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Psychiatry prof. talks health gaps in women’s prisons

Jennifer Johnson’s research focuses on mental health, substance abuse interventions

The criminal justice system must ensure both public safety and public health, said Jennifer Johnson, associate professor of psychiatry and human behavior. But jails and prisons in the United States do not provide effective health care for their prisoners, especially women.

Johnson delivered a lecture to an audience of about 40 people Friday at the School of Public Health, focusing on her research that examines mental health and substance use interventions in criminal justice settings. The lecture was part of a series sponsored by the Center for Alcohol and Addiction Studies.

Since she began working with women prisoners in Rhode Island, prisoner health has become a personal issue, Johnson said. After seeing the harsh circumstances from which many of the prisoners came from, she decided to focus her research on improving health care for women in prison.

Incarcerated women tend to be substance abusers and commonly have histories of physical and sexual assault, Johnson said. These kinds of issues usually necessitate continuous mental health interventions. Though women prisoners are a very vulnerable population, they receive little attention from the justice system, politicians and the public, she said.

Johnson and her colleagues conducted a series of studies in Rhode Island prisons that analyzed the feasibility and efficacy of mental health interventions for female prisoners.

The first study focused on the effectiveness of providing “adapted group interpersonal psychotherapy” for women, an intervention that “focuses on feelings and relationships,” she said.

After several weeks of implementing the trial intervention in Rhode Island prisons, the female inmates’ mental health had improved, Johnson said.

A second study examined the effectiveness of weekly small group therapy targeted at lowering depressive symptoms and minimizing suicidal behavior. The researchers analyzed both the therapy’s efficacy in reducing those behaviors and its cost-effectiveness and feasibility, Johnson said. Though effective in improving mental health, the intervention may not be financially viable given the lack of funding for prisoner health, she said.

One obstacle to improving prisoner health is that many formerly incarcerated women relapse to old habits once they are released from prison, Johnson said, noting that she and other prisoner health researchers have observed this phenomenon in previous work.

“They were using again, they were getting beat up by their boyfriends again,” she said.

To attempt to address this problem, Johnson and her colleagues carried out another study in which women recently released from prison were given cell phones to call mental health supporters, she said. This intervention was intended to be a low-cost alternative to intensive mental health support in prison. But the researchers found that the women did not use the phones at all, even if they needed support, Johnson said.

Researchers have a responsibility to bridge the gap between political advocacy and academic research on prisoner health, Johnson said.

To fix the criminal justice system’s health care problems, studying the effectiveness of certain interventions must be complemented by intelligent dialogue with politicians and the public, Johnson said. But advocates may face challenges because  “for most of the public, prisoner health doesn’t sell well politically.”


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