Prison Social Work
- Jason Matejkowski, Jason MatejkowskiSchool of Social Welfare, University of Kansas
- Toni JohnsonToni JohnsonSchool of Social Welfare, University of Kansas
- and Margaret E. SeversonMargaret E. SeversonSchool of Social Welfare, University of Kansas
This entry provides a description of prison social work and the array of responsibilities that social workers in prison settings have, including intake screening and assessment, supervision, crisis intervention, ongoing treatment, case management, and parole and release planning. The authors provide the legal context for providing social-work services to prisoners and delve into issues involving three specific populations of growing concern to corrections officials and to prison social work: women inmates, inmates who are parents, and inmates with mental illness. The tension between the goals of social work and corrections is explored and opportunities for social workers to apply their professional values within the prison setting are highlighted.
- Criminal Justice
- Social Work Practice Settings
- Social Justice and Human Rights
- Occupations, Professions, and Work
Historical Involvement of Social Work in Corrections
The relationship between the social-work profession in the United States and the dominant correctional approaches and institutions is best characterized as variable and ambivalent. Preprofessional social work was identified with correctional populations in the late 1800s through settlement workers’ efforts with juvenile offenders and, on an organizational level, in the early topics addressed by the National Conference of Charities and Corrections (Roberts & Brownell, 1999). However, formalization of the profession in 1904 and the adoption of core values that included the doctrine of self-determination led to an exclusion of corrections, with its authoritarian approach, from social work’s purview of concern by 1920 (Fox, 1983). Although social workers continued to work with delinquent children through the Depression Era and into the 1940s, it was not until Social Service Review published an influential debate centered on Kenneth Pray’s assertion that social workers should be involved with criminal justice professionals to assist adult offenders along their path to rehabilitation that prison social work began to regain a foothold in the profession (Brownell & Roberts, 2002). In 1959, the Council on Social Work Education formalized the discipline with its publication of an educational curriculum for teaching correctional social work (Brownell & Roberts). Since this time, training opportunities that prepare students to provide social-work services in correctional settings have increased substantially (Roberts & Brownell).
It is difficult to say just how many social workers are employed in the criminal justice system and in prisons specifically. A 2004 survey of a representative sample of 104,000 members of the National Association of Social Workers (NASW) suggests that approximately 2% of NASW members were involved in criminal justice practice at that time (for example, probation and parole, drug and truancy courts, public defender’s offices, jails, police departments, and victim assistance; Weismiller, Whitaker, & Smith, 2005). How many of those were actually working as social workers in prisons is unknown. Regardless, the dramatic rise in the imprisoned population coupled with the social and societal challenges that arise when so many community members are incarcerated has resulted in a desperate need for social-work services in all areas of criminal justice practice.
Inside the prison, social workers are responsible for a variety of tasks, including completing intake screenings and assessments and providing clinical supervision, crisis intervention, ongoing treatment, case management, and release-planning services (Gibelman, 1995). The paragraphs that follow contain a description of prison social work, including a review of the work required to complete these various tasks. The authors then delve into certain timely issues involving three specific populations of growing concern to corrections officials and to prison social work: women inmates, inmates who are parents, and inmates with mental illness. Given social workers’ involvement in addressing their associated challenges in the prison setting, it should be noted that there are many other subpopulations worthy of special attention here (for example, the growing numbers of aging or elderly inmates; inmates who identify or fear identifying as lesbian, gay, bisexual, and transgender; developmentally disabled inmates; and juveniles). However, space limitations do not allow for such an exhaustive review. Nevertheless, the social work with women inmates, inmates who are parents, and inmates with mental illness described within this entry comprises a good overview of the myriad activities involved with prison social work. The entry begins with a definition of prisons and a description of adult prison populations. When possible, international statistics and perspectives are provided.
The term prison is applied to correctional facilities that operate under local, state, and federal government authority. Indeed, in certain U.S. jurisdictions, local detention centers are formally called prisons (for example, Pennsylvania’s county prisons, the Parish prisons found in Louisiana) rather than jails. Traditionally, however, local prisons or jails house persons for shorter periods of time than do state or federal prisons, and their principal mandate is to ensure people detained for trial will appear in court to answer the criminal charges brought against them. By state statute and local ordinance, individuals may be sentenced to the local jail (or prison) when convicted of certain offenses (for example, misdemeanors). These sentences generally do not extend beyond one or two years.
The prisons that are the subject of this entry are postconviction, postsentencing facilities that operate under the authority of state and federal governments. In general, these prisons house individuals who have been convicted of felony criminal offenses and sentenced to lengthy periods of detention. Federal prisons house individuals who have been convicted of certain federal crimes (crimes defined by federal legislation that are often interstate in nature and that violate a specific federal statute). State prisons house individuals who have been convicted of breaching state-defined and state-prosecuted criminal laws. According to the most recent census of state and federal correctional facilities (Stephan, 2008), there were 1,190 state and 102 federal confinement facilities operating in the United States.
