An Unsupported Population: The Treatment of Women in Texas’ Criminal Justice System

1. Invest in Programs and Tools that Help Address Women’s Unique Needs

Ensure Access to Gender-Specific, Recidivism-Reducing Programming that Improves the Reentry Transition

TDCJ and county jail administrators should implement treatment and trauma-informed programming in all-female settings, where women may feel more nurtured, supported, and comfortable when speaking about issues like domestic violence, sexual abuse and incest, shame, and self-esteem. Where possible, the treatment curriculum should address many of the common barriers to success for women leaving confinement: how to shoulder parenting responsibilities, avoid abusive relationships, handle money, and address health issues.

It is imperative that program staff regularly evaluate the requirements for program participation and amend those requirements to ensure the maximum level of participation.

Furthermore, where possible, treatment programs should be part of a comprehensive continuum of care that continues after each woman’s release from custody. Given the many needs of system-involved women, TDCJ and county jails must be given all necessary resources to effectively provide gender-specific programming and services.

Programming aimed at reducing recidivism among women is an especially cost-effective approach to crime reduction. Women tend to have a more difficult time with reentry and higher recidivism rates than men. In fact, according to a study by the Urban Institute of previously incarcerated women returning to Houston:

The unique obstacles that women face during their post-prison reintegration, driven largely by their differences in pre-prison substance use and employment histories, continue to play a role in terms of subsequent criminal behavior. At one year out, women are more likely than men to engage in drug use, to have problems stemming from drug use, and to have partners who drink or use drugs daily. Perhaps not surprisingly, women are almost twice as likely as men to be back behind bars in a year’s time, typically due to a drug related offense or a property offense driven by addiction problems.

To the extent the State and counties can develop effective, recidivism-reduction treatment programs aimed at women, it will likely get a great return on its investment.

Utilize Gender-Specific Risk and Needs Assessments to Ensure Particular Issues are Addressed

Traditional risk and needs assessments that are used to determine a person’s programming needs have been faulted for having little pertinence for women. The lack of gender-specific factors makes it difficult for women to be connected with programs that are relevant to their lives: “Correctional policy claims a gender-neutral stance, ignoring the psychological and social literature differentiating men and women’s criminological pathways. The misinformed nature of the criminal justice system has only exacerbated the problem of mass incarceration of women.”

While risk assessments have some predictive validity for women, the evaluation of gender-sensitive needs will likely produce a higher rate of predictive validity. The following factors have been identified through theoretical frameworks and evidence-based research as playing crucial roles in a woman’s criminality and recovery.

a. Trauma and Abuse: Some studies have found that as many as 98% of justice system-involved women have trauma histories. The high discrepancy variance between men and women makes trauma and abuse a gender-specific issue, and the prevalence at which women experience abuse should be considered during the development of tools used for their rehabilitation.

b. Mental Illness: While the prevalence for mental illness is high among both genders, women are disproportionately affected, indicating a substantial need for mental health treatment geared toward women.

c. Substance Use: Women in TDCJ report higher rates of substance use disorder than their male counterparts, with 70% of women having been identified as suffering from a substance use disorder, compared to 58% of men. Given that “the connection between substance abuse and female criminality is incredibly strong, as is its connection to recidivism,” it is critical for this issue to be addressed.

d. Self-Esteem: Low self-esteem tends to be a product of abuse, mental health issues, socio-economic status, dysfunctional relationships, and other factors. Gender-responsive assessments should measure women’s self-esteem levels so they can be properly matched with treatment that empowers women to make good decisions and facilitates a greater sense of control in their lives.

e. Dysfunctional Relationships: A study by the American Probation and Parole Association on women’s pathways to crime found a link between dysfunctional abusive intimate relationships and an erosion of the woman’s self-esteem. Another study found that living with a criminal partner is a statically strong predictor of recidivism. Women must learn more about the extent to which they are influenced by the relationships in their lives and learn how to extricate themselves from dysfunctional relationships.

f. Parental Responsibilities: A staggering 81% of women in TDCJ have children, compared to 68% of men, and women who were primary caretakers of their children prior to incarceration risk having their parental rights terminated. Because of the sheer number of incarcerated women who have children, they must learn how to maintain healthy, positive relationships.

2. Improve Conditions of Confinement for Women to Ensure They are Treated with Dignity

Better Assess the Needs of Pregnant Women, and Ban Shackling While Pregnant

In 2017, the Texas Legislature passed HB 239, requiring TDCJ to report on the implementation of health care services for pregnant inmates and provide a summary on nutritional standards, housing conditions, physical restraints, and miscarriages experienced by pregnant inmates. While this is a step in the right direction, Texas must use the information derived from this legislation to put into place policies that will effectively address the unique challenges facing pregnant inmates across the state.

Separately, Texas must take additional steps to ban shackling of women while pregnant in prison or jail.

Improve the Time that Mothers Can Spend with Newborn Children

The American College of Obstetricians and Gynecologists and the American Public Health Association strongly recommend allowing women to remain with their infant children for longer hospital stays, in in-custody nursery programs, or through diversion programs.

TDCJ should expand the BAMBI program, which allows a mother and her infant to bond in a residential facility for up to 12 months, with longer stays considered on a case-by-case basis.

Providing more mothers the opportunity to bond with
their newborns in a safe and secure environment will promote healthy growth and development, socialization, and psychological development during the infant’s formative years

Increase Access to Quality Health Care

TDCJ must ensure that women have regular access to a psychiatrist. Access to mental health care is an imperative component in rehabilitation.

Additionally, TDCJ must ensure that the $100 co-pay for health care does not deter women from seeking necessary services. An incarcerated woman should not have to choose between the health care she needs to be able to focus on her rehabilitation and basic necessities like hygiene products and stamps to communicate with her loved ones.

