Pathways to psychiatric care in European prison systems.

Science.gov (United States)

Dressing, Harald; Salize, Hans-Joachim

2009-01-01

The aims of this study were to describe and analyse the concepts of provision of mental health services for prison inmates in 24 countries in the European Union and the EFTA. Data were gathered by means of a structured questionnaire that was completed by national experts in the participating countries. This article stresses the different organizational models of mental health care for inmates, different legal standards for screening their mental health status and different pathways to psychiatric care and aftercare. The study revealed serious shortcomings. Even the most rudimentary health reporting standards for mental health care in prison are lacking almost everywhere in Europe. Psychiatric screening and assessment procedures at prison entry and during imprisonment differ substantially and do not fulfil recognized quality standards. In many countries, the appointment of inadequately trained staff to perform such screenings increases considerably the risk that mental disorders or psychiatric needs of the inmates will remain undetected. Furthermore, the pathways to care in the case of an acute psychotic episode differ significantly, since referral to prison hospitals, medical prison wards, forensic hospitals, or general psychiatric hospital are used in various combinations depending on different national legal regulations and on the availability of services or other regional circumstances. Therefore, the collaborating experts place the quality of European prison mental health care into serious question. (c) 2009 John Wiley & Sons, Ltd.

Mental health in prisons: A public health agenda.

Science.gov (United States)

Fraser, A

2009-01-01

Mental illness affects the majority of prisoners. Mental health issues are beginning to take a central position in the development of prison health services, reflecting this burden of disease. This change in focus is not before time. But prison mental health services cannot exist in isolation. Public health systems should lead provision of care for patients with acute and severe illness. A whole prison approach to health and, specifically, mental health will offer the greatest likelihood that offenders will thrive, benefit from imprisonment, and lead law-abiding lives after release. Public awareness of the scale and commitment of prisons to mental health and illness, and understanding of prisons' role in society, are necessary developments that would protect and enhance public mental health, as well as creating a healthier and safer society. This article draws on recent reviews, information and statements to set out a public health agenda for mental health in prisons.

Key successes and challenges in providing mental health care in an urban male remand prison: a qualitative study.

Science.gov (United States)

Samele, Chiara; Forrester, Andrew; Urquía, Norman; Hopkin, Gareth

2016-04-01

This study aimed to describe the workings of an urban male remand prison mental health service exploring the key challenges and successes, levels of integration and collaboration with other services. A purposive sampling was used to recruit key prison and healthcare professionals for in-depth interviews. A thematic analysis was used to analyse transcripts based on an initial coding frame of several predefined themes. Other key themes were also identified. Twenty-eight interviews were conducted. Prisoners referred to the service had complex, sometimes acute mental illness requiring specialist assessment and treatment. Key successes of the in-reach service included the introduction of an open referral system, locating a mental health nurse at reception to screen all new prisoners and a zoning system to prioritise urgent or non-urgent cases. Achieving an integrated system of healthcare was challenging because of the numerous internal and external services operating across the prison, a highly transient population, limited time and space to deliver services and difficulties with providing inpatient care (e.g., establishing the criteria for admission and managing patient flow). Collaborative working between prison and healthcare staff was required to enable best care for prisoners. The prison mental health in-reach service worked well in assessing and prioritising those who required specialist mental health care. Although the challenges of working within the prison context limited what the in-reach team could achieve. Further work was needed to improve the unit environment and how best to target and deliver inpatient care within the prison.

Mental health care in prisons and the issue of forensic hospitals in Italy.

Science.gov (United States)

Peloso, Paolo Francesco; D'Alema, Marco; Fioritti, Angelo

2014-06-01

Mental health (MH) care for Italian prisoners and offenders with mental illness is a paradoxical issue. Theory and practice remained unchanged throughout the 20th century, despite radical changes to general psychiatric care. Until recently, Italy had one of the most advanced National Health Service (NHS)-run community psychiatry care systems and a totally obsolete system of forensic psychiatry managed by criminal justice institutions. Not until 2008, after substantial pressure by public opinion and International Human Rights bodies, did the government approve a major reform transferring health care in prisons and forensic hospitals to the NHS. Forensic hospitals were to be progressively closed, and specialized small-scale facilities were to be developed for discharged offenders with mental illness, along with diversion schemes to ordinary community care. Despite some important achievements, three major problem areas remain: this reform happened without changes to the Criminal Code; regions differ in organization and resources for ordinary psychiatric services; and legal/criminological expertise among NHS MH professionals is limited.

Use of Veterans Health Administration Mental Health and Substance Use Disorder Treatment After Exiting Prison: The Health Care for Reentry Veterans Program.

Science.gov (United States)

Finlay, Andrea K; Stimmel, Matthew; Blue-Howells, Jessica; Rosenthal, Joel; McGuire, Jim; Binswanger, Ingrid; Smelson, David; Harris, Alex H S; Frayne, Susan M; Bowe, Tom; Timko, Christine

2017-03-01

The Veterans Health Administration (VA) Health Care for Reentry Veterans (HCRV) program links veterans exiting prison with treatment. Among veterans served by HCRV, national VA clinical data were used to describe contact with VA health care, and mental health and substance use disorder diagnoses and treatment use. Of veterans seen for an HCRV outreach visit, 56 % had contact with VA health care. Prevalence of mental health disorders was 57 %; of whom 77 % entered mental health treatment within a month of diagnosis. Prevalence of substance use disorders was 49 %; of whom 37 % entered substance use disorder treatment within a month of diagnosis. For veterans exiting prison, increasing access to VA health care, especially for rural veterans, and for substance use disorder treatment, are important quality improvement targets.

Is mental heal care in women's prisons adequate?

Science.gov (United States)

Sims, Joyce

Some individuals and groups, find it difficult to seek healthcare, including prisoners. This group is recognised as needing input but are often difficult to engage, yet failure to meet their needs can be devastating for the health of individuals and have wider implications on society. This qualitative study explored the perceptions of female prisoners who had not yet consulted the mental health team. I aimed to find out what support these women seek out while in prison, what difficulties they encountered in getting psychological help and whether they avoided statutory mental health services. Participants revealed during semistructured interviews that continuing to have a caring role for their families encouraged them to feel more positive and supported. Support from family members, specialist prison officers and the multi-faith centre staff team was also highly regarded. Some of the participants reported experiencing problems self-referring to prison mental health services, for example when transferred to a new prison. They identified the prison application system and inreach administrative failings as weaknesses, alongside other variables. I found that prisoners did not avoid mental health services and often once settled in the prison, they reconsidered their need for statutory support.

Health needs of prisoners in England and Wales: the implications for prison healthcare of gender, age and ethnicity.

Science.gov (United States)

Harris, Francesca; Hek, Gill; Condon, Louise

2007-01-01

This paper aims to provide evidence of the healthcare needs of prisoners in relation to gender, age and ethnicity, drawing from a larger systematic overview of the policy and research literature concerning primary care nursing in prisons in England and Wales. The literature overview shaped the initial stages of a research project funded by the Department of Health to examine the views and perspectives of prisoners and nurses working in prisons, and to identify good primary care nursing in the prison environment. At total of 17 databases were searched using search terms related to primary healthcare in prisons (health, nurs*, primary care, healthcare, family medicine, prison*, offender*, inmate*) with terms truncated where possible in the different databases. Following this, a sifting phase was employed using inclusion/exclusion criteria to narrow and focus the literature perceived as relevant to the research questions. All papers were critically appraised for quality using standardised tools. Findings from the literature overview show that prisoners are more likely to have suffered some form of social exclusion compared to the rest of society, and there are significantly greater degrees of mental health problems, substance abuse and worse physical health in prisoners than in the general population. Women, young offenders, older prisoners and those from minority ethnic groups have distinct health needs compared to the prison population taken as a whole, with implications for the delivery of prison healthcare, and how these needs are met effectively and appropriately.

Human rights and mental health in post-apartheid South Africa: lessons from health care professionals working with suicidal inmates in the prison system.

Science.gov (United States)

Bantjes, Jason; Swartz, Leslie; Niewoudt, Pieter

2017-10-12

During the era of apartheid in South Africa, a number of mental health professionals were vocal about the need for socio-economic and political reform. They described the deleterious psychological and social impact of the oppressive and discriminatory Nationalist state policies. However, they remained optimistic that democracy would usher in positive changes. In this article, we consider how mental health professionals working in post-apartheid South Africa experience their work. Our aim was to describe the experience of mental health professionals working in prisons who provide care to suicidal prisoners. Data were collected from in-depth semi-structured interviews and were analyzed using thematic content analysis. Findings draw attention to the challenges mental health professionals in post-apartheid South Africa face when attempting to provide psychological care in settings where resources are scarce and where the environment is anti-therapeutic. Findings highlight the significant gap between current policies, which protect prisoners' human rights, and every-day practices within prisons. The findings imply that there is still an urgent need for activism in South Africa, particularly in the context of providing mental health care services in settings which are anti-therapeutic and inadequately resourced, such as prisons.

Delivering primary care in prison: the need to improve health information

Directory of Open Access Journals (Sweden)

Sudy Anaraki

2003-12-01

Conclusions To provide 'equivalence of care' for prisoners, primary care trusts need to implement full electronic clinical records in prisons and ensure staff have access to resources on the internet.

Health status of the prisoners in a central jail of South India.

Science.gov (United States)

Kumar, Sunil D; Kumar, Santosh A; Pattankar, Jayashree V; Reddy, Shrinivas B; Dhar, Murali

2013-10-01

Health care in prisons is one of the neglected health areas in our country. Looking into the health problems of prisons will show us a way for the approach in providing the heath care for prisoners. To assess the health status of convicted inmates of prison and to study their sociodemographic profile. A cross-sectional study was conducted among the inmates of central prison over a period of 1 year. Study population comprised of 300 convicted life-term prisoners. The inmates were interviewed using predesigned and pretested proforma. Sociodemographic data were analyzed by frequencies and percentages along with 95% confidence interval using statistical package SPSS18. In health status, 29 (9.6%) inmates suffered from acute upper respiratory tract infections and 15 (5%) from acute lower respiratory tract infections. A total of 54 (18%) inmates had ascariasis. Diseases of musculoskeletal system and connective tissue contributed to 26 (8.7%) of inmates. A total of 252 (84%) prisoners had anemia. In sociodemographic profile, it was found that rural people, unmarried, illiterates, lower socioeconomic status people were more likely to have committed the crime resulting in the conviction for life. As there is an increase in number of prisoners and morbidities among them, there is an urgent need for prison health care services in developing countries like India and provide training to the health care providers to manage the commonly existing health problems among prisoners in the prisons.

The role of primary health care services to better meet the needs of Aboriginal Australians transitioning from prison to the community

OpenAIRE

Lloyd, Jane E.; Delaney-Thiele, Dea; Abbott, Penny; Baldry, Eileen; McEntyre, Elizabeth; Reath, Jennifer; Indig, Devon; Sherwood, Juanita; Harris, Mark F.

2015-01-01

Background Aboriginal Australians are more likely than other Australians to cycle in and out of prison on remand or by serving multiple short sentences?a form of serial incarceration and institutionalisation. This cycle contributes to the over-representation of Aboriginal Australians in prison and higher rates of recidivism. Our research examined how primary health care can better meet the health care and social support needs of Aboriginal Australians transitioning from prison to the communit...

The effect of health and penal harm on aging female prisoners' views of dying in prison.

Science.gov (United States)

Deaton, Dayron; Aday, Ronald H; Wahidin, Azrini

With tougher sentencing laws, an increasing number of individuals are finding themselves spending their final years of life in prison. Drawing on a sample of 327 women over the age of 50 incarcerated in five Southern states, the present study investigates the relationship between numerous health variables and the Templer Death Anxiety Scale (TDAS). Qualitatively, the article also provides personal accounts from inmates that serve to reinforce death fears when engaging the prison health care system. Participants reported a mean of 6.40 on the TDAS indicating a substantial degree of death anxiety when compared to community samples. Both mental and physical health measures were important indicators of death anxiety. Qualitative information discovered that respondents' concerns about dying in prison were often influenced by the perceived lack of adequate health care and the indifference of prison staff and other instances of penal harm.

Prison staff and the health promoting prison.

Science.gov (United States)

Dixey, Rachael; Woodall, James

2011-01-01

This paper aims to discuss some of the obstacles to implementing policy and strategy related to health promoting prisons. It focuses on the role of prison officers and raises issues concerning their conditions of service, training and organisational culture in a situation where the prison system faces security issues, overcrowding and high levels of ill health among prisoners. This paper emerged as a result of significant overlapping themes between two separate studies conducted by the authors. The paper draws on the authors' qualitative data from these studies. The findings demonstrate the ambiguities and tensions in changing organisational cultures and among prison staff. Alongside the qualitative data, the paper draws on theory regarding policy implementation at the micro-level to show how staff can block or speed up that implementation. Prison officers are an essential part of health promoting prisons, but have been relatively ignored in the discussion of how to create healthier prisons. The contribution that prison staff make to creating health promoting prisons has been under-explored, yet pertinent theory can show how they can be more effectively involved in making changes in organisational culture.

Developing the mental health awareness of prison staff in England and Wales.

Science.gov (United States)

Walsh, Elizabeth; Freshwater, Dawn

2009-10-01

In 2010, the prison population in England and Wales could reach a high of 91,500, according to a recent population projection. HM Prison Service (U.K.) reports that in 2004 to 2005, there were 33,144 prison officers employed to care for the prisoners in the prison system. This article focuses on the mental health of this prisoner population and the training needs of staff caring for them. It reports the experience of a national project, funded by the Department of Health, in which the project team developed and piloted mental health awareness training for prison officers on the residential units and for staff who work with prisoners and lack a mental health background. Key findings from the posttraining evaluation are highlighted. Participant feedback demonstrates the value placed on this type of training by those working in the prison setting.

Prison mental health in-reach teams, serious mental illness and the Care Programme Approach in England.

Science.gov (United States)

Brooker, Charlie; Webster, Russell

2017-08-01

The delivery of prison mental health services in England is examined over the last 12 years. Resources for services have grown significantly during this period and improved organisational models for the delivery of services are now in place. During this period however the challenges of working in the prison environment have increased. The paper argues that a history of sexual abuse or violence are common amongst prisoners and the Care Programme Approach (CPA) provides the vehicle to assess these histories through the use of routine enquiry. Commissioners of prison mental health services now need to ensure that teams are delivering cogent trauma-based interventions where relevant and the outcomes are measured. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Lost in the crowd: prison mental health care, overcrowding, and the courts.

Science.gov (United States)

Appelbaum, Paul S

2011-10-01

Skyrocketing inmate populations have put considerable pressure on prison mental health services. In California, prison populations have exceeded 200% of capacity, and litigation to rectify constitutionally inadequate care has been under way for more than two decades. After the failure of other remedies, a federal court ordered the state to reduce its inmate population to 137.5% of capacity in two years. The U.S. Supreme Court upheld the order, although it signaled that California could obtain more time to comply. Other states now are on notice that the justices will not permit grossly inadequate treatment conditions to continue indefinitely.

