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12 Women Prisoners and Mental Health Issues Assessment Task Three: Research Proposal Word Count: 1883 Referencing: Harvard Wafa Fatima 218391615 Women Prisoners and Mental Health Issues Introduction Mental health issues are very prevalent among women prisoners as it is reported that 68 percent of women in jail have a history of mental health illnesses as compared to 41 percent of men who reported having mental health issues while in prison (Bellamy et al., 2019:188). It is thus imperative to have effective programs and strategies in place to help women prisoners address the mental health issues they face so they can achieve better health outcomes and improve their quality of life. The research will help to identify the experiences and the most effective programs and strategies that could be used to address the issue of mental health challenges among women prisoners. Research Rationale & Theoretical Framework The majority of predominant research literature addresses the prevalence of mental health issues among women prisoners. One of the articles stipulates that 68 percent of women in jail had reported having a history of mental illnesses whereas only 41 percent of men had reported having mental health issues while in prison (Bellamy et al., 2019:188). This article clearly specifies the prevalence of mental health issues and psychological distress among women prisoners under incarceration. A survey conducted as per Marshall Project, from February 2011 to March of 2012 and asked more than 100,000 men and women in prisons whether they have experienced any mental health issues such as anxiety, depression, bipolar disease, schizophrenia, post-traumatic stress disorder (PTSD) and other mental health illnesses over previous 30 days mark and 39 percent of participants had been diagnosed with a mental illness and 19 percent stated they had experienced mental distress. 66 percent of women almost twice the percentage of men reported history of mental health illness. (Equal Justice Initiative, 2017). Other research articles have identified some factors contributing to the prevalence of mental health issues among women prisoners in Australia. For instance, Bright, Higgins, and Grealish (2022:2) illustrated how the type of services accessed by the women prisoners, the challenges encountered, the erosion of privacy and dignity, and the strained relationships between the women prisoners and the prison staff as well as the reduced capacity to self-manage the mental well-being of the women prisoners contributed to the prevalence of mental health issues among women prisoners. This research article is limited because it failed to address the programs and strategies that should be implemented to address the prevalence of mental health issues among women prisoners. The research rationale for this project, therefore, will be to identify the most effective programs and strategies that should be implemented to address the prevalence of mental health issues among women prisoners. This will be important because it will not only help to understand prison-based mental health care from the perspective of women but also improve the quality of life and health outcomes for women prisoners. For this research proposal, the theoretical framework that will be used is the eco-social theoretical framework. As eco-social theoretical framework will cover the experiences of women prisoners and identify the most effective programs and strategies that can be used to address the issue of mental health challenges among women prisoners. The eco-social theory will assist in exploring 1) how the context of the individual and social choices is connected to the biological understanding and the physical reaction to the health and bodies of the women and 2) identify what and who is responsible for health disparities affecting women (Henry, 2020:271; Jahn et al., 2020:112). Research Proposition: Research Question(s)/Hypotheses Women in correctional facilities endure a wide range of mental health issues such as anxiety, depression, bipolar disease, schizophrenia, and post-traumatic stress disorder (PTSD) and other mental health issues (Equal Justice Initiative, 2017). The research rationale led to the formulation of the following research questions pertaining to mental health issues among women prisoners. Research Questions RQ1. What are the prison-based mental health care experiences of Australian women in prison settings? RQ2. What are the most effective programs that can be used to address the issue of mental health challenges among women prisoners? RQ3. What are the most effective strategies that can be used to address the issue of mental health challenges among women prisoners? Research Approach & Scope Research Approach The research approach that will be used for the project will be an evaluative analysis. An evaluative analysis is more suitable for this project as it will help to conduct a systematic assessment of some of the programs and strategies in