Patients or Prisoners – Implications of Overlooking Mental Health Needs of Female Offenders

Published 23/01/2019
Type Article
Author(s) Samantha Mason, Jon Parry, Sabina Enback, Adela Sobrepera
Corresponding Authors

Read the journal article corresponding to this blog: Patients or Prisoners: Implications of Overlooking Mental Health Needs of Female Offenders

The Corston report (1) is a government commissioned research and recommendations paper on imprisoned women issues, led by Baroness Corston and published in 2007.  It highlights that issues such as physical and mental health, education and family are particularly pertinent to female prisoners and contribute to the social isolation that many of these women feel. The report provided a set of recommendations to better address the particular circumstances female prisoners face such as improved treatment programs designed to reduce reoffending. Even though initiatives have been put in place to conduct further research linking mental health and offending behaviour in women (e.g. the recently published Female Offender Strategy (2) is looking to shift emphasis from custody to non-custodial sentences), several recommendations from the Corston report around mental health remain unmet.

The link between mental health and other factors in offending women.

Numerous studies have been published on the relationship between mental health and offending in the last decade with women prisoners being found five times more likely to have a mental health issue than women in the general population (3) with symptoms likely to be either exacerbated or triggered by their time in prison (4).

In addition, co-occurring disorders is significantly prevalent amongst female offenders (10). However, it has been found that one third of women offenders with complex needs (co-occurrence of substance misuse and mental illness) remained without treatment for a considerable time (10), showcasing the added need to better understand the treatment requirements of women prisoners.

Corston recommendations: sentencing and custodial centres

Corston put forward the case that many problems listed in female offending pathways (addiction, mental health, unemployment, unsuitable accommodation and debt) could be better resolved through casework, support and treatment than through prison.  The length of sentencing also needs to be taken into account as sentences that are too short may not leave enough time for treatment completion1, and can also have a significant effect on family relationships as some women are unable to care for their children (11,9).

The recent Female Offender Strategy (2) has come some way in promoting community sentences and recognising the need for targeted treatments for female offenders yet it is too soon to measure the impact of this strategy. However, these is still a need for a fully updated picture on mental health needs and effective interventions amongst female offenders.

The Corston report (2007) is based on data from twenty years ago (14), when the stigma around mental health was more predominant. Besides outdated recidivism prevalences (14), mixed results on intervention efficacy have also been recorded, and may not be applicable to a UK setting as most of the studies have been carried out in the USA (15, 16). Thus, court diversion schemes in the UK have been inconsistent (17), and robust evaluation strategies of current initiatives (18), by which a rationale for evidence-based practice could be founded, is lacking.

In conclusion, evidence shows that prison is an unsuitable environment in which to establish a rehabilitation system that will support women prisoners with a variety of complex needs. Therefore, a re-evaluation of the current mental health prevalence and needs in female prisoners is required to develop a useful model of rehabilitation.


(1) Corston (Baroness), J. (2007) The Corston Report: A review of women with particular vulnerabilities in the criminal justice system. London: Home Office, [Online] Available at: [Accessed June 6. 2016].

(2) Ministry of Justice (2018) Female Offender Strategy. Ministry of Justice [Online] [Accessed 17th of December 2018]

(3) Plugge, E., Douglas, E., & Fitzpatrick, R. (2006) The Health of Women in Prison Study Findings, Oxford: Department of Public Health, University of Oxford, [Online] Available at: [Accessed June 18. 2016].

(4) Dixon. A., Howie. P., & Starling, J. (2004) Psychopathology in female juvenile offenders.  Journal of Child Psychology and Psychiatry, [Online] Volume 45(6), p. 1150-8. Available at: [Accessed June 8. 2016]

(7) Cauffman, E., Feldman, S.S., Waterman, J., and Steiner, H. (1998) Posttraumatic stress disorder among female juvenile offenders. Journal of the American Academy of Child and Adolescent Psychiatry, [Online] Volume 37 (11), p. 1209-1217. Available at: [Accessed June 10. 2016].

(7) Sheldon, C. T., Aubry, T. D., Arboleda-Florez, J., Wasylenki, D., & Goering, P. N. (2006) Social disadvantage, mental illness and predictors of legal involvement. International Journal of Law and Psychiatry, [Online] Volume 29(3), p. 249-256. Available at: [Accessed August 21. 2016].

(8) Brekke, J. S., Prindle, C., Bae, S. W., & Long, J. D. (2001) Risk for individuals with schizophrenia who are living in the community. Psychiatric Services, [Online] Volume 52, p. 1358-1366. Available at: [Accessed August 20. 2016].

(9) Prison Reform Trust (2015) Bromley Prison Fact file: Autumn 2015, [Online] Available at: [Accessed June 20. 2016].

(10) Nowotny, K. M., Belknap, J,Lynch, S.,& DeHart, D.(2014) Risk Profile and Treatment Needs of Women in Jail with Co-Occurring Serious Mental Illness and Substance Use Disorders, Women & Health, [Online] Volume 54(8), p. 781-795. Available at: [Accessed July 15. 2016].

(11) Revolving Doors Agency (2004) Bad Girls? Women, Mental Health and Crime, [Online] Available at: [Accessed June 9. 2016].

(13) Department of Health (2014) Closing the Gap: Priorities for essential change in mental health, [Online] Available at:  [Accessed August 19. 2016].

(14) Singleton, N., Gatward, R., & Meltzer, H. (1998). Psychiatric morbidity among prisoners in England and Wales. London: Stationery Office.

(15) Boothroyd, R. A., Calkins Mercado, C., Poythress, G., Christy, A., & Petrila, J. (2005) Clinical outcomes of defendants in mental health court. Psychiatric Services, [Online] Volume 56(7), p. 829-834. Available at: [Accessed August 20. 2016].

(16) Moore, M. E., & Hiday, V. A. (2006) Mental health court outcomes: A comparison of re-arrest and re-arrest severity between mental health court and traditional court participants. Law and Human Behavior, [Online] Volume 30(6), p. 659-674. Available at: [Accessed August 25. 2016].

(17) See for example: Ministry of Justice (2009) Access to Justice: A review of the existing evidence of the experiences of adults with mental health problems, KM Research and Consultancy Ltd, [Online] Available at:  [Accessed August 19. 2016].

(18) Disley, E., Taylor, C., Kruithof, K., Winpenny, E., Liddle, M., Sutherland, A., Lilford, R., Wright, S., & McAtee (2016) Evaluation of the Offender Liaison and Diversion Trial Schemes. Santa Monica, CA: RAND Corporation, [Online]. Avalable at: [Accessed 22/08/2016]