“Prison life is very hard and it’s made harder if you’re isolated”: COVID-19 risk mitigation strategies and the mental health of incarcerated women in California

• DOI: https://doi.org/10.1108/IJPH-09-2021-0093
• Published date: 21 November 2022
• Date: 21 November 2022
• Pages: 95-108
• Subject Matter: Health & social care,Criminology & forensic psychology,Prisoner health,Sociology,Sociology of crime & law,Public policy & environmental management,Policing,Criminal justice
• Author: Jennifer E. James,Leslie Riddle,Giselle Perez-Aguilar

“Prison life is very hard and it’smade

harder if you’re isolated”: COVID-19 risk

mitigation strategies and the mental health

of incarcerated women in California

Jennifer E. James, Leslie Riddle and Giselle Perez-Aguilar

Abstract

Purpose –This study aimsto describe the COVID-19 risk mitigation strategiesimplemented in California

prisonsand the impact of these policies on the mental healthof incarcerated women.

Design/methodology/approach –The authors conducted semi-structured qualitative interviews with

ten women who were over the age of 50 and/or had a chronic illness and had been incarcerated in

California prisons during the COVID-19 pandemic. The authors also interviewed ten health-care

providers working in California jails or prisons during the pandemic. Interviews were analyzed using a

grounded theory coding frameworkand triangulated with fieldnotes from ethnographic observations of

medicaland legal advocacy efforts during the pandemic.

Findings –Participantsdescribed being locked in their cells for 23 hoursper day or more, often for days,

weeks or even months at a time in an effort to reduce thespread of COVID-19. For many participants,

these lockdowns and theresulting isolation from loved ones both inside and outside of the prison were

detrimental to both their physicaland mental health. Participants reported that access to mental health

care for those in the general population was limited prior to the pandemic, and that COVID-19 risk

mitigation strategies, including the cessation of group programs and shift to cell-front mental health

services,created further barriers.

Originality/value –There has been little qualitative research on the mental health effects of the COVID-19

pandemic on incarcerated populations. This paper provides insight into the mentalhealth effects of both the

COVID-19 pandemic and COVID-19 risk mitigation strategies for the structurally vulnerable older women

incarcerated in California prisons.

Keywords Mental health, Qualitative research, Women prisoners, Correctional health care,

Elderly prisoners, COVID-19

Paper type Research paper

Introduction

The COVID-19 pandemic has wreaked havoc on structurally vulnera ble populations in the USA,

with a disproportionate impact on Black, Indigenous and People of Co lor (BIPOC) (Laster Pirtle,

2020). Nowhere can this be seen more clearly than in correctional facilities, where COVID-19 has

spread with abandon. J. Clark Kelso, the Federal Receiver overs eeing health care across the

California Department of Corrections and Rehabilitation (CD CR), described the catastrophic

potential of the pandemic noting, “If the coronavirus were designing its ideal home , it would build

aprison”(

Coleman v Newsom,2021). Indeed, early in the pandemic, health experts raised alarm

about the unique risks the virus would undoubtedly pose for incarcerated populations (Hewson

et al.,2020

;McCoy et al., 2020;Stewart et al.,2020), given that the structural realities of carceral

settings, such as crowded conditions, limited sanitation, freque nt turnover and a high prevalence

(Informationabout the

authorscan be found at the

end of this article.)

Received 11 September 2021

Revised 18 February 2022

Accepted 21 April 2022

©Jennifer E. James, Leslie

Riddle and Giselle Perez-

Aguilar. Published by Emerald

Publishing Limited. This article

is published under the Creative

Commons Attribution (CC BY

4.0) licence. Anyone may

reproduce, distribute, translate

and create derivative works of

this article (for both commercial

and non-commercial

purposes), subject to full

attribution to the original

publication and authors.

The full terms of this

licence may be seen at http://

creativecommons.org/licences/

by/4.0/legalcode

The authors would like to thank

the participants for sharing their

stories and experiences with

us. This project was funded by

the University of California, San

Francisco, School of Nursing

Intramural Research Fund and

by the National Institute on

Drug Abuse, R25DA037190.

DOI 10.1108/IJPH-09-2021-0093 VOL. 19 NO. 1 2023, pp. 95-108, Emerald Publishing Limited, ISSN 1744-9200 jINTERNATIONAL JOURNAL OF PRISONER HEALTH jPAGE 95