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A Multisite Study of the Prevalence of Serious Mental Illness, PTSD, and Substance Use Disorders of Women in Jail
Shannon M. Lynch, Ph.D.; Dana D. DeHart, Ph.D.; Joanne E. Belknap, Ph.D.; Bonnie L. Green, Ph.D.; Priscilla Dass-Brailsford, Ed.D.; Kristine A. Johnson, Ph.D.; Elizabeth Whalley, B.A.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300172
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Dr. Lynch is with the Department of Psychology, Idaho State University, Pocatello (e-mail: lyncshan@isu.edu). Dr. DeHart is with the College of Social Work, University of South Carolina, Columbia. Dr. Belknap and Ms. Whalley are with the Department of Sociology, University of Colorado, Boulder. Dr. Green and Dr. Dass-Brailsford are with the Department of Psychiatry, Georgetown University, Washington, D.C. Dr. Johnson is with the Geneva Foundation, Tacoma, Washington.

Copyright © 2014 by the American Psychiatric Association


Objectives  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?

Methods  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.

Results  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.

Conclusions  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.

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Table 1Prevalence of lifetime and 12-month serious mental illness, PTSD, and substance use disorders among 491 female offenders, by region and jaila
Table Footer Note

a Metropolitan-area jails are in urban areas with population centers of >50,000 and a population density of >1,000 people per square mile. Nonmetropolitan-area jails are in areas with population centers of 2,500–50,000. Rural jails are in areas with <500 people per square mile.



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