An interprofessional education project to address the health care needs of women transitioning from prison to community reentry.

Science.gov (United States)

Busen, Nancy H

2014-01-01

With the implementation of the Patient Protection and Affordable Care Act, the need for health care providers to work collaboratively in teams to provide cost-effective, quality health care has become even more apparent because an estimated additional 22 million Americans gain health care coverage by 2014. The need for evidenced-based care that combines the expertise of various disciplines has been acknowledged by policy makers and health educators. With support from national Association for Prevention, Teaching and Research, an interprofessional education course was designed and implemented by health professionals in nursing, nutrition, and dentistry, in collaboration with a local community agency, to address the health care needs of women transitioning from prison to the community. Health care needs of women in prison are often overlooked, and access to care is limited. When released from prison, utilization of even basic health services is rare. Four interactive teaching-learning sessions were offered at a residential facility for women in transition over a 12-week period. Topics were selected based on feedback from the participants and included stress reduction, self-beast examination, hypertension, and common dental conditions. Teaching methods and materials were interactive and designed for sustainability. The model for this interprofessional education project, which employed a service-learning approach, can be adapted for other communities. Working with our communities requires innovative thinking to be effective but provides an enriching life experience to those involved. A community-based reciprocal learning environment benefits all partners in the real-world environment. Copyright © 2014 Elsevier Inc. All rights reserved.

[The long road for psychiatric care in prisons].

Science.gov (United States)

Laurencin, Gérard

2016-01-01

From the 19th century to the present day, the history of psychiatry in prisons has evolved considerably. In parallel with successive laws, codes and articles, psychiatry has gained in structure. From the "medical prison", mental health consultations in every detention centre, the regional medico-psychological services, to today's specially equipped hospital units (UHSA), prisoners receive both preventive care as well as curative treatment. Copyright © 2016. Published by Elsevier Masson SAS.

The Health of America's Aging Prison Population.

Science.gov (United States)

Skarupski, Kimberly A; Gross, Alden; Schrack, Jennifer A; Deal, Jennifer A; Eber, Gabriel B

2018-03-23

Older incarcerated individuals comprise the fastest growing demographic in the US prison system. Unhealthy lifestyles among incarcerated individuals and inadequate health care lead to earlier onset and more rapid progression of many chronic conditions that are prevalent among community-living older adults. There are limited peer-reviewed epidemiologic data in this area; however, there is growing interest in identifying strategies for housing aging incarcerated individuals, delivering appropriate health care in prisons, and coordinating after-release health care. In this systematic review, we summarize the epidemiologic evidence of the health challenges facing the aging US prison population. Our comprehensive literature search focused on health outcomes, including diseases, comorbid conditions, mental health, cognition, and mobility. From 12,486 articles identified from the literature search, we reviewed 21 studies published between 2007 and 2017. All the studies were observational and cross-sectional, and most (n = 17) were based on regional samples. Sample sizes varied widely, ranging from 25 to 14,499 incarcerated people (median, 258). In general, compared with their younger counterparts, older incarcerated individuals reported high rates of diabetes mellitus, cardiovascular conditions, and liver disease. Mental health problems were common, especially anxiety, fear of desire for death or suicide, and depression. Activities of daily living were challenging for up to one-fifth of the population. We found no empirical data on cognition among older incarcerated individuals. The findings of this review reveal few empirical data in this area and highlight the need for new data to drive policy and practice patterns that address critical health issues related to the aging prison population.

Looking behind the bars: emerging health issues for people in prison.

Science.gov (United States)

Stürup-Toft, S; O'Moore, E J; Plugge, E H

2018-03-01

There are more than 10 million people imprisoned worldwide. These individuals experience a higher burden of communicable and non-communicable disease, mental health and substance misuse problems than the general population and often come from marginalized and underserved groups in the community. Prisons offer an important opportunity for tackling health problems in a way that can deliver benefits to the individual and to the community. This paper focuses specifically on emerging health issues for prisons across the world. This paper uses sources of international data from published systematic reviews and research studies, the Ministry of Justice for England and Wales, the Prisons and Probations Ombudsmen Review and other United Kingdom government briefing papers. Deaths in custody are a key concern for the justice system as well as the health system. Suicide is the leading cause of mortality in prisons worldwide but non-communicable diseases, such as cardiovascular disease, are increasing in importance in high-income countries and are now the leading cause of mortality in prisons in England and Wales. The prison population is ageing in most high-income countries. Older people in prison typically have multiple and complex medical and social care needs including reduced mobility and personal care needs as well as poor health. Further research is needed to understand the complex relationship between sentencing patterns, the ageing prison population and deaths in custody; to model its impact on prisons and healthcare provision in the future and to determine effective and cost-effective models of care. Research into the health of prisoners is important in improving the health of prisoners but there is considerable variation in quantity and quality between countries. Recent innovations seek to address this disparity and facilitate the sharing of good practice.

Current and emerging practice of end-of-life care in British prisons: findings from an online survey of prison nurses.

Science.gov (United States)

Papadopoulos, Irena; Lay, Margaret

2016-03-01

There are concerns about prisoners and detainees not having equal access to end-of-life care while in prison. There is a lack of existing literature about the standards of end-of-life care in UK prisons. The aim of this study was to investigate the views of current and former prison nurses with regard to the end-of-life care being provided in UK prisons. Prison nurses were invited to participate in an online survey and asked about their role in the prison, prisoners' access to healthcare facilities, and any barriers and good practices to end-of-life care. The survey included open-ended and closed questions. The closed questions were analysed using descriptive statistics. The open-ended responses were coded and grouped into themes. 31 (N=31) prison nurses responded to the survey. The reported barriers to end-of-life care included some prison regimes, lack of appropriate care and visiting facilities, lack of privacy and inadequate visiting hours. Respondents also reported examples of good practice, including having access to specialist palliative care and specialist equipment, and being able to receive visits from family and friends. The findings suggest that there is considerable variability in the end-of-life care provided to prisoners in the UK. Further research is needed in order to reduce the health inequalities and improve the quality of end-of-life care experienced by prisoners in the UK. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Oral Health Status of a Sample of Prisoners in Enugu: A ...

African Journals Online (AJOL)

Background: The aim of this study is to determine the oral health status of a sample of prisoners at the Federal Prison in Enugu. The health status of inmates in the prison system needs to be incorporated into data and reports that summarize the state of the nation's health; this will encourage the provision of health care to ...

A Theoretical Framework for Goal-directed Care within the Prison System

NARCIS (Netherlands)

Bulten, B.H.; Vissers, A.W.T.M.; Oei, K.

2008-01-01

Mental health care in prisons involves many stakeholders. As a consequence, the goals involved are divergent but there is no sound theoretical framework that accounts for the complexity of care in prison. This paper considers a broad theory and its conceptual framework that differentiates between

Finding the moral heart of treatment: mental health care in a French prison.

Science.gov (United States)

Fernandez, Fabrice; Lézé, Samuel

2011-05-01

Morality is one of the most important elements of social actions, specifically in medical settings. Unfortunately, in social science, morality is often undertheorized and can lead to moralism. The aim of the paper is to test the "moral economy theory" which highlights the link between some local moral evaluations and a political context. We focus on "treatment" as therapeutic tool and as moral regulation of patients in a French remand centre. On the basis of an ethnography of forms of care for prisoners (2009-2010), and semi-directed interviews with working mental health professionals (n = 10), we analyse their engagement and their moral expectations of the prisoners under their care. Firstly, we show how prisoners are selected and then converted into patients deserving of attention (expectations of honesty, sincerity and compliance). Secondly, we show how these patients are divided into three main intervention categories, in which the treatment is both therapeutic and moral (expectations of responsibility, recognition of guilt, and self-esteem). Finally, we discuss these moral criteria within a new moral economy of vulnerability. Copyright © 2011 Elsevier Ltd. All rights reserved.

Prison mental health in-reach teams in England: the care programme approach and sexual abuse/violence.

Science.gov (United States)

Brooker, Charles G D; Forrester, Andrew

2017-12-01

Prison mental health in-reach teams have doubled in size over the past decade and case-loads have reduced. Since 2010 it has been mandatory for keyworkers to ask whether prisoners with serious mental illness being treated under the care programme approach have experienced sexual or physical abuse. This is known as routine enquiry and should take place for these prisoners but NHS England, the commissioners, do not audit this activity. It is time to review current interventions and their associated outcomes. © The Royal College of Psychiatrists 2017.

Exploring the drivers of health and healthcare access in Zambian prisons: a health systems approach.

Science.gov (United States)

Topp, Stephanie M; Moonga, Clement N; Luo, Nkandu; Kaingu, Michael; Chileshe, Chisela; Magwende, George; Heymann, S Jody; Henostroza, German

2016-11-01

Prison populations in sub-Saharan Africa (SSA) experience a high burden of disease and poor access to health care. Although it is generally understood that environmental conditions are dire and contribute to disease spread, evidence of how environmental conditions interact with facility-level social and institutional factors is lacking. This study aimed to unpack the nature of interactions and their influence on health and healthcare access in the Zambian prison setting. We conducted in-depth interviews of a clustered random sample of 79 male prisoners across four prisons, as well as 32 prison officers, policy makers and health care workers. Largely inductive thematic analysis was guided by the concepts of dynamic interaction and emergent behaviour, drawn from the theory of complex adaptive systems. A majority of inmates, as well as facility-based officers reported anxiety linked to overcrowding, sanitation, infectious disease transmission, nutrition and coercion. Due in part to differential wealth of inmates and their support networks on entering prison, and in part to the accumulation of authority and material wealth within prison, we found enormous inequity in the standard of living among prisoners at each site. In the context of such inequities, failure of the Zambian prison system to provide basic necessities (including adequate and appropriate forms of nutrition, or access to quality health care) contributed to high rates of inmate-led and officer-led coercion with direct implications for health and access to healthcare. This systems-oriented analysis provides a more comprehensive picture of the way resource shortages and human interactions within Zambian prisons interact and affect inmate and officer health. While not a panacea, our findings highlight some strategic entry-points for important upstream and downstream reforms including urgent improvement in the availability of human resources for health; strengthening of facility-based health services systems

Validating the CORE-10 as a mental health screening tool for prisoners

OpenAIRE

Lewis, Gwen

2016-01-01

Background: Few mental health screening tools have been validated with prisoners and existing tools, do not assess severity of need in line with contemporary stepped care service models. \\ud \\ud Aims: The current research aims to assess the CORE-10’s psychometric reliability, validity and predictive accuracy as a screening tool for common (primary care) and severe (secondary care) mental health problems in prisoners. \\ud \\ud Method: Cross –sectional study of 150 prisoners. All participants co...

Accessibility to health services in the prison population in Colombia: a public health challenge

Directory of Open Access Journals (Sweden)

Luz Mery Mejía O

2010-08-01

Full Text Available This article is the result of a product of a study elaborated with the aim of systematizing the available information related to the accessibility to the health services of the prison population in the penitentiary centers. To this end, we reviewed the literature and systematic collection of the academic available material in the principal university libraries in the city of Medellin, scientific databases and the web pages of national and international organizations that have dealt with this topic. The information was systematized considering some historical references to prisons and health, the record of experiences in some countries and the current regulations for health care in the prison population in the Colombian case. We conclude that although significant progress has been made to ensure health care for the prison population, in the prison there are still obstacles and limitations that infringe the right to health of this population. Likewise, it is evidenced that it has not been considered a public health problem in the country, which it is considered a challenge to incorporate it as such.

The role of primary health care services to better meet the needs of Aboriginal Australians transitioning from prison to the community.

Science.gov (United States)

Lloyd, Jane E; Delaney-Thiele, Dea; Abbott, Penny; Baldry, Eileen; McEntyre, Elizabeth; Reath, Jennifer; Indig, Devon; Sherwood, Juanita; Harris, Mark F

2015-07-22

Aboriginal Australians are more likely than other Australians to cycle in and out of prison on remand or by serving multiple short sentences-a form of serial incarceration and institutionalisation. This cycle contributes to the over-representation of Aboriginal Australians in prison and higher rates of recidivism. Our research examined how primary health care can better meet the health care and social support needs of Aboriginal Australians transitioning from prison to the community. Purposive sampling was used to identify 30 interviewees. Twelve interviews were with Aboriginal people who had been in prison; ten were with family members and eight with community service providers who worked with former inmates. Thematic analysis was conducted on the interviewees' description of their experience of services provided to prisoners both during incarceration and on transition to the community. Interviewees believed that effective access to primary health care on release and during transition was positively influenced by providing appropriate healthcare to inmates in custody and by properly planning for their release. Further, interviewees felt that poor communication between health care providers in custody and in the community prior to an inmate's release, contributed to a lack of comprehensive management of chronic conditions. System level barriers to timely communication between in-custody and community providers included inmates being placed on remand which contributed to uncertainty regarding release dates and therefore difficulties planning for release, cycling in and out of prison on short sentences and being released to freedom without access to support services. For Aboriginal former inmates and family members, release from prison was a period of significant emotional stress and commonly involved managing complex needs. To support their transition into the community, Aboriginal former inmates would benefit from immediate access to culturally- responsive

Mental Health of Prisoners: Identifying Barriers to Mental Health Treatment and Medication Continuity

Science.gov (United States)

Connell, Nadine M.

2014-01-01

Objectives. We assessed mental health screening and medication continuity in a nationally representative sample of US prisoners. Methods. We obtained data from 18 185 prisoners interviewed in the 2004 Survey of Inmates in State and Federal Correctional Facilities. We conducted survey logistic regressions with Stata version 13. Results. About 26% of the inmates were diagnosed with a mental health condition at some point during their lifetime, and a very small proportion (18%) were taking medication for their condition(s) on admission to prison. In prison, more than 50% of those who were medicated for mental health conditions at admission did not receive pharmacotherapy in prison. Inmates with schizophrenia were most likely to receive pharmacotherapy compared with those presenting with less overt conditions (e.g., depression). This lack of treatment continuity is partially attributable to screening procedures that do not result in treatment by a medical professional in prison. Conclusions. A substantial portion of the prison population is not receiving treatment for mental health conditions. This treatment discontinuity has the potential to affect both recidivism and health care costs on release from prison. PMID:25322306

[Overcrowding in prisons and its impact on health].

Science.gov (United States)

García-Guerrero, J; Marco, A

2012-02-01

Overcrowding in prisons is a common problem that affects many countries. It is difficult to define this term because there is no single internationally accepted standard. However, this is a situation that must be counteracted, because people's behaviour can be affected to the extent that it leads to self-harm or violent behaviour to others. But prison overcrowding also has other effects on the health and well being of the people living in these conditions and may also adversely affect public health and the prison system. It can increase the prevalence of diseases, particularly infectious and psychiatric disorders. It may also hinder the work of social rehabilitation and lead to inhuman, cruel or degrading treatment. This paper reviews the scant literature about overcrowding in prisons. Increasing awareness about the issue in the international community and prison administrations and above all, assigning specific economic resources, are key elements in preventing this deficit in social welfare and health care.

