Assessing incarcerated women\u2019s physical and mental health status and needs in a Swiss prison: a cross-sectional study

Aurélie Augsburger,Véronique Jaquier,Patrick Bodenmann,Carole Clair,Bruno Gravier,Céline Neri

doi:10.1186/s40352-022-00171-z

Abstract

BackgroundWomen make up 5% of the European prison population on average. Almost invisible in prison and health research, and suffering the stigma associated with female offending, incarcerated women are often forgotten, and their specific healthcare needs remain much ignored. Combining face-to-face survey interviews and medical chart data, we aim to assess the health status, healthcare needs, and access to preventive medicine of women incarcerated in Switzerland.ResultsSixty incarcerated adult women participated in a cross-sectional study to assess their life and incarceration histories, physical and mental health problems, medication, and use of medical services. Eligibility criteria were (a) an incarceration of at least four weeks and (b) the ability to provide written informed consent. Exclusion criteria were psychiatric instability and insufficient language competence.Women’s average age was 34.3 years old (SD = 9.8); 45.0% of them were born in Switzerland, 33.3% in Europe and 15.0% on the African continent. Overall, 61.7% of women self-reported physical or mental health problems and 13.3% indicated they were once diagnosed with a sexually transmitted infection. Further, 78.3% of women were active cigarette smokers; more than one in three women reported alcohol use problems and almost one in two women had used at least one illicit drug in the year before incarceration. Depression and perceived stress scores were above clinical cut-off points for more than half of interviewed women. When asked how they rated their health, 68.3% of women felt it had worsened since incarceration. All but four women had accessed prison medical services; however, our study does not indicate whether women’s use of healthcare was indeed adequate to their needs.ConclusionsThis study demonstrated incarcerated women’s poor health and health-risk behaviours. Structural changes and gender-responsive health promotion interventions have the potential to improve the health of incarcerated women and help them return to the community in better health.

Highlights

Women make up 5% of the European prison population on average
We found a selection bias in our sample with significant differences in terms of age and in terms of nationality, the latter likely being the result of the lack of interpreters
Incarceration could represent an opportunity for women to have access to healthcare for their pre-existing medical conditions and to benefit from adequate medical and psychosocial care to prevent further health decline

Summary

Introduction

Almost invisible in prison and health research, and suffering the stigma associated with female offending, incarcerated women are often forgotten, and their specific healthcare needs remain much ignored. With the social disadvantage and serious health problems of the prison population, access to quality health services in prison is of vital importance (Ismail, Lazaris, O’Moore, Plugge, & Stürup-Toft, [29]). Incarcerated women have more, and more specific health problems than men, which places additional constraints on prison health services (van den Bergh, Gatherer, Fraser, & Moller, [61]). Outnumbered by men in criminal justice and correctional populations, the specificities of women’s trajectories are often ignored (Jaquier & Vuille, [31]), and their specific health and social needs remain much neglected (Braithwaite, Treadwell, & Arriola, [7]; Swavola, Riley, & Subramanian, [59])

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