place to enhance the mental well-being of the women prisoners and to establish the most effective programs and strategies for improved mental health of women prisoners (Bellamy et al., 2019:188). Through this project, it is expected that the existing strategies and programs will be evaluated to identify their impact on improving the mental health issues of women prisoners. This research approach will also help to evaluate the experiences of the women prisoners regarding their mental health during their incarceration. Scope The scope of this project will be to discuss the mental health experiences of Australian women in prison settings and to determine the most effective programs and strategies that can be used to address their issue of the deteriorating mental health well-being. Research Conceptualization The key concepts are mental health, women prisoners, prison, vulnerable populations, determinants of health, health disparities, and public health. Mental health will refer to the emotional, social, and psychological well-being of the women prisoners that affects the way they think, act, and feel (Thomas, 2015:66). A prison is a facility where those who have committed crimes or are waiting for a trial are held. Women prisoners are the women who have been incarcerated and deprived of their liberty against their will in correctional facilities or prisons. The vulnerable populations are the groups of people in a community who are economically disadvantaged, the elderly, homeless, the racial and ethnic minorities, the uninsured, those with human immunodeficiency virus (HIV) infection, and those with other chronic health conditions such as severe mental illnesses (Thomas, 2015: 140). Determinants of health will refer to a wide range of factors that influence the health of an individual (Lipshutz et al., 2022:380). These factors that determine the health of an individual include genetic factors, environmental factors, social factors, behavioral factors, physical influences, as well as medical care (Lipshutz et al., 2022:380). The definition of determinants of health defers from the definition used by the Healthy People 2030 which defined the five key areas (determinants) of health to include economic stability, education, social and community context, health, and health care, as well as neighborhood and built environment (Healthy People, 2030: para.2). Health disparities will refer to the preventable differences in the burden of the disease, violence, injury, or opportunities intended to help the women prisoners achieve the optimal care. In this case, health disparities will be considered based on socioeconomic status, gender, citizenship status, sexual identity and orientation, and disability status. The final concept will be public health which will refer to the act of protecting and promoting the health of the people and the communities in which the people live (Parkes et al., 2020:60). In this project, public health will be the term to refer to the promotion and protection of the health of the women and the community in which they live. Research Operationalization To identify the indicators in a more scholarly manner, the research project will utilize prior empirical and theoretical work in interest. Theories will point the research project in the right direction to effectively identify the appropriate concepts and possible indicators. For instance, empirical work will help to identify how some of the concepts regarding the mental health issues among women prisoners had been measured in the past and the indicators that may have been used. Mental issues such as anxiety, depression, bipolar disease, schizophrenia, and post-traumatic stress disorder (PTSD) will be considered to be independent variables while improved health outcomes will be considered to be dependent variables. This is because as mental health issues reduce, patient outcomes improve. Scales and indexes will be used to measure the variables. For example, the Beck Depression Inventory (BDI-6), General Health Questionnaire (GHQ-12), and Mental Health Index (MHI-5) will be used to screen for depression and the severity of depression (Elovanio et al., 2020: 112973). Sampling, Data Collection and Analysis Sampling/Units of Analysis To test the research question, a systematic review will help to collect the data. PRISMA guidelines helped to conduct the systematic review and identified 21 articles of which 18 were empirical studies while the remaining 3 articles were literature reviews and were thus excluded. The full texts of the empirical studies were read and the results were synthesized. The quality of the studies included was assessed based on AMSTAR-2 criteria to ensure the quality of the studies. Data Collection Studies will be selected by selecting the title and abstract for full-text review to determine the relevance of the articles to meet the objectives of the review. The articles will be selected from EBSCOhost and Google Scholar. This systematic review will be limited to only empirical studies. As