Diabetes and hypertension care among male prisoners in Mexico City: exploring transition of care and the equivalence principle.

Science.gov (United States)

Silverman-Retana, Omar; Servan-Mori, Edson; Lopez-Ridaura, Ruy; Bautista-Arredondo, Sergio

2016-07-01

To document the performance of diabetes and hypertension care in two large male prisons in Mexico City. We analyzed data from a cross-sectional study carried out during July-September 2010, including 496 prisoners with hypertension or diabetes in Mexico City. Bivariate and multivariable logistic regressions were used to assess process-of-care indicators and disease control status. Hypertension and diabetes prevalence were estimated on 2.1 and 1.4 %, respectively. Among prisoners with diabetes 22.7 % (n = 62) had hypertension as comorbidity. Low achievement of process-of-care indicators-follow-up visits, blood pressure and laboratory assessments-were observed during incarceration compared to the same prisoners in the year prior to incarceration. In contrast to nonimprisoned diabetes population from Mexico City and from the lowest quintile of socioeconomic status at the national level, prisoners with diabetes had the lowest performance on process-of-care indicators. Continuity of care for chronic diseases, coupled with the equivalence of care principle, should provide the basis for designing chronic disease health policy for prisoners, with the goal of consistent transition of care from community to prison and vice versa.

Primary medical care in Irish prisons.

Science.gov (United States)

Barry, Joe M; Darker, Catherine D; Thomas, David E; Allwright, Shane P A; O'Dowd, Tom

2010-03-22

An industrial dispute between prison doctors and the Irish Prison Service (IPS) took place in 2004. Part of the resolution of that dispute was that an independent review of prison medical and support services be carried out by a University Department of Primary Care. The review took place in 2008 and we report here on the principal findings of that review. This study utilised a mixed methods approach. An independent expert medical evaluator (one of the authors, DT) inspected the medical facilities, equipment and relevant custodial areas in eleven of the fourteen prisons within the IPS. Semistructured interviews took place with personnel who had operational responsibility for delivery of prison medical care. Prison doctors completed a questionnaire to elicit issues such as allocation of clinician's time, nurse and administrative support and resources available. There was wide variation in the standard of medical facilities and infrastructure provided across the IPS. The range of medical equipment available was generally below that of the equivalent general practice scheme in the community. There is inequality within the system with regard to the ratio of doctor-contracted time relative to the size of the prison population. There is limited administrative support, with the majority of prisons not having a medical secretary. There are few psychiatric or counselling sessions available. People in prison have a wide range of medical care needs and there is evidence to suggest that these needs are being met inconsistently in Irish prisons.

Medication management and practices in prison for people with mental health problems: a qualitative study.

Science.gov (United States)

Bowen, Robert A; Rogers, Anne; Shaw, Jennifer

2009-10-20

Common mental health problems are prevalent in prison and the quality of prison health care provision for prisoners with mental health problems has been a focus of critical scrutiny. Currently, health policy aims to align and integrate prison health services and practices with those of the National Health Service (NHS). Medication management is a key aspect of treatment for patients with a mental health problem. The medication practices of patients and staff are therefore a key marker of the extent to which the health practices in prison settings equate with those of the NHS. The research reported here considers the influences on medication management during the early stages of custody and the impact it has on prisoners. The study employed a qualitative design incorporating semi-structured interviews with 39 prisoners and 71 staff at 4 prisons. Participant observation was carried out in key internal prison locations relevant to the management of vulnerable prisoners to support and inform the interview process. Thematic analysis of the interview data and interpretation of the observational field-notes were undertaken manually. Emergent themes included the impact that delays, changes to or the removal of medication have on prisoners on entry to prison, and the reasons that such events take place. Inmates accounts suggested that psychotropic medication was found a key and valued form of support for people with mental health problems entering custody. Existing regimes of medication and the autonomy to self-medicate established in the community are disrupted and curtailed by the dominant practices and prison routines for the taking of prescribed medication. The continuity of mental health care is undermined by the removal or alteration of existing medication practice and changes on entry to prison which exacerbate prisoners' anxiety and sense of helplessness. Prisoners with a dual diagnosis are likely to be doubly vulnerable because of inconsistencies in substance

Primary medical care in Irish prisons

Directory of Open Access Journals (Sweden)

Allwright Shane PA

2010-03-01

Full Text Available Abstract Background An industrial dispute between prison doctors and the Irish Prison Service (IPS took place in 2004. Part of the resolution of that dispute was that an independent review of prison medical and support services be carried out by a University Department of Primary Care. The review took place in 2008 and we report here on the principal findings of that review. Methods This study utilised a mixed methods approach. An independent expert medical evaluator (one of the authors, DT inspected the medical facilities, equipment and relevant custodial areas in eleven of the fourteen prisons within the IPS. Semistructured interviews took place with personnel who had operational responsibility for delivery of prison medical care. Prison doctors completed a questionnaire to elicit issues such as allocation of clinician's time, nurse and administrative support and resources available. Results There was wide variation in the standard of medical facilities and infrastructure provided across the IPS. The range of medical equipment available was generally below that of the equivalent general practice scheme in the community. There is inequality within the system with regard to the ratio of doctor-contracted time relative to the size of the prison population. There is limited administrative support, with the majority of prisons not having a medical secretary. There are few psychiatric or counselling sessions available. Conclusions People in prison have a wide range of medical care needs and there is evidence to suggest that these needs are being met inconsistently in Irish prisons.

Health profile of freedom-deprived men in the prison system.

Science.gov (United States)

Pinheiro, Marília Cléssia; de Araújo, Janieiry Lima; de Vasconcelos, Renata Borges; do Nascimento, Ellany Gurgel Cosme

2015-01-01

To understand the needs and health profile of men incarcerated in the Pau dos Ferros Regional Criminal Complex (Rio Grande do Norte, Brazil). Quanti-qualitative research conducted with 30 men incarcerated in November 2012. Semi-structured interviews were the primary data collection method. Descriptive statistics and thematic analysis of the speeches were used for data analysis. The participants' health profile, resulting from deficits in living conditions prior to their imprisonment, is heightened by the degrading conditions of their prison stay, and plays a role in their exclusion and lack of care when admitted as prisoners. The disorders and symptoms most often self-reported by participants were: headache (86.6%), respiratory infections (66.6%), diarrhea (60.0%), stress (60.0%), and depression or deep sadness (56.6%). The responses showed that there is a social gap, especially related to health care, in the prison complex. We recognize a need to ensure the physical and moral integrity of inmates, which is compromised by life in prison; the inmates' health problems and needs differ from those of the general population, and require solutions; the inmates' health-disease process deteriorates due to the mere situation of entering the prison system; the inmates' health problems and health needs are treated with palliative and / or no assistance by those legally responsible for their protection; few human and financial resources exist to ensure health actions for the inmates; and there are no interventions or actions of disease prevention and health promotion.

Trajectories of psychological distress after prison release: implications for mental health service need in ex-prisoners.

Science.gov (United States)

Thomas, E G; Spittal, M J; Heffernan, E B; Taxman, F S; Alati, R; Kinner, S A

2016-02-01

Understanding individual-level changes in mental health status after prison release is crucial to providing targeted and effective mental health care to ex-prisoners. We aimed to describe trajectories of psychological distress following prison discharge and compare these trajectories with mental health service use in the community. The Kessler Psychological Distress Scale (K10) was administered to 1216 sentenced adult prisoners in Queensland, Australia, before prison release and approximately 1, 3 and 6 months after release. We used group-based trajectory modeling to identify K10 trajectories after release. Contact with community mental health services in the year following release was assessed via data linkage. We identified five trajectory groups, representing consistently low (51.1% of the cohort), consistently moderate (29.8%), high increasing (11.6%), high declining (5.5%) and consistently very high (1.9%) psychological distress. Mood disorder, anxiety disorder, history of self-harm and risky drug use were risk factors for the high increasing, very high and high declining trajectory groups. Women were over-represented in the high increasing and high declining groups, but men were at higher risk of very high psychological distress. Within the high increasing and very high groups, 25% of participants accessed community mental health services in the first year post-release, for a median of 4.4 contact hours. For the majority of prisoners with high to very high psychological distress, distress persists after release. However, contact with mental health services in the community appears low. Further research is required to understand barriers to mental health service access among ex-prisoners.

Deficiencies in pastoral care with prisoners in Cameroon

Directory of Open Access Journals (Sweden)

Abraham K. Akih

2012-08-01

Full Text Available Cameroon celebrated fifty years of independence from colonial rule on 20 May 2010. Major problems facing the nation are economic, social and political crises and the appalling condition of its prisons. This article focuses on pastoral care with prisoners in Cameroon. Most churches in Cameroon have no pastoral care programme for prisoners. The churches in general are not yet committed to this kind of work. The article argues that changes and reform of the penitential system will be difficult if not impossible without collaboration with other institutions and resources, which include the different faith communities and faith based organisations. The focus should be on the care and well-being of those within its walls if successful rehabilitation is to take place. Spiritual care will contribute to the general well-being of prisoners. The article gives a broad overview of the situation of prisons and prisoners in Cameroon and presents a pastoral care approach that could contribute to the overall improvement of the lives of people in Cameroon prisons.

Medication management and practices in prison for people with mental health problems: a qualitative study

Directory of Open Access Journals (Sweden)

Rogers Anne

2009-10-01

Full Text Available Abstract Background Common mental health problems are prevalent in prison and the quality of prison health care provision for prisoners with mental health problems has been a focus of critical scrutiny. Currently, health policy aims to align and integrate prison health services and practices with those of the National Health Service (NHS. Medication management is a key aspect of treatment for patients with a mental health problem. The medication practices of patients and staff are therefore a key marker of the extent to which the health practices in prison settings equate with those of the NHS. The research reported here considers the influences on medication management during the early stages of custody and the impact it has on prisoners. Methods The study employed a qualitative design incorporating semi-structured interviews with 39 prisoners and 71 staff at 4 prisons. Participant observation was carried out in key internal prison locations relevant to the management of vulnerable prisoners to support and inform the interview process. Thematic analysis of the interview data and interpretation of the observational field-notes were undertaken manually. Emergent themes included the impact that delays, changes to or the removal of medication have on prisoners on entry to prison, and the reasons that such events take place. Results and Discussion Inmates accounts suggested that psychotropic medication was found a key and valued form of support for people with mental health problems entering custody. Existing regimes of medication and the autonomy to self-medicate established in the community are disrupted and curtailed by the dominant practices and prison routines for the taking of prescribed medication. The continuity of mental health care is undermined by the removal or alteration of existing medication practice and changes on entry to prison which exacerbate prisoners' anxiety and sense of helplessness. Prisoners with a dual diagnosis are likely

Variations in prison mental health services in England and Wales.

Science.gov (United States)

Forrester, Andrew; Exworthy, Tim; Olumoroti, Olumuyiwa; Sessay, Mohammed; Parrott, Janet; Spencer, Sarah-Jane; Whyte, Sean

2013-01-01

In responding to high levels of psychiatric morbidity amongst prisoners and recognising earlier poor quality prison mental health care, prison mental health in-reach teams have been established in England and Wales over the last decade. They are mostly provided by the National Health Service (NHS), which provides the majority of UK healthcare services. Over the same period, the prison population has grown to record levels, such that prisons in England and Wales now contain almost 90,000 of the world's overall prison population of over 10 million people (roughly the size of Paris or Istanbul). This study provides an overview of mental health in-reach services in prisons in England and Wales, including variations between them, through a telephone survey of senior staff in all prisons and young offender institutions in England and Wales. 73% of prisons took part; of them 13% had no in-reach team at all (usually low security establishments) and the majority of services were run by NHS teams, usually according to a generic community mental health team (CMHT) model rather than other specialist models. Team size was unrelated to prison size. Each nurse covered around 500 prisoners, each doctor over 3700. Many provided few or no healthcare cells and 24-h psychiatric cover (including on-call cover) was uncommon. Despite developments in recent years, mental health in-reach services still fall short of community equivalence and there is wide variation in service arrangements that cannot be explained by prison size or function. The aim of community equivalence has not yet been reached in prison healthcare and a more sophisticated measure of service improvement and standardisation would now be useful to drive and monitor future development. Copyright © 2013 Elsevier Ltd. All rights reserved.

Federally-Assisted Healthcare Coverage among Male State Prisoners with Chronic Health Problems.

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David L Rosen

Full Text Available Prisoners have higher rates of chronic diseases such as substance dependence, mental health conditions and infectious disease, as compared to the general population. We projected the number of male state prisoners with a chronic health condition who at release would be eligible or ineligible for healthcare coverage under the Affordable Care Act (ACA. We used ACA income guidelines in conjunction with reported pre-arrest social security benefits and income from a nationally representative sample of prisoners to estimate the number eligible for healthcare coverage at release. There were 643,290 US male prisoners aged 18-64 with a chronic health condition. At release, 73% in Medicaid-expansion states would qualify for Medicaid or tax credits. In non-expansion states, 54% would qualify for tax credits, but 22% (n = 69,827 had incomes of ≤ 100% the federal poverty limit and thus would be ineligible for ACA-mediated healthcare coverage. These prisoners comprise 11% of all male prisoners with a chronic condition. The ACA was projected to provide coverage to most male state prisoners with a chronic health condition; however, roughly 70,000 fall in the "coverage gap" and may require non-routine care at emergency departments. Mechanisms are needed to secure coverage for this at risk group and address barriers to routine utilization of health services.

Federally-Assisted Healthcare Coverage among Male State Prisoners with Chronic Health Problems.

Science.gov (United States)

Rosen, David L; Grodensky, Catherine A; Holley, Tara K

2016-01-01

Prisoners have higher rates of chronic diseases such as substance dependence, mental health conditions and infectious disease, as compared to the general population. We projected the number of male state prisoners with a chronic health condition who at release would be eligible or ineligible for healthcare coverage under the Affordable Care Act (ACA). We used ACA income guidelines in conjunction with reported pre-arrest social security benefits and income from a nationally representative sample of prisoners to estimate the number eligible for healthcare coverage at release. There were 643,290 US male prisoners aged 18-64 with a chronic health condition. At release, 73% in Medicaid-expansion states would qualify for Medicaid or tax credits. In non-expansion states, 54% would qualify for tax credits, but 22% (n = 69,827) had incomes of ≤ 100% the federal poverty limit and thus would be ineligible for ACA-mediated healthcare coverage. These prisoners comprise 11% of all male prisoners with a chronic condition. The ACA was projected to provide coverage to most male state prisoners with a chronic health condition; however, roughly 70,000 fall in the "coverage gap" and may require non-routine care at emergency departments. Mechanisms are needed to secure coverage for this at risk group and address barriers to routine utilization of health services.

