Goldman School student Jessie Harney speaks with host Jonathan Stein (MPP/JD '13) about mental health support for people suffering from PTSD, especially victims of sexual assault.
Jessie is a Master of Public Policy candidate at the Goldman School of Public Policy. She has a Bachelor of Science in Psychology from Truman State University and a Master of Science in Biostatistics from Washington University in St. Louis. Jessie’s research interests lie in criminal justice, and more specifically, prison reform. Her hobbies include Muay Thai, anything from the Legend of Zelda series, and cheese.
Jonathan: I'm Jonathan Stein and this is talk policy to me. Today we're talking about mental health in a particularly difficult context: the mental health challenges of sexual assault survivors and the difficulties they face in getting treatment. The “Me Too” movement has forced this country to confront how it thinks about, how it talks about it, and how it punishes or too often doesn't punish sexual harassment and sexual assault. The movement has empowered survivors to speak out. It has shined a light on predatory behavior and sexual assault by powerful figures like Harvey Weinstein. Now it remains to be seen if this important cultural moment will continue and bring justice for survivors who work and live outside of the spotlight. One group of sexual assault victims that was completely in the shadows are prisoners. According to one Department of Justice study. More than 200,000 people are victims of some kind of sexual abuse in prisons, jails, and juvenile facilities every year. Prison guards, the people responsible for keeping order in incarceration facilities are responsible for half of sexual assaults. For all survivors of assault, the mental health consequences can be dire. PTSD is common. Both seeking treatment and seeking justice can be hard for survivors on the margins, including in prison, it can be next to impossible. Our guest has worked on and studies these issues. Jessie Harney is a graduate student at the Goldman School of Public Policy. She has been a statistician and researcher studying mental health in America. She's also provided direct services to survivors of sexual assault and domestic violence. Today her policy interests revolve around prison reform with a focus on providing access to mental health services for survivors of prison rape and sexual assault. Thanks for joining us Jessie.
Jessie: Thanks for having me.
Jonathan: let's start by talking about PTSD. The public most commonly associates PTSD with soldiers and people in war zones. Tell us about how society conceptualizes PTSD and how it leaves certain people out.
Jessie: Right. I do think society does conceptualize PTSD very specifically with people in war zones with soldiers most specifically. And I think a lot of this is because the research has been focused on that population but it has left a lot of people out. There's a stigma to talking about sexual abuse sexual assault or anything of the like. And it has it's definitely kept a lot of people out of the conversation that haven't had their voices heard. That could certainly use someone to listen.
Jonathan: So, I suspect what that means for people who are suffering from PTSD because of some sort of traumatic experience in their life, or perhaps sexual assault, something outside of a war zone, it makes it harder to seek treatment because people may question the legitimacy of your experience.
Jessie: Yeah for sure. There's definitely a lot of stigma associated with disclosing sexual assault with just being able to understand that people will see it as legitimate even if you know there may be some that that will see it as legitimate but maybe just don't feel comfortable interfering because there is such a stigma around its acceptance in the first place. So yeah there's definitely some conversation that needs to be had and stigma to be reduced for sure.
Jonathan: You studied resilience factors with PTSD. Can you tell us what those are?
Jessie: Yeah, mainly social support. Pretty much all literature will strongly back social support. And that's for PTSD and for essentially all mental health issues. It's just extremely important that people have that connection with someone that maybe if they don't particularly connect with it themselves but that they'll be willing to listen that they feel that they have someone to really be there for them and to provide that support is just extremely crucial. You'll see that for sure within PTSD as well as with other mental health issues. But you certainly will also see early access to treatment. It's really important for people with PTSD to get treatment early and get the right treatment early. There's cognitive processing therapy. There's EMDR which is eye movement desensitized response. These are both true therapies that are very common. Trauma focus therapies. It's extremely important that people with PTSD get access to this because it's very hard to recover from trauma if you don't have the right kind of treatment.
Jonathan: So the more resilience factors you have the easier it is to recover from trauma. Is that what you're saying? So, things like the presence of an empathetic listener, early access to treatment, early access to the correct treatment, those sorts of things.
Jonathan: I would love if we could talk about what draws you to this issue. So, what drew you into studying mental health you've done it as a researcher as a statistician. Now you're doing it as an advocate. What drew you to the area?
Jessie: I think just being able to help people in need to help people who need to have their voice heard. And that's a very stereotypical answer but it's accurate and really, I wouldn't be honest if I said that it didn't have to do with my own experience. I think I think there's a there's a fine line between allowing your experience to dominate and bias your work. But I think there's also something very strong to be said for using your experience to power you forward but kind of leaving those biases at the door when you're approaching your work. I developed PTSD when I was 20. It was actually delayed from events that happened in my childhood through childhood sexual abuse and it's been a long road for sure. I really struggled in my undergraduate degree even my previous graduate degree. You'll be surprised how many people go through life very high functioning but are experiencing some really significant issues.
