Women in Prison – Recovery through Change


The fact that prisoners have higher rates of psychological distress and mental health problems when compared to the general population are well established (Fazel & Danesh, 2002). Needless to say, the rates are much higher in the case of women in custody. Although women still constitute a small minority of the prison population across the world, the number of incarcerated women is increasing (Slotboom et al., 2007).

In addition to the common kinds of distress both men and women experience in prison, women are more vulnerable for gender discrimination, neglect, violence, physical and sexual abuse. Studies have documented that relative to their male counterparts, women incarcerated in state prisons are more likely to have mental disorders and a history of physical and sexual abuse (Blitz et al., 2006; Brown et al., 1999; Hartwell, 2001). Despite the magnitude of problems, little attention has been given to the unique health concerns of women prisoners, or any local help for withdrawing from drugs.

Women with Children

Cali Farmer, 4, cries as she hugs her mother, Netta Farmer.

“You need to have a lot of strength and patience to deal with things that come. I’m just glad my parents are still alive, and I could see them. Others aren’t so lucky. I’m just very happy for the things I do have. I always try to stay positive.”

Mental health care and attention to the psychological distress that occurs because of imprisonment of women, is almost non-existent.

The relevance of gender issues Women usually lead protected lives and are good home makers. They are not exposed to the travails of the outside world. When they come in conflict with law and areimprisoned, they find it very difficult to cope with the prison environment. Prison isolates the women from their family and friends. They cannot perform their usual duties. This causes sadness, guilt and puts tremendous stress on them. The physical and mental health needs of women are different compared to men. Traditionally, most of the prison inmates are males, and the prison environment is therefore shaped by the needs of males(Slotboom et al., 2007) and do not cater to the special needs of women prisoners.

Women in prison have a double disadvantage.

The gender disadvantage and discrimination gets worsened during imprisonment, which is further amplified upon their release from prison. Gender sensitive interventions need to take into account psychological distress in a life stage perspective. As women in prisons are frequently victims of physical and sexual abuse, United Nations on Human Rights Rule 53 of the Standard Minimum Rules for the Treatment of Prisoners state that women prisoners must only be guarded by female officers (United Nations, 1955).

Male staff continue to have unchecked visual and physical access to women in what constitutes their rehabilitation rooms, bedrooms, restrooms and living rooms in many Indian prisons. At times, male staff does not hesitate to do frisk search on female prisoners. There are instances when prison staff have endorsed and supported bullying and verbal abuse of women prisoners, if they do not listen to them (Human Rights Watch 1996).

International Review

Women prisoners are found to suffer from a variety of health problems in the custodial environment. A recent study on women prisoners in the UK reported that imprisonment impacted their health negatively. The initial shock of imprisonment, separation from families and enforced living with other women suffering drug withdrawal and serious mental health problems affects their own mental health. Over the longer term, women complained of detention in unhygienic facilities by regimes that operated to dis-empower them, even in terms of management of their own health (Douglas et al., 2009).

A Russian prison official has been jailed for at least two months after footage of him punching, kicking and pulling the hair of female inmates was leaked online, sparking outrage and calling the country’s penal system into question.

The videos, which were filmed in 2008 at a prison in Russia’s eastern Amur region, shows a prison official, identified as deputy warden Sergei Zychkov, viciously beating his female detainees in a cell. Posted on October 24 2011, the graphic footage quickly caused a scandal in the blogosphere, prompting Russian authorities to open an official investigation into the case. Three days later, Zychkov was arrested on charges of abuse of power.

Women described responses to imprisonment that were also health negating such as increased smoking, eating poorly and seeking psychotropic medication. The study avers that there is little evidence that the UK policy initiatives have been effective in addressing the health needs of women prisoners (Douglas et al., 2009). According to the fact sheet of Amnesty International on women in prison, women are denied essential medical resources and treatments, especially during pregnancy. There are studies which have reported high prevalence of syphilis among women prisoners as compared to general population. HIV infection is also high (M.C.De Azcarraga Urteaga et al., 2010).

Women prisoners suffer menstrual disorders, stress, and depression.

The WHO guidelines on HIV infection and AIDS in prisons (World Health Organization, 1993) contain the following recommendations specific to women in prison.

a) Special attention should be given to the needs of women in prison. Staff dealing with detained women should be trained to deal with the psycho-social and medical problems associated with HIV infection in women.

b) Women prisoners, including those who are HIV-infected, should receive information and services specifically designed for their needs, including information on the likelihood of HIV transmission, in particular from mother to infant, or through sexual intercourse. Since women prisoners, either upon release or during parole may be sexually active, they should be enabled to protect themselves from HIV infection, e.g., through imparting skills in negotiating for safe sex. Counselling on family planning should also be available, if national legislation so provides. It is possible that the woman discovers her pregnancy only after incarceration. For such women, there should be no pressure placed to terminate their pregnancies. Women should be able to care for their young children while in detention regardless of their HIV status.

c) The following should be available in all prisons holding women:

 Gynacological consultations at regular intervals, with particularattention paid to the diagnosis and treatment of sexually transmitted diseases;
 Family planning and counselling services oriented to women’s needs;
 Care during pregnancy in appropriate accommodation;
 Care for children, including those born to HIV-infected mothers;
 Condoms and other contraceptives during detention and prior to parole periods or release.