Medication management and practices in prison for people with mental health problems: a qualitative study

OpenAIRE

Bowen, Robert A; Rogers, Anne; Shaw, Jennifer

2009-01-01

Abstract Background Common mental health problems are prevalent in prison and the quality of prison health care provision for prisoners with mental health problems has been a focus of critical scrutiny. Currently, health policy aims to align and integrate prison health services and practices with those of the National Health Service (NHS). Medication management is a key aspect of treatment for patients with a mental health problem. The medication practices of patients and staff are therefore ...

Health profile of freedom-deprived men in the prison system

Directory of Open Access Journals (Sweden)

Marília Cléssia Pinheiro

2015-08-01

Full Text Available Objective. To understand the needs and health profile of men incarcerated in the Pau dos Ferros Regional Criminal Complex (Rio Grande do Norte, Brazil. Methodology. Quanti-qualitative research conducted with 30 men incarcerated in November 2012. Semi-structured interviews were the primary data collection method. Descriptive statistics and thematic analysis of the speeches were used for data analysis. Results. The participants' health profile, resulting from deficits in living conditions prior to their imprisonment, is heightened by the degrading conditions of their prison stay, and plays a role in their exclusion and lack of care when admitted as prisoners. The disorders and symptoms most often self-reported by participants were: headache (86.6%, respiratory infections (66.6%, diarrhea (60.0%, stress (60.0%, and depression or deep sadness (56.6%. The responses showed that there is a social gap, especially related to health care, in the prison complex. Conclusion. We recognize a need to ensure the physical and moral integrity of inmates, which is compromised by life in prison; the inmates' health problems and needs differ from those of the general population, and require solutions; the inmates' health-disease process deteriorates due to the mere situation of entering the prison system; the inmates' health problems and health needs are treated with palliative and / or no assistance by those legally responsible for their protection; few human and financial resources exist to ensure health actions for the inmates; and there are no interventions or actions of disease prevention and health promotion.

Influence of environmental factors on mental health within prisons: focus group study.

Science.gov (United States)

Nurse, Jo; Woodcock, Paul; Ormsby, Jim

2003-08-30

To increase understanding of how the prison environment influences the mental health of prisoners and prison staff. Qualitative study with focus groups. A local prison in southern England. Prisoners and prison staff. Prisoners reported that long periods of isolation with little mental stimulus contributed to poor mental health and led to intense feelings of anger, frustration, and anxiety. Prisoners said they misused drugs to relieve the long hours of tedium. Most focus groups identified negative relationships between staff and prisoners as an important issue affecting stress levels of staff and prisoners. Staff groups described a "circle of stress," whereby the prison culture, organisation, and staff shortages caused high staff stress levels, resulting in staff sickness, which in turn caused greater stress for remaining staff. Staff shortages also affected prisoners, who would be locked up for longer periods of time, the ensuing frustration would then be released on staff, aggravating the situation still further. Insufficient staff also affected control and monitoring of bullying and reduced the amount of time in which prisoners were able to maintain contact with their families. Greater consideration should be given to understanding the wider environmental and organisational factors that contribute to poor mental health in prisons. This information can be used to inform prison policy makers and managers, and the primary care trusts who are beginning to work in partnership with prisons to improve the mental health of prisoners.

Health Conditions Prior to Imprisonment and the Impact of Prison on Health: Views of Detained Women.

Science.gov (United States)

Alves, Joana; Maia, Ângela; Teixeira, Filipa

2016-05-01

Detained women have certain health conditions prior to incarceration and these conditions can improve, worsen, or remain the same in prison, depending on the prisoner's background, the characteristics of the prison, and the arrest experience. This study investigated the health of detained women and the influence of incarceration from their perspective. Three focus groups were conducted among 15 inmates, and data were analyzed according to thematic analysis procedures. Detainer's health backgrounds varied with regard to their level of health concerns, contact with health services, and health behaviors. A positive influence of incarceration was described by patients with chronic illness, patients with drug addiction, and victims of interpersonal violence. Among women with mental illnesses or those without previous health problems, reports do not reveal benefits of imprisonment for mental health. These data emphasize the importance of specialized health care and the need to invest in mental health care in corrective institutions. © The Author(s) 2015.

The influence of prison climate on the mental health of adult prisoners: a literature review.

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Goomany, A; Dickinson, T

2015-08-01

Little is known about how the prison environment may impact upon the mental health of adult prisoners. This paper highlights that prisoners perceive that the prison environment has a negative influence upon their mental health. However, a small number regarded prison as a place of respite, which afforded structure and an opportunity to access health services. There is a need for more research in this area specifically relating to the impact the prison climate may have upon those from black and minority ethic groups. Nurses must recognize the aspects of the prison environment that may impact upon the mental health of prisoners and demonstrate innovation and imagination in their application of interventions. Little is known regarding how the prison environment may affect the mental health of adult prisoners. Consequently, there is a need to investigate how this setting may exacerbate mental distress among this community. This literature review explores how the prison climate influences the mental health of adult prisoners. A thematic synthesis approach was used to elicit data relating to the aspects of the prison climate, which influence the mental health of prisoners. Four primary themes emerged from the synthesis: social, emotional, organizational and physical aspects. Prisoners perceive the prison climate to have a negative influence upon their mental health. However, perceived positively, prison was regarded as a place of respite, which afforded structure and an opportunity to access health services. There is limited research available specifically exploring the potential impact of the prison climate upon those from black and ethnic minorities groups. Nurses must recognize the aspects of the prison environment that may impact upon the mental health of prisoners and demonstrate innovation and imagination in their application of interventions. Additionally nurses need to take an active role in influencing and structuring the political agenda, which governs the

Physical and mental health: from youth to age in Ohio prisons.

Science.gov (United States)

Lynd, Alice

2014-01-01

Who cares about health care in prisons? You do if you have a son or a granddaughter in prison. Maybe you care anyway if you have had to wait a long time to see a doctor or if you could not have the treatment you needed because it cost too much. Maybe you have run into the attitude, "You ain't bleedin', you ain't needin'." Maybe you have found it hard to face the future with little or no hope that you could ever be in a better place. Or maybe you, like some older prisoners, have been able to develop new interests, new skills, to review your life and review it, and to redefine what matters.

[Hospital pharmaceutical practice in prison].

Science.gov (United States)

Harcouët, L

2010-09-01

Since 1994, hospital pharmaceutical teams have been in charge of pharmaceutical tasks in "unités de consultation et de soins ambulatoires" (UCSA), which are hospital consulting care units in French prisons. In 2008, pharmaceutical team in Parisian prisons received 6500 prescriptions and prepared 85,000 nominative bags containing drugs. Prisoners were 1.3% to receive treatments against HIV, 8.2% cardiovascular drugs, 7.2% opioid substitution treatments, and 52.9% psychoactive drugs, including 39.3% hypnotics, 40.5% anxiolytics, 11.3% antidepressants and 12.2% neuroleptics. In prison, the dichotomy between somatic and mental care is marked, attitudes of prisoners about their medicines are complex (important claims, embezzlement, etc.) and it is difficult for law defendants to maintain treatment confidentiality and to prepare prison outing in terms of health. To attenuate the heterogeneity of drug distribution systems in French prisons, we propose pharmaceutical analysis of prescriptions and nominative dispensation, computerization in UCSA in coordination with hospitals, a better contribution of prison medical and pharmaceutical staff in hospital "drug committees" and the redaction of pharmaceutical guidelines. Acting in concert with multidisciplinary medical staff in UCSA, pharmaceutical teams have to develop epidemiological studies to improve knowledge in prisoner's health and also prevention and health care in prison. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Primary medical care in Irish prisons

OpenAIRE

ALLWRIGHT, SHANE PATRICIA ANN; DARKER, CATHERINE; BARRY, JOSEPH; O'DOWD, THOMAS

2010-01-01

PUBLISHED Background: An industrial dispute between prison doctors and the Irish Prison Service (IPS) took place in 2004. Part of the resolution of that dispute was that an independent review of prison medical and support services be carried out by a University Department of Primary Care. The review took place in 2008 and we report here on the principal findings of that review. Methods: This study utilised a mixed methods approach. An independent expert medical evaluator (one of ...

Primary medical care in Irish prisons

OpenAIRE

Barry, Joe M; Darker, Catherine D; Thomas, David E; Allwright, Shane PA; O'Dowd, Tom

2010-01-01

Abstract Background An industrial dispute between prison doctors and the Irish Prison Service (IPS) took place in 2004. Part of the resolution of that dispute was that an independent review of prison medical and support services be carried out by a University Department of Primary Care. The review took place in 2008 and we report here on the principal findings of that review. Methods This study utilised a mixed methods approach. An independent expert medical evaluator (one of the authors, DT)...

Detained and Dying: Ethical Issues Surrounding End-of-Life Care in Prison.

Science.gov (United States)

Stensland, Meredith; Sanders, Sara

2016-01-01

Prisons are increasingly being called upon to provide end-of-life (EOL) care within the restrictive correctional environment. Several relatively recent phenomena have brought medical ethics to the forefront of prison EOL care-including aging behind bars, a paradigm shift in prison culture, the increasing rate of in-prison deaths, and the corresponding prison hospice movement. This article examines prominent ethical issues that emerge for prison personnel who are tasked with providing care to terminally ill offenders by presenting three offender composite characters that exemplify dying offenders and emergent ethical issues surrounding their care. Identification and critical analysis of these ethical issues demonstrate the need for strong commitment to ethical practice and highlights specific issues for prisons to examine in their own EOL care practice.

HUMAN RIGHTS AND NIGERIAN PRISONERS--ARE PRISONERS NOT HUMANS?

Science.gov (United States)

Joshua, I A; Dangata, Y Y; Audu, O; Nmadu, A G; Omole, N V

2014-12-01

In Nigeria, just like in many other parts of the world, one of the most extensively discussed issues on the public agenda today is the increase in prison population. The aims of imprisonment are protection, retribution, deterrence, reformation and vindication. Investigations revealed that the prison services have been,neglected more than any other criminal justice agency in Nigeria. For example, most of the prisons were built during the colonial era for the purpose of accommodating a small number of inmates. Human Rights are the basic guarantees for human beings to be able to achieve happiness and self-respect; consequently, in most jurisdictions, the Human Rights Act confirms that these Rights do not stop at the prison gates. However, most States fail to meet the Human Rights obligations of their prisoners. As regards to health, for example, every prison should have proper health facilities and medical staff to provide dental and psychiatric care among others. This article discusses the Nigerian Prison System and challenges, trends and the related Human Rights and Ethical issues in Nigerian prisons. Some of the unmet needs of Nigerian prisoners which include, inter alia, living in unwholesome cells, delayed trial of inmates, lack of voting rights, access to information, lack of conjugal facilities for married prisoners, poor and inadequate nutrition, poor medical care, torture, inhumane treatment and the need to protect prisoners in a changing world. The present report has policy implications for reforming prison services in Nigeria, and countries that sing from the same song sheet with Nigeria on prison services, to conform to the Fundamental Human Rights of prisoners in the 21St century.

The health needs of young people in prison.

Science.gov (United States)

Lennox, Charlotte

2014-12-01

There has been an unprecedented reduction in the number of young people in prison; however, questions remain about the appropriateness and effectiveness of custody, given the high prevalence of health needs, self-inflected deaths while in custody and high reoffending rates. Articles relating to the health needs of young people, aged 10-17 years in prison in England and Wales were sourced through PubMed and ISI Web of Knowledge, plus additional key reports were included if deemed relevant. Young people in prison have much higher rates of multiple and complex health problems compared with young people in the general population. However, many of their health-care needs are unrecognized and unmet. There is an urgent need for up-to-date and robust prevalence data of all health needs across the age ranges in England and Wales. Research has neglected physical health and neurodevelopmental disorders and the quality of research for females and Black and Minority Ethnic group's requires improvement. There is a dearth of high-quality evaluations of health interventions with robust and sensitive short- and long-term outcome measures. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Growing health in UK prison settings.

Science.gov (United States)

Baybutt, Michelle; Dooris, Mark; Farrier, Alan

2018-05-29

Globally, prisoners tend to come from marginalized and socially disadvantaged sections of the society and exhibit a high incidence of ill health, linked to social exclusion and multiple complex needs. Prisons therefore offer an important opportunity to tackle inequality and injustice, through promoting health, reducing reoffending and facilitating community reintegration.This paper reports on and critically discusses findings from an evaluative research study, which aimed to identify and explore impacts of prisoners' participation in an innovative social and therapeutic horticultural programme, 'Greener on the Outside for Prisons' (GOOP), delivered in prisons in North West England. Focus groups with 16 prisoners and semi-structured interviews with six prison staff were conducted at five sites. Presented under three overarching themes (health and well-being; skills development, employability, and work preparedness; and relationships), findings suggest that engagement with and participation in GOOP were important in improving positive mental well-being, increasing physical activity and knowledge about healthier eating; developing skills and work readiness; and building relationships and catalysing and strengthening prosocial behaviours, important for good citizenship and effective resettlement. The paper concludes that - in the context of the current UK prison reform agenda and concern about the high incidence of violence, substance misuse, self-harm and suicide - prison-based horticulture can offer multiple benefits and make a significant contribution to the creation of safe, secure, supportive and health-enhancing environments. Furthermore, it contends that by joining up health and justice agendas, programmes such as GOOP have the potential to serve as powerful catalysts for wider systemic change, thereby helping tackle inequalities and social exclusion within societies across the globe.

Identifying health promotion needs among prison staff in three English prisons: results from a qualitative study.

Science.gov (United States)

Woodall, James

2013-03-01

Prisons are seen as a (temporary) home and community for offenders, yet they also have a dual role as a workplace for prison staff. This article explores how the "healthy settings" philosophy, commonly used in schools, applies in the prison environment. The article explores the concept of the health-promoting prison from the perspective of prison staff using semistructured interviews in three English prisons. Data were analyzed using Attride-Stirling's thematic network approach. The findings indicate that working in a prison can be highly stressful and can have a negative impact on physical and mental health. Staff perceived that the focus of health promotion efforts was in many cases exclusively focused on prisoners, and many suggested that prison staff needs were being overlooked. The article argues that the theory and practice of a health-promoting prison have developed rapidly in recent years but still lag behind developments in other organizations. The article suggests that health promotion policy and practice in prison settings may need to be reconfigured to ensure that the needs of all those who live and work there are recognized.

The state of health care provision and extent of mental health in the prisons of the Arab world: A literature review and commentary.

Science.gov (United States)

Gharaibeh, Numan; El-Khoury, Joseph

2009-01-01

Relevant literature was searched using MEDLINE, PsycINFO and Google in addition to Arabic search engines for information. Due to the shortage of scholarly articles on the subject, we broadened our search to publications from human rights organisation and articles in the mainstream press. We estimated the total carceral population in the member countries of the Arab league at 338,500 prisoners, over 46,000 of whom could be suffering from severe mental illness. We relied on indirect indicators of mental health services such as the quality of medical care in general, accounts of prison conditions by prisoners and their families, and the abundant literature on human rights abuses. Despite a grim overall picture, we highlight signs of improvement in recent years. Psychiatrists working in Arabic prisons face a number of challenges.We comment on directions for the future in the field of correctional psychiatry in the Arab countries including from the perspective of research.

