Survey of Women Inmates: A Survey of Lifetime Victimization Experiences Among Women at the New Mexico Women’s Correctional Facility, Grants, NM Betty Caponera, Ph.D. New Mexico Interpersonal Violence Data Central Repository Overview Background on the Survey of Women Inmates Demographic and Health History Findings Examine the differences in the rates of victimization experiences between convicted women offenders and women in the general population Examine the family of origin household dysfunction of convicted women to women and men in the general population Discuss implications for effective prevention and rehabilitation ACE Study Adverse Childhood Experiences Study (ACE) (CDC-Kaiser Permanente, San Diego, CA) A study of the relationship between adverse childhood experiences and specific health outcomes: Examined 10 risk factors that contribute to the leading causes of morbidity and mortality (smoking, severe obesity, physical inactivity, depressed mood, suicide attempts, alcoholism/drug abuse, parental drug abuse, a high lifetime number of sexual partners and a history of having a sexually transmitted disease) Disease conditions among the leading causes of mortality in the US (heart disease, cancer, stroke, chronic bronchitis or emphysema, diabetes, hepatitis or jaundice, and any skeletal fractures). Citation - Felitti, V. et al. Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study, Am J Prev Med 1998:14(4), 245-258. ACE Study Questions The seven categories of adverse childhood experiences examined were: Abuse Categories: Psychological abuse Physical abuse Sexual abuse Household dysfunction Categories: Substance abuse Mental Illness Mother/Step-mother treated violently Criminal behavior in the household ACE Study Questions Q: While you were growing up during your first 18 years of life, did a parent or other adult in the household… Psychological a. Often or very often swear at, insult, or put you down? b. Often or very often act in a way that made you afraid that you would be physically hurt? Physical a. Often or very often push, grab, shove, or slap you? b. Often or very often hit you so hard that you had marks or were injured? Q: While you were growing up during your first 18 years of life, did an adult or person at least 5 years older ever… Sexual a. Touch or fondle you in a sexual way? b. Have you touch their body in a sexual way? c. Attempt oral, anal, or vaginal intercourse with you? d. Actually have oral, anal, or vaginal intercourse with you? ACE Study Questions Q: While you were growing up during your first 18 years of life… Substance Abuse a. Did you live with anyone who was a problem drinker or alcoholic? b. Did you live with anyone who used street drugs? Mental Illness a. Was a household member depressed or mentally ill? b. Did a household member attempt suicide? Q: While you were growing up during your first 18 years of life, was your mother or stepmother Mother Treated Violently a. Sometimes, often, or very often pushed, grabbed, slapped or had something thrown at her? b. Sometimes, often, or very often kicked, bitten, hit with a fist or hit with something hard? c. Ever repeatedly hit over at least a few minutes? d. Ever threatened with, or hurt by a knife or gun? Criminal Behavior in Household a . Did a household member go to prison? ACE Study Findings: Most patients in the study who were exposed to one category of childhood abuse or household dysfunction were also exposed to at least one other category If a person experienced any single category of exposure, the probability of exposure to any additional category ranged from 65-93% depending on the category The more categories of exposure the greater the prevalence of many risk factors and disease conditions ACE Study Persons who experience these adverse childhood experiences adopt coping mechanisms to deal with the resulting anxiety, anger and depression from these experiences The coping behaviors adopted of course, are those that offer immediate relief: smoking, over eating, alcohol or drug abuse, or sexual acting out Research Questions Q. Do women who offend experience sexual or physical abuse at significantly greater rates than women in the general population? Q. Does polyvictimization (experience of more than one type of abuse) exist at significantly greater rates among women who offend than women in the general population? Q. Do women who offend experience significantly greater rates of “household dysfunction” (measured by a childhood living environment characterized by substance abuse, mental illness, criminal behavior, and violent treatment of a mother or stepmother) than women in the general population? Q. If exposure to childhood abuse and household dysfunction makes one at risk for offending, what are the implications for prevention and rehabilitation? Survey of Women Inmates Questions to measure adverse childhood experiences were taken from the ACE Study Questions to measure other interpersonal violence victimization experiences, including victimizations in adulthood were taken from the National Violence Against Women Study (National Institute of Justice and Centers for Disease Control Prevention, 1998, NCJ17237) Questions to measure criminal histories, current offenses and sentences were taken from the Survey of Inmates in State Correctional Facilities (SISCF), (Bureau of Justice Statistics, National Archive of Criminal Justice Data,ICPSR 4572, 2004) Survey of Women Inmates The survey was conducted over 10 visits to the New Mexico Women’s Correctional Facility in Grants between February 2010 and November 2010 All incarcerated women with the exception of high risk inmates (those highly dangerous