Policy Brief
Survey Examines Victimization inside Prisons
Concern about victimization inside prisons and jails has been growing at the same time
that the number of people with mental illness residing in these facilities has increased.
This double spiral is troubling because, as research indicates, rates of victimization are elevated for people with serious mental illness living in community and psychiatric settings.
Furthermore—although empirical evidence has been lacking—the international advocacy
organization, Human Rights Watch, documented the mistreatment and victimization
of people with mental illness inside prisons. This elevated the issue to a policy level that
culminated in federal legislation known as the Prison Rape Elimination Act of 2003.
To better understand the issue of victimization inside prison as it relates to individuals
with mental illness, the Center, as part of research funded by the Prison Rape Elimination
Act, recently conducted a survey on the quality of prison life. This research was conducted
in cooperation with the New Jersey Department of Corrections. A random sample of adult
inmates reported on the quality of medical and mental health treatment, vocational, educational, and legal services available to them; their treatment by officers and medical staff;
sexual and physical victimization attempted or perpetrated by other inmates and staff, as
well as the grievance procedures and physical environment.

“The first duty of a prison…
is to perform the function
assigned to it by law… .
It must, however, be clear
that it is the imprisonment,
and not the treatment in
prison, that constitutes the
punishment. Men come
to prison as a punishment,
not for punishment.”
— Sir Alexander Paterson

Approximately 7,500 randomly selected male and female
inmates completed an hour-long survey using audio computer-assisted self-interview technology. A 40 percent random
sample was drawn from each of 13 male adult institutions
and a 60 percent sample from the only female institution
involved in the survey.
Mental Disorder inside Prison
For reporting purposes, mental disorder was based on selfreported previous mental health treatment for particular
mental disorders. More than one in five male inmates and
one in two female inmates reported prior mental health
treatment for a mental disorder. Prior treatment for schizophrenia or bipolar disorder was reported by roughly one
third of male and female inmates reporting prior mental
health treatment. 1

Prevalence of Victimization
Six-month prevalence rates of sexual victimization were higher for male and female
inmates with a mental disorder, compared to inmates without a reported disorder (Table
1). For those reporting mental disorders, female inmates reported rates of sexual victimization that were nearly two to three times higher than rates estimated for their male
counterparts.
Physical victimization was more common than sexual victimization among both male
and female inmates. Both males and females with mental disorder were disproportionately
represented among victims of physical violence inside prison (Table 2). Six-month prevalence rates of physical victimization for males with any mental disorder were 1.6 times
higher for victimization perpetrated by other inmates and 1.2 times higher if perpetrated
by staff than that of males with no mental disorder. For female inmates, those with a mental disorder were 1.7 times more likely to report being physically victimized by another
inmate than their counterparts with no mental disorder. 2

Authors

Nancy Wolff, Ph.D., Director
of the Center and Professor of
Public Policy, Rutgers
University, New Brunswick.
(nwolff@ifh.rutgers.edu)
Jing Shi, M.S., Statistician,
Center for Behavioral Health
Services & Criminal Justice
Research. (jshi@ifh.rutgers.edu)
Jane Siegel, Ph.D., Associate
Professor and Chair of the
Department of Sociology,
Anthropology, and Criminal
Justice, Rutgers UniversityCamden, and a Research
Affiliate of the Center.
(jasiegel@camden.rutgers.edu)

About the Policy Brief

The policy brief series is
produced monthly and highlights a policy issue under
study at the Center. Policy
topics include reentry,
diversion, sentencing,
recidivism, employment,
treatment, and recovery. For
more information, see the
News page on the Center’s
website.

The Center is a research unit
in the Institute for Health,
Health Care Policy, and Aging
Research.
Center for Behavioral Health Services
& Criminal Justice Research
176 Ryders Lane
New Brunswick, NJ 08901
Tel: 732.932.1225
Fax: 732.932.1233
www.cbhs-cjr.rutgers.edu

Survey Examines Victimization inside Prisons

“. . . . ain’t nobody cares.” — New Jersey inmate
Practice and Policy Implications
People inside prison with mental disorders and prior
histories of violent victimization are more likely to be
victimized inside prison. Using these factors to classify
people upon admission to prisons is critical for keeping
them safe from predatory inmates. The increased vulnerability of people with mental illness inside correctional
settings should be considered as a mediating factor in
sentencing and as a justification for promoting diversion in lieu of incarceration for non-violent offenses. As a
result of this study, the New Jersey Department of Corrections added curriculum on victimization to correctional
officer training. It also introduced a zero tolerance policy
on prison rape and an educational campaign among the
inmate population focusing on prevention, reporting, and
treatment of sexual victimization.