[The actions of the Public Prosecution Service in the field of health in prisons].

Science.gov (United States)

Puppim, Érika Bastos Targino

2016-06-01

In the violent, insalubrious and overpopulated prison environment in which the concerns of penitentiary managers are predominantly focused on security, several actors of the legal world work incessantly to ensure that prisoners enjoy living conditions and access to health care in accordance with their constitutional rights. However, their discourses only appear infrequently in academic research and studies on health in prisons. We decided to ask for the opinion of a District Attorney of the State Public Prosecution Office, Dr. Érika Puppim to share with readers her view and the difficulties in her role in the protection of prisoners.

Pilot randomised controlled trial of the ENGAGER collaborative care intervention for prisoners with common mental health problems, near to and after release.

Science.gov (United States)

Lennox, Charlotte; Kirkpatrick, Tim; Taylor, Rod S; Todd, Roxanne; Greenwood, Clare; Haddad, Mark; Stevenson, Caroline; Stewart, Amy; Shenton, Deborah; Carroll, Lauren; Brand, Sarah L; Quinn, Cath; Anderson, Rob; Maguire, Mike; Harris, Tirril; Shaw, Jennifer; Byng, Richard

2018-01-01

Rates of common mental health problems are much higher in prison populations, but access to primary care mental health support falls short of community equivalence. Discontinuity of care on release is the norm and is further complicated by substance use and a range of social problems, e.g. homelessness. To address these problems, we worked with criminal justice, third sector social inclusion services, health services and people with lived experiences (peer researchers), to develop a complex collaborative care intervention aimed at supporting men with common mental health problems near to and following release from prison. This paper describes an external pilot trial to test the feasibility of a full randomised controlled trial. Eligible individuals with 4 to 16 weeks left to serve were screened to assess for common mental health problems. Participants were then randomised at a ratio of 2:1 allocation to ENGAGER plus standard care (intervention) or standard care alone (treatment as usual). Participants were followed up at 1 and 3 months' post release. Success criteria for this pilot trial were to meet the recruitment target sample size of 60 participants, to follow up at least 50% of participants at 3 months' post release from prison, and to deliver the ENGAGER intervention. Estimates of recruitment and retention rates and 95% confidence intervals (CIs) are reported. Descriptive analyses included summaries (percentages or means) for participant demographics, and baseline characteristics are reported. Recruitment target was met with 60 participants randomised in 9 months. The average retention rates were 73% at 1 month [95% CI 61 to 83] and 47% at 3 months follow-up [95% CI 35 to 59]. Ninety percent of participants allocated to the intervention successfully engaged with a practitioner before release and 70% engaged following release. This pilot confirms the feasibility of conducting a randomised trial for prison leavers with common mental health problems. Based

[Commune prison camp's health care and Versailles military hospital share].

Science.gov (United States)

Delahaye, R P

1995-01-01

Between June 1871 and December 1872, about five thousand prisoners were kept in Versailles among some places of detention. This high death rate was indebted for worst hygienic states (individual or collective) and food wretched quality during first weeks. Military Health Service, under Hippolyte Larrey's management with Adolphe Thiers and staff assent involved living conditions owing to tubs and toilets not forgiving accurate clothes and well-balanced food. In every prison was fitted and infirmary managed by a military physician. Sick people were sent into hospital. Versailles city's archives show that, during 1871, 154 insurgent people died in the military hospital while the number dropped to 55 during 1872.

Inpatient care of mentally ill people in prison: results of a year's programme of semistructured inspections

Science.gov (United States)

Reed, John L; Lyne, Maggi

2000-01-01

Objective To investigate the facilities for inpatient care of mentally disordered people in prison. Design Semistructured inspections conducted by doctor and nurse. Expected standards were based on healthcare quality standards published by the Prison Service or the NHS. Setting 13 prisons with inpatient beds in England and Wales subject to the prison inspectorate's routine inspection programme during 1997-8. Main outcomes measures Appraisals of quality of care against published standards. Results The 13 prisons had 348 beds, 20% of all beds in prisons. Inpatient units had between 3 and 75 beds. No doctor in charge of inpatients had completed specialist psychiatric training. 24% of nursing staff had mental health training; 32% were non-nursing trained healthcare officers. Only one prison had occupational therapy input; two had input from a clinical psychologist. Most patients were unlocked for about 3.5 hours a day and none for more than nine hours a day. Four prisons provided statistics on the use of seclusion. The average length of an episode of seclusion was 50 hours. Conclusion The quality of services for mentally ill prisoners fell far below the standards in the NHS. Patients' lives were unacceptably restricted and therapy limited. The present policy dividing inpatient care of mentally disordered prisoners between the prison service and the NHS needs reconsideration. PMID:10764360

"The will's there and the skill's there": prison mental health care

OpenAIRE

Jordan, Melanie

2017-01-01

This discussion explores some of the data from a social science PhD whose fieldwork took place in a category B, adult male, local and remand prison in England run by Her Majesty’s Prison Service (HMPS). The debate analyses National Health Service (NHS) staff experiences of mental healthcare provision in a penal context and debates achievements, problems, and implications for future improvement. To summarise using a staff member narrative: “The will’s there and the skill’s there, but …” – staf...

Prison nursing and its training

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M. Sánchez-Roig

Full Text Available The main task of nurses is to take care of sick and healthy people and evaluate changes in their health conditions. The goal is to take the appropriate measures to help their recovery or guarantee a dignified death, and if possible, help them regain autonomy and independence. Nursing is present in different areas: primary health, mental health, accident and emergencies, intensive and coronary care, surgical care, paediatrics, geriatrics, public health, occupational health, teaching, etc. In our case, prison nursing, one of the least known branches of the profession, we wanted to investigate more deeply the work of nurses in prisons, which aspect of health care they are responsible for and to what type of population they are geared towards, as well as the necessary training to be able to work in such a particular environment. To conclude, we have seen that university degrees in general nursing do not include knowledge in this area, and that authors from different countries support the specialization of prison nursing and the need for nurses to be trained according to the health conditions of inmates and the characteristics of prisons.

Prison nursing and its training.

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Sánchez-Roig, M; Coll-Cámara, A

2016-12-01

The main task of nurses is to take care of sick and healthy people and evaluate changes in their health conditions. The goal is to take the appropriate measures to help their recovery or guarantee a dignified death, and if possible, help them regain autonomy and independence. Nursing is present in different areas: primary health, mental health, accident and emergencies, intensive and coronary care, surgical care, paediatrics, geriatrics, public health, occupational health, teaching, etc. In our case, prison nursing, one of the least known branches of the profession, we wanted to investigate more deeply the work of nurses in prisons, which aspect of health care they are responsible for and to what type of population they are geared towards, as well as the necessary training to be able to work in such a particular environment. To conclude, we have seen that university degrees in general nursing do not include knowledge in this area, and that authors from different countries support the specialization of prison nursing and the need for nurses to be trained according to the health conditions of inmates and the characteristics of prisons.

[Monitoring system on prison health: feasibility and recommendations].

Science.gov (United States)

Develay, Aude-Emmanuelle; Verdot, Charlotte; Grémy, Isabelle

2015-01-01

This article presents the results of two studies designed to define the feasibility and framework of the future prison health monitoring system in France. The objective of the first study was to obtain the points of view of professionals involved in prison health and the second study was designed to assess the feasibility of using prisoner's medical files for epidemiological purposes. The point of view of various professionals was collected by questionnaire sent to 43 randomly selected prison physicians and by 22 semi-directive interviews. The feasibility study was based on analysis of the medical files of 330 randomly selected prisoners in eleven prisons chosen in order to reflect the diversity of correctional settings and prison populations. Additional interviews were conducted with the medical staff of these prison facilities. There is a consensus on the need to monitor prison health, but there are contrasting views on data collection methods (surveys or routinely collected data]. The feasibility study also showed that the implementation of a prison health monitoring system based on routinely collected data from prisoner's medical records was not feasible at the present time in France. In the light of these findings, it is recommended to initially develop a monitoring system based on regular nationwide surveys, while pursuing computerization and standardization of health data in prison.

Health and beyond...strategies for a better India: using the "prison window" to reach disadvantaged groups in primary care

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Soumyadeep Bhaumik

2015-01-01

Full Text Available As of 2013, the latest statistics available, more than 400,000 individuals are lodged in Indian prisons. Prisoners represent a heterogeneous population, belonging to socially diverse and economically disadvantaged sections of society with limited knowledge about health and healthy lifestyles. There is considerable evidence to show that prisoners in India have an increased risk of mental disorders including self-harm and are highly susceptible to various communicable diseases. Coupled together with abysmal living conditions and poor quality of medical services, health in prisons is a matter of immense human rights concern. However, the concept and the subsequent need to view prison health as an essential part of public health and as a strategic investment to reach persons and communities out of the primary health system ambit is poorly recognized in India. This article discusses the current status of prison healthcare in India and explores various potential opportunities the "prison window" provides. It also briefly deliberates on the various systematic barriers in the Indian prison health system and how these might be overcome to make primary healthcare truly available for all.

Health and beyond…strategies for a better India: using the "prison window" to reach disadvantaged groups in primary care.

Science.gov (United States)

Bhaumik, Soumyadeep; Mathew, Rebecca J

2015-01-01

As of 2013, the latest statistics available, more than 400,000 individuals are lodged in Indian prisons. Prisoners represent a heterogeneous population, belonging to socially diverse and economically disadvantaged sections of society with limited knowledge about health and healthy lifestyles. There is considerable evidence to show that prisoners in India have an increased risk of mental disorders including self-harm and are highly susceptible to various communicable diseases. Coupled together with abysmal living conditions and poor quality of medical services, health in prisons is a matter of immense human rights concern. However, the concept and the subsequent need to view prison health as an essential part of public health and as a strategic investment to reach persons and communities out of the primary health system ambit is poorly recognized in India. This article discusses the current status of prison healthcare in India and explores various potential opportunities the "prison window" provides. It also briefly deliberates on the various systematic barriers in the Indian prison health system and how these might be overcome to make primary healthcare truly available for all.

Oral health of female prisoners in HMP Holloway: implications for oral health promotion in UK prisons

NARCIS (Netherlands)

Rouxel, P.; Duijster, D.; Tsakos, G.; Watt, R.G.

2013-01-01

Objectives This study describes the oral health status and associated risk factors in a sample of female prisoners and compares their oral health to that of the female population from the 2009 Adult Dental Health Survey. Method A random sample of prisoners was selected from HMP Holloway, London.

Federally-Assisted Healthcare Coverage among Male State Prisoners with Chronic Health Problems

OpenAIRE

Rosen, David L.; Grodensky, Catherine A.; Holley, Tara K.

2016-01-01

Prisoners have higher rates of chronic diseases such as substance dependence, mental health conditions and infectious disease, as compared to the general population. We projected the number of male state prisoners with a chronic health condition who at release would be eligible or ineligible for healthcare coverage under the Affordable Care Act (ACA). We used ACA income guidelines in conjunction with reported pre-arrest social security benefits and income from a nationally representative samp...

HIV and STD testing in prisons: perspectives of in-prison service providers.

Science.gov (United States)

Grinstead, Olga; Seal, David W; Wolitski, Richard; Flanigan, Timothy; Fitzgerald, Christine; Nealey-Moore, Jill; Askew, John

2003-12-01

Because individuals at risk for HIV and STDs are concentrated in prisons and jails, incarceration is an opportunity to provide HIV and STD testing. We interviewed 72 service providers working in U.S. prisons in four states about their experiences with and perceptions regarding HIV and STD testing in prison. Providers' job duties represented administration, education, security, counseling, and medical care. Providers' knowledge of prison procedures and programs related to HIV and STD testing was narrowly limited to their specific job duties, resulting in many missed opportunities for prevention counseling and referral. Suggestions include increasing health care and counseling staff so posttest counseling can be provided for those with negative as well as positive test results, providing additional prevention programs for incarcerated persons, improving staff training about HIV and STD testing, and improving communication among in-prison providers as well as between corrections and public health staff.

Adjustment and mental health problem in prisoners

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Sudhinta Sinha

2010-01-01

Full Text Available Background : "Crime" is increasing day by day in our society not only in India but also all over the world. In turn, the number of prisoners is also increasing at the same rate. They remain imprisoned for a long duration or in some cases for the whole life. Living in a prison for long time becomes difficult for all inmates. So they often face adjustment and mental health problems. Recent findings suggest that mental illness rate in prison is three times higher than in the general population. Objective: The aim of the present study was to investigate the adjustment and the mental health problem and its relation in the prisoners. Materials and Methods : In the present study, 37 male prisoners of district jail of Dhanbad District of Jharkhand were selected on purposive sampling basis. Each prisoner was given specially designed Performa - Personal Data Sheet, General Health Questionnaire-12 and Bell Adjustment Inventory. Appropriate statistical tools were used to analyze the data. Results: The results obtained showed poor adjustment in social and emotional areas on the adjustment scale. The study also revealed a significant association between adjustment and mental health problem in the prisoners. Conclusion: The prisoners were found to have poor social and emotional adjustment which has strong association with their mental health.

Graduate Students' Reflections on Elder and End-of-Life Care for Prisoners.

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Baumann, Steven L; Todaro-Franceschi, Vidette

2017-07-01

The focus of this report was graduate nursing students' reflections on elder and end-of-life care for prisoners. The personal reflections of 21 graduate nursing students who attended a presentation by Susan J. Loeb on October 26, 2016 were included in this report. The title of the presentation was "Enhancing End-of-Life Care for Prisoners Through Partnering With the Prison Community." The student essays were synthesized to construct a summary essay, from which four themes were identified: aging in prison, dying in prison, ethical and professional issues in the elder and end-of-life care of prisoners, and ethical and professional issues in research involving elderly and end-of-life care of prisoners. These findings were interpreted from a global perspective in light of two different nursing perspectives: the humanbecoming tradition and the science of unitary human beings.

Health conditions of prisoners in the state of Rio de Janeiro, Brazil.

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Minayo, Maria Cecília de Souza; Ribeiro, Adalgisa Peixoto

2016-06-01

We present the results of a quantitative and qualitative study on the living conditions and health of prisoners in the state of Rio de Janeiro. The goal was to produce strategic information to support the action of public officials who work in prisons. The results show that prisoners are young (average age: 30 years), poor, mostly black and brown (70.5%), have little education (only 1.5% of them have a higher education), and have been in prison for less than four years. Among the problems that indirectly affect their health, we emphasize: overcrowding (1.39 prisoners per one vacancy), idleness (only 4.4% of them work), lack of perspective, violence and relationships of conflict. The most common physical health problems include: musculoskeletal problems, such as pain in the neck, back, and spine (76.7%), joint dislocation (28.2%), bursitis (22.9%), sciatica (22, 1%), arthritis (15.9%), bone fracture (15.3%), problems with bone and cartilage (12.5%), and muscle and tendon injuries (15.7%); respiratory problems, such as sinusitis (55.6%), allergic rhinitis (47%), chronic bronchitis (15.6%), tuberculosis (4.7%) and others (11.9%); and skin diseases. Despite legal requirements that include prison health care among the Universal Health System's (SUS) obligations, services are scarce and inefficient and a major cause of inmate dissatisfaction.

