Women in American prisons encounter numerous difficulties that often involve mental health problems, drug and alcohol issues, and trauma. These challenges not only make navigating the criminal justice system more difficult for women but also highlights broader societal issues such as gender-based violence, economic inequalities, and lack of mental health support. People in prison are more likely than the general United States population to have received a mental disorder diagnosis, and women in prison have higher rates of mental illness and mental health treatment than do men in prison. Furthermore, women in prisons are three times more likely than the general population to report poor physical and mental health.Starr-Sered, Susan and Maureen Norton-Hawk. 2014. Can't Catch a Break: Gender, Jail, Drugs and the Limits of Personal Responsibility. Berkeley: University of California Press. Women are the fastest growing demographic of the United States prison population.Hall, Martin T., Seana Golder, Cynthia L. Conley, and Susan Sawning. 2012. "Designing Programming and Interventions for Women in the Criminal Justice System." American Journal of Criminal Justice 38(1):27–50. As of 2019, there are about 222,500 women incarcerated in state and federal prisons in the United States. Women comprise roughly 8% of all inmates in the United States. This surge is largely attributed to the rising use of imprisonment for drug-related offenses rather than violent crimes. A considerable portion of incarcerated women are serving time for drug-related offenses, with the proportion increasing significantly between 1986 and 1991. Even among those in maximum security facilities, a majority are not imprisoned for violent felonies. The data also reveal that in states like New York, a substantial proportion of incarcerated women are serving time for drug-related offenses, with a smaller percentage incarcerated for violent crimes or property offenses.

In 2011, 11% of male inmates had an overnight hospital stay due to psychiatric problems, while the proportion of women who did was roughly twice that of men. In 2010, 73% of incarcerated women and 55% of incarcerated men self-reported mental health problems. This statistic accounts for the reporting of at least one of two criteria, as a self-reported mental or emotional problem, or a reported overnight hospital stay. Women who end up in prison often have different backgrounds and experiences compared to men. Unfortunately, many women experience further violence while in prison, which is a significant concern for their well-being. According to international human rights law, it is the responsibility of the State to prevent and address violence against women in all contexts, including prisons. The most common mental health problems among incarcerated women are substance abuse/dependence, post-traumatic stress disorder, and depression. Other common disorders include schizophrenia, bipolar disorder, and dysthymia.Visher, Christy A., and Nicholas W. Bakken. 2014. "Reentry Challenges facing Women with Mental Health Problems." Women and Health 54(8): 768-780.

Before crime

Early experiences of victimization Criminality among females is intimately associated with experiences of trauma and victimization occurring early in life.Dehart, D., S. Lynch, J. Belknap, P. Dass-Brailsford, and B. Green. 2013. "Life History Models of Female Offending: The Roles of Serious Mental Illness and Trauma in Women's Pathways to Jail." Psychology of Women Quarterly 38(1):138–51. The majority of incarcerated females have experienced some kind of victimization, defined as experiences of physical, sexual, or emotional trauma. Among female offenders 78% of have reported prior sexual or physical abuse, compared to only 30% of male offenders. Furthermore, "research consistently links histories of violence with negative mental health outcomes, such as depression, substance abuse, and intimate partner violence among incarcerated women at higher rates than those in the general female population".Liebman, R. E. et al. 2013. "Piloting a Psycho-Social Intervention for Incarcerated Women With Trauma Histories: Lessons Learned and Future Recommendations." International Journal of Offender Therapy and Comparative Criminology 58(8):894–913. Early experiences of victimization predispose women to be more likely to suffer from certain psychiatric disorders, particularly post-traumatic stress disorder (PTSD), depression, and dysthymia.Horwitz, Allan V., Cathy Spatz Widom, Julie Mclaughlin, and Helene Raskin White. 2001. "The Impact of Childhood Abuse and Neglect on Adult Mental Health: A Prospective Study." Journal of Health and Social Behavior 42(2):184–201.Messman-Moore, Terri L. and Patricia J. Long. 2003. "The Role of Childhood Sexual Abuse Sequelae in the Sexual Revictimization of Women." Clinical Psychology Review 23(4):537–71. A study conducted in 2017, found that 60% of participating female inmates had been diagnosed with a mental illness.

