Corrections_Today_May_June_2020_Vol.82_No.3

n Correctional Health

the males and may form surrogate families while incar- cerated. They often have intense emotional experiences they need to talk about and may want to seek help so they can be around their children. They seem to “act in” as opposed to the males who have been physically and/or sexually abused, who tend to “act out.” The women see their children as a big motivator to improve their mental health and work on their issues. Men, however, seem to externalize their stress through physical aggression and combative behavior. Male in- mates bond as “associates in teams,” which can lead to formal or informal gang activities. Men have a tendency to “act out” and be hostile and aggressive and have a need to prove themselves. They are less likely to process their feelings and/or seek help; they wear psychological masks and try and hide past wounds. For men with justice involvement, rates of physical, sexual, and emotional trauma seem to be higher in child- hood than in adulthood and can range from 45% physical trauma in childhood to 5% sexual trauma in adulthood. 8 Trauma exposure was found with men to be strongly associated with wide ranges of behavioral problems and clinical symptoms. In this current study, over half of male inmates reported experiencing childhood physical trauma, while reports of sexual trauma were much less — at about 10%. Accumulated experiences and witnessing trauma often continues into adulthood and elevates the risk of lifetime re-victimization. Repeated trauma over a life

cycle has been found among incarcerated men. 9 Experi- ences for some incarcerated men continue inside prison. The rate of prevalence for inmate on inmate and staff on inmate physical victimization for males was approxi- mately 21% and 25%, respectively. The rate of sexual victimization was much lower. Theorists argue that women have different risk factors than men for entry into the criminal justice system. There is a growing recognition that incarcerated women experi- ence higher rates of interpersonal violence and that their exposure is often repeated and includes multiple forms of violence. This has led to increased risk for PTSD and substance abuse in women. They often enter into the cor- rections system by running away to escape abuse, using drugs to cope with abuse, and through involvement with violent partners. 10 Poly-victimization and mental health problems often are found in incarcerated women. In a Pathways Study, it was found that mental health and sub- stance use disorders significantly mediated the association between child and adult trauma exposure and offending behaviors. 11 What is Trauma Informed Care? According to the Substance Abuse Mental Health Services Administration (SAMHSA), a program or orga- nization that is trauma informed realizes the widespread impact of trauma and understands potential paths for re- covery. 12 It recognizes the signs and symptoms of trauma in clients, families, staff, and others involved within the system and responds by fully integrating knowledge about trauma into policies, procedures, and practices, and seeks to actively resist the re-traumatization of individu- als with justice involvement. In corrections, resisting re-traumatization is key, as too often staff are unaware of how their abrupt approach, their voice level, and their non-verbal cues may affect individuals with justice involvement. In someone who has been victimized, these can trigger uncomfortable thoughts and feelings and possibly re-traumatize the individual. A trauma informed approach is a mind set for correc- tional staff to not only do no damage but also, through practice and procedure, help individuals with justice involvement deal with their adjustment to the correc- tions system and find hope in the professionalism and understanding of staff. This does not come easily, as

Graphic: istock/Victor_85; Background: istock/MHJ

56 — May/June 2020 Corrections Today