The Prison Population
The United States has the highest incarceration rate in the world. In 2011, state and federal prisons were home to just over 1.5 million prisoners. After rising precipitously over the past three decades and peaking in 2009, there is recent evidence that the American prison population is beginning to decline, with the 2011 population (1,598,780) nearing what it was in 2005 (Carson & Sabol, 2012). Still, the problem persists. According to data updated monthly by the International Centre for Prison Studies (ICPS) in London (2013), as of the end of January 2013 the rate of incarceration in the United States was 716 per 100,000 residents. Although prisons are the focus of these data, ICPS includes in their calculations those individuals who are also detained in jails (for example, pretrial detainees). The ICPS data are cited here and presented in Charts 1, 2, and 3 to provide an international context that is not available without including jail detainees. However, the U.S. Bureau of Justice Statistics identifies the 2011 rates of incarceration in American state prisons as 423 per 100,000 and 69 per 100,000 for federal prisons (Carson & Sabol). In contrast to American rates reported both by ICPS and by the U.S. Bureau of Justice Statistics, other western democracies detain between 70 and 150 persons per 100,000 of their population on any given day (see Chart 1). The demographic characteristics of prisoners influence the nature of both prison policy and social-work services in prisons.
Internationally as well as in the United States, prisoners are predominately male (see Chart 2). In 2011, 6.7% of the total state and federal prison population was female, an increase from 6.4% in 2000. Between 2000 and 2011, the average annual percentage change of the female prison population has been +1.4% (Carson & Sabol, 2012). The vast majority of prison inmates are adults age 18 years and older (see Chart 3; ICPS data). In the United States, the number of juveniles in state prisons under the age of 18 has decreased over time, from 5,400 in 1997 (Austin, Johnson, & Gregoriou, 2000) to 1,790 at the end of 2011 (Carson & Sabol). Although about 61% of the U.S. sentenced prison population in 2011 was under the age of 40, the aging population (those 65 or older) constitutes the fastest growing segment of the American prison population (Human Rights Watch, 2012).
Racial and ethnic minorities are imprisoned in numbers that are disproportionate to their representation in general society. In the United States, 63% of the general population is identified as White non-Hispanic, 13% as Black, and 17% as Latino or Hispanic in origin (U.S. Census Bureau, 2013). However, White, non-Hispanic/Latino males make up approximately 32% of sentenced male prisoners under state and federal jurisdiction, whereas Black, non-Hispanic/Latino males comprise 38% and Hispanics 23%. The racial and ethnic makeup of female prisoners is only slightly more proportionate to the general population; 49% of female prisoners are White, 25% are Black, and 18% are Hispanic/Latino (Carson & Sabol, 2012).
Prison inmates often present with myriad social, psychiatric, and general medical challenges. In general, prisoners are less educated (Harlow, 2003), have higher rates of learning disabilities (Fazel, Xenitidis, & Powell, 2008), are more loosely tethered to the labor force (Holzer, Raphael, & Stoll, 2003), and have higher rates of poverty (Petersilia, 2003), alcohol and drug addiction (Fazel, Bains, & Doll, 2006), other mental illness (Diamond, Wang, Holzer, Thomas, & Cruser, 2001; Ditton, 1999), and severe mental illness (Haney, 2006, p. 249; Jemelka, Rahman, & Trupin, 1993) than the general population. Prisoners are also frequently encumbered with multiple medical problems. In a 2004 national survey, 44% of state and 39% of federal inmates in the United States reported a current medical problem other than a cold or virus, most commonly arthritis and hypertension (Maruschak, 2008). Moreover, the rate of HIV/AIDS among prison inmates in the United States was 1.5% at yearend 2010 (Maruschak, 2012), a rate nearly four times that of the general population in the United States (McQuillan & Kruszon-Moran, 2008). In addition, in 1999, 55% of state prisoners and 63% of federal prisoners in the United States reported being a parent of a child under the age of 18. Of these parents, 46% reported living with their children prior to their imprisonment (Mumola, 2000). Similarly, in England and Wales, a 1991 national prison survey found 32% of male and 47% of female prisoners were living with their dependent children prior to their incarceration (Johnson & Waldfogel, 2004). The multiple and complex needs of prisoners incur an obligation upon the prison system to address these needs.
The Legal Context of Correctional Social Work
Although concerns about prisoners’ physical and mental-health conditions and care have been documented for centuries, it was only in the latter part of the 20th century that the U.S. Supreme Court took notice, situating attention on inmates’ health conditions as being a matter of constitutional rights and institutional responsibilities. Since the late 1960s, a long line of federal cases, many of which were filed under theories of deliberate indifference and deleterious conditions of confinement, have firmly established the legal context in which prisons must operate. Starting with the Supreme Court’s decision in Estelle v. Gamble (1976), the courts have repeatedly found prisoners to have a constitutional right to health and mental-health care and, further, have demanded humane conditions of confinement, reasonable responses to serious medical and psychiatric needs, and conduct that avoids exposing inmates to substantial “risk(s) of serious damage” (Helling v. McKinney, 1993, p. 2482) to their future health. For prison inmates, those rights are primarily couched within the Eighth Amendment’s prohibition against “cruel and unusual punishment.”
