“You Have to Take Care of Your Own Mental Status”: Incarcerated Women Seeking Care Within and Beyond Mental Health Treatment

Incarcerated women in the United States commonly experience prison-based mental health treatment. Feminist scholars stress the need to explore how incarcerated women exercise agency while navigating controlling treatment dynamics and how they experience these dynamics in relation to aspects of their selves (e.g., their thoughts and feelings). To explore these dynamics, we conducted semi-structured individual interviews with 42 incarcerated women in a Midwestern state prison and with life history calendars, elucidated women's treatment encounters over time. Through analysis of these interviews, we contend that women experienced dehumanizing dynamics within treatment, particularly curtailed communication from the staff that silenced women, created unfamiliar selves, and contributed to physical harm and psychological harm. Based on these findings, we conceptualize prison-based mental health treatment as health harm rather than health care. We also found that women responded to controlling dynamics with forms of self-preservation including strategies of treatment decision-making that affirmed their selves, active treatment refusal as self-protection, and forming meaningful connections with others that validated aspects of their selves. Based on women's care-based strategies, further feminist theorizing and practice directions are needed that align with, build upon, and are guided by incarcerated women's varied definitions of care to improve their mental health and well-being.