Lynch Shannon M, Dehart Dana D, Belknap Joanne E, Green Bonnie L, Dass-Brailsford Priscilla, Johnson Kristine A, Whalley Elizabeth
Psychiatr Serv. 2014 May 1;65(5):670-4. doi: 10.1176/appi.ps.201300172.
This multisite study aimed to answer the following research questions about women in urban and rural jails. First, what is the current and lifetime prevalence of serious mental illness (major depressive disorder, bipolar disorder, and psychotic spectrum disorders) of women in jail? Second, what level of impairment is associated with their serious mental illness? Third, what is the proportion of incarcerated women with serious mental illness who also have posttraumatic stress disorder (PTSD), a substance use disorder, or both?
Participants were 491 women randomly sampled in jails in Colorado, Idaho, South Carolina, and the metropolitan area of Washington, D.C. Structured interviews assessed lifetime and 12-month prevalence of disorders and level of impairment.
Forty-three percent of participants met lifetime criteria for a serious mental illness, and 32% met 12-month criteria; among the latter, 45% endorsed severe functional impairment. Fifty-three percent met criteria for ever having PTSD. Almost one in three (29%) met criteria for a serious mental illness and PTSD, 38% for a serious mental illness and a co-occurring substance use disorder, and about one in four (26%) for all three in their lifetime.
The prevalence of serious mental illness and its co-occurrence with substance use disorders and PTSD in this multisite sample suggest the critical need for comprehensive assessment of mental health at the point of women's entry into the criminal justice system and the necessity for more programs that offer alternatives to incarceration and that can address the complexity of female offenders' treatment needs.
这项多地点研究旨在回答以下关于城乡监狱女性的研究问题。第一，监狱中女性严重精神疾病（重度抑郁症、双相情感障碍和精神病性谱系障碍）的当前及终生患病率是多少？第二，她们的严重精神疾病会导致何种程度的功能损害？第三，患有严重精神疾病的在押女性中，同时患有创伤后应激障碍（PTSD）、物质使用障碍或两者皆有的比例是多少？
研究对象为在科罗拉多州、爱达荷州、南卡罗来纳州以及华盛顿特区都会区的监狱中随机抽取的491名女性。通过结构化访谈评估疾病的终生患病率和12个月患病率以及功能损害程度。
43%的研究对象符合严重精神疾病的终生标准，32%符合12个月标准；在符合12个月标准的对象中，45%表示有严重功能损害。53%的对象符合曾患PTSD的标准。近三分之一（29%）的对象符合严重精神疾病和PTSD的标准，38%符合严重精神疾病和同时存在的物质使用障碍的标准，约四分之一（26%）的对象在一生中符合所有三项标准。
在这个多地点样本中，严重精神疾病及其与物质使用障碍和PTSD共病的患病率表明，在女性进入刑事司法系统时对心理健康进行全面评估至关重要，并且需要更多能够提供替代监禁措施并能满足女性罪犯复杂治疗需求的项目。
