In her dorm at Dr. Eddie Warrior Correctional Center in Taft, anxiety attacks used to waken Nikki Frazier in the middle of the night. For about an hour she would sit on her bed, shaking, sweaty and nauseous.
“It would feel like I was having a heart attack,” Frazier said. “It was just a big ball of weight in my chest, and it was so bad.”
Frazier could point to one source of her anxiety: In 2005, she got into a dispute with her then-husband, and he kicked her repeatedly in the face with steel-toed boots, for which he was later convicted. Six years later, a doctor cited the beating in diagnosing Frazier with post-traumatic stress disorder, severe anxiety and depression.
Serving a prison sentence for forging checks, Frazier suffered attacks for months until she was able to see a psychiatrist and get on a different medication. But she said she could never truly calm her anxiety until she was released in February. She gained control over her life and began receiving one-on-one counseling.
Frazier’s mental-health struggles reflect those of hundreds of women in Oklahoma prisons.
Oklahoma Women Suffer PTSD
Oklahoma Watch obtained detailed data on mental health diagnoses for men and women in prison from the state Department of Corrections and found dramatic differences in their conditions.
About 62 percent of female inmates showing signs of a serious mental illness are classified as nonviolent offenders. That compares with 43 percent of male inmates.
According to the data – a snapshot in late March – nearly 60 percent of female inmates show signs of mental illness, about twice the percentage of male inmates. A total of 3,104 women and 25,620 men were in the corrections system at the time.
Women also suffer disproportionately from depression – 64 percent versus 59 percent of men.
But the most striking difference occurs with trauma disorders. PTSD is the second most common mental illness among incarcerated women, with about one in five showing symptoms, or five times the rate for men.
Nationally, women are twice as likely as men to suffer from PTSD because they tend to face more emotional and sexual abuse, according to the Anxiety and Depression Association of America.
In prison, the effects can be worsened by separation from family or children, the stressful environment and failure to get consistent, quality treatment, other than psychotropic drugs, inmates and mental health experts said.
“No fault in the prison system, that’s just what they’re trained to do: ‘Here, take this pill,’” said Kimberly Cummings, of Just the Beginning, a Tulsa-based nonprofit that helps women released from prison. “Because it will numb them. It will numb that pain (from trauma).”
Women in prison also can easily get illicit drugs, which allow them to avoid confronting trauma issues, inmates and experts said.
“They’re good avoiders, and drug use itself is a good way to avoid,” said Roxanne Hinther, clinical director for Tulsa-based Women in Recovery, which offers women an alternative to incarceration.
The Justice Safety Valve Act, signed into law on May 4, may open the door for more trauma victims convicted of nonviolent crimes to receiving mental health and trauma treatment. The measure, House Bill 1518, authorizes judges to depart from certain mandatory minimum prison sentences.
A new challenge for prisoners is the decline in therapy sessions in recent years. From 2012 to 2014, the average number of mental-health group therapy sessions per month in prisons fell by nearly 50 percent, to 176, according to Corrections Department data. The average number of offenders in those sessions per month also dropped. Corrections officials attributed the decline to a shortage of psychiatrists, which occurred even as the prison population increased to well above official capacity.
For years Oklahoma has incarcerated more women per capita than any other state in the nation. Two prisons house female inmates: Dr. Eddie Warrior in Taft, with 965 inmates in late March, and Mabel Bassett Correctional Center in McLoud, with 1,206 inmates.
Terri Watkins, spokeswoman for the Corrections Department, said Eddie Warrior offers a substance abuse program called Helping Women Recover that includes trauma therapy. Funded by the George Kaiser Family Foundation, the program has curricula called "Beyond Trauma" and "Beyond Violence" that are "trauma informed," Watkins said. (The Kaiser Foundation is a funder of Oklahoma Watch.)
Six Months of Anxiety
Frazier was incarcerated in both 2012 and 2014 for forging checks. For her second sentence, she was court-ordered to participate in a boot camp-style treatment program to help her recover from a meth addiction.
Frazier said it was difficult to participate in the boot camp at first because she was prescribed Prozac for her anxiety. The drug “zombified” her, she said.
“I had to get up at 5 o’clock in the morning and be roaring and ready to go,” Frazier said. “So something that made me very sleepy was not OK.”
She said she submitted a “sick call” five times requesting she be given another drug instead, Wellbutrin, which she had taken before she was sentenced to prison and which worked well. The switch wasn’t approved for six months.
“They process them (sick calls) daily, but with over a thousand inmates, sometimes it just takes awhile to get to everybody,” Frazier said.
Frazier also had a meth addiction, which reflected the prevalence of addictions among female inmates. About 65 percent of incarcerated women, and 40 percent of men, exhibit signs of a substance abuse disorder, according to Corrections Department data.
“You’ll have dreams about it,” Frazier said of meth. “Sometimes I’ll wake up tasting it in the back of my throat.”
After leaving prison in February, Frazier moved into Exodus House, a reentry program in Oklahoma City that provides temporary housing to released inmates and drug addicts. She recently left the facility.
Lifelong Risks of Trauma
Trauma disorders afflict women more than men for several reasons.