Jonathan: I'm not surprised. Navigating mental health systems can be notoriously difficult. I'd love if you could share a little bit about the barriers you had in accessing the right care for you.
Jessie: Yeah. It's a mess. I've gone through more than a dozen counselors. I started going to counseling when I was young through some family issues that were going on. My mother did help me get into treatment and certainly I was dealing with you know anxiety and depression when I was younger and then later on through some other precipitating events develop PTSD. But really there were a handful of really great counselors and then there were those that you know particularly weren't that helpful. You know I've definitely heard things when I was going to a counselor in my undergraduate degree. She actually she told me she's like I don't know how to handle PTSD. I haven't experienced this before. I haven't had to treat someone before. And you know I understood, you know, I was in a rural town in Missouri for college and I understood that that wasn't, you know, quote-on-quote “common” which you know, it is. I believe eight to 10 percent of women in their lifetime will have PTSD. She was actually happy when I told her I found someone else. She was like “oh great so we won't we won't see each other anymore?” And I was like “oh sure. All right.” So yeah. It's definitely difficult because you're already dealing with your friends who are frustrated with you for not being yourself and not doing well and then you have a counselor who's telling you the same thing that they can't handle you or having a counselor that asked me “oh have you tried thinking positively?” And I was like “yeah no I didn't think of that. Thanks though.” That'll stop it. But yeah. And like I joke and honestly having a sense of humor about it is… I can't describe how extremely important that is. But I've had friends that have more than made up for some of these difficulties for sure.
Jonathan: Sometimes informal systems of support have to replace the formal ones that are supposed to work.
Jessie: Absolutely. Absolutely.
Jonathan: So you've known researchers and policy advocates that work on mental health, the mental health of sexual assault survivors. Does your history make you rare among them or are a lot of people fueled by their personal experience?
Jessie: Yeah, my history makes me rare among nobody really. I think it's again like there's that fine line between bringing in your experiences to kind of help inform your work. And I think there's plenty of people that do that. I think a lot of people use their life experiences to propel them forward and to give them that purpose in their work. And I think it's good to talk about. But you know there's also you know a time and a place and sometimes it's also really important to keep that in check especially if you're doing advocacy work because you do you need to leave your biases out the door when you're sitting and working with someone for sure.
Jonathan:The personal is political and it's inevitable. There's no way for that to not be true for so many of us. Personal experiences and the experience of our family members have driven us in our lives to pursue higher education, to pursue a certain career, to pursue a particular academic degree, to pursue advocacy. Right? So, I think all of us take those experiences and make them fuel. You've worked on this as a statistician as a researcher I've talked about that before as a sexual assault victim advocate. You've also been a legal advocate for domestic violence survivors. Can you compare those experiences? What have you found to be the most impactful of them.
Jessie: It's difficult to say. I think for me and why I ended up coming to Goldman was the intersection of data and people oriented and people centric work was really what attracted me here. I loved being a sexual assault victim advocate and I know that sounds a little weird to say but being able to be whatever that person needed in that moment was extremely fulfilling and there's definitely nothing else I've experienced in my life that can really replace that. And sometimes that was just a comforting presence sometimes that was even just kind of a quiet presence. But often it was humor. There are definitely times where you can make jokes and you know people appreciate that and just really being able to advocate for people who are in that position. And it helped for sure inform why I'm here as far as the data aspect goes. You know it's interesting because I really do thrive on the emotional side of advocacy for sure but when it comes to data I'm definitely a nerd. I love programming. I enjoy pretty much all kinds of data analysis. There is something I do really remember when I was doing my thesis on distinguishing between fully diagnosed and subclinical PTSD. I remember coding and just being so excited. I'm generally excited when I'm coding but this was like this next level excitement and you can use the experiences you had as an advocate when you're when you're doing your research and then maybe it's not the most efficacious way to proceed with data analysis. But I have certainly tested things because of life experience and their things that came out actually really significant. Now granted I didn't publish my thesis and it is not peer reviewed. But to say that it hasn't influenced the way that I proceed with research would just be wrong.
Jonathan: So, your direct services informed your research into data analysis and both can inform your advocacy once you leave Goldman. I mean that's Goldman sits at that intersection, you know? How did you make the turn to focus on prisons and sexual assault in prison?
Jessie: When I was doing the sexual assault victim advocacy. There were limitations on being able to work with individuals that were currently incarcerated. So, if someone had been assaulted in prison and they were brought to a hospital we actually weren't able to serve them. It was just it wasn't due to the organization or the rules particularly but their grant funding had limited them in terms of you know just because of liability they weren't able to provide services for people who were currently incarcerated. And that to me just I had a hard time I guess moving forward knowing that these people didn't have access to services they really needed someone to be there for them. And I think for sure. My past experience of feeling that I also had needed someone to be there for me. I felt I needed to do something about it.
