Chapter

Institutional Captives: US Women Trapped in the Medical/Correctional/Welfare Circuit: Critical Perspectives on Treatment and Confinement

Authors:
To read the full-text of this research, you can request a copy directly from the authors.

Abstract

Based on a five-year ethnographic study of formerly incarcerated Massachusetts women, this paper explores interconnections among the penal, welfare and healthcare bureaucratic institutions in the United States. The authors use the term ‘institutional captivity’ to describe the experiences of women trapped in a circuit made up of battered women’s shelters, homeless shelters, prisons, jails, probation, parole, rehabilitation facilities, detoxification facilities, clinics, respite care, hospitals, welfare offices, food stamp and Women Infant & Children offices, psychiatric units, child welfare offices, family court, drug courts, public housing, sober houses, recovery meetings and parenting classes. These interlocking institutions frame public policies and personal lives. Despite ostensibly different mandates, all preach and reinforce a cultural ethos that individualises suffering rather than recognising the institutionalised and gendered patterns of these women’s life experience. Their shared ideology casts women as victims while simultaneously holding women responsible for their own victimisation. Representative of the larger sample, the stories of two women who navigate the institutional circuit serve to illustrate the larger bureaucratic and gendered social issues addressed in the paper.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the authors.

... Conclusions: To promote client use of services at this critical point of care, jail diversion programs might consider ongoing negotiations with clients to balance expectations between the criminal justice and mental health systems of care by using "slow" client engagement, limiting police involvement, and adopting trauma-informed and harmreduction approaches. Some individuals with a serious mental illness experience an insidious cycle between homelessness and jail (1)(2)(3). Individuals experiencing "chronic homelessness" are homeless for at least 1 year, have a serious disability, and frequently rely on crisis services in nonideal settings (4)(5)(6). In the United States, 19.8% of individuals experiencing chronic homelessness also had a diagnosis of serious mental illness (7); moreover, they were often in jail or overpoliced (7)(8)(9)(10)(11). ...
Article
Full-text available
Objective: In this study, the authors elicited the perspectives of criminal justice and mental health stakeholders about a prebooking jail diversion program, the Judge Ed Emmett Mental Health Diversion Center, serving primarily individuals experiencing chronic homelessness and diagnosed as having a serious mental illness. Methods: The authors analyzed semistructured interviews with 19 participants and observational fieldnotes from 60 hours of ethnographic fieldwork, conducted from January to July 2020 and including five administrative-level meetings. They used qualitative coding to develop themes. Administrative data were also reviewed. Results: Engagement of clients in the program was a major theme. Barriers to engagement included clients’ fear of police involvement and strict rules around smoking. Facilitators to engagement included “slow” engagement, or gradual, gentle microengagements over time and across multiple visits, ideally with peer counselors. Conclusions: To promote client use of services at this critical point of care, jail diversion programs might consider ongoing negotiations with clients to balance expectations between the criminal justice and mental health systems of care by using “slow” client engagement, limiting police involvement, and adopting trauma-informed and harm-reduction approaches.
Article
Historically, there has been a disparity between men and women rates of incarceration, even though there has been a significant increase in the number of women imprisoned over the past 20 years, globally. Women have unique health care needs that are often not adequately addressed within the correctional institutions in which they are held. The focus of this study was to explore women’s experiences when accessing health services within Canadian provincial correctional institutions. Narrative inquiry was used to investigate the life stories of five women who accessed health care in provincial correctional institutions. A total of two storylines and five sub-storylines resulted from the analysis of interviews conducted with the participants. The findings suggest that during incarceration, participants experienced compromising conditions that contributed to the worsening of their health, and faced difficulties accessing their prescribed treatments and medications. Consequently, this contributed to the worsening of their physical and mental wellbeing.
