‘It’s like they don’t want you to get better’: Psy control of women in the carceral context

Abstract

This article examines how women incarcerated in provincial and federal prisons in Canada experience medicalization as the predominant form of correctional psy intervention. In order to privilege the oft ignored and typically silenced voices of incarcerated women, this article draws on life history interviews with 22 formerly incarcerated women who were living in halfway houses and working to transition from prison to the community. The analysis highlights the (over)use of prescription psychotropic medications as a governance strategy and the impact this practice has on women serving time. Participants had limited access to non-medical interventions in general, and no access to counselling services outside the purview of correctional control. The overlapping of correctional and psy interventions in the prison setting transforms psy treatment not only into a mechanism of social control, but also into a punitive and disciplinary enterprise that delegitimizes the women’s self-identified needs.

Gender and Programming

“…There are considerable concerns that U.S. prisons are resorting to the use of psychotropic medication as a strategy for treating mentally ill incarcerated women (Kilty, 2012). However, research has also indicated that women in general society are much more likely to use drugs for mental health issues than men, with around a quarter of women in the United States taking some sort of medication (Medco, Inc., 2010).…”

Nursing Practice With Incarcerated Women

“…In general, the categories I identified include research articles, again mostly qualitative, designed to improve mental health, health promotion, harm reduction, or legal advocacy practice with incarcerated women (Pedlar et al, 2008;Rehman, Gahagan, DiCenso, & Dias, 2004); methodology articles describing participatory action research methods (Martin et al, 2009); essays on program and policy reform (Alfred & Chlup, 2009;Kilty, 2012); and essays on the sociopolitical underpinnings of incarceration, which frequently call for political activism of various types (Allspach, 2010;Maidment, 2006;Reynolds, 2008). Kilty (2012) reviewed life history interviews with 22 formerly incarcerated Canadian women to argue that "psy" treatment (psychiatry and psychology) in prison is used for social control including discipline and punishment. She argues that, through processes of medicalization and pathologization, behavior interpreted as deviant is characterized as illness and treated with psychotropic medications; in essence, prison health care is reframed as a mechanism of behavioral control.…”

“…Authors such as Sherwood and Kendall (2013) write from a progressive, politicized viewpoint and call for the deconstruction of colonized nursing knowledge and relationships, but they would appear to be somewhat unique in this perspective. In contrast, the feminist literature routinely contains critiques and explorations of the politics of race, class, and gender as it relates to women's criminalization and calls for changes at the systemic, upstream level (Alfred & Chlup, 2009;Allspach, 2010;Haney, 2004;Kilty, 2012;Maidment, 2006;Reynolds, 2008).…”

“…Nursing would do well to consider Kilty's (2012) troubling idea that healthcare providers are complicit in processes of medicalization and social control of criminalized women in prisons. Similarly, Maidment's (2006) suggestion that the dichotomizing effects of neoliberal rhetoric provide some of us, including nurses, with jobs "correcting" the criminalized members of society ought to give nurses pause to reflect on our complicity in this regard.…”

The Pains of Jail Imprisonment: Experiences at The Ottawa-Carleton Detention Centre

“…While in the outside world, Chloe was able to make health choices that enabled her to manage her condition, inside the jail, she was forced to experience her illness as a salient aspect of her punishment. Her case also highlights the 'fallacy of self-governance' noted by Kilty (2012), whereby prisoners lose control over their bodies at the same time as they are expected to become responsibilized agents.…”