Jonathan: So let's talk more about that. What mechanisms exist in prison or incarceration generally, formal mechanisms and informal mechanisms to silence survivors of assault or make it harder for them to report?
Jessie: Yeah for sure there's the power dynamic issue that that permeates throughout all aspects of the prison system. There's power dynamics between inmates that people coming into prison for the first time are often more likely to be victimized. There's issues with the correctional officers but they too have their own mental health issues often there's barriers that have been reduced. Surely with PRIA. That's certainly increased the number of incidence or the reporting of incidents really the prisons have been able to track
Jonathan: Tell everyone what PRIA is.
Jessie: Sorry. Yeah. PRIA is the prison rape elimination act. PRIA has certainly increased the number of reported incidents and that's really an important distinction. Being able to more accurately quantify. I wouldn't say it's particularly accurate. There's still a lot of barriers in terms of reporting and this really plays more into the informal barriers for sure is that you know there's always the threat of ramifications. And the overall power structure certainly facilitates silencing individuals.
Jonathan: Are there certain populations in prison that are more vulnerable to sexual assault?
Jessie: Yeah from the research I've looked into, the individuals that are just entering prison that haven't been incarcerated before are certainly more likely to be victimized. I think those that are gender nonconforming, so transgendered individuals, gender and sexual minorities certainly are more likely to be victimized as well. And really just you know rape is about taking power away from individuals and so those that are perceived as weak would be more likely to be targeted.
Jonathan: What solutions do advocates in the field see as capable of reducing sexual assault between inmates or even between guards or by guards against inmates?
Jessie: I think in terms of correctional officers establishing more accountability can be targeted as a solution. But that being said again there's the issue of correctional officers themselves have their own mental health issues… They have a really difficult job. Actually, Amy Lerman's research has pointed to this really quite clearly that I believe it was about 65 percent of correctional officers had at least one symptom of PTSD. So, there's a difficult problem there as well. You have people who are hurting trying to provide some kind of support or services to other people who are hurting as well. And so, I think really when it comes down to it there's certainly some solutions that you could suggest. But I think ultimately it comes down to making the whole system more rehabilitative, focusing on punishing and making people pay for their crime. I think that just fuels this whole power dynamic and just causes less of an empathetic response.
Jonathan: Let's look to the future. Right now, Me Too is enabling a more honest conversation about sexual misconduct mostly by high profile men in entertainment and journalism and politics. There's another conversation, maybe another dozen conversations, about sexual misconduct that's out of the limelight. Situations where victims lack the resources they need to report or change their position. Domestic workers women working minimum wage jobs, men working minimum wage jobs, perhaps people in prison. There is a whole other part of this conversation we have yet to have.
Jessie: Right. There is certainly a need to amplify the voices of those that don't have the opportunity to speak and to have their experiences shared with other people. I think it's important that we that we extend this movement to capture everyone that can identify. And I think sometimes it can be difficult to do that effectively.
Jonathan: How do we use the momentum of the Me Too movement to create change on the ground, to create change locally?
Jessie: Right. I think there's a lot that we can do, even on the Berkeley campus and in communities specifically on the Berkeley campus. We can have support systems, we could have support groups to have people come together and be able to share their experiences to share what's worked for them and kind of fill in those gaps when it comes to getting access to mental health services. I think the current state of student mental health on Berkeley's campus is kind of in turmoil. I think it's hard for people to get into counseling. The demand is really high. And I think Berkeley has done a good job trying to meet the demands. But it's just it's too much. And so, I think in the meantime we can do a better job as a community to support each other in really processing everything that we've gone through and healing together.
Jonathan: What advice would you give to people who have watched loved ones go through mental health challenges and want to help but don't know how to start the conversation?
Jessie: Yeah. I think trying to be as empathetic and judgment free as possible is really important. I think just lending an ear and really just being a constant presence. I know it can be frustrating to watch people you love really struggle and continue to struggle. And having patience is really important because it's certainly a process. And I think the flip side of that too is that there are things that people who are experiencing mental health issues can do and sometimes that's being forgiving if someone isn't there for you all the time or if they know if they mess up and they come back and they apologize. Accept that and know that people are imperfect and we all are doing our best but you know we all can do better. And I think approaching everyone with understanding and forgiveness and an empathetic attitude is really important and I really think that can enrich people's relationships with one another.
Jonathan: Jessie we really appreciate you being here to have this conversation with us today.
Jessie: Thank you.
Jonathan: Talk policy to me is a production of the UC Berkeley's Goldman School of Public Policy and the Berkeley Institute for the future of young Americans. For show notes, visit us at talkpolicytome.org. Music heard today's episode is by Pat Mucidi Miller. Talk Policy to Me's executive producers are Bora Lee Reed and Sarah Swanbeck. The fabulous Allyssa John Perry is our producer and engineer. I'm Jonathan Stein with Jasmine Jones.