Effects of a Prison Nursery Program on Recidivism Lorie S. Goshin Mary W. Byrne Columbia University School of Nursing Alana M. Henninger John Jay College of Criminal Justice The Graduate Center City University of New York

Acknowledgements Research Participants Studies: “Maternal and Child Outcomes of a Prison Nursery Program”, Principal Investigator Mary Byrne Funders: National Institutes of Health/National Institutes of Nursing Research RO1 NR00782, 2003-2013 Columbia University Institute for Child and Family Policy NYS Department of Health Commissioner’s Priority Award

On any given day in the US…. 1 in 746 women are in prison or jail Are under some form of criminal justice control Pew Center on the States (2008, 2009). One in 100: Behind bars in America 2008. retrieved from http://www.pewcenteronthestates.org/uploadedFiles/8015PCTS_Prison08_FINAL_2-1-1_FORWEB.pdf Pew Center on the States (2009). One in 31: The long reach of American corrections. Retrieved from http://www.pewcenteronthestates.org/uploadedFiles/PSPP_1in31_report_FINAL_WEB_3-26-09.pdf

Criminal Justice Involvement & Health Disparities Higher prevalence of asthma, high blood pressure, mental illness, substance use disorders, hepatitis, HIV/AIDS, and other sexually transmitted infections than general adult population (Fazel & Baillargeon, 2010). ≈ 20-26% of all Americans infected with HIV, 29-43% with Hep C, 40% with TB passed through a correctional facility in 1997 (Hammett, Harmon, & Rhodes, 2002) Incarcerated women are more likely than incarcerated men to report: Medical, mental health, and substance use disorders (Binswanger, Merrill, Krueger, White, Booth, & Elmore, 2010) A lifelong history of trauma and exposure to adverse childhood events (Messina et al., 2007) A history of homelessness (Glaze & Maruschak, 2008)

Imprisoned Women and their Minor Children Glaze, L.E., & Maruschak, L.M. (2008).

Prison Nursery Programs Allow women to live with their children in correctional settings Prison Nurseries: 8 prisons in 8 states General eligibility criteria: 1) Pregnant upon admission, 2) Convicted of a nonviolent crime, 3) Expected release date 12-18 months after due date, 4) No history of crimes against children.

New York State’s Prison Nursery History New York State Corrections Law §611 Signed into law in 1930 by FDR, then Governor of New York. Remains virtually unchanged. Gives eligible women the right to care for infants born in custody Length of stay: up to 1 year, up to additional 6 months if mother’s release date expected between 12-18 months of age Gives superintendent and medical officer broad discretion Includes shackling language since 2009 Implementation of §611 Eligibility: Main screening goal to determine whether an applicant would threaten the safety of other nursery participants History of violence and indicated child welfare cases are reviewed closely and generally denied entry Prison disciplinary record reviewed Best interest of the child as guide

New York State’s Prison Nursery Operations Photo by Joseph Rodriguez (2001) Funded by DOC. Managed by non-profit social service agency. Staffed by civilians & corrections Facility: Segregated from general population. Can house <= 29 mothers and infants Working Mother Model: daily childcare provided to facilitate attendance in other educational and rehabilitative programs Mandated parenting course and weekly group meeting

Prison Nursery Outcomes: Recidivism Rates of return to prison appear lower than offenders from general population Nebraska: 16.8% 3 year rate for women who completed the program (Carlson, 2009) New York: 13% 3 year rate for women released in 1997 (NYSDOC, 2001) Washington State: 15% return to prison within unspecified time frame (Roland & Watts, 2007) Methodological limitations in available research Data sources unspecified or unsystematic (e.g., nursery staff, self report of women who could be located) Time frames not standardized Recidivism not well defined- Alternately used for return to prison and rearrest. Felony reconviction not assessed.

Methods Recruitment from Bedford Hills and Taconic prison nurseries Total N = 139 Cross-Sectional Phase 2001 N = 56 women, 58 children Longitudinal Phase 2003 – 2007 N = 97 women, 100 children Excluded N = 14 (Deported or imprisoned in another state on release, Youthful offender, not yet in the community for 3 years)

Measurement & Data Analysis 3 Year Recidivism: 1) Felony Reconviction, 2) Prison Reincarceration Data sources: Primary data from prison nursery studies New York State Department of Criminal Justice Services unsealed data matched by criminal justice identification number. Cross checked by birth date and nursery incarceration date. Data Analysis: Kaplan-Meier for Categorical (Nursing intervention, Minority, Release with baby, PV). Substance abuse history not explored due to lack of variability. Cox Regression for Continuous (Age at release, Length of Stay, Prior Arrests)

Sample Description Time on Nursery M = 6.9 months (SD = 4.7) Age at release = 29 years (SD = 6.4, Range 18 – 49) Race/Ethnicity: Black (African, African-American, Afro-Caribbean) 42% Latina 27% White 31% Mother and child released together 66% Substance abuse history 77% Clinically significant depression symptoms 75%

Criminal Justice History Conviction: Drug Sales or Possession: 54.7%, Property Crime: 24.1% VFO (Assault, Robbery, Negligent Manslaughter): 14.6% Other (DUI, conspiracy, leaving the scene, weapons): 6.5% Nursery incarceration due to PV 24.6% Unsealed prior arrests M = 4.0 (SD = 5.8) Unsealed prior convictions M = 3.0 (SD = 3.9)

Results: 3 Year Felony Reconviction Crimes: Drug Sales or Possession (N = 2) Property (N = 5) VFO (N = 2) Mean time to reconviction = 20.6 months (SD = 9.8)

Results: 3 Year Return to Prison New Commitment: 4.3% (N = 6) Parole Violation: 9.4% (N = 13) Predictors of Return to Prison: Women in the nursery on PV 2 ½ times more likely to be reincarcerated by 3 years (HR = .42, p = .06)

Nursery Incarceration for PV Not in nursery for PV Nursery for PV Mantel-Cox χ2 = 3.8, p = .05

Nursery Incarceration for VFO No VFO VFO Mantel-Cox χ2 = .76, NS

Race/Ethnicity African-American or Latina White, non-Latina Mantel-Cox χ2 = .49, NS

Baby Released with Mother Alternate Caregiver Mother Mantel-Cox χ2 = .65, NS

Discussion Women released from a prison nursery program have very low likelihood of felony reconviction or return to prison within 3 years Sample at high risk for recidivism: Younger women Drug offenders Property offenders

Discussion Comparison between prison nursery recidivism and all women released from NYS prisons in 2007 and 1985-2007 New Commitment Parole Violation Prison Nursery 4.3% 9.4% All Female NYS Releases 1985-2007 Cohort 8.9% 20.4% 2007 Cohort 4.5% 29.3%

Conclusions Consider prison nurseries with supportive services as a best practice in corrections for imprisoned pregnant women Cost efficiency: partnership with local non-profits Quality: positive infant and preschool outcomes, low recidivism X Access: LIMITED Compared to what? Quasi-Experimental research needed to compare prison nursery residents to Women in states without access to prison nursery Women allowed to remain in the community with their infants and older children.

For more information please contact: Thank you! For more information please contact: Mary W. Byrne, PhD, MPH mwb4@columbia.edu