Over time, the Supreme Court has clarified its standards for determining whether prison officials, including health-care providers, acted with “deliberate indifference” to inmates’ “serious medical needs” (see Farmer v. Brennan, 1994), applying these standards equally to medical and mental-health conditions [see, for example, Newman v. Alabama (1974) and Bowring v. Godwin (1977)]. In one early and widely cited prison case, the Federal Court in Ruiz v. Estelle (1980) laid out six requirements for a minimally constitutionally adequate mental-health program in the Texas prison system. Still cited for these substantive ideas in the early 21st century, the requirements include providing initial intake screening and assessments, treatment programs, mental-health professionals in numbers and with the experience to provide necessary services, the maintenance of complete and accurate records, supervision over the administration of medication and ongoing evaluation of its allocation, and a program for identifying and interdicting in suicide crises. Collins (2007) has since distilled these mandates down to three maxims: (a) identify problems and, where needed, treat; (b) do so in a safe environment; and (c) do so with a trained contingent of staff. These maxims serve as a call to action for social-work services and interventions.
At the end of the 20th century, the courts were active in numerous California prison actions that involve the care of prisoners. Questions about the impact of isolation on prisoners in “super max” prisons were raised in Madrid v. Gomez (1995). In Madrid, special focus was placed on persons with mental illness whose symptoms were exacerbated by solitary confinement and also on persons held in solitary confinement who developed severe mental symptoms, likely as a result of this confinement. More recently, two important California cases highlight overcrowding as the catalyst behind serious constitutional violations involving prisoners with mental disorders (Coleman v. Brown, 1990) and prisoners with serious medical conditions (Plata v. Brown, 2001). In both cases, remedial orders and agreements to increase the size and capabilities of mental health and medical staff ensued, but after years of struggle to finance an enhanced health-care system that meets constitutional muster, the respective judges in Coleman and Plata separately asked for a three-judge court to review the cases and order the release of prisoners. In fact, the three-judge court, after reviewing considerable testimony and evidence, ordered a reduction of the prison population to 137.5% of the system’s capacity, finding the reduction in population was likely the only way the separate courts’ remedial orders for improving medical and mental-health care could be implemented. This decision was upheld in the U.S. Supreme Court in 2011 (see Brown v. Plata, 2011).
Why is knowledge of this legal context important for social workers? Unlike their work in public nonprofit and for-profit settings, social work in a prison (or a jail) occurs in the context of power and control, that is, the social worker’s power and control. In the prison environment, the very fact that the state has legal and physical custody of the prisoner marks the prisoners’ right to health and mental-health care. The prisoner is at the mercy of the state for his or her physical and mental well-being. She cannot seek services in the open marketplace, nor, in her quest to improve her lot, can she simply remove herself from the environment that has deleterious effects.
Although a prisoner has an established right to some modicum of health and mental-health care so as not to be left worse off than when he or she arrived at the prison gate, the average person in the community has no such constitutional right to free health and mental-health services. Unlike a prisoner, the “free” person can shop the marketplace for a mental-health professional, can be expected to pay for services, and can (theoretically, at least) alter his or her environment to better his or her condition. This free person may have statutory rights to access certain kinds of health care, for example, those rights granted under the federal Emergency Medical Treatment and Labor Act (EMTALA), 42 USC 1395dd (1986). The EMTALA mandates that persons be assessed and, if needed, treated for emergencies in hospital emergency rooms, but there, the patient is free to leave without accepting any or all of the care recommended, the hospital is free to charge the patient its going rates for the care it provides, and all providers are free to pursue payment for services rendered. By contrast, prisoners are not free to seek treatment elsewhere and must rely on the prison staff, including social workers, to provide a constitutionally adequate level of intervention. In the end, custody of the prisoner and the control over his or her access to care translates into a need for competent, diligent, and compassionate responses of the social worker and every other health or mental health-care provider.
Social Work in Prison
Social-work services have been offered in prisons for nearly a century and were advanced by the advocacy efforts of Kenneth Pray, the former dean of the University of Pennsylvania School of Social Work (now the School of Social Policy and Practice). Pray’s impassioned pleas for social-work involvement with prisoners is a must read for every social worker who wonders why our involvement is necessary and what we would do while there (Pray, 1943; Pray & Towle, 1945). Unfortunately, despite Pray’s efforts, social work has assumed an ambivalent stance toward its work in prisons, perhaps because of the conflicting values of the profession and the institution. However, the explosion in the prison population experienced since the 1980s, along with the federal court actions described above, has created an ever-expanding need for the unique set of professional skills that social workers bring to correctional institutions.
The NASW’s Social Work Speaks (2012) recognizes the importance of providing quality services to the incarcerated population in its policy statement related to social work in the criminal justice system. Social Work Speaks is a comprehensive collection of policies adopted and revised by the NASW’s key policy-making body, the Delegate Assembly, and, in relevant part, the policy recommendations vis-à-vis the incarcerated population challenge social workers to do the following:
Provide ongoing advocacy to address the disproportionate rate of incarceration of racial or ethnic minorities, juveniles, women, and undocumented individuals;
Provide culturally competent treatment to and intervention for the growing populations of inmates with mental illness, substance issues, or co-occurring disorders;
Seek access to quality health care, medications, nutrition, treatment, and rehabilitation programs for inmates;
Identify appropriate educational and vocational opportunities to assist incarcerated individuals with transitioning back into their communities; and
Provide advocacy and social-work leadership to establish national policy on criminal justice issues.