Article
This paper lays out a model of diminished citizenship as a tool for understanding the experiences of the large population of people who, at least in part by virtue of their relations with criminal justice apparatuses, do not benefit from the full complement of responsibilities and rights associated with citizenship in a modern democracy. The frame of diminished citizenship places mass incarceration within a larger historical and social context, moving ideas about “criminals” away from the individual focus of mainstream criminology and providing a useful framework for considering how a variety of marginalized groups navigate the American landscape. At the same time, the frame of mass incarceration offers insights into a crucial mechanism for constructing, diminishing and enforcing citizenship in the United States. Our argument draws on our decade-long ethnographic research with a cohort of women who had been released from prison in Massachusetts in 2007–2008.
Article
Full-text available
Incarceration of women in the United States is at a historic high, but understanding of women's experiences in prison, their responses to treatment, their lives after prison, and how changing prison regimes have affected these things remains limited. Individual attributes, preprison experiences, and prison conditions are associated with how women respond to incarceration, but assessments of their joint and conditional influences are lacking. Needs assessments abound, but systematic evaluations of interventions based on these assessments are rare, as are studies of the long-term consequences of imprisonment. Understanding of ways women negotiate power and construct their lives in prison is greater than in the past; new theoretical frameworks have provided important insights, but fundamental questions remain unanswered.
Article
Full-text available
This research explores the correlates of desistance and recidivism among a modern cohort of men released from prison. Using eight years of follow-up data, we estimate a series of multivariate models to differentiate offenders who recidivate in the short term from men who failed after an extended period or who do not return to criminal behavior at all. Consistent with research of this type, the odds of recidivism increased sharply after release and leveled off over time. In addition, younger men with more extensive criminal histories were the least likely to desist and failed early in the release period. The results also reveal heterogeneity in patterns of recidivism over the short and long term, and highlight the importance of post-release context in understanding prisoner reentry.
Article
Full-text available
This essay examines the major conceptual issues concerning medicalization and social control, emphasizing studies published on the topic since 1980. Several issues are considered: the emergence, definition, contexts, process, degree, range, consequences, critiques, and future of medicalization and demedicalization. Also discussed are the relation of medicalization and social control, the effect of changes in the medical profession and organization on medicalization, and dilemmas and lacunae in medicalization research.
Article
Full-text available
The study of desistance from crime is hampered by definitional, measurement, and theoretical incoherence. A unifying framework can distinguish termination of offending from the process of desistance. Termination is the point when criminal activity stops and desistance is the underlying causal process. A small number of factors are sturdy correlates of desistance (e.g., good marriages, stable work, transformation of identity, and aging). The processes of desistance from crime and other forms of problem behavior appear to be similar. Several theoretical frameworks can be employed to explain the process of desistance, including maturation and aging, developmental, life-course, rational choice, and social learning theories. A life-course perspective provides the most compelling framework, and it can be used to identify institutional sources of desistance and the dynamic social processes inherent in stopping crime. Sociology
Article
Full-text available
Research on homelessness among persons with severe mental illness tends to focus on aspects of demand, such as risk factors or structural and economic forces. The authors address the complementary role of supply factors, arguing that "solutions" to residential instability-typically, a series of institutional placements alternating with shelter stays-effectively perpetuate homelessness among some persons with severe mental illness. Thirty-six consecutive applicants for shelter in Westchester County, New York, in the first half of 1995 who were judged to be severely mentally ill by intake workers were interviewed using a modified life chart format. Detailed narrative histories were constructed and reviewed with the subjects. Twenty of the 36 subjects had spent a mean of 59 percent of the last five years in institutions and shelters. Analysis of the residential histories of the 36 subjects revealed that shelters functioned in four distinctive ways in their lives: as part of a more extended institutional circuit, as a temporary source of transitional housing, as a surrogate for exhausted support from kin, and as a haphazard resource in essentially nomadic lives. The first pattern dominated in this group. Shelters and other custodial institutions have acquired hybrid functions that effectively substitute for more stable and appropriate housing for some persons with severe mental illness.
