12 Latina (4.8%) females. The average age of participants was 36.2, and 82.4% were mothers. A key finding in this study was that TRC-Total was best predicted by trauma associated with the prison environment (IBT) and PTSD severity. Our findings indicated that for Black and Latina women, higher levels of trauma-related cognitions about "self" were predictive of a lower potential for vocational readiness in the area of motivation. Future examination of trauma's effect on the development of negative trauma-related cognitions about self (e.g., self as incompetent) has the potential to inform prison mental health practice and the development of clinical interventions to decrease trauma-related cognitions about self for incarcerated women with multiple trauma experiences.

Mothering and Incarceration: A Conceptual Model Supporting Maternal Identity

Current literature expounds on community and personal factors contributing to the rapidly growing number of women involved in the criminal justice system. Contributing factors are complex and interwoven, leaving women with life patterns of trauma exposure, mental illness, and substance use disorders. Consequences of these life patterns and incarceration have a significant impact on maternal role attainment. The conceptual model Mothering and Incarceration organizes the multifaceted life patterns of incarcerated women and the influences on a woman's ability to mother her children during and following incarceration. The model has the potential to provide direction to program developers, researchers, and correctional systems to tailor programs for women. The most significant implication of the conceptual model is ending the intergenerational influences of incarceration on children.

Correlates of a Positive Parenting Experience in Prison

The two goals of this study were: (1) to explore the relationship of a parent's experience in prison in combination with a range of characteristics relating to the parent in prison, to the children, and to the caregiver, and (2) to explore the role of sex and nationality in this relationship. A total of 202 parents in prison (99 men and 103 women; 106 Spanish and 96 foreigners) participated in this study. To maximize the understanding of the questions, in-person interviews were conducted to collect answers to the questionnaire. The findings particularly highlight the importance of the role of the primary caregiver in ensuring that the parent in prison has a positive parenting experience during incarceration. More specifically, the parent in prison reports a better parenting experience when they perceive the primary caregiver as a link between themselves and their children in a positive way. This finding points to the importance of intervention and research on this relationship in order to enhance parental satisfaction and the relationship between the imprisoned parent and their children, as well as the family's resilience during parental imprisonment.

Debt, Incarceration, and Re-entry: a Scoping Review

People involved with the criminal justice system in the United States are disproportionately low-income and indebted. The experience of incarceration intensifies financial hardship, including through worsening debt. Little is known about how people who are incarcerated and their families are impacted by debt and how it affects their reentry experience. We conducted a scoping review to identify what is known about the debt burden on those who have been incarcerated and their families and how this impacts their lives. We searched 14 data bases from 1990 to 2019 for all original research addressing financial debt held by those incarcerated in the United States, and screened articles for relevance and extracted data from pertinent studies. These 31 studies selected for inclusion showed that this population is heavily burdened by debt that was accumulated in three general categories: debt directly from criminal justice involvement such as LFOs, preexisting debt that compounded during incarceration, and debts accrued during reentry for everyday survival. Debt was generally shown to have a negative effect on financial well-being, reentry, family structure, and mental health. Debts from LFOs and child support is very common among the justice-involved population and are largely unpayable. Other forms of debt likely to burden this population remain largely understudied. Extensive reform is necessary to lessen the burden of debt on the criminal justice population in order to improve reentry outcomes and quality of life.

Expectations and Experiences of Women Imprisoned for Drug Offending and Returning to Communities in Thailand: Understanding Women’s Pathways Into, Through, and Post-Imprisonment

Thailand places a high priority on the gender-specific contexts out of which offending arises and the differential needs of women in the criminal justice system. Despite this, Thailand has the highest female incarceration rate in South East Asia and there has been substantial growth since the 1990s. This increase has been driven by punitive changes in drug law, criminal justice policy/practice which have disproportionately impacted women. As female representation in Thailand’s prisons grows, so does the number of women who return to communities. Thus, one of the challenges facing Thai society is the efficacious re-integration of growing numbers of formally incarcerated women. However, what is known about re-entry comes almost exclusively from studies of prisoners (usually men) returning home in western societies. Re-integration does not occur in a vacuum. Supporting women post-release necessitates knowledge of their pathways to, experiences of, and journeys out of prison. Utilising in-depth interviews with (n = 80) imprisoned/formally incarcerated women and focus groups with (n = 16) correctional staff, this paper reports findings from the first comprehensive study of women’s re-integration expectations and experiences in Thailand. Findings showed that women had multifaceted and intersectional needs which directed their pathways into, during, and out of prison.

