There is a growing awareness that past traumatic experiences can play a significant role in women’s criminal justice involvement, adjustment within institutional settings, and success in the community. Paying attention to this shift towards trauma-informed practices in corrections is critical for a number of reasons (Lynch et al., 2012; Miller & Najavits, 2012):
- There is an extremely high prevalence of trauma among female inmates;
- Some of the basic features of female correctional facilities can function as significant trauma triggers for female inmates.
- Evidence suggests that the lack of trauma-informed practices in facilities has a negative effect and compromises inmate mental health and success inside and outside of facilities.
- Creating a trauma-informed culture can contribute to greater institutional safety and security.
Principles of Trauma-Informed Practice
The broad principles of trauma-informed practice (Harris & Fallot, 2006) require that we offer female inmates opportunities to experience safety, trust, choice, collaboration and empowerment. Corrections agencies might consider the adoption of the following strategies to address each of the principles of trauma-informed practice (NRCJIW, forthcoming):
|TRAUMA INFORMED PRINCIPLE||STRATEGIES FOR APPLYING PRINCIPLE INTO CORRECTIONAL PRACTICE|
Adapted from: Elliott et al., 2005; Harris & Fallot, 2006
While the translation of these principles and strategies to policy and practice can be quite challenging in institutional environments, examples of trauma-informed practice in prisons and jails are beginning to emerge. For example, Lynn Bissonnette, Superintendent of Massachusetts Correctional Institution at Framingham, has made great progress in implementing changes to make her facility trauma-informed.
MCI Framingham is a medium security correctional facility for females, located 22 miles west of Boston. MCI-Framingham is the Massachusetts Department of Correction’s only committing institution for female offenders. The facility houses women at various classification levels, including state sentenced and county offenders, and inmates awaiting trial.
Interview with Lynn Bissonnette, Massachusetts Correctional Institution – Framingham
Lynn Bissonnette, Superintendent of Massachusetts Correctional Institution at Framingham (MCI Framingham), is pioneering the implementation of trauma-informed practice for the women housed within the facility. Ms. Bissonnette has enjoyed a 30 year career with the Massachusetts Department of Corrections; and has worked in several institutional positions on her rise to Superintendent. Over her career, she has served as superintendent at two male facilities and has been the superintendent of MCI Framingham since 2003.
Q How did you become interested in working with justice involved women?
A When I started working in corrections 30 years ago, it was a means to an end. I thought it would be a great stepping stone for other jobs, but I never left. I felt like I was making a difference for women, for those less fortunate.
Q In your experiences working in male and female institutions, what’s different about working with women?
A Women offenders are more challenging to manage because of their mental health and medical issues, histories of trauma, and responsibilities as primary caretakers of children. While male offenders suffer as well, the majority of men tend to be easier to manage and “do their time” more easily. Women tend to share more of their emotions, issues, and challenges with staff. For these reasons, I think staff who manage women are more susceptible to burnout.
Another critical challenge comes from trying to apply state-level policies – which were developed for the majority male population – to women offenders. There are two ways we have been successful in navigating this issue. First, we turn to multi-disciplinary problem solving. When we are having difficulty managing women under a certain policy, we get a variety of staff together – security, reentry, medical, mental health, for example – and discuss ways that we can work together to apply the policy in a way that makes sense for females. We have also had to submit waivers to the department for permission to waive a policy or standard operating procedure. One policy that we were successful in changing required inmate workers in segregation to be strip searched every time they entered or left the unit. We didn’t think it made sense for the women, who we know have likely suffered from extensive trauma histories.
Q When did you first become aware of the trauma backgrounds of the women you work with? What information or resources were available to you at that time? How has that changed over time?
A I was the superintendent at two male facilities and when I came back to the women’s institution, the differences hit me in the face. At the time corrections was also shifting the way it looked at offender behavior: whereas in the past we would see negative behavior as simply a management issue, now we are looking more closely at the root causes of negative behavior. This shift allowed us to break new ground and look at the impact of trauma on the behavior of women.
NIC and SAMHSA have provided a number of helpful resources over the years, we have made an effort to operationalize gender-informed practices with women. We are also working with staff to realign their duties and interactions with women to be more gender responsive and in line with the latest research.