Book
This is a book about people who make their living by engaging in street-based sex trading and criminal justice and social services efforts to curtail it through the work of police officers, public defenders, judges, probation officers, or court-mandated therapeutic treatment providers. Coauthored by an anthropologist and a legal scholar, the book explores these interactions and the cultural context in which they take place by drawing upon six years of ethnographic research with hundreds of women involved in street-based prostitution and illicit drug use, as well as dozens of the criminal justice and social services professionals who regularly interact with them. The book focuses on the criminal justice–social services alliance, which positions itself as a punitive-therapeutic partnership among law enforcement agencies and state, municipal, or independent nonprofit social services entities that police or otherwise regulate women involved in street-based prostitution and illicit drug use. Such policing and regulation rely on an interventionist discourse that positions the women’s decision making as the product of traumatic interpersonal encounters rather than of the exclusionary socioeconomic realities that frame their lives. The book’s balanced approach results from its unique methodology, with Dewey inhabiting a number of distinct roles as a participant observer on the streets, in services providers’ offices, and in correctional facilities, and as an alliance professional through her work as the admissions coordinator of one of the few transitional housing facilities for women leaving street-based sex trading.
Article
The article explores correlates of criminal recidivism in women. The relatively limited amount of female-specific recidivism research suggests the presence of gender-specific differences between men and women in variables related to the patterns of reoffense. The present study combines the relatively lean body of female-specific empirical findings with related theoretical and anecdotal information, and, using a sample of 60 imprisoned women, assesses the relationship of 26 variables to women's rates of recidivism. Analysis of the data determined that five of the variables (age, arrest(s) while under legal supervision, offense type, age of first imprisonment, and looking forward to release from prison) were significantly correlated with recidivism. A sixth variable, quality of healthcare in prison, approached statistical significance. Suggestions for improvements in present treatment and rehabilitation models are made.
Article
This article explores the notion of gender overdetermination in relation to a community of criminalised women in Massachusetts. Re-examining classic writings on overdetermination by Louis Althusser, Sigmund Freud, Frantz Fanon and Jean-Paul Sartre, we query the notion of gender overdetermination and posit it as an effective lens for thinking about the persistence of gender as a social construct. The combination of the structural processes of overdetermination with the discursive and ideological power of overdetermination complicates and reduces possibilities and effectiveness of sustained acts of resistance. The criminalised women of our study permanently inhabit a space in which aetiology, practice, discipline and interpretation are all hyper-gendered, meaning that acts of resistance are construed as more evidence of inescapable and essential gender identity.
Article
Drawing on 3 years of fieldwork with a community of criminalized women in eastern Massachusetts, this article explores their ambivalent, often negative, relationship with and feelings about Alcoholics Anonymous/Narcotics Anonymous (AA/NA). We suggest that coerced participation in AA/NA undermines any potential value that these programs may have for other types of participants and that the Twelve Step ideology of personal responsibility and turning oneself over to a Higher Power fails to resonate for women who are homeless, poor, incarcerated, abused, and have had their children taken from them.
Article
Age is one of the most robust correlates of criminal behavior. Yet, explanations for this relationship are varied and conflicting. Developmental theories point to a multitude of sociological, psychological, and biological changes that occur during adolescence and adulthood. One prominent criminological perspective outlined by Gottfredson and Hirschi claims that age has a direct effect on crime, inexplicable from sociological and psychological variables. Despite the attention this claim has received, few direct empirical tests of it have been conducted. We use data from Pathways to Desistance, a longitudinal study of over 1,300 serious youthful offenders (85.8 % male, 40.1 % African-American, 34.3 % Hispanic, 21.0 % White), to test this claim. On average, youths were 16.5 years old at the initial interview and were followed for 7 years. We use multilevel longitudinal models to assess the extent to which the direct effects of age are reduced to statistical and substantive non-significance when constructs from a wide range of developmental and criminological theories are controlled. Unlike previous studies, we are able to control for changes across numerous realms emphasized within differing theoretical perspectives including social control (e.g., employment and marriage), procedural justice (e.g., perceptions of the legitimacy and fairness of the legal system), learning (e.g., gang membership and exposure to antisocial peers), strain (e.g., victimization and relationship breakup), psychosocial maturity (e.g., impulse control, self-regulation and moral disengagement), and rational choice (e.g., costs and rewards of crime). Assessed separately, these perspectives explain anywhere from 3 % (procedural justice) to 49 % (social learning) of the age-crime relationship. Together, changes in these constructs explain 69 % of the drop in crime from ages 15 to 25. We conclude that the relationship between age and crime in adolescence and early adulthood is largely explainable, though not entirely, attributable to multiple co-occurring developmental changes.