The Mental Health of Mothers Currently and Formerly Incarcerated in Jails and Prisons: An Integrative Review on Mental Health, Mental Health Treatment, and Traumatic Experiences

Most incarcerated women in the United States are mothers who report high rates of mental health issues and traumatic experiences, yet their needs are often overlooked because they comprise a smaller proportion of the incarcerated population compared with men.

OBJECTIVE

This integrative review aimed to synthesize the literature on the mental health, mental health treatment, and traumatic experiences of currently and formerly incarcerated mothers.

METHODS

We searched PsychINFO, CINAHL, and Criminal Justice Abstracts for all research articles that were written in English; included adult mothers who were incarcerated or incarcerated and released; and contained findings related to mental health, mental health treatment, or traumatic experiences.

RESULTS

Thirty-four articles met the inclusion criteria. Mothers had high rates of moderate-to-severe mental health problems and high childhood and adult trauma rates, especially intimate partner violence. Mothers faced barriers to treatment yet showed psychological resilience and active coping skills.

IMPLICATIONS

Nurses can recognize risk factors for women's incarceration and assess mental health symptoms and trauma, especially interpersonal violence. Nurses can use assessment findings to refer mothers to treatment and community resources and support their reuniting with their children. Nurses can also provide trauma-informed care and education about mental health topics and advocate for mental health treatment prerelease and postrelease. Staff education and organizational interventions to reduce burnout may remove additional barriers to care.

Family Matters: Moving Beyond "If" Family Support Matters to "Why" Family Support Matters during Reentry from Prison

OBJECTIVES

Informed by social control and differential coercion and social support theories, we examine how multiple theoretically and methodologically distinct factors of family support relate to reincarceration, substance use, and criminal offending during prison reentry.

METHOD

Using four waves of data from the Serious and Violent Offender Reentry Initiative, we identified three separate factors of family support-interactional (e.g., providing guidance and support), instrumental (e.g., providing housing and transportation), and emotional (e.g., providing love and belongingness). A series of mixed-effects models examined how each form of family support related to reincarceration, substance use, and criminal offending.

RESULTS

Findings demonstrated that instrumental, but not interactional or emotional, support related to significantly lower odds of reincarceration and lower levels of substance use and criminal offending. Interaction terms revealed that the effect of instrumental family support is almost entirely independent, and not interactive, on each outcome.

CONCLUSIONS

Family support appears to relate to prosocial reentry outcomes not because of emotional or interactional bonds, but because families provide for the basic needs of returning individuals. Instrumental familial support mechanisms such as providing housing and financial support appear more salient in promoting prosocial reentry outcomes than mechanisms of emotional or interactional support.

Gender and Programming

The current study examines U.S. prison programming availability and participation by gender on a national level. The authors build upon previous literature by using national-level data, something that has been done in very limited cases previously. The main concern of this study is gender and its effects on programming availability and participation. The U.S. corrections field has undergone major changes in regard to population trends, fiscal constraints, policies, and research over the last few decades without a large-scale examination of the effects of these changes on programming across the United States. In this study, multiple types of programming areas were examined and results indicated that often female prisons (i.e., prisons housing only females) were more likely to offer programs (e.g., mental health options) and women were more likely to participate in many programming options compared with male prisons and men, respectively. We discuss the possible reasons for this and implications for future research.