Q Would you describe MCI Framingham as a trauma informed facility? What are some characteristics, in your mind, of a facility that is trauma informed?
A A trauma informed facility is one that is humane, respectful and caring. These are concepts that we have integrated into the Department of Correction’s vision, and MCI Framingham’s mission and core values. One of the overarching goals in our Department’s strategic plan is to create a healing environment, not just for inmates but also for staff.
Another key element is that staff are engaged and buy into the goals of being trauma-informed. This is an ongoing effort: I am constantly discussing these concepts with staff. Initially staff thought that experiences of trauma were an excuse for problem behavior, not the cause of it or something to be addressed. Also, I emphasize with staff the importance of serving as role models for inmates. Staff set the tone for the entire facility, so it is important to acknowledge appropriate behavior and address behavior that is not acceptable.
Q We understand that you are currently operating a trauma-informed peer support program. Can you tell us about the program?
Engaging Women in Trauma-Informed Peer Support: A Guidebook
This guide was created to help make trauma-informed peer support available to women who are trauma survivors and who receive or have received mental health and/or substance abuse services. It is a resource which can be used by corrections professionals who want to learn how to integrate trauma-informed principles into their work. The guide provides peer supporters with the understanding, tools, and resources needed to engage in culturally responsive, trauma-informed peer support relationships with women trauma survivors. Click here to download the guidebook.
A The idea for a peer support program started when mental health clinicians submitted a proposal to me. Custody staff were referring women to the mental health crisis clinician for various reasons that were not crisis situations and referrals were increasing. For instance, rather than women being at risk for suicide, self-harming behavior or violence, their acting out was more a reflection of a stressful or traumatic situation (e.g. problems with other inmates, staff, or family visits, etc.) They wanted to talk to clinical staff, not because they were having a crisis, but simply because they wanted to talk to someone that they could trust.
A multi-disciplinary team of staff interviewed inmates who submitted applications and selected 30 inmates to be trained as peer supporters, most from the long termer and lifer population. The National Center for Trauma Informed Care trained the peer mentors based on content in the guide they developed: Engaging Women in Trauma-Informed Peer Support: A Guidebook. Clinicians also meet with the peer supporters on a weekly basis to provide ongoing support and processing.
Rather than having staff refer inmates to mental health clinicians for non-crisis situations, women can put in a slip to see a peer supporter. A mental health clinician reviews the slips and assigns the inmates as appropriate to a peer supporter. In the general population, inmates meet one-on-one with peer supporters and in the Intensive Treatment Unit (ITU), inmates have the opportunity to participate in a group led by two peer supporters (under the supervision of a mental health clinician). There are also “office hours” when women can “drop in” to talk to the peer supporter on duty.
While staff were initially concerned about how the program would work, they are now fully supportive of the peer support program. A major concern voiced by staff initially was whether they had the ability to distinguish between a woman who “just needed to talk” and a woman who was experiencing a true crisis.This was remedied by the development of a procedural statement requiring a uniformed supervisor to triage the issue before a call was made to a crisis clinician.
A recent example of the success of this program was an inmate who found out over the phone that a loved one had passed away. Rather than being referred to a mental health clinician for support (as would have occurred in the past), the officer referred the inmate to a peer supporter instead.
Q What are some other steps you took to make MCI Framingham a trauma-informed facility?
Intensive Treatment Unit
MCI Framingham’s vision for the ITU included the creation of a safe, therapeutic and self-contained environment to house inmates and detainees. The focus of the ITU included:
- Providing short-term crisis stabilization and meaningful treatment opportunities for women at risk
- Providing close monitoring, assessment and effective treatment opportunities for women with chronic behavior management issues who are also clinically contra-indicated for segregation
A An important step we took was opening a new unit in April 2012 called the Intensive Treatment Unit (ITU). The impetus for the unit was to separate inmates/detainees who were detoxing upon admission from those who were on mental health watch (suicide watch). The ITU was designed exclusively for inmates on mental health watch or crisis intervention and manages women under a phased system. A team of clinical staff, whose office and group space is directly on the unit, provides treatment groups on the unit, meets daily with each inmate to review her progress/behavior, and assesses and then and assigns them to one of four phases: inmates on one-to-one watch; inmates on 15 minute watch; inmates allowed to join the community for meals, exercise, structured and unstructured activities; and inmates who can leave the unit to attend programs in the general population and then return to the unit.