Health promotion and young prisoners: a European perspective.

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MacDonald, Morag; Rabiee, Fatemeh; Weilandt, Caren

2013-01-01

The purpose of this paper is to assess the health promotion needs of vulnerable young prisoners and the existing health promotion activities in custodial settings in seven European Union (EU) Member States. The research comprised two components: the first involved identifying existing health promotion practices. The second involved mapping out young offenders' health promotion needs by carrying out a needs assessment. Both quantitative and qualitative methods were adopted. The quantitative element comprised surveys among young prisoners and prison staff and focused on the availability and perceived importance of health promotion activities in prison. The qualitative element comprised focus groups with young offenders and individual interviews with prison staff, field experts and NGO members. The findings from the research have identified a number of similar, but also some diverse areas of unmet need for health promotion activities in prison settings across these diverse seven EU countries. There is no consistency of approach within and between countries regarding health promotion policy, guidance, resources and programmes for young prisoners. In order to improve the health of young prisoners and to establish and increase sustainability of existing health promotion programmes, there is a need for the establishment of National and EU standards. Providing health promotion activities for young prisoners while in custodial settings is key to addressing their unmet health and well-being needs and to facilitate their reintegration back into the community. Despite the barriers identified by this research, health promotion is to some extent being delivered in the partner countries and provides a foundation upon which further implementation of health promotion activities can be built especially when the benefits of health promotion activities, like dealing with the common problems of alcohol and drug addiction, mental health and communicable diseases are linked to successful

Health promoting prisons – An impossibility for women prisoners in Africa?

OpenAIRE

Dixey, R; Nyambe, S; Foster, S; Woodall, J; Baybutt, M

2015-01-01

The health needs of women in sub-Saharan African prisons are both neglected and poorly understood. Outside South Africa, little research exists on African prison health; what is available tends to be gender-blind and concerned with disease prevention rather than with health promotion. While Vetten (2008) has raised this concern previously, a comprehensive overview of women’s health and health promotion in African jails is clearly absent. Available evidence shows that the conditions in African...

Caring to learn, learning to care: Inmate Hospice Volunteers and the Delivery of Prison End-of-Life Care

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Cloyes, Kristin G.; Rosenkranz, Susan J.; Supiano, Katherine P.; Berry, Patricia H.; Routt, Meghan; Llanque, Sarah M.; Shannon-Dorcy, Kathleen

2017-01-01

The increasing numbers of aging and chronically ill prisoners incarcerated in Western nations is well documented, as is the growing need for prison-based palliative and end-of-life care. Less often discussed is specifically how end-of-life care can and should be provided, by whom, and with what resources. One strategy incorporates prisoner volunteers into end-of-life services within a peer care program. This article reports on one such program based on focused ethnographic study including in-depth interviews with inmate hospice volunteers, nursing staff, and corrections officers working in the hospice program. We describe how inmate volunteers learn hospice care through formal education and training, supervised practice, guidance from more experienced inmates, and support from correctional staff. We discuss how emergent values of mentorship and stewardship are seen by volunteers and staff as integral to prison hospice sustainability and discuss implications of this volunteer-centric model for response-ability for the end-of-life care of prisoners. PMID:28100141

From positive screen to engagement in treatment: a preliminary study of the impact of a new model of care for prisoners with serious mental illness.

Science.gov (United States)

Pillai, Krishna; Rouse, Paul; McKenna, Brian; Skipworth, Jeremy; Cavney, James; Tapsell, Rees; Simpson, Alexander; Madell, Dominic

2016-01-15

The high prevalence of serious mental illness (SMI) in prisons remains a challenge for mental health services. Many prisoners with SMI do not receive care. Screening tools have been developed but better detection has not translated to higher rates of treatment. In New Zealand a Prison Model of Care (PMOC) was developed by forensic mental health and correctional services to address this challenge. The PMOC broadened triggers for referrals to mental health teams. Referrals were triaged by mental health nurses leading to multidisciplinary team assessment within specified timeframes. This pathway for screening, referral and assessment was introduced within existing resources. The PMOC was implemented across four prisons. An AB research design was used to explore the extent to which mentally ill prisoners were referred to and accepted by prison in-reach mental health teams and to determine the proportion of prison population receiving specialist mental health care. The number of prisoners in the study in the year before the PMOC (n =  9,349) was similar to the year after (n = 19,421). 24.6 % of prisoners were screened as per the PMOC in the post period. Referrals increased from 491 to 734 in the post period (Z = -7.23, p prison population on in-reach caseloads increased from 5.6 % in the pre period to 7.0 % in the year post implementation while diagnostic patterns did not change, indicating more prisoners with SMI were identified and engaged in treatment. The PMOC led to increased prisoner numbers across screening, referral, treatment and engagement. Gains were achieved without extra resources by consistent processes and improved clarity of professional roles and tasks. The PMOC described a more effective pathway to specialist care for people with SMI entering prison.

A longitudinal study of health outcomes for people released from prison in Fiji: the HIP-Fiji project.

Science.gov (United States)

Kinner, Stuart A; Winter, Rebecca; Saxton, Kate

2015-12-01

To examine the health of prisoners and ex-prisoners in Fiji, including risk behaviours, service access and HIV status. Longitudinal study of 198 men and women recruited prior to release from prison in Fiji, interviewed in the weeks preceding release, and again 1 and 4 months post-release. Dried blood spot samples taken at baseline were tested for HIV. Eighty percent of participants completed at least one follow-up interview. The prevalence of HIV was low (1%), despite evidence of widespread STI and BBV risk behaviours. A history of risky substance use was normative and more than a third reported high psychological distress prior to release. Fewer than one in four reported accessing health care within a month of release from prison. The health needs of this population are significant but differ in important ways from those of incarcerated populations in other countries. Further research is needed to inform evidence-based care for prisoners and ex-prisoners in Pacific Island nations. © The Royal Australian and New Zealand College of Psychiatrists 2015.

HEALTH PROTECTION OF PRISONERS IN THE REPUBLIC OF MACEDONIA

OpenAIRE

Tanja Jovanovska; Biljana Kocić; Viktorija Proanovska-Stojčevska; Domnika Rajchanovska; Izabela Filov; Biljana Bogdanova

2016-01-01

INTRODUCTION: Prisoners’ health is one of the major challenges of public health systems because of prisoners’ greater care needs due to the poor economic conditions connected to the numerous risks and higher morbidity and mortality related to incarceration. Malnutrition, infectious diseases, overcrowding, strict custodial physical infrastructure, and limited access to basic health services, among other factors, contribute to a worsening of the physical and mental health of prisonersOBJECTIVES...

Assessment of the Reproductive Health Status of Adult Prison Inmates in Osun State, Nigeria

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A. I. Olugbenga-Bello

2013-01-01

Full Text Available Introduction. All over the world, numbers of prisoners have being increasing with majority in the sexually active age group; hence diseases such as HIV, Tuberculosis and Hepatitis are more prevalent in prisons than in the community. This study thus aims to provide an overview of the reproductive health status of adult prison inmates in Osun State. Methodology. This is a cross-sectional study among adult inmates in Osun State prison. Data was obtained from 209 selected respondents using pre-tested semi structured questionnaire. Result. Majority of the respondents were in the age group 20–39 years with mean age of 30.9+7.5. 73.2% are aware of STIs, 93.3% HIV/AIDS and 81.3% contraception. 54.6% had multiple sexual partners before incarceration and 23.3% of them used condom always. 89.5% were not involved in any sexual practice inside the prison, 9.1% masturbated and 1.4% had homosexual partners. Less than 6% had access to male condoms gotten from prison staffs and prison clinics. Conclusion and recommendation. No comprehensive reproductive health care system to address reproductive health services in prisons. Respondents’ knowledge about STIs, HIV/AIDS and contraception is good, but their condom usage is low compared with the knowledge. Government should put in place specific reproductive health programmes in prisons.

Assessment of the Reproductive Health Status of Adult Prison Inmates in Osun State, Nigeria

Science.gov (United States)

Olugbenga-Bello, A. I.; Adeoye, O. A.; Osagbemi, K. G.

2013-01-01

Introduction. All over the world, numbers of prisoners have being increasing with majority in the sexually active age group; hence diseases such as HIV, Tuberculosis and Hepatitis are more prevalent in prisons than in the community. This study thus aims to provide an overview of the reproductive health status of adult prison inmates in Osun State. Methodology. This is a cross-sectional study among adult inmates in Osun State prison. Data was obtained from 209 selected respondents using pre-tested semi structured questionnaire. Result. Majority of the respondents were in the age group 20–39 years with mean age of 30.9 + 7.5. 73.2% are aware of STIs, 93.3% HIV/AIDS and 81.3% contraception. 54.6% had multiple sexual partners before incarceration and 23.3% of them used condom always. 89.5% were not involved in any sexual practice inside the prison, 9.1% masturbated and 1.4% had homosexual partners. Less than 6% had access to male condoms gotten from prison staffs and prison clinics. Conclusion and recommendation. No comprehensive reproductive health care system to address reproductive health services in prisons. Respondents' knowledge about STIs, HIV/AIDS and contraception is good, but their condom usage is low compared with the knowledge. Government should put in place specific reproductive health programmes in prisons. PMID:25763387

Prison mental health: context is crucial: a sociological exploration of male prisoners' mental health and the provision of mental healthcare in a prison setting

OpenAIRE

Jordan, Melanie

2012-01-01

This thesis represents a sociological exploration of Her Majesty’s Prison Service, male prisoners’ mental health, and the provision of National Health Service mental healthcare in a prison setting. This qualitative social science study is conducted in one prison establishment. The work is characterised as a policy and practice orientated exploratory case study. The study implements an inductive approach to the datum–theory relationship, a constructionist ontological position, and an interpret...

Health and beyond…strategies for a better India: using the “prison window” to reach disadvantaged groups in primary care

Science.gov (United States)

Bhaumik, Soumyadeep; Mathew, Rebecca J.

2015-01-01

As of 2013, the latest statistics available, more than 400,000 individuals are lodged in Indian prisons. Prisoners represent a heterogeneous population, belonging to socially diverse and economically disadvantaged sections of society with limited knowledge about health and healthy lifestyles. There is considerable evidence to show that prisoners in India have an increased risk of mental disorders including self-harm and are highly susceptible to various communicable diseases. Coupled together with abysmal living conditions and poor quality of medical services, health in prisons is a matter of immense human rights concern. However, the concept and the subsequent need to view prison health as an essential part of public health and as a strategic investment to reach persons and communities out of the primary health system ambit is poorly recognized in India. This article discusses the current status of prison healthcare in India and explores various potential opportunities the “prison window” provides. It also briefly deliberates on the various systematic barriers in the Indian prison health system and how these might be overcome to make primary healthcare truly available for all. PMID:26288765

A prison mental health in-reach model informed by assertive community treatment principles: evaluation of its impact on planning during the pre-release period, community mental health service engagement and reoffending.

Science.gov (United States)

McKenna, Brian; Skipworth, Jeremy; Tapsell, Rees; Madell, Dominic; Pillai, Krishna; Simpson, Alexander; Cavney, James; Rouse, Paul

2015-12-01

It is well recognised that prisoners with serious mental illness (SMI) are at high risk of poor outcomes on return to the community. Early engagement with mental health services and other community agencies could provide the substrate for reducing risk. To evaluate the impact of implementing an assertive community treatment informed prison in-reach model of care (PMOC) on post-release engagement with community mental health services and on reoffending rates. One hundred and eighty prisoners with SMI released from four prisons in the year before implementation of the PMOC were compared with 170 such prisoners released the year after its implementation. The assertive prison model of care was associated with more pre-release contacts with community mental health services and contacts with some social care agencies in some prisons. There were significantly more post-release community mental health service engagements after implementation of this model (Z = -2.388, p = 0.02). There was a trend towards reduction in reoffending rates after release from some of the prisons (Z =1.82, p = 0.07). Assertive community treatment applied to prisoners with mental health problems was superior to 'treatment as usual', but more work is needed to ensure that agencies will engage prisoners in pre-release care. The fact that the model showed some benefits in the absence of any increase in resources suggests that it may be the model per se that is effective. Copyright © 2014 John Wiley & Sons, Ltd.

Care control and collaborative working in a prison hospital.

Science.gov (United States)

Foster, John; Bell, Linda; Jayasinghe, Neil

2013-03-01

This paper reports findings from a qualitative research project, using interviews, focus groups and participant observations, which sought to investigate "good practice" in a nurse-led prison hospital wing for male prisoners. The study raised issues about tensions between "caring" and "control" of prisoners from the perspectives of professionals working or visiting the wing. This paper discusses collaborative working between professionals from different backgrounds, including nurses and healthcare (prison) officers who were based on the wing and others who visited such as probation, medical, Inreach team or Counselling Advice, Referral, Assessment and Through Care team staff (CARAT). The key finding was that there is a balance between therapy and security/risk. In order to maintain this, the two main groups based on the hospital wing--nurses and prison officers--moved between at times cooperating, coordinating and collaborating with each other to maintain this balance. Other themes were care and control, team working, individual and professional responsibilities and communication issues. Enhancing the role of nurses should be encouraged so that therapy remains paramount, and we conclude with some recommendations to encourage collaborative working in prison healthcare settings to ensure that therapy continues to be paramount while security and safety are maintained.

Health care mergers and acquisitions: implications of robbers cave realistic conflict theory and prisoner's dilemma game theory.

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Creasy, Todd; Kinard, Jerry

2013-01-01

Many health care mergers and acquisitions have proven highly successful because of the geographic proximity of the institutions, coalignment strategies, complementary services, and improved financial performance. Other health care mergers and acquisitions, however, have been dismal failures. This article seeks to explain a primary cause of less successful mergers or acquisitions through the prism of a multiscale, iterative prisoner's dilemma that occurs between department managers. Aspects of "Coping Theory," "Resource (Conservation) Theory," and "Social Comparison Theory" are used to analyze the experience of employees charged with making mergers or acquisitions successful. Lastly, this article suggests possible culture clash remedies drawn from the realistic conflict experiment conducted by Muzafer Sherif near Robbers Cave State Park in Oklahoma.

The right to health of prisoners in international human rights law.