Visiting Mom: A pilot evaluation of a prison-based visiting program serving incarcerated mothers and their minor children

We describe an evaluation of a prison visiting program, Extended Visiting (EV), for incarcerated mothers and their children. Mothers (N = 24) and caregivers (N = 19) were interviewed regarding experiences with the program. Mothers identified benefits including maintaining a relationship with children, physical contact, motivation, privacy, peer support, and personal growth. Caregivers echoed mothers' appreciation for the opportunity to maintain mother-child relationships and physical contact. Mothers identified barriers including desire for overnight visits and more age-appropriate activities. Caregivers perceived travel time and costs and children's adverse reactions as barriers. When comparing EV to typical visiting, participants unanimously preferred EV.

Household Incarceration in Early Adolescence and Risk of Premarital First Birth

In the second half of the 20th century, the United States experienced a massive increase in incarceration. In response to this growth, a burgeoning scholarship has sought to explore the collateral consequences of incarceration for young children. However, this scholarship has less frequently explored the impact of incarceration on long-term outcomes, how incarceration experienced in periods other than early childhood impacts children, and whether the incarceration of family members other than parents has negative implications for children. Using data from the children of the mothers in the National Longitudinal Survey of Youth, I explore whether household incarceration experienced in early adolescence is associated with a child's risk of growing up to have a premarital first birth. The results suggest that, even after including a rich set of covariates, children who experience household incarceration in early adolescence are at greater risk of having a premarital first birth, particularly when the father or an external household member is incarcerated.

The Effects of Collateral Consequences of Criminal Involvement on Employment, Use of Temporary Assistance for Needy Families, and Health

Criminal convictions are often associated with collateral consequences that limit access to the forms of employment and social services on which disadvantaged women most frequently rely--regardless of the severity of the offense. These consequences may play an important role in perpetuating health disparities by socioeconomic status and gender. We examined the extent to which research studies to date have assessed whether a criminal conviction might influence women's health by limiting access to Temporary Assistance for Needy Families (TANF) and employment, as a secondary, or "collateral" criminal conviction-related consequence. We reviewed 434 peer-reviewed journal articles retrieved from three electronic article databases and 197 research reports from three research organizations. Two reviewers independently extracted data from each eligible article or report using a standardized coding scheme. Of the sixteen eligible studies included in the review, most were descriptive. None explored whether receiving TANF modified health outcomes, despite its potential to do so. Researchers to date have not fully examined the causal pathways that could link employment, receiving TANF, and health, especially for disadvantaged women. Future research is needed to address this gap and to understand better the potential consequences of the criminal justice system involvement on the health of this vulnerable population.

Relational vulnerabilities of incarcerated and reentry mothers: therapeutic implications

A qualitative study involving a follow-up interview with 10 incarcerated and reentry mothers in rural southwest and central Virginia was conducted to explore the influence that women's close relationships have on their reentry experiences with their families. The Vulnerability Conceptual Model (VCM) was used to sensitize an examination of how incarcerated and reentry mothers negotiate relational vulnerabilities in the context of varying situational vulnerability. Grounded theory analysis revealed three themes that characterized relational vulnerabilities. Given our focus on close relationships and the potential of the VCM to identify opportunities for resilience and vulnerability, we highlighted the influence of ambiguous and ambivalent relationships and unresolved loss and grief due to relationship dissolution or the death of a parent, sibling, child, or intimate partner in the reentry process. The data revealed two types of reentry mothers with divergent trajectories for social reintegration. Implications of these types for therapeutic treatment approaches for reentry women are discussed.

Children's experiences of maternal incarceration-specific risks: predictions to psychological maladaptation

Children of incarcerated mothers are at increased risk for social and emotional difficulties, yet few studies have investigated potential mechanisms of risk within this population. This research simultaneously examined the association of children's experience of incarceration-specific risk factors (e.g., witness mother's arrest) and environmental risks (e.g., low educational attainment) to children's psychological maladaptation using a multi-informant design and a latent variable analytic approach. Participants were 117 currently incarcerated mothers (64.1% African American), their 151 children (53.6% boys, M age = 9.8 years, range = 6-12 years, 61.7% African American), and the 118 caregivers (74.8% female, 61.9% grandparents, 62.2% African American) of the children. Mothers, children, and caregivers each provided accounts of children's experiences related to maternal incarceration and children's internalizing and externalizing behavior problems. Mothers and caregivers each supplied information about 10 environmental risk factors. Findings from structural equation modeling indicate that children's incarceration-specific risk experiences predict internalizing and externalizing behavior problems whereas the influence of environmental risks was negligible. Follow-up analyses examining the contribution of specific risks indicate that significant predictors differ by reporter and separate into effects of family incarceration history and direct experiences of maternal incarceration. Incarceration-specific experiences place children at higher risk for maladjustment than exposure to general environmental risk factors. These findings indicate the need to critically examine children's exposure to experiences related to maternal incarceration and family incarceration history to help to clarify the multifaceted stressor of maternal incarceration.

