Addressing the rise of women’s incarceration in Missouri through a public health lens

Written by Emma Cunningham, AmeriCorps VISTA, and Laura Toledo, executive director of Center for Women in Transition

As a reentry organization, the Center for Women in Transition does not often frame its services as existing in the public health arena. A quick glance into the public health field, however, will lead one to recognize that reentry services are a critical piece in the puzzle that is public health.

Center for Women in Transition works with women interacting with the criminal justice system, providing them with tangible supports to prevent their return to incarceration. Women enter and exit incarceration at many points, and often become caught in a cycle of multiple incarcerations arising from a single charge. Last year, less than a quarter of female prison admissions in Missouri were new convictions. That means more than 75% of female prison admissions in Missouri were for 120-day drug treatment, long-term drug programs, and violations of probation or parole technical violations. Unsurprisingly, many of the probation and parole violations are direct results of substance abuse. Further, drug offenses accounted for 49% of new female prison admissions in Missouri in 2016.  We in this field have always been aware that substance abuse is a primary driver of entry into the criminal justice system, and remains a major barrier to successfully exiting that system, especially for women.

Delving deeper into the current opioid epidemic, and into the historic use of illegal and “recreational” drugs, we find that, more often than not, individuals that use these drugs are self-medicating physical and/or emotional pain and trauma. This trauma may be individual; abuse, neglect, loss. Or, it may be systemic: institutional racism, poverty, incarceration, the presence of gun violence in one’s community. At the Center, the majority of our clients have experienced significant trauma, both as children and adults. We are continually learning of the impact that this trauma has on these women’s lives, and the lives of their children and families.

Addressing systemic problems in our communities through a public health lens will help us create healthier, thriving communities, but we must act now. Missouri has the fastest growing female prison population in the United States. Between 2010 and 2015, Missouri’s female prison population increased 33 percent (Justice Reinvestment in Missouri, 2017). In order to address the mass incarceration in our state, we must address the circumstances that have led us to where we are now. We must comprehensively address the structural poverty and oppression that lead to the continued traumatization of our communities.

We must make mental health care and substance abuse treatment widespread and accessible, so that our children and neighbors may healthily cope with their experiences, rather than turning to a numbing high to survive another day. We need to focus on building up our communities, healing those with addictions, and addressing the underlying pain that leads to substance abuse. And we need to divert this care out of the criminal justice system: even though it is not the formal role of the criminal justice system to provide mental health care and substance abuse treatment, our jails and prisons have become primarily responsible for our citizens living with the challenges of substance abuse and mental illness.

As a restorative justice organization, from our founding we have focused on healing relationships with self, family, and community. Now, more than ever, healing is needed. Healing from social ills, and healing from interpersonal violence. We are calling on our fellow community providers in public health to join us in supporting our neighbors and communities, both as a preventative measure and as a means to reduce recidivism.

In taking a public health approach to the incarceration of women in our state, region, and city, we can stop the churning of women through the criminal justice system, both by preventing them from entering the system in the first place, and by bringing targeted community services to incarcerated women in need of treatment, thereby reducing recidivism.  With proper community supports in place, many women who are currently cycling through jails and prison could live stable lives in their communities while receiving necessary services.

A public health lens offers an opportunity to move away from mass incarceration, and to move towards a society in which we invest our resources in healing our neighbors and neighborhoods.