Young girls and boys are equally vulnerable to trauma, Hinther said. But as they enter puberty, boys get bigger and stronger, so their likelihood of experiencing sexual trauma and abuse starts to decline. The likelihood for women remains the same.
Also, when men are victims of violence, it’s often perpetrated by strangers, such as in the military or a bar fight, Hinther said. Women’s trauma is often inflicted by someone close to them.
More than half of female victims of rape reported that at least one perpetrator was a current or former intimate partner, according to a 2010 national sexual violence survey by the U.S Centers for Disease Control and Prevention.
“If your abuse is coming from someone who says ‘I love you,’ it’s a lot more personal than from someone who you don’t know,” Hinther said.
A lot of Women in Recovery participants have very complex trauma histories, Hinther said. They’re suffering from the effects of not just one traumatic event, but from a series of them, and that can play out over a lifetime.
Cummings said sending nonviolent offenders to prison while they’re struggling with trauma-related mental illness will only worsen their symptoms. About 62 percent of female inmates showing signs of serious mental illness were nonviolent offenders, according to corrections data.
At Eddie Warrior, Frazier was in an open dorm with about 90 other women. She said loud noises and women talking over other women would trigger her severe anxiety.
Today with counseling and more control over her life, “I feel a lot more stable, a lot more normal, than I did (in prison),” Frazier said.
In Prison, and Unaware of Trauma’s Sway
Many women in prison don’t realize they are suffering from long-term trauma effects.
If they did, says former inmate Tabitha Kincannon, they could take the first steps toward recovery.
Kincannon was 6 years old when she saw a man shoot her father in the head in their home.
Her babysitter had sought refuge from an abusive husband, and in the middle of the night her husband broke into the home and shot Kincannon’s father.
Her father lived, but Kincannon, now 37, can still picture the pool of blood on the floor.
At a young age, Kincannon developed issues with rage and began cutting herself on the arm. Her father took her to various therapists and mental institutions, and she was diagnosed with bipolar disorder.
At age 16, Kincannon left home, and a drug-clouded decade followed as she worked at a strip joint, went to prison and tried to become a drug dealer.
Kincannon said she didn’t seek mental health treatment or participate in any programs the first time she was in prison. She also said it was easy to get illicit drugs.
“You can get high quicker in prison than you can on the streets off of prescriptions, meth, weed,” said Kincannon, who left Mabel Bassett Correctional Center in March. “Heroin is real thick right now.”
Kincannon said the second time she went to prison, she saw dozens of additional inmates – a sign of the state’s rising prison population.
“You have very little room, there’s not enough room to put their stuff, their clothes, I mean nothing. You have to literally fold them up and put them under your mat,” Kincannon said.
“They’re keeping them on lockdown more. When you keep them on lockdown more, it’s awful. I mean imagine being locked in with 70 women in one pod.”
During her second sentence, Kincannon participated in a program in which inmates receive substance abuse treatment in a separate housing unit. She also started attending church, which she said that helped her more than any medication she’d received.
When Kincannon was released, she sought help from Just the Beginning in Tulsa. She said she’s felt empowered by learning what post traumatic stress disorder is and simply recognizing her trauma-induced symptoms.
Kimberly Cummings, of Just the Beginning, said that during one of Kincannon’s first meetings at the facility, others asked her if she realized she had trauma.
“(We said), ‘You do realize you have trauma,’” Cummings said, “and it broke her.”
Cummings said it’s essential for trauma victims to receive therapy in order to work through their experiences.
After Many Years, a Grasp at Recovery
The earliest jolts of trauma in childhood can last for a lifetime, unless help is accepted.
Patricia “Trisha” Munz said she was sexually molested when she was 6 years old. She said her mom used to blame her for the abuse, so she grew up believing it was her fault.
“I hated myself because of this one event,” Munz said.
At age 10 her grandmother adopted her and took her to a counselor, who diagnosed her with PTSD. Yet her self-blaming followed her through adolescence and she fell into abusive relationships.
Munz said she began smoking marijuana at age 12 and later began taking harder drugs like cocaine. At age 15 she left home.
“As I got older, in relationships I’d be with guys who would beat me, get me high and sexually abuse me,” Munz said. “I always blamed it on myself and thought everything that happened was my fault.”
Munz was convicted of robbery with a weapon twice in 2005 and 2006 and sentenced to prison.
Munz said she didn’t realize she had a serious mental disorder until fall 2013, when she began participating in cognitive processing therapy at Women in Recovery, a Tulsa diversion program.
Now, she no longer gets startled easily or has nightmares. She also doesn’t need medication for anxiety. As part of her therapy, she wrote down what she has control over, what is her fault and what she can do to change her thinking.
“I realized I never had control over what happened to me as a child,” Munz said. “I have control over what happens me today.”
Munz said she couldn’t have recovered as well in prison because she wasn’t yet committed to breaking her drug addiction. Court records show she was accused of probation violations starting in 2012. When she was diverted to the Women in Recovery program, she realized she needed to change.
“If I’d gone back to prison, I’d most likely be dead, the way I was going.”
This story is part of an Oklahoma Watch project titled, “Troubled State: A Series on Mental Health.”
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