Article
First an exposition is given of characteristics which mental hospitals share with other "total institutions" (e.g., jails, military camps, monasteries) and how their inmates adjust in similar ways to them. This process is then described as the "moral career of the mental patient," and the situation is further elaborated by a field study on "the underlife of a public institution: study of ways of making out in a mental hospital." Finally "some notes on the vicissitudes of the tinkering trades" are made in regard to "the medical model and mental hospitalization." (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Although the notion of taking gender into account in social analyses has been around for some time, for the large partit has not been taken seriously by criminologists. In this article, Laberge shows how the neglect of women's criminality has been to the detriment of criminological inquiry. Through an examination of the questions usually asked about women in contact with the penal system, the author takes us beyond an ‘additive’ approach to explaining crime. Reorganizing these questions, she outlines a number of analytical distinctions that will transform our understanding of criminalized women, specifically, and criminological inquiry, generally.
Article
The pursuit of health has become a highly valued activity in modern and contemporary life, commanding enormous resources and generating an expansive professionalization and commercialization along with attendant goods, services and knowledge. Health has also become a focal, signifying practice. As a 'key word', health is constructed in relation to social structures and experience and systematically articulated with other meanings and practices. Although the cogency of health as a practical concept is largely a product of the enormous influence of modern medicine, medical conceptions have never been able to contain the irrepressible proliferation of meanings associated with health. The meaningful - and ideological - practices of health can be illustrated by comparing three periods in American culture: (1) the late 19th and early 20th century; (2) the 1970s and 1980s; and (3) the first years of the 21st century.
Article
Prior studies indicate that incarcerated women are among the most economically disadvantaged populations in the U.S. An important difference between them and male offenders is that these women are usually custodial parents. Therefore, the consequences of incarceration for their well being are especially important because of its effect on children. In this paper we focus on the links between incarceration and use of the social welfare system. Is prison, for example associated with increased welfare dependency? To better understand this relationship, we examine the temporal pattern of social welfare receipt for 45,000 female offenders from Cook County, Illinois, the second most populated county in the United States. We find that this group does in fact have high rates of social welfare receipt, especially if they were incarcerated in state prison rather than in county jail. But incarceration is associated with modestly lower rates of social welfare receipt, especially for the less advantaged among the population of offenders. Further, bans on TANF receipt for drug felons enacted as part of welfare reform have not significantly affected this population’s attachment to the social welfare system.
Prison population trends 2017
  • N Cannata
  • G Papagiorgakis
Recidivism among female prisoners: Secondary analysis of the 1994 Bureau of Justice Statistics recidivism data set
  • E P Deschenes
  • B Owen
  • J Crow
  • EP Deschenes
Medical problems of prisoners. U.S. Department of Justice. Office of Justice Programs. NCJ 221740
  • L M Maruschak
Prisoners in state and federal institutions on
  • S Minor-Harper
Three year recidivism rates 2012 release cohort
  • G Papagiorgakis
Prison of poverty: Uncovering the pre-incarceration incomes of the imprisoned. Prison Policy Initiative
  • B Rabgy
  • D Kopf
Communities inmates released to in 2017
  • G Papagiorgakis
Doing gender as self-improvement
  • R Trammell
  • T Wulf-Ludden
  • N Pyfer
  • E Jakobitz
  • J Mullins-Orcutt
  • N Nowakowski