Mass incarceration is a public health issue, and ought to be treated as such by Oregon lawmakers.

That’s one of the key takeaways from a new report out Wednesday from the Oregon Justice Resource Center (OJRC). The report includes new numbers from OJRC’s recent survey of women currently incarcerated at the Coffee Creek Correctional Facility (CCCF) in Wilsonville, Oregon’s only state prison for women.

The survey was conducted in two parts in the winter of 2017 and spring of 2018. One hundred and forty-two women participated in the first part, while 66 answered questions for part two.

Of 142 women at CCCF who answered questions about how mental health and drug use affected their circumstances, 49 percent said they were experiencing mental illness at the time of their arrest. Sixty-nine percent were using drugs or alcohol when they were arrested.

CCCF holds about 1,220 people, meaning the sample sizes included in OJRC’s surveys aren’t large enough to be considered statistically significant. But they survey—which the report notes is the first of its kind to be conducted in a women’s prison—does provide insight into how prevalent health and addiction problems are among Oregon’s population of incarcerated women.

“When I used in high school, it was a handful of times partying,” wrote one anonymous survey respondent quoted in the report.

“When I was 25," she continued, "I had a mental breakdown, left my family and got with a guy and started right away using meth everyday.”

Another woman said that her drug and alcohol use was triggered by a "bad relationship, problems at home, [and] trying to be over and above what I could truly handle.” And a third woman said she started using because she was homeless and was unable to "fit into society."

Of the 66 women who participated in the second part of OJRC’s survey, 75 percent said they have been diagnosed with a mental illness at some point in their life, and 73 percent have experienced being homeless. Twenty percent said they have mental health problems that have never been addressed, and 86 percent said they have at least one family member who has struggled with addiction.

Beyond mental health and addiction, OJRC also asked women about their physical health. The 66 participants in part two reported a range of physical health issues, and 64 percent said they had developed new medical problems since entering prison.

“Prison and jail environments are not conducive to good health,” the report reads. “The food is usually nutritionally inadequate. Facilities may be dirty and unhygienic and offer insufficient opportunity for physical activity that would promote improved physical and mental health.”

The report goes on to say that taken as a whole, the survey results “highlight the significant interplay between health issues and the criminal system and the urgent need to reimagine our systems, recognizing mass incarceration as a public health crisis."

“Marginalized and targeted individuals and communities are caught in a cycle of poor health and incarceration,” the report continues. “This entanglement raises critical questions about the criminalization of social and public health problems, such as substance abuse, problems with mental health, homelessness, trauma and poverty.”

OJRC released a similar report earlier this year with data related to incarcerated women’s experiences with abuse and trauma. That report found that of women who were in a relationship at the time of their arrest, 65 percent were experiencing abuse.

OJRC director Bobbin Singh told the Mercury then that their research was important because women have “remained largely outside the conversation of criminal justice reform,” and “the systems that we have are designed largely by men.”

The organization has a played a key role in recent criminal justice reform efforts in Salem, including influencing legislation that reversed harsh youth sentencing laws during the Oregon Legislature’s 2019 session. In the report’s conclusion, OJRC calls on Governor Kate Brown to “declare mass incarceration a public health issue and convene a statewide work group to create a statewide plan to end the cycle of poor health and incarceration.”

The report also calls for an independent review of health services in all of Oregon’s correctional facilities, and for law enforcement agencies to review their trainings and policies around dealing with people who may be using drugs or are mentally ill.

“Law enforcement agencies are often the first responders to mental health crises,” it reads, “and end up directing individuals suffering such crises into the criminal system.”