What Prison Social Workers Do
Social workers in criminal justice settings often assess new arrivals to the prison, develop treatment and support plans for inmates, provide individual therapy and psychosocial educational support groups, provide referrals to medical or mental-health services, and monitor the progress and compliance of inmates in treatment. As in most settings, social workers in criminal justice facilities document inmates’ progress in their health records, write progress reports, and, in some institutions, present their cases at “grand rounds” or in other institutional forums.
In many prison systems, the initial assessment of the inmate involves a battery of psychological tests and interviews with social workers and other treatment professionals to determine the presence of acute (psychosis, anxiety, depression, suicide ideation) and chronic conditions (severe and persistent mental illness, history and current manifestations of trauma and substance abuse). During the assessment phase the social worker determines the inmate’s eligibility for services and treatment and, in theory if not in reality, begins to plan for the inmate’s discharge. The latter is no small task: in the United States the vast majority of prisoners return to the community; about 1,600 prisoners a day are released from state and federal prisons (Travis, Solomon, & Waul, 2001).
Based on the assessment data, intervention and treatment plans are developed, taking into consideration the unique needs of the inmate; these may include a combination of individual counseling, involvement in a specialized treatment group, and case management services. A growing body of research indicates that strengths-based case management is an effective response to inmates in need of skills in daily living or those who struggle with alcohol and drug addiction or with serious physical or mental-health issues (Bauserman et al., 2003). Hess, Vanderplasschen, Rapp, Broekaert, and Fridell (2007) looked at the relevant body of research from 15 randomized studies of case management for persons with substance-abuse disorders and found a moderate effect size in the effectiveness of case management in linking clients with treatment and other services. Although a smaller effect was detected, Hess and colleagues also found that case management services had a positive impact on long-term drug use and may have contributed to a reduction in criminal behavior.
Social workers in prison frequently face uncommon ethical challenges and value dilemmas. Prisons are no longer associated with rehabilitation but instead focus on punishment and control (Gibelman, 1995). Such an environment makes it difficult to protect confidentiality or promote individuals’ rights. Competent performance of the social-work activities enumerated above is complicated by the growing number of inmates who present with special needs. In an industry often defined by crises, there are certain clear, demanding, and unique challenges in the prison environment that would benefit from social-work expertise. In this section, a few of those problems are highlighted, chosen because of their significant systems impact and the enormous implications they have for the health of future generations.
The United States is the world leader in per-capita rate of incarceration (Walmsley, 2009), but it remains a fact in obscurity that the United States also leads the world in the per-capita number of women incarcerated. In 2008, of the nearly 200,000 women locked up in jails and prisons in the United States, 105,000 were serving prison sentences of one or more years (Sabol, West, & Cooper, 2009). In general, these incarcerated women hold high school diplomas, but are largely young, poor, and unmarried parents to children under the age of 18 (Greenfeld & Snell, 1999).
Common to incarcerated women are their histories of child and adulthood emotional, physical, and sexual abuse, a phenomenon reported by many researchers over the past 10–20 years. These women are more than three times as likely as incarcerated males to report having been abused as children and adults prior to their incarcerations (Greenfeld & Snell, 1999; Veysey, 1998). Many of these women, approximately two thirds of those in prison, were sentenced for drug or property crimes and some experts suggest that these crimes are economic crimes—committed in the effort to support families or, unfortunately, to support drug addictions. Slightly more than one third of women in 2007 were incarcerated for violent crimes (West & Sabol, 2008).
Considerable focus has been placed on women’s histories of violence and trauma and the consequences of those experiences. The danger, of course, is in the social worker becoming caught up in the pathologized portraits of these women. Although interventions focused on resolving the consequences of exposure to traumatic events are important for prison-based social work, an understanding of the system forces that place a woman at higher risk for traumatic injuries through the experiences of intimate partner violence, poverty, and drug possession and use is also essential. Treatment, therefore, must also take into account the systemic change that must occur to reduce the risk of traumatic injury. In prison this might include advocating for women to have access to evidence-based employment and educational opportunities, opportunities that are often afforded male prisoners but, because female inmates only comprise about 7% of the total prisoner population, are not offered to women in the same substantive ways (Morash, Bynum, & Koons, 1998).
There is considerable research evidence that points to women prisoners’ improved health and mental-health statuses while incarcerated (Postmus & Severson, 2006). Thought to be related, in part, to being removed from the stressors of partners and children and in part to having access to health and mental-health services, social workers must also be willing to help women anticipate and identify what will help them succeed upon release and be willing to accept what these women tell them. At least one study indicates that women identify tangible assistance as the most helpful. What is tangible? Among other things, Severson, Postmus, and Berry (2005) indicate child care, job training, and education.
There is much more to be said about women in prison, about their needs and corresponding system responses or lack thereof. Whether answering these needs with gender-responsive intervention strategies, that is, taking into account the knowledge that women’s specific issues and needs are different than men’s and that treatment must account for these differences (Covington & Bloom, 2006), or making the nature and numbers of confined women more visible to the larger society, prison social workers must serve as key informants, investigators, and advocates.
