Date of Award


Degree Name

Doctor of Philosophy




Jennifer Eno Louden


For women in the criminal justice system, mental illness is a complicated and prevalent factor, with rates ranging from 49.2% to 67.9% (Bronson & Berzofsky, 2017). To address the mental health care that justice-involved women need, scholars have called for a closer examination of barriers that hinder access to mental health and substance use treatment among this population (Winham et al., 2015; Wilfong et al., 2021). Barriers to treatment can be attitudinal (i.e., stigma and fear) or structural (i.e., transportation, cost of treatment), yet few, if any, studies have examined how these barriers present in a group of justice-involved women living in the U.S.-México border region. The current project explored the relationship of barriers to treatment among 85 justice-involved women living in the Paso del Norte border region located in El Paso, Texas, and surrounding areas. The project investigated (1) what barriers women frequently identified as hindering their treatment, (2) how the barriers contributed to receipt of services, and (3) whether internalized stigma mediated a relationship between endorsed attitudinal barriers and perceived public stigma. Findings show attitudinal barriers were more frequently endorsed as barriers to seeking treatment compared to structural barriers. For the second aim, attitudes and public stigma were at decreased odds for past treatment seeking, yet internalized stigma was associated with increased odds of past treatment seeking and future treatment seeking. However, structural barriers did not emerge as significant predictors for past, present, or future treatment seeking. Finally, internalized stigma was a significant mediator between public stigma and attitude barriers. Results suggest that stigma and attitudes, while complex, are associated with help-seeking and should be addressed to increase utilization of treatment services for justice-involved women in the Paso del Norte border region.




Received from ProQuest

File Size

138 p.

File Format


Rights Holder

Rebekah Ruth Adair-Russell

Included in

Psychology Commons