Health Care for Women Inmates. Part 7
Individuals from several disciplines — law (Friedman, 2004; Nordberg, 2002; Stratton, 2004), medicine and social science (Berkman, 1995; Munetz & Teller, 2004; Ross & Lawrence, 1998), and journalism (Bernstein, 1999; Butterfield, 1992) — have discussed the role of prisons and jails as social safety nets, especially with regard to the mentally ill and homeless. Some observers relate this aspect of corrections to an increased willingness to spend tax dollars on incarcerating people, rather than providing them with adequate social services that might prevent their incarceration (Butterfield, 1992). Friedman (2004), for example, contrasts the social safety nets of other Western democracies, especially in their provision of health care, with the United States’ preference for criminal justice solutions to long-standing social problems such as concentrated poverty or addictions. According to one physician, “It is fatuous for politicians or social planners to deny the relationship between rising unemployment, deepening poverty, and the parallel growth in the prison population” (Berkman, 1995, p. 1617).
In correctional facilities, people in need of limited social services can receive shelter, food, and medical care that would either not be available to them or that is available only in very poor quality (Butterfield, 1992). Some social services — such as subsidized housing, treatment, and mental health treatment — have long waitlists that also put them out of immediate reach (Nordberg, 2002). Mentally ill individuals appear to have difficulty accessing certain resources in their communities, even where referrals and guidance have been provided prior to release (Bernstein, 1999). Marquart et al.’s (1997) notion that jails are sometimes the sole resource for a dealing with a community’s mentally ill is confirmed by a state supreme court justice, who has described correctional facilities as the “de facto mental health system of our day” (Stratton, 2004).
These views of correctional facilities as safety nets, however, largely disregard the particular circumstances of inmates. Essentially, it is a view of prisons and jails that works for men in a way that it cannot for women. Information about the socio-economic difficulties of inmates discussed above clearly demonstrates their need for social services. Incarceration can also provide relief to these women from poverty and violence (Bradley & Davino, 2002), yet with regard to health care, what is available to inmates is very limited, as discussed below. Furthermore, jails and prisons functioning as safety nets provides little for these women in their roles as mothers and nothing for the children they leave behind while incarcerated. In short, correctional facilities may be literally safer for women facing lives of violence, as has been claimed by some observers (Acoca, 1998; Bradley & Davino, 2002). But to claim that they provide social safety nets for women to the same degree as they might for men is inaccurate. This is especially true with regard to health care, when “some correctional systems… justify their often inadequate women’s health care services by comparing them to the nonexistent care the women were receiving on the street” (Acoca, 1998. p. 61).