Children of Incarcerated Parents
Estimates suggest that approximately 75% of women and 65% of men who are U.S. prison inmates are also parents (Glaze & Maruschak, 2010; Mauer, Nellis, & Schirmir, 2009). In 2007, more than 1.7 million American children had a parent in prison or jail and nearly 10 million had a parent who is or has been under some form of criminal justice supervision, including parole and probation (Hairston, 2007; Mauer et al.). Research indicates that children of color are disproportionately affected by parental crime, arrest, and incarceration. Whereas 1 in 111 White children may experience parental incarceration, a much different impact is imagined when viewing the data related to families of color, where 1 in 42 Latino children and 1 in 15 Black children are affected by parental incarceration (Glaze & Maruschak; Mauer et al.).
Although children of incarcerated parents have only recently come into the national spotlight, anecdotal information and existing evidence suggest that parental incarceration can have significant consequences on children, including clinically significant internalizing problems (for example, depression, anxiety), clinically significant externalizing problems (for example, attention problems, disruptive behaviors), social stigma, poor school performance, economic losses, disruptions in home care arrangements, and impaired ability to cope with future stress and trauma (La Vigne, Davies, & Brazzell, 2008). When fathers go to prison, approximately 90% of their child(ren) remain with their mothers. In contrast, children of imprisoned mothers are more likely to live with a grandparent or another family member other than the father or be placed in the child welfare system (La Vigne et al.). Incarcerated parents, especially incarcerated mothers, lose their children to the child welfare system at a disproportionate rate largely because of the Adoption and Safe Families Act, which sets strict timelines for initiating termination of parental rights (Eddy & Reid, 2003; Johnston, 1995). The Adoption and Safe Families Act was intended to prevent youth from languishing in foster care and to provide permanent homes to those who needed them; however, for incarcerated parents or parents in long-term substance abuse treatment the act has had unintended negative consequences.
Most of what we know about children of incarcerated parents is primarily based on the 10–12% of children of prisoners involved in the child welfare system, which constitutes only a fraction of all children of prisoners (La Vigne et al., 2008). A consistent finding from the research on children whose parents are involved in the criminal justice system is that, on average, this population experiences a greater total accumulation of risk factors than comparable children in the general population (Dallaire, 2007; Johnston, 1995). Risk factors identified in the literature include sociodemographic and contextual risk factors such as parental substance abuse, single parenthood, and household poverty (Dallaire; Keller, Catalono, Haggerty, & Fleming, 2002) and community risk factors such as community violence and delinquent peers (Dallaire; Leventhal & Brooks-Gunn, 2000).
What Can Social Workers Do?
Of equal or greater importance than focusing on risk factors is the identification of programs and services that support protective factors to enhance the growth and development of youth affected by parental incarceration. Protective factors identified in the literature include, when appropriate, supporting the child’s relationship with the incarcerated parent, strengthening relationships between the incarcerated parent and the child’s primary caregivers, and encouraging social support from the family and community (Eddy & Reid, 2003; Johnson, 2012; La Vigne et al., 2008). Children with parents in prison need support and services, yet few programs exist that are specifically designed to meet their needs (La Vigne et al.). The available literature that examines existing interventions for children of incarcerated parents indicates that social workers are primarily involved in three types of services or programs: programs that provide mentors for youth, those that conduct support groups, and prison-based parent education programs. Those that conduct support groups may also assist with the child’s visits to the incarcerated parent. The incarcerated parent may be in a prison located hundreds of miles away from the family and inaccessible by any form of public transportation, placing severe and costly restrictions on child–parent visits. In some cases, children never get to visit their parent (Johnson; Margolies & Kraft-Stolar, 2006).
In 2003, the U.S. Congress established the Mentoring Children of Prisoners Program through the Promoting Safe and Stable Families Amendments (Pub. L. No. 107–133). The intention of the program is not to replace a parent but to provide a healthy adult role model for the child, someone the child can talk to and who can provide the child with new and growth-producing experiences. Funds for these programs have generally gone to Big Brother, Big Sister programs around the country (Davies, Brazzell, La Vigne, & Shollenberger, 2008).
Social workers conducting support groups consider this intervention a way to provide social support, guide group members in positive decision making, and provide an encouraging, stigma-free environment in which young people can express their opinions (Johnston, 1995; Springer, Lynch, & Rubin, 2000). Support groups discussed in the literature have been conducted by school-based social workers and social workers in community-based programs. The Girl Scouts beyond Bars program is an example of a community-based program that strives to reduce the stress of separation by supporting a healthy relationship between incarcerated mothers and their daughters. The program facilitates support group meetings with the girls, transports the girls to the prison to visit their mothers, and provides activities for the mothers and daughters to engage in (Soltes, 2012). The Living Interactive Family Education program is another example of an enhanced visitation program focused on developing stronger relationships between an incarcerated parent and his or her child (Dunn & Arbuckle, 2002). Along with monthly parenting classes, the LIFE program provides a child-friendly environment where parent and child can work together on 4-H activities (Dunn & Arbuckle).