Lastly, TDCJ must evaluate and expand its current prepartum and postpartum health care services. Pregnant women and their unborn children have many health care needs that are time-sensitive and require more attention than periodic check-ups. Women recovering from labor also have many individualized health care needs. Exceptional health care services should be available to women during their pregnancies and during the months immediately following delivery.

Increase Access to Quality Hygiene Products

Another critical component in treating incarcerated women with dignity means providing them with feminine hygiene products in a quantity and quality that is sufficient to meet their needs.

While TCJE’s sanitary products do pose issues with comfort, wear-ability, and absorption, they are also inadequate in number for many women in TDCJ. A woman uses on average 20 tampons per month, while TDCJ provides 6. Texas should provide all female inmates with an amount of toilet paper, tampons, and sanitary pads sufficient to provide for their health care and hygiene needs.

Without enough of these products, women are forced to barter and trade with other women who may have extras (which is technically against TDCJ rules) or suffer leaks through their white clothes and sheets. For women who are already struggling with their self-esteem, allowing women to soil themselves with blood is an unacceptable consequence of TDCJ’s failure to prioritize their health care needs.

Provide Nutritious Food and Allow More Access to Water

Providing women in TDCJ with enough nutritious food and with water is absolutely imperative; water is most critical during summer months. Otherwise, women are less likely to be physically healthy and more likely to require health care services in TDCJ. It is more cost-efficient to invest in preventive care by providing nutritional food and plenty of water to all women in Texas prisons.

Reduce Sexual and Physical Violence Against Incarcerated Women

Texas has an obligation to ensure that anyone placed under the supervision of a state or local facility is not subjected
to sexual violence. Texas should comply with the following recommendations:

Fully implement the Prison Rape Elimination Act (PREA) National Standards.
Convene a task force of state stakeholders and independent experts to assess the current practices and procedures in place to protect against physical and sexual assaults and to publish transparent accounts of these incidents in “live time” so the public can be aware of the incidents nearer in time to their occurrence.
Establish an Office of the Independent Ombudsman to provide independent oversight of all TDCJ and county jail facilities.
Provide resources to counties to bring jail facilities into PREA compliance, and provide training and technical assistance of staff of county jail facilities.

3. Remove Barriers to Family Unity

Texas must provide TDCJ with the resources necessary to improve mother-child interaction.

Children are better able to thrive when their mother remains in their lives; otherwise, losing a parent to incarceration can result in serious mental, physical, and emotional health issues. Many of the negative effects of parental incarceration can be nullified if children are considered and accounted for in policies and practices. The following are crucial: helping children understand what is happening to their parent, themselves, and their families; enabling them to stay connected with their incarcerated parent; and supporting children throughout the duration of their parent’s incarceration and reentry back into the home and community. Maximizing visitation opportunities is especially critical when the incarcerated parent was active in the child’s life prior to incarceration.

Research also shows that, besides benefiting their children, women inmates’ maintenance of family ties can help reduce their own recidivism. According to the Urban Institute, women reporting higher levels of family support were less likely to return to prison. Furthermore, women surveyed by the Urban Institute reported looking most forward to reuniting with their children upon release, leading the Urban Institute to call women’s relationships with their children a compelling motivator for reentry success.

TDCJ should remove communication barriers such as costly charges for phone calls from prison, allowing mothers to call their children on a regular basis at no cost.

TDCJ should also create more welcoming, family-friendly visitation areas for children that allow mothers to engage in play and interact in a meaningful way with their children. Texas should explore the possibility of allowing mothers to earn periodic, overnight stays with their children.

It is highly likely that significant anti-recidivism gains could be had for relatively small investments in encouraging maintenance of family ties.

4. Better Prepare Women for Release from Incarceration

The recommendations earlier in this report will each help women better prepare for reentry to their communities and families. However, it is also important to address the needs of women that are more specific to the reentry point, and to the first few weeks after leaving incarceration.

In FY 2016 alone, 11,595 women were released from a TDCJ facility. Although there are fewer overall female inmates, proportionally speaking, women have a higher release rate than men.

State and local officials must invest in programming and resources that give women the tools for a successful transition. Importantly, services implemented in prison institutions must be carried forward post-release, thereby ensuring that care is continued.

Provide Pre-Release Programming

If they have not been exposed to relevant programming throughout their time in confinement, women who will soon be transitioning out of confinement should undergo individualized pre-release programming with specific components, including economic planning; training in parenting, communication skills, and cognitive thinking; provision of basic information on legal rights in regard to reuniting with children, and on dealing with domestic violence; referrals to other agencies for assistance with housing and areas of particular importance to women with children; and support services and emergency assistance for basic necessities.

Significantly, one group of researchers found that women who receive gender-specific, trauma-informed care while incarcerated are 360% more likely to complete voluntary community-based treatment upon release and 67% less likely to return to prison than women who received gender-neutral or male-based therapeutic care treatment.

Provide Linkage to Child Welfare Agencies

In addition to offering the above programming, TDCJ should enter into inter-agency agreements with relevant child welfare agencies to increase the likelihood of family reunification upon a woman’s release from incarceration.

Improve Aftercare & Parole Assistance

After a woman’s release from confinement, TDCJ should provide aftercare and follow-up. Building upon pre-release training and skills building will decrease the likelihood of recidivism and strengthen families.

Furthermore, for greatest post-release outcomes, the Parole Division should encourage parole officers to tailor supervision methods based on the gender of the parolee. is is especially critical in regards to helping female parolees find employment. Because of systematic legal and societal barriers, women face significant obstacles in obtaining meaningful employment upon reentry as a result of their criminal record — particularly as it relates to employment that will sustain a family. Parole officers should vigorously assist women in finding safe, stable employment.