Who Benefits from Gender Responsive Treatment? Accounting for Abuse History on Longitudinal Outcomes for Women in Prison

This study explores outcome variation among women offenders who participated in gender-responsive substance abuse treatment (GRT). In order to identify subgroups of participants that may differentially benefit from this treatment, secondary analyses examined the interaction between randomization into GRT and a history of abuse (physical/sexual) on depression and number of substances used post- treatment. The sample consisted of 115 incarcerated women assessed at baseline and 6- and 12-months post parole. Longitudinal regression showed that women reporting abuse randomized into GRT had significantly reduced odds of depression (OR = .29, p < .05, 95% CI = .10 - .86) and lowered rates of number of substances used (IRR = .52, p < .05, 95% CI = 0.28-0.98), in comparison to those who reported abuse and were randomized to the non-GRT group. GRT for women offenders who have experienced prior abuse would maximize the benefits of the trauma-informed, gender-sensitive intervention.

Prisoners' assessments of mental health problems among their children

High rates of imprisonment among American men and women have motivated recent research on the well-being of children of incarcerated parents. Despite advances in the literature, little is known regarding the mental health status of children who experience maternal relative to paternal incarceration. Accordingly, we examine whether there are differences in mental health needs among children of incarcerated parents. Specifically, we assess whether incarcerated mothers are more likely than incarcerated fathers to report that their children suffer from mental health problems. Using cross-sectional data on children (N = 1,221) compiled from a sample of parents confined in the Arizona Department of Corrections, we find that children of incarcerated mothers are significantly more likely to be identified as suffering from mental health problems. This effect remained even after controlling for additional parent stressors and child risk factors such as exposure to violence, in utero exposure to drugs/alcohol, and parental mental illness. Policy implications and directions for future research are discussed.

Teenage Pregnancy in Adolescents With an Incarcerated Household Member

This study examines the association between the incarceration of a household member and adolescent pregnancy, and evaluates whether this association extends beyond that of other variables associated with sexual health. We used data from 12 waves of the National Longitudinal Survey of Youth: Child and Young Adult. After eliminating males and individuals who did not respond to key questions, a sample of 1,229 girls (ages 14-19) was analyzed. Girls who experienced the incarceration of a household member faced more demographic and family environment risk factors than those who did not. Regression analyses demonstrated that the addition of a household incarceration variable afforded superior prediction of teenage pregnancy relative to the prediction based on demographic and family features alone. Programs that are directed toward reducing teen pregnancy will benefit from attention to the home situation of the at-risk girl, particularly the experience of household member incarceration and related family dynamics.

Maternal distress and women's reentry into family and community life

This paper advances conceptualization of maternal distress following incarceration. We utilized a multiple case study methodology based on interviews with 10 mothers who demonstrated various permutations of "the triple threat" (depression, domestic violence, and substance abuse; Arditti & Few, 2006). Findings suggest that depressive symptomology persisted and worsened for mothers in our study and that maternal distress was indicative not only of women's psychological state, but also a relational and situational construct that embodied women's core experience. Maternal distress was largely characterized by health challenges, dysfunctional intimate relationships, loss related trauma, guilt and worry over children, and economic inadequacy. Further, maternal distress seemed to be intensified by the punitive traumatic context of prison and lessened by rehabilitation opportunities as well as support by kin and probation officers after reentry. Recommendations for clinicians and professionals who work with reentry mothers center around the need to alleviate maternal distress and better address women's emotional and physical health needs during incarceration and reentry.