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Lines, Rick

2008-01-01

This paper explores the health rights of prisoners as defined in international law, and the mechanisms that have been used to ensure the rights of persons in detention to realise the highest attainable standard of health. It examines this right as articulated within United Nations and regional human rights treaties, non-binding or so-called soft law instruments from international organisations and the jurisprudence of international human rights bodies. It explores the use of economic, social and cultural rights mechanisms, and those within civil and political rights, as they engage the right to health of prisoners, and identifies the minimum legal obligations of governments in order to remain compliant with human rights norms as defined within the international case law. In addressing these issues, this article adopts a holistic approach to the definition of the highest attainable standard of health. This includes a consideration of adequate standards of general medical care, including preventative health and mental health services. It also examines the question of environmental health, and those poor conditions of detention that may exacerbate health decline, disease transmission, mental illness or death. The paper examines the approach to prison health of the United Nations human rights system and its various monitoring bodies, as well as the regional human rights systems in Europe, Africa and the Americas. Based upon this analysis, the paper draws conclusions on the current fulfilment of the right to health of prisoners on an international scale, and proposes expanded mechanisms under the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment to monitor and promote the health rights of prisoners at the international and domestic levels.

Prisoners' views about the drugs problem in prisons, and the new Prison Service drug strategy.

Science.gov (United States)

Gore, S M; Bird, A G; Cassidy, J

1999-09-01

Three hundred and seventy-five out of 575 prisoners (222/299 drug users and 153/267 non-users) who responded to a self-completion health care questionnaire at two prisons in 1997 commented on drugs in prisons. One hundred and forty-eight out of 176 responses expressed negative opinions about mandatory drugs testing (MDT), and 107 said that MDT promoted switching to or increased use of heroin/hard drugs'. Sixty-two prisoners suggested that more help/counselling was needed for drug users, 52 segregation of drug users/drug-free wings, and 50 more security on visits/in corridors after medication. The new Prison Service drug strategy has revised random MDT. It targets those who supply drugs, and supports those who want to stop using drugs, and accords with prisoners' views about the heroin problem in prisons.

Programming and Process in Prisoner Rehabilitation: A Prison Mental Health Center.

Science.gov (United States)

Smith, James A., III; Faubert, Marie

1990-01-01

Reviews literature concerning men in prisons. Describes specific program at a prison mental health center which prepares men for reentry into society. Closes with reflections on one man's struggle to grow and prepare for the outside. (CM)

Prisons' preparedness for pandemic flu and the ethical issues.

Science.gov (United States)

van't Hoff, G; Fedosejeva, R; Mihailescu, L

2009-06-01

In Europe at any given time there are about 1,8 million people imprisoned in penal institutions. About 1 million personnel are working in prisons. With prisons, from the start there are fundamental problems in many parts of Europe. Poor housing conditions in prisons and a high proportion of prisoners who already suffer from severe health problems mean the chance of an outbreak in prison during a pandemic must be quite high. We expect it can be up to 90%. In this article we explain what the characteristics are of the prison population from a health point of view. A high rate of detainees suffers from mental health disorders and/or addiction. A high prevalence of communicable and infectious diseases is the rule, not an exception. According to the European Prison Rules and many other international rules, statements and documents prison health care should be an integral part of the public health system of any country. However, it has to be accepted that the prison population is the least popular in society and in politics. In reality in many countries in Europe the situation in prison cannot meet the level strived for by the European Prison Rules. We compare preparedness on pandemic flu in The Netherlands, Latvia and Romania. We explore the problems and ethical issues that may arise if a pandemic breaks out. There are three ethical dilemmas that require consideration: equivalence of care and prisoners' right to health care; prisoners' interests verses society's interests; countries in need and calls for bilateral help.

Health-promoting prisons: theory to practice.

Science.gov (United States)

Baybutt, Michelle; Chemlal, Khadoudja

2016-03-01

As a setting, prisons offer a unique opportunity to invest in the health of disadvantaged and marginalised populations and address health inequalities and social exclusion - thereby achieving sustainable improvements in well-being for offenders and their families and in turn, helping to reduce rates of re-offending. This article draws on English and French experiences and doctoral research to advocate a shift from a pathogenic model towards a salutogenic model of health as a helpful way to address inequalities and thus, by promoting joined-up working across justice and wider systems, impact positively beyond 'health' for the effective resettlement of prisoners. The paper utilises examples from horticulture to further argue the powerful role of nature in the prison setting in mediating aspects of culture particularly relating to processes of socialisation. Critical success lies in bridging across systems and a commitment to joined-up working at all levels across and beyond prison. © The Author(s) 2015.

Perinatal health care services for imprisoned pregnant women and associated outcomes: a systematic review.

Science.gov (United States)

Bard, Eleanor; Knight, Marian; Plugge, Emma

2016-09-29

Women are an increasing minority of prisoners worldwide, and most are of childbearing age. Prisons offer unique opportunities for improving the pregnancy outcomes of these high-risk women, and no systematic review to date has looked at their care. This systematic review identified studies describing models of perinatal health care for imprisoned women which report maternal and child health and care outcomes. We systematically searched for literature published between 1980 and April 2014. Studies were eligible if they included a group of imprisoned pregnant women, a description of perinatal health care and any maternal or infant health or care outcomes. Two authors independently extracted data. We described relevant outcomes in prisons (including jails) under models of care we termed PRISON, PRISON+ and PRISON++, depending on the care provided. Where outcomes were available on a comparison group of women, we calculated odds ratios with 95 % confidence intervals. Eighteen studies were reported, comprising 2001 imprisoned pregnant women. Fifteen were in the US, two in the UK and one in Germany. Nine contained a comparison group of women comprising 849 pregnant women. Study quality was variable and outcome reporting was inconsistent. There was some evidence that women in prisons receiving enhanced prison care, PRISON+, were less likely to have inadequate prenatal care (15.4 % vs 30.7 %, p prisons receiving usual care (PRISON). Women participating in two PRISON++ interventions, that is, interventions which included not only enhanced care in prisons but also coordination of community care on release, demonstrated reductions in long term recidivism rates (summary OR 0 · 37, 95 % CI 0 · 19-0 · 70) compared to pregnant women in the same prisons who did not participate in the intervention. Enhanced perinatal care can improve both short and long-term outcomes but there is a lack of data. Properly designed programmes with rigorous evaluation are needed to

Indonesian prisons and HIV: part of the problem, part of the solution?

Science.gov (United States)

Nelwan, Erni Juwita; Diana, Aly; van Crevel, Reinout; Alam, Nisaa Nur; Alisjahbana, Bachti; Pohan, Herdiman T; van der Ven, Andre; Djaya, Ilham

2009-07-01

Around the world, HIV-prevalence rates among prisoners are high compared to the general population. This is due to overrepresentation of injecting drug users (IDUs) in prison and possible HIV-transmission inside prison. Limited health services in penitentiary institutes, stigma, policy issues, and budgetary constraints may hamper delivery of appropriate services for HIV in prison. Prisons may, on the other hand, enable the access to a high risk population for HIV-prevention and -care. IDUs are namely hard to reach outside prisons, while in prison targeted interventions for IDUs can be used repeatedly and economically. Also, harm reduction and HIV-treatment can be supervised and monitored carefully. This paper reviews HIV-prevention and care in prison, and describes the experience in one particular prison in West Java, Indonesia. Based on the literature and local experience, one can conclude that effective and widespread HIV-testing and treatment can be established in prisons if there is commitment from prison authorities, endorsement of services by prison staff and inmates, and collaboration with health care providers from outside prison. Essential components of HIV-services in prison include appropriate health care services, a suitable environment for HIV-counseling and -testing and tailored services for injecting drug use. By partner counseling and linking HIV-services in prison with continued care afterwards, prisons may contribute significantly to HIV-control in the general population, especially in settings where HIV is often due to injecting drug use.

Health Care Needs of Prison Inmates: Treating a population that has special needs

OpenAIRE

Wachsmuth, Anne

1991-01-01

Prisoners in correctional facilities constitute a unique population requiring specialized medical care. Drug withdrawal, self-destructive behavior, infectious diseases (including AIDS), and serious mental disorders are some of the challenges to the physician who provides medical services to these inmates.

Evaluation of Routine HIV Opt-Out Screening and Continuum of Care Services Following Entry into Eight Prison Reception Centers--California, 2012.

Science.gov (United States)

Lucas, Kimberley D; Eckert, Valorie; Behrends, Czarina N; Wheeler, Charlotte; MacGowan, Robin J; Mohle-Boetani, Janet C

2016-02-26

Early diagnosis of human immunodeficiency virus (HIV) infection and initiation of antiretroviral treatment (ART) improves health outcomes and prevents HIV transmission. Before 2010, HIV testing was available to inmates in the California state prison system upon request. In 2010, the California Correctional Health Care Services (CCHCS) integrated HIV opt-out screening into the health assessment for inmates entering California state prisons. Under this system, a medical care provider informs the inmate that an HIV test is routinely done, along with screening for sexually transmitted, communicable, and vaccine-preventable diseases, unless the inmate specifically declines the test. During 2012-2013, CCHCS, the California Department of Public Health, and CDC evaluated HIV screening, rates of new diagnoses, linkage to and retention in care, ART response, and post-release linkage to care among California prison inmates. All prison inmates are processed through one of eight specialized reception center facilities, where they undergo a comprehensive evaluation of their medical needs, mental health, and custody requirements for placement in one of 35 state prisons. Among 17,436 inmates who entered a reception center during April-September 2012, 77% were screened for HIV infection; 135 (1%) tested positive, including 10 (0.1%) with newly diagnosed infections. Among the 135 HIV-positive patient-inmates, 134 (99%) were linked to care within 90 days of diagnosis, including 122 (91%) who initiated ART. Among 83 who initiated ART and remained incarcerated through July 2013, 81 (98%) continued ART; 71 (88%) achieved viral suppression (care within 30 days of release were virally suppressed at that time. Only one of nine persons with a viral load test conducted between 91 days and 1 year post-release had viral suppression. Although high rates of viral suppression were achieved in prison, continuity of care in the community remains a challenge. An infrastructure for post

Is health coaching effective in changing the health status and behaviour of prisoners?-a systematic review protocol.

Science.gov (United States)

Almondes, Nadja; Downie, Denise; Cinar, Ayse B; Richards, Derek; Freeman, Ruth

2017-07-03

This is a protocol for a systematic review of the impact of health coaching on changing the health behaviour of offenders. Prisoners are more likely to suffer from health-related issues when compared to the general population. Health coaching has been shown to influence health outcomes of patients with chronic conditions. This review, therefore, aims to assess the effectiveness of health coaching interventions on the health of adolescent and adult offenders in custodial institutions. We plan to conduct a systematic review of the current literature on health coaching interventions delivered in the prison setting. We will include randomised controlled trials and observational studies that compare health coaching to the usual care or other alternative interventions. The ideal interventions will be delivered either by health professionals or peer coaches, and the outcomes extracted in the data collection will be disease-specific, clients' life and self-management skills, behavioural and psychosocial outcomes. If appropriate, a meta-analysis of the data collected will be carried out on the last stage of the review. This systematic review will identify and gather evidence on the impact of health coaching interventions delivered in the prison setting and can function as a supporting material for health professionals, prison staff, the healthcare system, and public health departments when considering delivering health coaching. PROSPERO CRD42016053237 .

In their own words: older male prisoners' health beliefs and concerns for the future.

Science.gov (United States)

Loeb, Susan J; Steffensmeier, Darrell; Myco, Priscilla M

2007-01-01

U.S. prisons are experiencing an exponential growth in inmates aged 50 years and older, a group with disproportionately high disease burden. The purpose of this study was to examine, in largely exploratory terms, the health beliefs and concerns of older male inmates and the health challenges they anticipate facing upon their return to the community. Results indicate that there is much to be gained from the assessments and insights of older prisoners with regard to health changes that occur during incarceration, health programs that they desire, the reasons for their confidence (or lack thereof) in health self-management, and fears about their health upon release. Geriatric nurses are well positioned to heed these important insights of inmates and translate them into steps for 1) preventing many of the health deteriorations experienced by older prisoners and 2) advocating for more seamless health care when incarcerated offenders transition back into the community.

Characteristics of women in a prison mental health assessment unit in England and Wales (2008-2010).

Science.gov (United States)

Hales, Heidi; Somers, Nadia; Reeves, Chrissy; Bartlett, Annie

2016-04-01

The high prevalence of mental disorders among women in prison is recognised worldwide. In England and Wales, successive governments and independent reports have argued that the equivalent of community care in prisons is acceptable but that some mental health assessment units (MHAUs), staffed by professional clinicians, should remain. These have not been researched. This paper aimed to explore patterns of use of a MHAU in a women's prison in England and to test the hypothesis that it was being used only, as intended--to hold women pending transfer to a health service hospital or in a bona fide crisis. Anonymised data on all women transferred to one MHAU between 1 January 2008 and 31 August 2010 were obtained from the prison files and subjected to descriptive analysis. Less than a third of these women were transferred to an outside hospital; this group stayed longest in the unit. An overlapping group of 52% of the women was under a special assessment, care in custody and teamwork protocol because of suicide or serious self-harm risk. Thus, 188 (68%) admissions fulfilled national protocol criteria for MHAU admissions. Two in five women admitted were released or returned to ordinary prison locations. Nevertheless, over 80% of the women were known to external mental health services, and 64 (30%) were so unwell on arrival in prison that they were transferred directly to the MHAU. Over a third of admissions were of women admitted more than once during the 32 months of study, and this was significantly more likely after release from prison directly to the community. Our hypothesis was not sustained, and it seems unlikely that this prison MHAU is unique in being used outside its strict remit. A shift from studying the epidemiology of mental disorder in prisons to the epidemiology of mental health needs could benefit this vulnerable group and the wider community alike. Copyright © 2015 John Wiley & Sons, Ltd.

Shakespeare in Prison: affecting health and wellbeing.

Science.gov (United States)

Marie Heard, Emma; Mutch, Allyson; Fitzgerald, Lisa; Pensalfini, Rob

2013-01-01

This research aimed to investigate the impacts of the Queensland Shakespeare Ensemble Prison Project (QSEPP) on the health and wellbeing of participants, specifically with regard to social support. Semi-structured interviews were conducted with prisoners participating in the project to gain insight into perceived sense of support within the QSEPP and across the prison context more broadly. The QSEPP encouraged participants to foster a range of support networks through the development of relationships built on trust, respect and shared experiences. Participants also developed communication skills which may assist with establishing and maintaining supportive relationships inside and outside of prison. This research highlights the inevitable challenges for researchers working within the prison context, including: correctional services' limitations, time and space restrictions and small sample sizes. This research offers some potentially innovative ways to combat such challenges. The study highlights the potential of theatre-based interventions in the prison context and their role in fostering social support and enhancing wellbeing. The research explores the potential role theatre may play in improving the health and wellbeing of a disadvantaged and marginalised group, providing skills to enhance access to supportive networks inside and outside prison. To the best of our knowledge this is the first research of its kind and provides valuable insights into the role that theatre may play in fostering social support in the prison context.