Mental Illness as a Predictor of Victimization
Prior treatment for depression, post-traumatic stress disorder (PTSD), or anxiety increased the likelihood of a male
inmate being a victim of sexual assault and inappropriate
sexual contact by another inmate, while having prior treatment for schizophrenia or bipolar disorder predicted inappropriate sexual contact but not sexual assault. The most
significant predictor, however, was prior sexual victimization. Inmates, both male and female, who reported sexual
victimization prior to age 18 were two to four times more
likely to report being sexually victimized inside prison
than inmates without such victimization histories.3
Depression, PTSD, and anxiety also elevated rates of
physical assault and property theft, as well as the number
of such incidents among male inmates—but not at the
level found for sexual victimization. Physical victimization
prior to age 18 also predicted physical victimization
inside prison.4

Table 1. Six-month prevalence rates of sexual victimization, male and female inmates by mental disorder
Rate of Sexual Victimizationa per 1,000 Inmates
Male Sample (n=6,964)
Perpetrator-type

Female Sample (n=564)

Any Mental
Disorder
(n=1,494)

Seriousb
Mental
Disorder
(n=447)

No Mental
Disorder
(n=5,369)

Any Mental
Disorder
(n=325)

Serious
Mental
Disorder
(n=120)

No Mental
Disorder
(n=234)

Inmate

83c

101

31

234

224

185

Staff

95

91

70

79

95

75

Inmate or Staff

151

163

89

272

285

209

a

Defined as sexual assault or inappropriate touching that is sexually threatening.
Defined as self-reported prior treatment for schizophrenia or bipolar disorder.
c
Interpretation: For every 1000 inmates, 83 (or 8.3%) reported being sexually victimized by another inmate during a six-month period.
b

Table 2. Six-month prevalence rates of physical victimization, male and female inmates by mental disorder
Rate of Physical Victimizationa per 1,000 Inmates
Male Sample (n=7,221)
Perpetrator-type

a
b

2	

b

Female Sample (n=564)

Any Mental
Disorder
(n=1,609)

Serious
Mental
Disorder
(n=476)

No Mental
Disorder
(n=5,507)

Any Mental
Disorder
(n=325)

Serious
Mental
Disorder
(n=120)

No Mental
Disorder
(n=234)

Inmate

292

310

180

249

256

149

Staff

283

266

235

95

113

69

Inmate or Staff

428

428

324

289

303

173

Excludes property theft.
Defined as self-reported prior treatment for schizophrenia or bipolar disorder.

September 2008

Survey Examines Victimization inside Prisons

Next Step—Pilot Trial of Two Interventions for Trauma,
Substance Use, and Mental Illness
An abundance of evidence shows that the majority of women inside prison have
mental health problems; have experienced physical, sexual, or emotional abuse
during their formative years and often in adulthood; and have a substance use
problem. Each of these experiences and behaviors increases the risks for posttraumatic stress disorder (PTSD). Yet only a minority of these women receives
treatment for PTSD while incarcerated, even though these problems are risk
factors for returning back to prison after release. This is compounded by the
fact that women are entering and leaving prison in record numbers.
The Center is funding a double-randomized pilot trial of two manualized interventions for female inmates with mental illness, substance use disorders, and
trauma histories: “Seeking Safety” and “Trauma Recovery and Empowerment
Model.” Both of theses interventions have evidence supporting their effectiveness but it is unclear which is most effective. The goal of this study is to identify
which manualized intervention is most effective in a correctional setting (and for
whom) and to identify whether these interventions when combined with reentry
interventions improve clinical, behavioral, and social outcomes.
Women will be randomized first to the trauma-integrated interventions. After
completing one of the two trauma-integrated interventions, they will be randomized again to a skill-based reentry intervention or the usual reentry condition.
Subjects will be followed into the community upon release and compared
on mental health, substance use, independent living, and criminal justice
outcomes.

“During my many years in
prison, I have personally
witnessed hundreds of serious
stabbings, beatings, inmates
set on fire, and countless
actual killings. My question
to you [is] what makes the
trauma of seeing ‘man’s inhumanity to man’ first hand here
in prison any different than
that experienced by soldiers?”
— New Jersey inmate

For more information regarding this project, email Dr. Nancy Wolff (team leader)
at nwolff@ifh.rutgers.edu.
Co-investigators: Joan Cook (Columbia Medical School), Christopher Frueh
(Baylor College), Lisa Najavits (Boston University), Gregory McHugo (Dartmouth
College), and Thomas TenHave (University of Pennsylvania).

More Information on Victimization Inside Prison
See our website www.cbhs-cjr.rutgers.edu to find more publications describing findings from our research on victimization
inside prison.

Future Policy Issue Briefs
October 2008

Critical Time Intervention and Reentry by Jeffrey Draine and Beth Angell

November 2008

Mental Illness, Arrest, and Best Practice Interventions by William Fisher and Bob Drake

January 2009
	

Crisis Intervention Teams and Police Diversion by Amy Watson, Jeffrey Draine,
Melissa Schaefer Morabito, and William Fisher

Endnotes
Wolff, N., Blitz, C.L., & Shi, J. (2007). Rates of sexual victimization in prison for inmates with and without mental disorders. Psychiatric Services, 58,
1087-94.
1

2

Blitz, C.L., Wolff, N., & Shi, J. (2009). Physical victimization in prison: The role of mental illness. International Journal of Law and Psychiatry, in press.

Wolff, N., Shi, J., Blitz, C.L., & Siegel, J. (2007). Understanding sexual victimization inside prisons: Factors that predict risk. Criminology & Public Policy,
6(3), 201-231.
3

4

Wolff, N., Shi, J., & Siegel, J. (2009). Understanding physical victimization inside prisons: Factors that predict risk. Justice Quarterly, in press.

September 2008

3