continued on page 2 Women with “co-occurring disorders” are a diverse group— they may have major depression, bipolar disorder, or post- traumatic stress disorder, in addition to their addiction to one or more drugs. Some suffer from psychotic spectrum disorders, including schizophrenia. Treatment of their complex, interactive disorders will span a several year period and involve admissions to hospitals, participation in community programs, and, very possibly, episodic incarcerations. Female detainees have twice the rate of major mental illness (19%) than their male counterparts (9%) (N ational G A IN S Center). Adding to the challenge for an unprepared, ill-equipped justice system, is that these women are largely women of color (63.8%; BJS, 1994), with histories of physical and sexual abuse and who are responsible for one or more dependent children. Women involved in the justice system have followed various paths, including the following:  they may have been arrested for misdemeanors or felonies related to solicitation, drug possession and distribution,  been implicated in property crimes, or  have been brought up on child abuse and neglect charges, often related to the symptoms, behaviors, and cognitions associated with their mental health and substance use disorders. Most incarcerated women have, at the time of their arrest, one or more children in their custody; two-thirds of women in prison have children under 18 (BJS, 1994, March). While struggling to negotiate the criminal justice system, the women are confronted with the reality that they will be separated from their children—who may go to grandparents, sisters, fathers, or foster care placements. Out-of-home placement, without a stable permanency disposition, creates further risk for the child’s future involvement in the juvenile justice system. The requirement of a permanent placement for their child within a mandatory one-year period (A doption and Safe Families A ct, 1997) exists as a tremendous challenge for mothers initiating a symptom stabilization and recovery process. Identifying Women’s Issues Though many correctional administrators may agree that women bring different health and relationship issues to their period of Justic e -Invo lve d Wo me n with C o -O c c urring Diso rd e rs a nd The ir C hild re n Treating Women with Co-Occurring Disorders Involved in the Justice System and Their Children H olly H ills September 2002 Justice System Disorders in the Co-Occurring The National for People with GAINS Center GAINS 1 Wo me n in jail: In 1998, wome n c omprise d 22% (3.2 million) of annual arre sts in the U.S.. Be twe e n 1990 and 1998, the numbe r o f wo me n in p riso n inc re a se d b y 88%, o n p ro b a tio n b y 40% a nd o n p a ro le b y 80%. To d a y, wo me n a c c o unt fo r 11% o f the U.S. ja il p o p ula tio n (Be c k & Ka rb e rg , 2001). The fa c ts a re c o mp e lling : wo me n a re a ra p id ly inc re a sing p re se nc e in a ma le o rie nte d justic e syste m. Wo me n o ffe nd e rs p re se nt multip le p ro b le ms: me nta l illne ss a nd sub sta nc e use d iso rd e rs, c hild -re a ring , p a re nting a nd c usto d ia l d iffic ultie s, he a lth p ro b le m s, histo rie s o f vio le nc e , se xua l a b use a nd c o rre sp o nd ing tra um a (Ve yse y,1998). Amo ng wo me n e nte ring ja ils, 12.2% a re dia g no se d with se rio us me nta l illne sse s, a lmo st do ub le the ra te o f ma le s a t inta ke (Te p lin, 2001), a nd 72% p re se nt a c o -o c c urring sub sta nc e use diso rde r. Ma ny wo me n in ja il ha ve b e e n vic tims; a sta g g e ring 33% a re d ia g no se d with p o st-tra uma tic stre ss d iso rd e r (Te p lin & Mc C le lla nd , 1996). In a re c e nt ja il surve y, 48% o f wo me n re p o rte d a histo ry o f p hysic a l o r se xua l a b use a nd 27% re p o rte d ra p e (BJS, 2001). Wo me n e nte ring jail may be pre gnant, po st-partum o r le ave c hildre n in the c o mmunity. Mo re than 100,000 mino r c hildre n ha ve a mo the r in ja il (Blo o m & O we n, 2002). Histo ry o f a b use is kno wn a s a c o rre la te o f b e ha vio r le a ding to c o nta c t with the justic e syste m; the c yc le o f inte rg e ne ra tio na l vio le nc e is we ll do c ume nte d. Ea rly ide ntific a tio n o f this histo ry is c ritic a l in tre a tme nt de c isio ns, p la nning fo r c o mmunity re -e ntry a nd the re turn o f the e x-o ffe nde r-mo the r to a p a re nting ro le . Tho ug h ma ny c o rre c tio na l fa c ilitie s re c o g nize tha t wo me n b ring diffe re nt he a lth a nd re la tio nship issue s to the ir p e rio d o f inc a rc e ra tio n, o p e ra tio na lly mo st ha ve no t a d juste d p ra c tic e s a lre a d y e sta b lishe d fo r ma le inma te s. Ja ils p re se nt a c ha l- le ng e to se rvic e pro visio n due to the ir ‘ sho rt-te rm’ nature whe re le ng ths o f stay may rang e fro m o ve rnig ht de te ntio n to a se nte nc e o f up to o ne ye a r. This se rie s d isc usse s to p ic a l issue s re la ting to wo me n in ja ils a nd hig hlig hts p ro mising p ro g ra ms fro m aro und the natio n.