Women and Mental Illness

Week 6: Women with Mental Illness

• Announcements and reminders:
  • Quiz #3 was released Thursday and is due March 4.
  • Office Hours are on Wednesday via Zoom from 1-2 pm.
  • The Midterm was well done.
  • The Case Study is due March 20.
• This week focuses on women with mental illness following reading week.

Defining Mental Illness

• Mental health and mental illness are different.
• Mental health is a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well, work well, and contribute to their community.
• Mental illness involves health problems that affect thinking, mood, or behavior, encompassing mental disorders.
• The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) classifies all mental disorders.

Assessing Mental Disorder

• Main approaches to assessing mental disorders are:
  • Structured Interviews
  • Paper and Pencil Tests
  • Behavioral Observations
• Structured Interviews involve formal interviews with pre-set questions geared toward making a diagnosis.
• Paper and Pencil Tests are designed to identify symptoms associated with a range of mental disorders, the Beck Depression Inventory is an example.
• Behavioral Observations involve observing people and recording how they respond to various situations.

Prevalence among Criminalized Women

• Mental disorder among incarcerated women is four times higher than non-incarcerated women.
• 75% of incarcerated women have a substance use disorder.
• Over 50% have a personality disorder or substance use disorder, alongside another mental health disorder.
• Three in ten females enter federal custody with a pre-existing mental health issue.
• Not all mental disorders are associated with criminal activity; some are internalized.
• Lifetime mental disorder prevalence rates show differences between newly admitted federally sentenced men and women. Incoming women have higher rates of:
  • Any mental disorder (79.2% vs. 81%)
  • Anxiety disorders (44.2% vs. 34.1%)
  • Mood disorder (34.9% vs. 30.2%)
• Incoming men have higher rates of:
  • Alcohol/substance abuse disorder (61.6% vs. 66%)
  • Anti-social personality disorder (38.4% vs. 44.1%)
  • Borderline personality disorder (25.6% vs. 15.9%)
  • Psychotic disorders (5.8% vs. 4.7%)

NCRMD

• NCRMD means "not criminally responsible on account of a mental disorder."
• An NCRMD inquiry is triggered only by disorders that interfere with an accused's ability to know and understand that what they are doing is wrong.
• NCRMD does not result in an acquittal; instead, the offender is sent to a review board to determine treatment options.
• NCRMD cases represent only a small portion of cases in Canada, accounting for 1% of all cases per year.
• Individuals found NCRMD may be held in facilities for extended periods.

Treatment for Criminalized Women

• Custodial sentences have no effect on re-offending due to:
  • Low-risk offenders learning criminal behavior from others.
  • Custody creating new barriers by separating low-risk offenders from their support systems.
• Effective treatments are strength-based, holistic, and trauma-responsive.
• There is a lack of care in institutions due to under-funding and over-loading.

Treatments

• Cognitive Behavioral Therapy (CBT) is a form of talk therapy used to change maladaptive behaviors by having people reframe how they view situations.
• Third-wave Cognitive Behavioral Therapy augments existing CBT with additional approaches such as mindfulness, visualization, personal values, self-awareness, spirituality, and metacognition.
• Women Offender Correctional Programs (WOCP) and Indigenous Women Offender Correctional Programs (IWOCP) are available.

Specialized Courts - Drug Treatment Courts

• There is a large number of incarcerated individuals due to drug-related offenses.
• Drug Treatment Courts aim to reduce the number of processed offenses through court systems.
• Treatment courts divert non-violent offenders through court-monitored supervision and addiction treatment.
• These courts allow individuals to complete drug treatment programming.
• 7 out of 10 graduates have no new charges or convictions.
• There is a 76% reduction in recidivism among graduates.
• There are 67% fewer contacts with police among graduates.

Specialized Courts - Mental Health Courts

• MHC often involves a referral by a Mental Health Court Support Worker.
• There is a system that differs from traditional court system, but has similar processes (bail hearings, guilty pleas, pre-trails, etc).
• MHC offers tailored treatment programs for persons with mental illness (PMI).
• Participation in MHC is voluntary.
• MHC's can lead to diversion and/or a conviction.