There is also a need to focus on the preventive health care aspects for the women prisoners, especially with respect to cervical cancer screening, breast cancer, HIV testing and hepatitis (Nijhawan et al., 2010). Opportunities need to be provided for sex education, smoking cessation and drug de-addiction programmes (Jolley and Kerbs,2010). US based studies have reported that access to substance abuse treatment for women is necessary because at least half the women in state prisons were under the influence of illicit drugs/alcohol at the time of their offence and most women are in prison on drug-related convictions (Greenfeld and Snell 2000).

Women have a considerably greater risk of contracting HIV and Hepatitis C from sexual activity than men. Women who engage in injecting drug use have a particularly high risk through sharing syringes and needles. They might have had unprotected sex with their drug partners or have been engaged in sex work. Women’s cultural and societal conditions might be such that they are not in a position to control their own sexual lives (Bastick and Townhead 2008; Reyes, 2000; UNODC, 2009; World Health Organization, 1993).

Women prisoners have important mental health and drug treatment needs.

Studies have shown that the beneficial effects of treatment components oriented toward women’s health needs in prison sustain even after 12 months after release (Nena et al., 2010). The majority of offences for which women are imprisoned are non-violent such as property, dowry-harassment, drug-related offences, prostitution, bar dancing and so forth (Kumari, 2009; UNODC, 2009). Many women serve a short sentence, which means that the turnover rate is high.


The main goal of imprisonment must be rehabilitation and reformation instead of punishment. There is a need to enable prisoners to lead useful and law-abiding lives on their return to the community. Keeping such a focus, the negative effects of imprisonment should be minimised; mental health should be maintained and promoted. Women prisoners must feel safe, be treated with respect and dignity and need to be assisted towards developing insight into their offending behavior.

The Supreme Court directions need to be implemented regarding women prisoners’ requiring assistance in pregnancy, ante-natal, natal and post-natal care. Children of the women prisoners must be provided care as per the guidelines.

Any intervention must start with the prisoner, the moment she enters the prison.

  • Privacy and dignity: Women prisoners’ privacy and dignity must receive the topmost priority.
  • Female staff: There must be a female doctor inside the prison as well as female guards in charge of the female prison premises.
  • Health check-up: Women prisoners must be routinely screened for physical and mental health problems and provided treatment at the earliest.
  • Peer support group: Self-help groups among women prisoners can be of great help during stressful situations – Entry into prison, during bail, preparation for court appearances, unpleasant events at home like death of a family member, before, during and after judgement.
  • Mental health and counselling: Considering the mental health morbidity in women prisoners, mental health services and counselling needs to be provided. Effective planning for mental health care after release is vital, particularly for women with severe mental illness.
  • De-addiction facility: De-addiction facility should be made available to women with substance use problems.
  • Family counselling: Involvement of family members in counselling is an essential component to good health of women prisoners.
  • Vocational Rehabilitation: Adequate opportunities must be provided to work and keep them busy. Adequate planning for livelihood after release, particularly for women without family support is extremely important.
  • Behavioural rehabilitation: High-risk behaviors such as aggression, violence, selfinjurious behavior, impulsivity, sexual behavior and substance use need to be addressed with appropriate techniques.
  • Suicide prevention strategies: Frequent meetings with prisoners will help in prompt identification of their problems, generation of solutions and reduction in distress.

Prison staff requires training on how to identify mentally illness and use crisis intervention techniques.

Adequate planning before release, safeguards against prison re-entry, halfway home support systems for women without family support, and treatment continuation after release are critical components of effective treatment. Life skills training and encouraging further education in prison and health education also play a crucial role in empowering women and preventing recidivism and poor mental health outcomes. The circumstance of being within four walls of a prison is upsetting enough. It is important that mental health of women prisoners is preserved and enhanced, so that the prison experience will not scar their lives. FULL ‘pdf’ HERE

‘Very intimidating’ … a prison officer checks on inmates through the ‘Judas hole’ at HMP Holloway in London. Photograph: PA

Jade Thompson, 32, is a former drug addict who served several prison sentences for drug-related crimes. Last released in 2003, she has turned her life around, training and working as a drugs abuse support worker. She served time in four prisons – Holloway, Highpoint, Cookham Wood and Foston Hall – and says she witnessed and experienced sexual approaches from staff, male and female, in every jail.

“It was part and parcel of prison life, and very intimidating. If you are not going to buy into the approaches made by staff, you will not progress, you will not get the good jobs, or get on the courses that will help you get early release.”

Thompson says Holloway was the worst jail she was in.


Surviving the Sentence
25-year-old mother of four receives 10-year sentence in prison for selling $31 of marijuana in the USA ( Oklahoma ).

Women in prison unjustly, are to know that we care, and pray for you.

Those women that are associating in crowds, gangs, and any other activity or companions that could land YOU in PRISON – we beg you to Take Action and STOP TODAY.

Chloe Jon Paul – WOMAN of ACTION™ . As a lead facilitator for the Alternatives to Violence project, I had the privilege of working with these women in prison.

It was an awesome experience for me!


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