1. Participants Participants (N = 5) were employees of Taycheedah Correctional Institution: 1 administrator, 1 psychologist, 2 psychological associates, and 1 correctional officer. All participants were assigned to the Monarch Special Management Unit. Materials The researchers developed a structured interview to assess participants’ experiences with mental health service delivery at Taycheedah. The first section of the interview consisted of 3 questions that focused on assessment and access to mental health services. The second section consisted of 11 questions focusing on treatment. The third section consisted of 6 questions focusing on participants’ work with other staff members (i.e., medical providers). One final question gave participants the opportunity to talk about any other rewards and/or challenges they face in their day-to-day work. Procedure One of the researchers scheduled a 3-day visit to Taycheedah Correctional Institution. During the course of the visit, the researcher conducted one-on-one interviews with each participant. Audiotaping was not permitted in the facility; therefore, the researcher recorded responses via handwritten notes. Each interview took approximately 30 minutes. Incarcerated women are some of the most marginalized members of American society (Marcus-Mendoza, 2011). Not only is every minute of each day strictly accounted for, but female inmates have almost no freedom of personal choice. Each day, prison staff chooses what the woman will eat, when she will eat, when she can be let out of her cell, when she is allowed to socialize, what kind of psychological care is given to her, and if she is allowed to participate in group therapy. Given the incredible responsibility prisons have to make all of these choices for each woman, decision-making must be guided by research about what is best for the woman prisoner. Psychological care is especially important for women in prison because they have higher rates of sexual victimization during childhood, homelessness, abuse, having parents with substance abuse problems, and living in foster care as a child than non-incarcerated people (Belknap & Holsinger, 2006; James & Glaze, 2006). Incarcerated women also suffer from the same physical and mental health issues as other women, but with greater severity and higher frequency (Arriola, Braithewaite, & Newkirk, 2006). Kinsler and Saxman (2007) indicate that people tend to cope with prior abuse through anger and violence, depression, and substance abuse. Rather than rehabilitating offenders, Kinsler and Saxman argue that the U.S. prison system is “incarcerating last generation’s abuse survivors” (p. 84). According to Marcus-Mendoza (2011), access to feminist therapy is essential to the well-being of marginalized women. Some feminist principles have been applied to programming for female inmates, but feminist therapy is not the modal practice in women’s prisons. Marcus-Mendoza (2011) argues that the U.S. must work towards a fully feminist paradigm of corrections, one that “empowers incarcerated women and transforms women’s correctional facilities into rehabilitative environments” (p. 78). This purpose of this study was to assess the current status of mental health services for incarcerated women housed at Taycheedah Correctional Institution in Fond du Lac, Wisconsin. Taycheedah is maximum/medium security facility that houses approximately 700 female inmates. The Monarch Special Management Unit (MSMU) is Taycheedah’s specialized unit for inmates with mental health needs. MSMU has the capacity to house and provide on-unit treatment to 64 inmates. In 2008, the U.S. Department of Justice (USDOJ) and the Wisconsin Department of Corrections entered into a Memorandum of Agreement related to mental health care for female inmates housed at Taycheedah. The USDOJ identified 13 areas of need to be addressed within four years’ time. Given the resource and programming challenges associated with providing mental health services to female inmates in general, as well as the difficulties currently being experienced at Taycheedah, it is hypothesized that staffing and services will be inadequate. It is also expected that mental health providers at Taycheedah will engage in the typical correctional practice of using assessment instruments and programming developed for men, as opposed to using feminist practices. Introduction Mental Health Services for Incarcerated Women: A Study of Taycheedah Correctional Institution Alyssa Loveland and Dr. Lori Bica, Faculty Mentor (Psychology) Assessment and Access to Mental Health Services Although the administrator expressed satisfaction with assessment procedures, all three mental health providers reported dissatisfaction. They indicated that there were no standard assessment instruments available for use at Taycheedah. The psychologist also expressed concern about the fact that standard assessments were developed with male offenders and may not be able to accurately determine the risk or needs of women. All participants reported that mental health care is readily available to all inmates at Taycheedah. There are no instances in which inmates are denied access to treatment. There are times, however, when non-emergency treatment may be delayed for an inmate if mental health providers are dealing with a crisis situation. Treatment All participants reported that a cognitive-behavioral approach is the dominant orientation of mental health providers at Taycheedah. Treatment goals are determined by a team of providers, including the unit supervisor, psychiatrist, psychologist, social worker, security supervisor, and a health care representative. Only one participant indicated that inmates were involved in their own goal-setting. Additionally, all participants indicated that so much time is devoted to crisis-intervention (e.g., suicide attempts) that there are few resources left to adequately address long-standing cognitive or behavioral issues with inmates before they are released. Participants reported engaging in a number of practices that are compatible with feminist principles. For example, the mental health providers all stressed the importance of developing inmates’ self-efficacy. Skill development in such areas as financial literacy, health and wellness, coping with stress, education, and employment is also emphasized. This is accomplished during individual sessions and through group programming. All participants indicated that the issue of racism is discussed regularly at