We also manage women in the ITU who require behavior management plans and those who are contraindicated for segregation. Incentive plans are used in lieu of formal discipline and has been more effective in changing behavior.
In addition, almost all of the staff members in the facility have received training on trauma-informed care. SAMHSA’s National Center for Trauma-Informed Care provided a two-day training for more than 300 of the 400 staff in the facility on the impact of trauma on behavior in 2011. I also speak at the weekly in-service training on emerging issues with women offenders including how to operationalize the principles of trauma-informed practice.
We took a number of other steps towards making the facility more trauma-informed including starting two service dog training programs, offering a trauma-informed (Timbo) yoga program, and requiring staff and all contracted service providers (which include mental health, substance abuse and medical services) to be trained in trauma-informed approaches. We are working on adding a horticultural program as well.
Q What benefits have you seen in MCI Framingham as a result of being more trauma-informed?
A Since implementing the various efforts I’ve discussed, we have seen dramatic differences in the behavior of our female population.
Since the opening of the ITU (first three quarters) the following performance objectives have been realized:
- 15% reduction in all self-injurious behaviors
- 20% reduction in transfers to inpatient psychiatric hospitalization (DMH)
- 33% reduction in days on constant mental health watch
- 46% decrease in total crisis contacts (since May 2010)
Between 2011 and 2012, MCI Framingham has witnessed a notable decrease in behaviors facility-wide such as inmate-on-staff and inmate-on-inmate assaults, the use of segregation, suicide attempts and the need for mental health watches. See the chart below for more information.
|Benefits of Implementing Trauma-Informed Approaches at MCI Framingham|
|Frequency of Incidents in 2011 and 2012|
|Type||2011||2012||Frequency Change||% Change|
|One-on-one mental health watches||147||98||-49||-33%|
|Petitions for psychiatric evaluation||44||37||-7||-16%|
Q What is the biggest challenge you faced in building a more trauma-informed environment?
A The toughest challenge has been dealing with the lack of understanding about trauma-informed practice, what it is, and what it means. Staff initially saw it as an excuse for behavior rather than a reason negative behavior occurs. It is still viewed as being soft, rather than smart by some in the field.
Q What advice do you have for professionals working in the field who want to achieve better outcomes with the justice-involved women with whom they work?
A First, I would say that sometimes you have to create the crisis for something to change. To do this, it is important that you benchmark and collect data. For others to listen, you need data in order to support the changes you want to make. Second, you should always operate in a multi-disciplinary way. Making collaborative decisions is necessary in order to get the buy-in needed to support your efforts. Finally, be creative in making things work in a prison environment. Changes don’t necessarily have to cost money and sometimes you just need to take a chance.
For additional resources on trauma and trauma-informed approaches in corrections, visit the GAINS Center Topical Resources page on Trauma or visit the NRCJIW’s resources pages. Also, stay tuned for an upcoming NRCJIW brief on trauma-informed practices for correctional facilities.
Elliott, D.E., Bjelajac, P., Fallot, R.D., Markoff, L.S., & Reed, B.G. (2005). Trauma-informed or trauma-denied: Principles and implementation of trauma-informed services for women. Journal of Community Psychology, 33 (4): 461–477.
Harris, M. & Fallot, R. (2006). Trauma-Informed Services: A Self-Assessment and
Planning Protocol. Washington, DC: Community Connections. http://smchealth.org/sites/default/files/docs/tisapprotocol.pdf
Lynch, S.M., Heath, N.M., Mathews, K.C., & Cepeda, G.J. (2012). Seeking Safety: An Intervention for Trauma-Exposed Incarcerated Women? Journal of Trauma & Dissociation (13):88-101. http://www.seekingsafety.org/7-11-03%20arts/2012%20lynch.pdf
Miller, N.A. & Najavits, L.M. (2012). Creating trauma-informed correctional care: a balance of goals and environment. European Journal of Psychotraumatology. http://nicic.gov/Library/026965
National Resource Center on Justice Involved Women (NRCJIW) (Forthcoming). Trauma-informed Practices: A Strategy for Enhancing Safety and Security in Female Correctional Facilities.