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.

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 capacity.

For years Oklahoma has incarcerated more women per capita than any other state in the nation. Two prisons house women: 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 Risk 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 normal, than I did (in prison),” Frazier said.

Facts

* 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.

* 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.

* Oklahoma has at least 122 mandatory minimum prison sentences for anyone convicted of certain crimes, according to the Oklahoma Policy Institute, a nonprofit think tank.

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