An example of innovative programming that goes beyond bridging the parent–child relationship by enhancing the incarcerated parent’s self-esteem and literacy skills and bringing a measure of comfort to a child left behind is the prison reading programs that are being established in prisons across the country. The Father2Child Literacy Project, operating in several California prisons and modeled after the Hope House reading project in Washington, DC, seeks to promote literacy in both father and child and provides a meaningful way for parent and child to connect when frequent visits are often impossible (Castro, 2013). The project provides children’s books to the prison and volunteers work with the incarcerated parent on making an audio- or videotaped recording of the book. This particular project is supported by Grace Community Church in Calipatria, California, whereas others have been started by community-based organizations or local businesses or initiated by prison staff. In Colorado, a male or female inmate who wants to participate in the Read to the Children prison reading program sends a request to the library that is evaluated by a case manager. The case manager confirms that the inmate can have contact with the child and has not lost privileges because of behavioral problems. Once approved, the inmate is coached by a member of the library staff or a trained peer volunteer on selecting an age-appropriate book and taught the importance of reading for emphasis and using different voices for characters. Both the book and the tape are packaged and sent to the child at no cost to the inmate or the family (Walden, 2004).
Most prison reading programs are prepared to work with inmates who are less than confident readers. The 2003 National Assessment of Adult Literacy estimates that 70% of inmates in the United States are functionally illiterate, meaning the ability to read and write is inadequate to complete daily living and employment tasks beyond a basic skill level (National Center for Educational Statistics, 2004). Approximately 40% of inmates who are parents enter prison with less than a 12th-grade education (Glaze & Maruschak, 2010) and struggle with literacy skills, placing their children at risk of becoming less than proficient readers. Reading to a child is a frequent activity and a natural part of parenting for many parents; however, for many incarcerated parents participating in prison reading programs, this is the first time that the parent has ever read to his or her child (Castro, 2013; Walden, 2004).
Studies suggest that parenting behavior may be an important variable to consider when evaluating the effects of parental incarceration on children (Murray & Farrington, 2008) and parenting courses are increasingly integrated into correctional programming in the United States and facilitated by social-work professionals (Robbers, 2005). Parenting curricula such as Love and Logic and InsideOut Dad were developed specifically for incarcerated parents and cover such topics as the importance of parent involvement, communication with the child and the child’s caregiver, child development, discipline techniques, and anger management (McKay et al., 2010).
As with the incarcerated parent, the need for strengths-based case management services is pressing for these children and their caregivers. Several community-based studies suggest that a single-service focus such as mentoring may fail to meet the multiple and varied needs of children and families of offenders (Johnson, 2012; Phillips & O’Brien, 2012).
In summary, the information provided here can serve as a guide for social workers who may come in contact with children of prisoners through the incarcerated parent, the school system, community-based organizations, or church programs.
Inmates With Mental-Health Problems
For many complex and not fully understood reasons, individuals with mental-health problems are overrepresented in America’s prisons. Estimates vary from study to study, but in general, “somewhere between 10% and 25% of prisoners have some form of serious mental illness” (Haney, 2006, p. 249). In an international review, Fazel and Danesh (2002) reported a prevalence rate of 3.7% for psychotic disorders among males and 10% for major depression. Among female prisoners, these rates increased to 4% and 12%, respectively. Compared with the general American population of similar age (Kessler et al., 2003; 2005), rates of psychotic illnesses and major depression are about two to four times higher among prisoners.
As noted earlier, social workers in corrections play an important role in identifying the presence of mental-health treatment needs among inmates. Assessments, conducted at the intake or orientation to incarceration, are used to identify inmates who have mental illnesses that might contribute to adjustment and behavior problems and require treatment (Morgan, 2003). As such, social workers may administer a range of assessment tools that aid in the identification of psychiatric and substance-use disorders, risk for suicide, and educational and vocational needs among inmates.
Challenges to conducting these assessments among the prison population include reluctance by some prisoners to reveal the psychiatric symptoms they are experiencing, often because of concerns of being perceived as weak and associated fears of being victimized by predatory inmates (Hills, Siegfried, & Ickowitz, 2004). On the other hand, feigning illness (that is, malingering) may be used by inmates to be admitted to therapeutic units within the prison that are perceived as more comfortable than general population areas (Hills et al.). In addition, inmates with mental-health problems may lack the verbal skills to respond to assessment questions or to convey to the interviewer their experiences or psychiatric symptoms (Hills et al.). Therefore, when conducting assessments it is important to not only consider the inmate’s responses to questions but also evaluate his or her appearance and behavioral indications that a mental illness may be present, as well as to seek collateral sources of information that can be brought to bear on assessment.
Inmates with mental illnesses report more complex histories than do inmates without mental illness. For example, using a definition of mental illness based on a self-reported “mental or emotional condition” or an overnight stay in a mental hospital, unit, or treatment program, Ditton (1999) reported that state prison inmates with a mental condition were twice as likely as other inmates to have been homeless in the 12 months prior to their arrest (20% compared with 9%), and males with a mental condition were more than twice as likely as other males to report sexual or physical abuse histories (33% and 13% among males and 78% and 51% among females, respectively). In addition, Ditton found that a higher percentage of state prison inmates with mental illness when compared with other inmates were more likely to have been unemployed prior to their offense (39% and 30%, respectively), to have had a family member who has ever been incarcerated (55% and 47%, respectively), to have had a parent who abused alcohol or drugs (44% and 30%, respectively), and to have a history of alcohol dependence (34% and 22%, respectively).