in solitary confinement or those confined for mental illness) were allowed to participate All incarcerated women not occupied in work assignments during the morning or afternoon times of the day during which the survey was conducted, were escorted to a designated room where the survey would be conducted and asked to participate Survey of Women Inmates Participation was voluntary Those that did not wish to participate were escorted back to their prior or preferred authorized destinations Over the months of the survey, there was an average 513 women incarcerated at the facility. Those eligible to participate because of the absence of the aforementioned disqualifications numbered 236 Twenty six women chose not to participate A total of 210 women completed the survey Women Inmate Demographics Median age = 36 years Women Inmate Demographics * *US Census, 2010 Women Inmate Demographics Most women (60%) were married once, but the proportion of those no longer married (38%) is similar to those never married (40%) Women Inmate Demographics Approximately half (51% or 106) of the women did not graduate from high school. The median grade completed = 11th; approximately half (49% or 101) graduated high school or went to college or graduate school: 21% (43) graduated high school; 28% (58) went to college or graduate school. Women Inmate Demographics 92% of women inmates have children, including step or adopted children Median/mean number of children = 3 Median age when having their first child is 19 years old Women Inmate Demographics Two thirds 134 (64%) of women inmates worked in the 12 months before their incarceration. One-third (44) of the women that worked, had multiple jobs at the same time. Of these, 37 were full-time workers. Women Inmate Demographics Of 207 women respondents, 36% (74) received income from illegal sources in the month before their incarceration. Median income per month from all sources of income = $1,000 Health History One-fifth (43 or 20%) reported having a physical disability (disabling injury) compared to 7% of respondents with disabling injury in the general population as reported in the SVV* 58% (25 of 43) of those with a physical disability reported that it was the result of a violent attack 88% (38 of 43) reported their disabling injury interfered with their normal activities * Survey of Violence Victimization in New Mexico, 2005 Health History 69% (145) of the women experienced two or more weeks of depressed mood in the past year One third (32% or 68) reported that they attempted suicide 75% of those that attempted suicide had more than one attempt Health History Mean = 3.7 times | Median = 2 times Health History 95% (200) reported that they drank alcohol; median age first time = 13 years; however most started at 12 years 78% (155) of those that drank, did so in the 12 months before their incarceration 33.5% (67) considered themselves an alcoholic 20.5% (41) were told by their doctor or other practitioner that they were an alcoholic Health History 87% (183) reported having used illegal drugs; median age was 15, however most started at age 13 81% (148) of those that use illegal drugs did so in the 12 months before their incarceration 96% (202) of the 210 women reported having sexual intercourse. The median age the first time they willingly engaged in intercourse is 15.5 years, however the first age for most was 14 years. 21% (43) of the women that engage in sexual intercourse reported having 50 or more partners Health History Of the 210 women, 53% (111) reported being homeless, living in the street or a shelter at some point in their lives 37% were homeless, living in the street or in a shelter in the 12 months prior to their incarceration 73% (154) of women spent some time in prison, jail or other correctional facility at some point in the 12 months before their current incarceration Lifetime Victimization Sexual Assault *National Violence Against Women Study Lifetime Victimization Sexual Assault *National Violence Against Women Study Lifetime Victimization Sexual Assault *National Violence Against Women Study Lifetime Victimization Sexual Assault *National Women’s Study Lifetime Victimization Sexual Assault Lifetime Victimization Physical Assault *National Violence Against Women Study Childhood Abuse Experiences Childhood Abuse Experiences Of the 210 women inmates: 44% (93) reported experiences of psychological and physical abuse 38% (80) reported experiences of psychological and sexual abuse 35% (73) reported experiences of physical and sexual abuse 33% (69) reported all three (psychological, physical and sexual abuse) Household Dysfunction Polyvictimization Polyvictimization 77% women inmates compared to 30.5% ACE population experienced multiple categories of adverse childhood experiences ACE found that those with 4 or more categories of exposure had a 4 to 12-fold increase risk for alcoholism, drug abuse, depression and suicide attempts; and a 2 to 4-fold increase for having intercourse with 50 or more sexual partners and contracting sexually transmitted diseases Health Risk Factors *Only 140 women inmates (sexual assault victims) were asked this question Childhood Psychological Abuse Childhood Physical Abuse Childhood Sexual Abuse Household Substance Abuse Household Mental Illness Household Criminal Behavior Mother’s Violent Treatment Conclusions Q: Do women who offend experience sexual and physical abuse at significantly greater rates than women in the general population? Rape victims among women inmates is 3 (3.2) times that of women in the NM general population, and 6 (5.6) times that of women nationally Nearly twice (41%) as many women inmates that were raped experienced their rape by age 12, compared to women that reported being raped by age 12 nationally (22%) Women inmates were twice as likely to experience multiple rapes (81%) than women nationally (39%); 51% of women inmates victims reported 4 or more rapes. 