Priscilla Dass-Brailsford

Life History Models of Female Offending The Roles of Serious Mental Illness and Trauma in Women’s Pathways to Jail

Our mixed-methods study advances understanding of pathways to offending for jailed women with and without mental illness. Life history interviews with 115 women from five U.S. states examined how onset of crime and delinquency varied based on mental health status and trauma exposure. Women in jails had high rates of mental health disorders, with a majority meeting lifetime diagnostic criteria for a serious mental illness (50%), posttraumatic stress disorder (51%), and/or substance use disorder (85%). Cox regression analyses were utilized to examine associations between life experiences and risk of engaging in specific criminalized behaviors. Serious mental illness was associated with substance use, running away as a teen, and drug offending. Substance use disorder was related to earlier onset of substance use and driving under the influence. Intimate partner violence increased women’s risks for property crimes, drug offending, and commercial sex work. Witnessing violence increased risks for property crimes, fighting, and use of weapons. Experiences of caregiver violence increased the risk of running away as a teen. Qualitative narratives were reviewed to provide insight into connections between women’s experiences and onset of criminal behavior. Findings demonstrate a need for gender-responsive and trauma-informed practices to address mental disorders and victimization among women offenders.

Integrated Trauma Treatment in Correctional Health Care and Community-Based Treatment Upon Reentry

Given the crisis of mass incarceration in the United States and the high prevalence of trauma histories among those incarcerated, it is imperative to improve service delivery to inmates in correctional facilities and to those undergoing reentry in community-based treatment settings. This article provides trauma definitions and categories, describes the sequelae of trauma, reviews research on the high prevalence of incarceration in this nation, and reviews research on the high prevalence of trauma among the incarcerated. This article also provides a menu of evidence-based and promising treatment approaches to address the overlap among trauma, mental illness, substance abuse, and behavioral problems. A synthesis of research via seven points is meant to guide practitioner and policy responses to the national challenge of meeting the needs of those undergoing reentry.

Trauma-Informed Medical Care: Patient Response to a Primary Care Provider Communication Training

ABSTRACT Trauma exposure predicts mental disorders and health outcomes; yet there is little training of primary care providers about trauma’s effects, and how to better interact with trauma survivors. This study adapted a theory-based approach to working with trauma survivors, Risking Connection, into a 6-hour CME course, Trauma-Informed Medical Care (TI-Med), to evaluate its feasibility and preliminary efficacy. We randomized four primary care sites to training or wait-list conditions; PCPs at wait-list sites were trained after reassessment. Primary care providers (PCPs) were Family Medicine residents (n = 17; 2 sites) or community physicians (n = 13; 2 sites). Outcomes reported here comprised a survey of 400 actual patients seen by the PCPs in the study. Patients, mostly minority, completed surveys before or after their provider received training. Patients rated PCPs significantly higher after training on a scale encompassing partnership issues. Breakdowns showed lower partnership scores for those with trauma or posttraumatic stress symptoms. Future studies will need to include more specific trauma-related outcomes. Nevertheless, this training is a promising initial approach to teaching trauma-informed communication skills to PCPs.

Trauma experiences and mental health among incarcerated women.

OBJECTIVE Female offenders have different risk factors for offending than do male offenders, and elevated rates of interpersonal victimization such as physical, emotional, and sexual abuse, and family and community violence, are common in histories of incarcerated women. We used factor analysis to examine patterns of traumatic events experienced by women in jail and explored how these patterns were associated with 4 psychiatric disorders (posttraumatic stress disorder [PTSD], major depression, bipolar disorder, and substance use disorder) observed in this sample. METHOD A total of 464 women from 9 jails in 4 geographic regions in the United States comprised the sample. Women participated in diagnostic interviews to assess trauma exposure and psychiatric disorders. RESULTS Three factors described the observed patterns of trauma exposure: family dysfunction (FD), interpersonal violence (IPV), and external events (EE). Life events were analyzed as a separate group of items. FD and IPV each contributed independently to the odds of having each of the 4 mental disorders studied; significant odds ratios were in the range of 1.38-2.05. All 3 factors contributed to the diagnosis of bipolar disorder. The only diagnosis to which stressful life events made a unique contribution was to the likelihood of having PTSD. CONCLUSION This work provides further support for the importance of assessing trauma exposure of women in jail, especially the family context, as well as mental health. Implementation and testing of evidence-based treatment approaches that address trauma-related distress in correctional settings are warranted. (PsycINFO Database Record

Culturally Sensitive Therapy with Low-Income Ethnic Minority Clients: An Empowering Intervention

In this article the author discusses how to engage low-income ethnic minority clients in psychotherapy. She proposes the empowering model of clinical intervention, which views clients and their difficulties in the context of their cultural identities, and social backgrounds and intervenes within a framework that is ecological and empowering. Further, clinicians need to clearly identify clients’ abilities and cultural needs in order to accurately assess and utilize their strengths and resources. The empowering model of clinical intervention is described as culturally sensitive and ecologically valid. The model provides a structured and predictable format that maintains client safety and control while addressing the challenges of race, class, sexual orientation, and other client differences.

An Examination of the Associations Among Victimization, Mental Health, and Offending in Women:

This study examines mental health as a mediator of the victimization and offending link in women. We administered structured diagnostic interviews to 491 women in urban and rural jails in four geographic regions of the United States to obtain detailed lifetime mental health, substance use, victimization, and conviction history. Structural equation modeling (SEM) was used to examine associations among adult and childhood experiences of interpersonal violence, lifetime mental health and substance use disorders, treatment utilization, and total number of convictions. Lifetime mental health and substance use disorders mediated the relationship between childhood victimization and adversity and number of convictions, and between adult victimization and number of convictions. In addition, greater treatment utilization was significantly associated with number of convictions. The findings offer support for including mental health and treatment utilization in models of women’s offending and conducting comprehensive mental health assessments of women entering jail.

Using Walk-In Counseling Services After Hurricane Katrina: A Program Evaluation

This article describes a program for walk-in counseling services (WICS) used after Hurricane Katrina. The program was designed to meet the mental health needs of storm survivors. The psychological changes of survivors were assessed at baseline and 6 months later. We found a significant reduction in depression, anxiety, and trauma symptoms among participants who received WICS. The WICS model might be a feasible cost-effective intervention for individuals without the time or resources to commit to long-term therapy.

Exploring the Traumatic Experiences of Women Living with HIV: Using the Life History Calendar

ABSTRACT Trauma exposure can result in negative health outcomes, making it important to accurately identify the trajectory of traumatic experiences. The purpose of this study was to examine the traumatic experiences of women living with HIV using the Life History Calendar in order to identify common factors that may have accounted for either risk or resiliency outcomes. Individual interviews were conducted with 30 women living in a major US city. Most participants (73%) reported experiencing childhood sexual abuse and more than one trauma. We identified several important themes in the lives of HIV positive women: chaotic upbringing in violent and dysfunctional homes, exposure to interpersonal violence (physical, sexual, and emotional abuse, intimate partner violence), substance abuse, and criminal involvement. Family and social support was identified as positive factors in trauma recovery.