Prisons are not well equipped to respond to the myriad needs of persons with mental-health problems. Mental-health training for correctional officers is minimal (National Institute of Corrections, 2001) and may contribute to the higher rates of disciplinary infractions reported among inmates with mental illness (Adams, 1986; Ditton, 1999; Jemelka, Lovell, & Wilson, 1996; Matejkowski, Caplan, & Cullen, 2010; Matejkowski, Draine, Solomon, & Salzer, 2011; Morgan, Edwards, & Faulkner, 1993; Toch & Adams, 1986). For example, suicide is the second leading cause of death in prisons (Morgan, 2003) and, not surprisingly, a history of mental illness is a significant predictor of prison suicide (Felthous, 2011; Fruehwald, Matschnig, Koenig, Bauer, & Frottier, 2004; Tripodi & Bender, 2008; Way, Miraglia, Sawyer, Beer, & Eddy, 2005; White, Schimmel, & Frickey, 2002) as well as sexual assault (for example, Austin, Fabelo, Gunter, & McGinnis, 2006) and which may lead to self-harming behaviors. Although self-harm attempts by inmates may indicate a psychiatric crisis, they tend to be interpreted as behavioral problems and treated as institutional infractions (Human Rights Watch, 2003). The interdisciplinary nature of social work and its value of advocacy can benefit inmates in this and like situations (Severson, 1994). Prison social workers must understand that they are part of a team of professionals that includes correctional officers and wardens, all of whom value the safety of the inmates, the institution, and its staff. Understanding how to communicate within this team, while at the same time understanding potentially opposing perspectives, will improve the social worker’s ability to advocate for appropriate and therapeutic responses to inmates in psychiatric crises. These responses can include recommendations for placement of the inmate in a crisis stabilization unit or for the employment of a regimen of psychotropic medications or other treatment or programming.
In-Prison Programs and Treatment
Basic therapeutic services for inmates with mental illness focus on the stabilization of offenders so that they can function safely within the prison (Morgan, 2003). In this endeavor, prison social workers may be called upon to provide individual and group psychotherapy services to inmates with mental-health problems. According to Morgan, individual psychotherapy is less common than group therapy, tends to be employed with more psychiatrically disturbed inmates, and focuses on symptom reduction and adaptation to the prison environment. Group psychotherapy services are more problem focused and can include topics on anger and stress management and problem solving (Morgan, p. 64). Social workers are trained in various techniques that have been shown to be effective with mentally ill offenders in these contexts, including empathic listening, nonconfrontational communication, and the modeling of prosocial behaviors (Hills et al., 2004).
Prisons offer varying amounts of treatment-oriented services like life skills training, vocational rehabilitation, and educational programming; however, prison programming is often not provided in a way that is responsive to the unique needs of mentally ill offenders. The presence of a mental illness is a characteristic of program participants that must be addressed if the programming is to be effective (Andrews & Bonta, 2006). Inmates with mental illnesses may have difficulty paying attention to or concentrating on particular tasks, remembering and recalling information, or relating and communicating to other people. Although taking into consideration these special needs may improve program outcomes, responsivity to the special needs of mentally ill inmates is rarely taken into account in correctional programming (Van Voorhis, 1997). As a result, these institutional programs have low rates of initiation and retention of inmates and are not highly effective at providing inmates with the skills and tools necessary to improve their adjustment to prison or their chances of successful community reintegration.
Prison social workers possess a unique set of skills that can be used to increase the ability of prisons to enroll and retain inmates in effective institutional programs (for example, motivational interviewing and the stages-of-change model). Trained in evidence-based practices, social workers should be involved in identifying programming that has rigorous empirical support for alleviating a specific type of problem common in the inmate population. Once identified, the social worker can advocate for the implementation of these programs. Subsequent to their implementation, social workers can advocate for institutional procedures that will facilitate access to programming among those with psychiatric disorders. This may mean helping prison staff rethink classification and program entry criteria or modifying the criteria to make room for persons with mental illnesses. Such efforts may smooth the way of recovery and educational attainment conducive to the successful community reentry of inmates with mental illness. Parole services can also assist in this transitioning process.
The Postprison Experience
In 2011, over 850,000 offenders served portions of their prison sentences under the supervision of parole boards (Maruschak & Parks, 2012). Parole can function to support offenders in their transition and extend community tenure by providing linkages to appropriate services, evaluating adherence and responsivity to treatment, supporting movement toward treatment objectives, and reassessing offenders’ treatment needs (Bogue, Nandi, & Jongsma, 2003; Campbell, 2008), as well as by deterring criminal behavior through increased certainty of sanction that results from enhanced monitoring (Durlauf & Nagin, 2011). However, parole agencies are often ill prepared to address the treatment and support needs of their service populations. These needs are often considerable given the high rates of mental illness (Skeem & Louden, 2006) and severe mental illness (Lurigio, 2001) among those under community supervision.