89% of women inmates reported being a victim of physical assault at some time in their lives, compared to 52% of women nationally (NVAWS) Conclusions Q: Does polyvictimization (experience of more than one type of abuse) exist at significantly greater rates among women who offend than women in the general population? The SVV demonstrated that at some time in their life, 45% of NM women were physically attacked, 24% of women were sexually assaulted, and 21% of women were both physically attacked and sexually assaulted The Survey of Women Inmates found that at some time in their life, 89% of women inmates were physically attacked, 70% were sexually assaulted, and 64% of women were both physically attacked and sexually assaulted 77% of women inmates compared to 30.5% of women and men in the general population were exposed to multiple categories of adverse childhood experiences Women inmates were six times more likely than men and women in the general population to experience 4 ≥ adverse childhood experiences Conclusions Q: Do women who offend experience significantly greater rates of “household dysfunction” (measured by a childhood living environment characterized by substance abuse, mental illness, criminal behavior, and violent treatment of a mother or stepmother) than men and women in the general population? Women inmates were: Almost 3 times more likely to grow up with someone who was a problem drinker/alcoholic Almost 5 times more likely to grow up with someone that used street drugs Almost 3 times more likely to grow up with someone that was depressed or mentally ill 4.5 times more likely to have a household member attempt suicide Almost 4 times more likely to have a mother or step-mother that was treated violently Almost 8 times more likely to have a household member go to prison Conclusions Prevalence of high risk behavior is significantly greater among women inmates than the general population Women inmates are: 3 times more likely to experience depressed mood in the past year 9 times more likely to ever attempt suicide 6 times (5.5) more likely to consider herself an alcoholic 3 times (2.8) more likely to ever use elicit drugs 3 times more likely to have 50 or more sexual intercourse partners 3 times more likely to contract a sexually transmitted disease Implications for Prevention Efforts National Survey of Children’s Exposure to Violence (Finkelhor, et al, 2009) Measures exposure across several major categories, including conventional crime, child maltreatment, victimization by peers and siblings, sexual victimization, witnessing and indirect victimization (including exposure to community violence and family violence, school violence and threats, and internet victimization [sexual harassment and solicitation]) NaSCEV Recommendations Those who work with children must assess for a broader range of victimizations Give priority for polyvictims Professionals who work with children need to pay particular attention to polyvictims because of their vulnerability to mental health, behavior, school performance and other problems Identify these children in schools, in social welfare and mental health caseloads, in foster care and juvenile justice systems Do not minimize their victimization histories by focusing on one type of problem (sexual abuse, or bullying, etc.) Give particular attention to bully-victims (victims of violence who also bully others) and sexual assault victims as studies have shown the worst outcomes for these children who are more likely than others to have multiple victimizations NaSCEV Recommendations Professionals must develop new interventions to encompass multiple victimizations that involve a team of professionals to collaborate in the treatment strategies of each polyvictim child Assess for environmental conditions that perpetuate victimization and develop strategies to address them – e.g. teaching parenting and guardianship skills to parents and other adult caregivers Interrupt the onset of the pathway to victimization – there are many early warning indicators for future polyvictimization for children living in dangerous families and neighborhoods, and children with emotional problems. Professionals must help build the supervision and protection capacities of family members, guardians, caregivers, teachers, and other adults who may be in a position to intervene to help children and stop the progression toward polyvictimization. Implications for Rehabilitation What is clear about the rehab experience for women offenders is that effective rehab is really synonymous with personal recovery from life victimization experiences. But most of these women have children and are responsible for supporting these children, so they must be offered recovery treatments, as well as family supports; and waiting until after the women are released is ineffective. Access to viable substance abuse programs Access to parenting education/skills development Access to mental health treatment Access to sexual assault counseling Access to family counseling Access to educational classes to get their high school equivalency degree Access to skills development classes focused on training for specific employment that allows the women to support their families Contact Information New Mexico Interpersonal Violence Data Central Repository Director Betty Caponera, Ph.D. (505) 883-8020 office (888) 883-8020 toll-free www.nmcsap.org