a result, meta-analytic studies, literature reviews, special government reports, commentaries, and editorials will be excluded from the study. The articles selected described the study participants, who included a specific number of women with mental health issues in an Australian-based prison or correctional facility. The research objectives will have to be related to improving mental health issues while the theoretical framework should be the ecological theoretical framework. Data Analysis The research will use a cross-sectional study approach. A cross-sectional study approach will help to record information about the subjects without the need for the researchers to manipulate the environment (Spector, 2019: 125). This will help to record the information without the need to influence the variables. A cross-sectional study is advantageous because it allows the researchers simultaneously compare different variables under study. For example, both the age, gender, level of education, income, and support of the women prisoners could be studied at the same time without additional costs (Spector, 2019: 125). Ethical, Political, and Other Considerations Ethical Issues Since the project will be a systematic review, informed consent will not be sought from the study participants. Besides, a systematic review does not collect sensitive, personal, and confidential information from the study participants. The ethical considerations that will be prioritized will be to accurately represent the interests of all the stakeholders. Accurately presenting the findings will help to address and potentially reduce conflicts of interest, issues of voice, as well as representation (Suri, 2020:41). Political Considerations There were no political considerations to declare. The findings and conclusions of the systematic review are those of the author and do not represent the position of any outside entity or organization. Therefore, there were no conflicts of interest declared politically. Other Considerations The paper was not funded or supported by any individual or organization. The benefit of the proposed study is that it will help to fill some gaps in the existing literature. The proposed study will also help identify the experiences of and the most effective programs and strategies that could be used to address the issue of mental health challenges among women prisoners. The possible risk of the study is that it is subject to bias from multiple sources since it is systematic research. Reference List Bellamy, C., Kimmel, J., Costa, M.N., Tsai, J., Nulton, L., Nulton, E., Kimmel, A., Aguilar, N.J., Clayton, A. and O’Connell, M., 2019. Peer support on the “inside and outside”: building lives and reducing recidivism for people with mental illness returning from jail. Journal of Public Mental Health, 18(3), pp. 188-198. https://doi.org/10.1108/JPMH-02-2019-0028. Bright, A.M., Higgins, A. and Grealish, A., 2022. Women’s experiences of prison-based mental healthcare. A systematic review of qualitative literature. International Journal of Prisoner Health. https://doi.org/10.1080/08974454.2022.2071376 Elovanio, M., Hakulinen, C., Pulkki-Råback, L., Aalto, A.M., Virtanen, M., Partonen, T. and Suvisaari, J., 2020. General Health Questionnaire (GHQ-12), Beck Depression Inventory (BDI-6), and Mental Health Index (MHI-5): psychometric and predictive properties in a Finnish population-based sample. Psychiatry Research, 289, p.112973. Equal Justice Initiative (07.10.2017). More Incarcerated Women than Men Report Mental Health Problems. https://eji.org/news/more-incarcerated-women-report-mental-health-problems/ Healthy People, 2030. Social determinants of health. Available from: https://health.gov/healthypeople/priority-areas/social-determinants-health Henry, B.F., 2020. Adversity, mental health, and substance use disorders as predictors and mediators of rule violations in US prisons. Criminal justice and behavior, 47(3), pp.271-289. Jahn, J.L., Chen, J.T., Agénor, M. and Krieger, N., 2020. County-level jail incarceration and preterm birth among non-Hispanic Black and white US women, 1999–2015. Social Science & Medicine, 250, p.112856. Lipshutz, J.A., Hall, J.E., Penman-Aguilar, A., Skillen, E., Naoom, S. and Irune, I., 2022. Leveraging Social and Structural Determinants of Health at the Centers for Disease Control and Prevention: A Systems-Level Opportunity to Improve Public Health. Journal of public health management and practice: JPHMP, 28(2), p.E380. Parkes, M.W., Poland, B., Allison, S., Cole, D.C., Culbert, I., Gislason, M.K., Hancock, T., Howard, C., Papadopoulos, A., and Waheed, F., 2020. Preparing for the future of public health: ecological determinants of health and the call for an eco-social approach to public health education. Canadian Journal of Public Health, 111(1), pp.60-64. Spector, P.E., 2019. Do not cross me: Optimizing the use of cross-sectional designs. Journal of Business and Psychology, 34(2), pp.125-137. Thomas, R.K., 2015. In sickness and in health. Springer New York.