Nurse-Led Trauma-Informed Correctional Care for Women

PURPOSE: Incarcerated women are a vulnerable and unique population of special concern to nurses as they have high rates of mental illness. In this article, the authors discuss how trauma exposure contributes to mental illness in incarcerated women through abuse, socioeconomic factors, and the prison environment, how this trauma exposure manifests in the inmate survivor, and the related implications for practice. CONCLUSIONS: A history of trauma and victimization is related to complex mental health issues which affect the majority of justice-involved women. The correctional environment can exacerbate these issues. PRACTICE IMPLICATIONS: Nursing implications include discussion of the trauma-informed care model. The authors recommend a model of traumainformed care named “the 4 Es” that can guide nurses in preparing a traumainformed correctional environment and discuss the importance of nurse-led policy change in finding alternatives to incarceration for women with mental illness. Incarceration rates for women have risen dramatically in the past several decades. In 6 years’ time, incarceration rates for women increased by 16% internationally and by 23% in the United States (Walmsley, 2012). Although females constitute the minority of incarcerated persons, they are of unique concern to nurses because they carry a higher incidence of mental illness than male prisoners (James & Glaze, 2006). The majority of female offenders have a history of trauma exposure, such as physical or sexual violence, often from an early age (James & Glaze, 2006; Van den Bergh, Gatherer, Fraser, & Moller, 2011). In this article, we elucidate how a history of trauma contributes to mental illness in incarcerated women, discuss how this trauma exposure manifests in the inmate survivor, and offer recommendations for nurse-led trauma-informed care in the correctional environment. More specifically, we have developed a nurse-led model of trauma-informed correctional care named the 4E s and discuss the importance of nurse-led policy change in finding alternatives to incarceration for women with mental illness.