Parole supervision can decrease recidivism among inmates with mental-health problems (Ostermann & Matejkowski, 2012). However, people with mental illness who are under parole supervision tend to experience both criminal and noncriminal (that is, technical violations of the conditions of their parole) recidivism at higher rates than parolees without mental-health problems (Baillargeon et al., 2009; Porporino & Motiuk, 1995). Together these findings indicate that, for those offenders with mental-health problems, parole supervision can aid in their community adjustment, but to do so, parole officials must know and use effective methods to respond to the needs of those under their supervision.
A first step in this process is providing parole boards with information about inmates’ risks and needs for release decisions and supervision plans to take these factors into account. Social workers use evidence-based assessment tools to assess inmates’ level of risk for criminal behavior following release (for example, the Level of Service Inventory–Revised) as well as tools to assess needs for health, mental-health, and addictions care and for housing, vocational, and employment assistance. Social workers summarize the information gleaned from these instruments and offer recommendations for release and case planning to the parole board.
Incorporating social-work approaches into parole supervision can improve responses to problematic behaviors of parolees with mental illness. Simply increasing supervision along with rigid adherence to sanctions for violating parole requirements tends to result in increased incarcerations (Solomon, Draine, & Marcus, 2002; Veysey, 1996). Specialized mental-health caseloads that involve parole officers trained in a therapeutic philosophy and intermediate sanctions and who work with treatment providers may reduce short-term recidivism (Skeem & Louden, 2006). When parole violations are a function of mental illness, social workers can advocate for services rather than sanctions and encourage parole officers to view violations by parolees as “opportunities to build closer alliances with parolees” and to assist them in “avoiding future, and more serious, problems” (Lurigio, 2001, p. 457). Therapeutic responses built on a strong working alliance and positive regard, rather than strategies aimed at control and deterrence, are associated with greater participation in treatment and rehabilitation programs and improved client outcomes (Norcross, 2011; Rogers, 1951). Extending these social-work values to the parole setting may reduce risks for reincarceration and increase treatment access and adherence for individuals with psychiatric disorders and ultimately improve both public health and safety.
Any discussion of prison social work would be incomplete without some reference to the rehabilitation efforts made by connecting the services delivered inside the prison to services made available to the offender in the community at the time of release. Indeed, the reintegration process must start the moment the offender enters the prison. From the point of assessment onward, when risks for criminal behavior and needs for specific and tailored interventions are identified, the prison social worker must think about what will be needed on the other end of the sentence, at that critical point when it is literally show time for the offender. Have the services offered in prison benefited the offender in such a way as to ease his or her reentry into the community? Have they empowered the offender to recognize his or her choices and make healthy decisions? Have they provided the community with an awareness of offenders’ needs and with the reminder of the community’s concomitant responsibility to receive the offender with the knowledge that he or she has served his or her punishment and has the skills and potential to contribute to the health of the community? When Gresham Sykes (1958) penned his famous book The Society of Captives, he described a world—a society—quite separate in organization and rule from the reality in which most lived. In the 21st century, although it can be argued that an imprisoned life is still significantly different from a free life, the importance of having collaborative, working relationships with service providers, employers, landlords, and educators in the community to which the offender will return cannot be underestimated in the rehabilitation process. Much remains to be shown effective in reentry designs and efforts, and work continues to find the right mix of human and programmatic responses that will yield fewer returns to prison for any reason.
Despite a history of ambivalence toward corrections, social workers are now firmly entrenched in prisons. Although the profession’s values may have taken a secondary role to corrections’ focus on public safety in this setting (Reamer, 2004), judicial enforcement of constitutionally adequate levels of care along with a ballooning prison population with complex treatment and support needs has created an immense need for the unique set of professional skills that social workers can bring to correctional institutions. The social-work profession has answered this call through its involvement in inmate care from the moment the individual arrives at the correctional institution until he or she is released and oftentimes beyond the prison walls into community supervision settings.
In summary, social work in prisons must increasingly accommodate the growing numbers of women in prisons, the high proportions of inmates with mental-health problems, and the children of prisoners on whom the impact of incarceration weighs for decades.
Social-work interventions assist with resolving the consequences of exposure to traumatic events that is all too common among female inmates. As with male inmates, social workers help women anticipate and identify what will help them succeed at release and then assist in putting necessary supports into place.
In their daily activities, prison social workers encounter the effects of the dynamic relationship between mental illness and incarceration. With an awareness of how a history of mental-health problems can lead to incarceration and how incarceration itself can exacerbate the symptoms and course of mental illness, social workers develop appropriate treatment and support plans for the length of the incarceration and again for the postrelease period when these former prisoners reenter the community.
Finally, to reduce the collateral consequences of incarceration, social workers are increasingly called upon to conduct prison-based parent support groups, education programs, and programs designed to facilitate a child’s visits to the prison. All of these efforts are made to support and nurture the relationships children have, need, and often long for with their incarcerated parent(s).
There are clear, demanding, and unique challenges in the prison environment that benefit from social-work expertise. Inmates and society can benefit from social workers who advocate for and provide culturally competent and gender-relevant treatment, interventions, and programming opportunities to assist incarcerated individuals in their transitions back to the community (NASW, 2012). Through competent and compassionate advocacy and intervention efforts that are based firmly upon social-work values, “the social worker can make his own contribution to the achievement of the prison’s purpose, which is dedicated alike to the welfare of the prisoner and the protection of the community” (Pray, 1943, p. 7).
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