38 Gender and Security Toolkit Box 13: Women’s risk need assessment Developed in the USA, WRNAs are actuarial risk assessment tools delivered from a gender perspective and created to account for women’s risk factors, or criminogenic needs, associated with recidivism and future misconduct. Actuarial risk assessments are numerical scoring tools used to help correctional agencies classify offenders, and consequently place them in appropriate custody levels and relevant treatment programming based upon their predicted risk for misconduct or reoffending. WRNAs were developed in response to the call for strategies that consider the specific needs of women through trauma-informed approaches. The process of conducting a WRNA involves a case file review, a semi-structured interview, a written survey and a case management treatment plan. There are three versions of the WRNA, for women entering prison, pre-release and on probation. In addition, the WRNA includes factors that research has shown to be effective at predicting women’s and men’s recidivism; for example, past and current substance abuse, criminal history, employment and financial stability, educational strengths and needs and antisocial attitudes. WRNAs have been successful at predicting recidivism, showing the effectiveness of assessing women in this way. Specifically, items on the WRNA showed statistically significant positive correlations with measures of reincarceration, technical violations, new arrests and new convictions. The WRNA tool has now been rolled out in multiple jurisdictions across the USA. Other states including the Czech Republic, Namibia, Singapore and Switzerland have investigated how the WRNA can be applied to their specific contexts. Sources: University of Cincinnati (2010) “Women’s risk factors and their contributions to existing risk/need assessment”, Criminal Justice and Behavior, 37(3), pp. 261–288; B. Boppre and E. J. Salisbury (2016) “The women’s risk needs assessment: Putting gender at the forefront of actuarial risk assessment”, blog post, Penal Reform International, 12 April, www.penalreform.org/blog/womens-risk-needs-assessment-putting-gender-forefront-actuarial/ (accessed 17 October 2019). Health Overall, as well as having higher rates of mental health issues than the general population, prisoners are at increased risk of all-cause mortality, suicide, self-harm, violence and victimization.18 It is therefore vital that persons deprived of their liberty maintain access to healthcare at least to the standard available in their community. There are clearly many additional health considerations for places of deprivation of liberty working with women and girls, yet these are often overlooked or ignored. Box 14 lists some good practices in relation to supporting women’s physical and mental health. Moreover, both the Mandela Rules and the Bangkok Rules make clear statements on the treatment of women and girls while pregnant, during giving birth and in a post-natal context. See Mandela Rules, Rule 48(2). Many people who are detained will have ongoing health concerns and treatments. It is therefore extremely important that any detention, however temporary, does not undermine an individual’s ability to receive treatment. The Pan-American Health Organization (PAHO) has identified HIV treatment as a particular concern, and this should be fully integrated into the primary healthcare of the detaining institution.19