Following PTSD and substance abuse/dependence, depression is the third most common psychiatric disorder among incarcerated women. Depression and substance abuse, too, are closely linked with experiences of victimization or PTSD, and more so for women than for men. In fact, according to the National Comorbidity Survey, women are twice as likely as men to experience co-occurring PTSD and depression. The prevalence of depression among incarcerated females links to trends within the general population as well. A study found that of the 54% of incarcerated women diagnosed with lifetime PTSD, 63% reported experiencing three or more traumatic events. Another common mental illness is antisocial personality disorder. It is relatively rare among women in the general non-criminal population, with only about 1 in 100 women being affected by ASPD. But, It is common to find a higher prevalence of ASPD among females who commit criminal offences. This increased prevalence often receives less attention compared to male offenders, who exhibit an even higher occurrence of ASPD. While women are more likely than men to suffer internalized problems, such as anxiety and depression, men are more likely to be treated for externalized problems such as delinquency, aggression, and substance abuse.Thompson, Melissa. 2010. "Race, Gender, and the Social Construction of Mental Illness in the Criminal Justice System." Sociological Perspectives 53(1):99–126. This difference coincides with a gendered discrepancy in the experiences of mentally ill offenders once they enter the criminal justice system.

Victimization and criminal offending In both males and females, sexual abuse, physical abuse, and neglect increase the likelihood of arrest for a juvenile by 59% and as an adult by 28%.Widom, Cathy Spatz and M. Ashley Ames. 1994. "Criminal Consequences of Childhood Sexual Victimization." Child Abuse & Neglect 18(4):303–18. Although sociologists do not point to a single explanation for the association between victimization, trauma, and incarceration, researchers have found that trauma frequently cause women to abuse drugs and alcohol as a coping mechanism.McClellan, D. S., D. Farabee, and B. M. Crouch. 1997. "Early Victimization, Drug Use, and Criminality: A Comparison of Male and Female Prisoners." Criminal Justice and Behavior 24(4):455–76. Sociologists also point out that early victimization increases the likelihood of women's continued or exacerbated involvement in harmful settings.Steffensmeier, Darrell and Emilie Allan. 1996. "Gender and Crime: Toward a Gendered Theory of Female Offending." Annual Review of Sociology 22(1):459–87. According to one ethnography of female offenders in Boston, "In fact, running away from home—often to escape abuse in households dominated by violent men—is the charge in the first arrest for nearly a quarter of girls in the juvenile justice system… On the streets, women are vulnerable to harassment, exploitation, and drug use, all of which drag them into the correctional circuit". In addition to symptoms of trauma, other mental health problems such as major depression, schizophrenia, and mania are linked with patterns of violent offending and homelessness prior to arrest.

Race The Prison Policy Initiative writes: "Incarcerated women are 53% White, 29% Black, 14% Hispanic, 2.5% American Indian and Alaskan Native, 0.9% Asian, and 0.4% Native Hawaiian and Pacific Islander."

Since the 2000s, the incarceration rates for African American and Hispanic American women have declined, while incarceration rates have increased for white women. Between 2000 and 2017, the incarceration rate for white women increased by 44%, while at the same time declining by 55% for African American women. The Sentencing Project reports that by 2021, incarceration rates had declined by 70% for African American women, while rising by 7% for white women. In 2017, the Washington Post reported that white women's incarceration rate was growing faster than ever before, as the rate for black women declined.

From 2000 to 2009, while incarceration rates declined for Black and Hispanic women, they actually increased for White women. Women who end up in prison often have different profiles compared to men, facing higher levels of abuse, trauma, mental health issues, and substance dependence. These statistics underscore the urgent need for comprehensive support and intervention programs tailored to the specific needs of incarcerated women.

A 2013 study examined the effects of race on the employment opportunities of incarcerated women. "Pages 36–37: White women have odds of receiving a favorable response from hiring managers that are nearly 50 percent smaller than the odds of Hispanic women with a prison record, the odds of white women with a prison record are only five percent smaller than black women's with a prison record. Page 39: More than half—52 percent—of the positive outcomes observed during the audit benefitted the employment prospects of Hispanic women. White women received 36 percent of favorable responses. A complete breakdown of the distribution of favorable responses is reported in Table 3." Page 50: "Black men with a prison record have the most difficulty moving through the hiring process—their odds of a getting a callback for an interview or offered a job are 125 percent smaller than white male ex-prisoners. The likelihood that Hispanic men with a record will get another interview or will be offered a job is 18 percent smaller than the likelihood for white men." Hispanic women with a prison record fared most favorably in receiving a phone call back from potential employers, while African American women had modest results, and white women received the poorest results, having the lowest probability of receiving a phone call from a potential employer. These results were quite different from those of incarcerated men; among them, it was White men who had the best employment opportunities.

Substance abuse