Taycheedah; however, participants gave mixed reports with respect to discussing issues of homophobia. Findings were also mixed with respect to participants’ beliefs about the importance of building an egalitarian relationship between therapist and client. The psychologist indicated that she fosters an egalitarian relationship by allowing inmates to talk about her or other staff members as they wish during individual therapy sessions. Other participants stressed that safety must come first, stated that limits must be clear, and indicated that a power differential is always present. Issues of power and oppression within the prison setting are addressed during individual therapy sessions and through group programming. No mention was made of attempts to discuss the patriarchal structure of society with inmates. All participants reported that there is not enough time, money or staff to assist inmates with issues having to do with past histories of being victims of violence and abuse. The psychologist indicated that her greatest challenge was reconciling the goals of prison programming with her goals as a therapist. Other participants stressed that safety and security must come first, that their purpose is not to be the inmates’ friend, and that, ultimately, they work for the State. Collaboration with Other Staff The psychologist facilitates training for staff quarterly, which has included such topics as suicide prevention, general mental health training, and trauma education. All other training is determined by the Department of Corrections and not by Taycheedah staff. All participants described opportunities for furthering their knowledge/skills as inadequate. Opportunities for mental health providers to collaborate with medical providers, both formally and informally, are numerous. All participants indicated that there are not problems of overmedicating inmates. If anything, inmates are undermedicated as a result of the State trying to cut costs. Participants reported that medical providers at Taycheedah are inadequately prepared with respect to caring for victims of trauma, abuse, and/or violence. When asked about opportunities for inmates to speak their opinions and contribute to decision-making about their care, participants emphasized problem situations. For example, inmates are entitled to submit a complaint form to be reviewed by an administrator or the Inmate Complaint Examiner. Participants did not mention attempts on the part of staff to develop positive, proactive contributions from inmates. In terms of support for inmates once they are released, both the administrator and the psychologist mentioned programs like Opening Avenues for Re-entry Success (OARS) and Steps to Success, as well as “wraparound services” involving medication, clothing and transportation. The other participants were generally unaware of these programs/services, indicating that these supports were the responsibility of Taycheedah’s social workers. This study is important because it brings attention to some of the most marginalized members of our society, incarcerated women. These women, no matter what they have done to be in prison, deserve basic rights, such as access to physical and mental health care. Although mental health care is available at Taycheedah, not all inmates have adequate access due to limits on staff and other resources. In addition, because staff members spend so much time dealing with crises, time to spend working on underlying issues that could lead to healing and a lower recidivism rate is limited. Incarcerated women need the one-on-one attention of a therapist because so many have experienced traumatic life events (James & Glaze, 2006). In addition to individual counseling, Taycheedah offers a limited number of counseling groups. These groups focus on empowering women to make better life choices, which gives the women confidence and the conviction to lead better lives. By offering individual and group programming, prison is changed from a punitive environment that focuses on punishing bad behavior to a rehabilitative environment that fosters change and growth in women (Marcus-Mendoza, 2011). If resources allowed for more women to participate, imagine the results. Not only are resources needed to expand staff and programming, resources should also be devoted to educating existing staff about assessment tools available at Taycheedah and when to use them. Many of the psychologists did not know if Taycheedah had certain assessment tools, and all participants agreed that assessments were used rarely, if ever. Also, the assessments available at Taycheedah have not been normed specifically for women. More resources should be devoted to research on gender-responsive assessment measures, and training for mental health providers to implement these assessments. Also, mental health providers at Taycheedah and around the nation should be encouraged and receive support to apply feminist principles to programming for women in prison. This study does have limitations, including a small sample size. Another limitation is that the researcher conducted interviews only with staff from the Monarch Special Management Unit. It is not clear how representative the participants are of staff from other units within Taycheedah or of prison staff in general. References & Acknowledgements Arriola, K. J., Braithwaite, R. L., & Newkirk, C. (2006). An overview of incarcerated women’s health. In R. L. Braithwaite, K. J. Arriola, & C. Newkirk (Eds.), Health issues among incarcerated women (pp. 3-17). New Brunswick, NJ: Rutgers University Press. Belknap, J., & Holsinger, K. (2006). The gendered nature of risk factors for delinquency. Feminist Criminology, 1(1), 48-71. James, D. J., & Glaze, L. E. (2006). Mental health problems of prison and jail inmates, (NCJ 213600). Washington, D.C.: Bureau of Justice Statistics. Retrieved from http://bjs.ojp.usdoj.gov /content/pub/pdf/mhppji.pdf Kinsler, P., & Saxman, A. (2007). Traumatized offenders: Don’t look now but your jail’s also your mental health center. In K. Quina & L. S. Brown (Eds.), Trauma and disassociation in convicted offenders: Gender, science, and treatment issues (pp. 81-95). Binghamtom, NY: The Haworth Medical Press. Marcus-Mendoza, S. (2011). Feminist therapy with incarcerated women: Practicing subversion in prison. Women & Therapy, 34, 77-92. Funding for this project was made possible by UW-Eau Claire’s Center of Excellence for Faculty and Undergraduate Student Research Collaboration. Method Discussion Results