Estrategias asistenciales de los problemas de salud mental en el medio penitenciario, el caso español en el contexto europeo Health care strategies for mental health problems in the prison environment, the Spanish case in a European context

Directory of Open Access Journals (Sweden)

J. M. Arroyo-Cobo

2011-02-01

Full Text Available Introducción: Se ha revisado la literatura científica sobre estrategias de atención a los problemas de salud mental en el medio penitenciario. Se aportan datos de las principales actuaciones puestas en práctica por las administraciones penitenciarias para responder a las preocupantes cifras que señalan los más recientes estudios epidemiológicos de trastornos mentales en prisión, con tasas que comparadas con la población general, duplican los Trastornos Mentales Comunes (TMC y cuadriplican los Trastornos Mentales Graves (TMG entre las personas que se encuentran en prisión. Material y métodos: Se han revisado las bases de datos bibliográficas más importantes sobre las políticas asistenciales a los problemas de salud mental en el medio penitenciario, que han sido publicadas por los responsables de las administraciones penitenciarias en los últimos 10 años. Estos datos se han completado con datos obtenidos con el análisis de los indicadores disponibles en la Coordinación de Sanidad sobre las estrategias propias en materia de asistencia a problemas de salud mental en centros dependientes de la Secretaría General de Instituciones Penitenciarias, en España. Resultados: Hay poca literatura científica donde se enuncien las políticas asistenciales de las diferentes administraciones sobre la asistencia a problemas de salud mental en el medio penitenciario. Las que lo hacen están de acuerdo en una serie de afirmaciones: se debe ofrecer una respuesta terapéutica de igual calidad a la recibida por los enfermos en la comunidad, debe ser un equipo multidisciplinar el encargado de atender a este tipo de pacientes, es preciso un esfuerzo de coordinación entre las administraciones que en un momento determinado deben atender a estos pacientes, la asistencial, la social, la judicial y la penitenciaria.Introduction: A review was carried out of scientific literature on health care strategies for mental health problems in the prison environment

Revision and Implementation of "Clinical Guideline for Tuberculosis and HIV in Prisons", Great Tehran Prison, Iran.

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Farhoudi, Behnam; SeyedAlinaghi, SeyedAhmad; Tabarsi, Payam; Mohraz, Minoo; Golrokhy, Raheleh; Farnia, Marzieh; Shahbazi, Mohammad; Alasvand, Ramin; Ebrahimi, Bahman; Esfehani, Jafar; Tashakoriyan, Mehrzad

2018-01-01

To evaluate the feasibility of the revised "Clinical Guideline for HIV and TB" in the Great Tehran Prison during October 2013 to June 2014. The guideline includes all aspects of HIV/TB diagnosis based on active case finding (ACF), treatment and care services. Before the implementation, a focus group discussion was conducted, and attended by experts on prison health. The objective was to identify defects and limitations of the guideline. After the discussion, the guideline was revised. The Great Tehran Prison contains three separate units; all prisoners are taken first to "reception and identification unit (quarantine)" and then send to two housing units according to their legal status. An HIV ACF strategy was employed in the quarantine, and two units through a voluntary provider-initiated HIV testing. Three staff of the triangular clinic trained the prisoners about common routes of HIV transmission and the symptoms of TB in the units. In the quarantine, all prisoners were examined for all HIV-risk factors, HIV testing and symptoms of TB. In unit one, healthcare staff continued the ACF process, while in unit two, the peers of prisoners were assigned as the healthcare communicators to proceed with the strategy. At this caring process, when the test result was positive, then the process of care, treatment and follow ups was initiated. Moreover, the use of directly observed therapy (DOT) for antiretroviral therapy (ART) and TB was applied to the sick prisoners. There was also a follow-up caring for released prisoner to refer them to care and treatment services outside the prison. The guideline was implemented in the prison successfully. Regarding feasibility of the guideline, the investigators of this study suggest that the guideline should be implemented in other prisons across the country. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Mapping the Zambian prison health system: An analysis of key structural determinants.

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Topp, Stephanie M; Moonga, Clement N; Luo, Nkandu; Kaingu, Michael; Chileshe, Chisela; Magwende, George; Henostroza, German

2017-07-01

Health and health service access in Zambian prisons are in a state of 'chronic emergency'. This study aimed to identify major structural barriers to strengthening the prison health systems. A case-based analysis drew on key informant interviews (n = 7), memos generated during workshops (n = 4) document review and investigator experience. Structural determinants were defined as national or macro-level contextual and material factors directly or indirectly influencing prison health services. The analysis revealed that despite an favourable legal framework, four major and intersecting structural factors undermined the Zambian prison health system. Lack of health financing was a central and underlying challenge. Weak health governance due to an undermanned prisons health directorate impeded planning, inter-sectoral coordination, and recruitment and retention of human resources for health. Outdated prison infrastructure simultaneously contributed to high rates of preventable disease related to overcrowding and lack of basic hygiene. These findings flag the need for policy and administrative reform to establish strong mechanisms for domestic prison health financing and enable proactive prison health governance, planning and coordination.

Acute mental health care according to recent mental health ...

African Journals Online (AJOL)

acute care, treatment and rehabilitation as a 72-hour assessment unit in a .... resemble prisons, such as unnecessary bars on windows and one-way glass. ..... model to consider design solutions for other acute mental health care settings.

Prison health service directors' views on research priorities and organizational issues in conducting research in prison: outcomes of a national deliberative roundtable.

Science.gov (United States)

Simpson, Paul Leslie; Guthrie, Jill; Butler, Tony

2017-06-12

Purpose Given that prisoners have significant health needs across most areas, the paucity of prisoner health research, and the difficulties involved in the conduct of research in this setting, there is a need to develop research priorities that align with key stakeholder groups. One such group are those responsible for health service provision in prisons - prison health service directors. The paper aims to discuss these issues. Design/methodology/approach Prison health service directors in each Australian state and territory were invited to participate in a national (deliberative) roundtable where the consensus building nominal group technique was utilized. This involved the identification of research priorities and organizational issues in conducting research with prisoners, and ranking research priorities. A thematic analysis was conducted on organizational issues. Findings In total, 13 participants attended the roundtable. Participants identified 28 research priorities and 12 organizational issues. Top ranked research priorities were mental health, cognitive and intellectual disability, post-release health maintenance, ageing prisoners, chronic health conditions and Aboriginal and Torres Strait Islander health. Themes identified from the organizational issues included prisoner access to research participation, health and research literacy of custodial staff, and institutional protectionism in response to research that may discover negative information about the custodial setting. Research limitations/implications These findings should inform future efforts to improve research infrastructures to undertake research to improve the health of people in Australian prisons, and help to align researchers' efforts with those of a key organizational stakeholder. Originality/value This is the first paper to determine the research priorities and organizational issues in conducting research in prisons of prison health service directors.

Mental Health Among Jail and Prison Inmates

Science.gov (United States)

Yi, Youngmin; Turney, Kristin; Wildeman, Christopher

2016-01-01

Previous studies provide insight into the mental health of jail and prison inmates, but this research does not compare the two groups of inmates. Using data from the Fragile Families and Child Wellbeing Study, this article examines how the association between incarceration and self-reported mental health varies by facility type, net of an array of demographic and socioeconomic characteristics. Both jail and prison inmates report high rates of depression, life dissatisfaction, heavy drinking, and illicit drug use. In adjusted logistic regression models, those incarcerated in jails, compared with those not incarcerated, have higher odds of depression (odds ratio [OR] = 5.06, 90% confidence interval [CI; 1.96, 13.11]), life dissatisfaction (OR = 3.59, 90% CI [1.40, 9.24]), and recent illicit drug use (OR = 4.03, 90% CI [1.49, 10.58]). Those incarcerated in prisons have higher odds of life dissatisfaction (OR = 3.88, 90% CI [2.16, 6.94]) and lower odds of recent heavy drinking (OR = 0.32, 90% CI [0.13, 0.81]) compared with those not incarcerated. Furthermore, jail inmates report significantly more depression, heavy drinking, and illicit drug use than prison inmates. These results suggest the association between incarceration and mental health may vary substantially across facilities and highlight the importance of expanding research in this area beyond studies of prisons. The results also indicate that public health professionals in the correctional system should be especially attuned to the disproportionately high levels of poor mental health outcomes among jail inmates. PMID:27932588

Mental Health Among Jail and Prison Inmates.

Science.gov (United States)

Yi, Youngmin; Turney, Kristin; Wildeman, Christopher

2017-07-01

Previous studies provide insight into the mental health of jail and prison inmates, but this research does not compare the two groups of inmates. Using data from the Fragile Families and Child Wellbeing Study, this article examines how the association between incarceration and self-reported mental health varies by facility type, net of an array of demographic and socioeconomic characteristics. Both jail and prison inmates report high rates of depression, life dissatisfaction, heavy drinking, and illicit drug use. In adjusted logistic regression models, those incarcerated in jails, compared with those not incarcerated, have higher odds of depression (odds ratio [ OR] = 5.06, 90% confidence interval [CI; 1.96, 13.11]), life dissatisfaction ( OR = 3.59, 90% CI [1.40, 9.24]), and recent illicit drug use ( OR = 4.03, 90% CI [1.49, 10.58]). Those incarcerated in prisons have higher odds of life dissatisfaction ( OR = 3.88, 90% CI [2.16, 6.94]) and lower odds of recent heavy drinking ( OR = 0.32, 90% CI [0.13, 0.81]) compared with those not incarcerated. Furthermore, jail inmates report significantly more depression, heavy drinking, and illicit drug use than prison inmates. These results suggest the association between incarceration and mental health may vary substantially across facilities and highlight the importance of expanding research in this area beyond studies of prisons. The results also indicate that public health professionals in the correctional system should be especially attuned to the disproportionately high levels of poor mental health outcomes among jail inmates.

Torture and Long-Term Health Effects Among Lebanese Female Political Prisoners.

Science.gov (United States)

Ghaddar, Ali; Elsouri, Ghadier; Abboud, Zeinab

2016-02-01

Lebanese prisoners during the Israeli occupation of Lebanon (1981-1999) were subject to regular torture. We examined the association between torture events and post-traumatic stress and cardiovascular diseases (CVDs) among former women political prisoners. We conducted a retrospective survey and performed health check-ups among 108 former women prisoners. Post-traumatic stress disorder (PTSD) was measured through the Clinician-Administered PTSD Scale (CAPS), and CVDs were assessed by physicians' diagnoses. The study was conducted between September 2008 and March 2010. All 67 participants in the study reported having been subjected to a variety of torture events. The prevalence of PTSD was 28.4% and that of CVD was 16.42%, respectively. PTSD and CVD were more likely to occur among women who had had longer imprisonment periods, and PTSD specifically was associated with exposure to torture (beating: OR = 1.49; 95% CI [0.48, 4.27] and threatening by rape: OR = 1.43; 95% CI [0.82, 9.30]). CVD was associated with asphyxia with water (OR = 3.86; 95% CI [0.03, 2.28]). Devoutness decreased the risk of PTSD (OR = 0.24; 95% CI [0.08, 1.41]). Torture had adverse long-term effects on prisoners' physiological and psychological health; devoutness played a significant protective role. This study highlights the importance of documenting torture events and identifying the indicators of associated morbidity among surviving political prisoners for the provision of additional resources to care. © The Author(s) 2014.

Multidisciplinary team working in an adult male prison establishment in the UK.

Science.gov (United States)

Heidari, E; Dickinson, C; Newton, T

2014-08-01

The first two articles in this series exploring the oral and dental health of male prisoners in the UK demonstrated how the general and oral health of prisoners is compromised compared to those of a similar age who are not prisoners. In caring for the oral health needs of this group the high demand for emergency dental services often precludes the delivery of preventive and routine care. Comprehensive oral care for this population requires a level of training to gain the skills and knowledge to manage prisoners' complex medical, dental and social needs and the heightened dental anxiety that prisoners exhibit. The type of training that might be required for prison dentistry will be discussed in the final article. This article will describe a number of cases selected to demonstrate the complex problems presented by male prisoners in Her Majesty's Prison (HMP), Brixton. This article will also discuss the establishment of a primary care inter-professional relationship network (IRN) developed within a prison setting involving a dentist and other healthcare professionals. After informal discussions between the dentist and other prison healthcare professionals, it became apparent that vulnerable patients were not accessing dental services. These patients also cancel/fail to attend their dental appointments more frequently. In order to improve access and provision of dental care for this group of prisoners, an IRN was developed between the dentist, diabetic nurse, forensic psychology team, communicable disease lead, general medical practitioner (GMP), prison officers and healthcare manager within HMP Brixton. The nature of the IRN is presented along with reviews with relevant patient cases. The IRN allowed information sharing between professionals and an open care culture. The network was valued by prisoners. Prison populations show higher rates of general and oral disease, therefore an IRN can help to identify vulnerable groups and allow healthcare providers to give

What motivates dentists to work in prisons? A qualitative exploration.

Science.gov (United States)

Smith, P A; Themessl-Huber, M; Akbar, T; Richards, D; Freeman, R

2011-08-26

To explore what motivates dentists to work in prisons using Vroom's theoretical model of motivation as an explanatory framework. In-depth interviews were conducted with ten of the 15 dentists working in Scottish prisons. The focus was to explore their motivations to work in Scottish prisons. The data were analysed using a thematic framework based on the three motivational dimensions of expectancy, instrumentality and valence. The dentists had the skills to help improve their prisoner-patients' oral health but their efforts were often hindered by institutional rationing and the requirement to fit in with prison routines and procedures (expectancy). Despite these institutional difficulties the dentists experienced work rewards associated with the improvement in the prisoners' oral health (instrumentality). Finally, the dentists experienced a feeling of personal worth and a sense of commitment to providing care to Scottish prisoners (valence). The dentists' motivation to work in Scottish prisons may be explained by Vroom's Expectancy Theory. The dentists' motivation is characterised by their beliefs that their work will improve clinical outcomes which will be rewarded by the satisfaction experienced when they overcome environmental obstacles and provide oral health care for their prisoner-patients.

The United States needs a WHO health in prisons project.

Science.gov (United States)

Weinstein, C

2010-11-01

Some facts about imprisonment in the USA are used to justify the comment that US is a country that loves prisons. The lack of provision of rehabilitative type services is stressed and the example of Valley Fever in one area of California demonstrates the public health disasters which can occur with the present arrangements. The organisations concerned with prisons seem to support the idea of prisons as a business. The article is a plea for a WHO health in prisons project as the way forward. Copyright © 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Prison hospice: an unlikely success.

Science.gov (United States)

Craig, E L; Craig, R E

1999-01-01

Efforts to introduce hospice and palliative care into American prisons have become fairly widespread, in response to the sharp increase in inmate deaths. The primary impetus originally came from the alarming number of AIDS deaths among prisoners. The new combination therapies have proved very successful in treating AIDS, but are very costly, and many problems must be overcome to ensure their effectiveness in correctional settings. Although the AIDS epidemic seems to be in decline, prisons are experiencing a rise in the number of deaths due to "natural causes." In this article we present a review of the prison hospice scene--the response to this crisis in correctional health care. First, we discuss the challenges facing the introduction of hospice into the correctional setting. Then, we present a brief overview of recent developments and a discussion of some ways hospice components have been adapted for life behind bars. Finally, we indicate some of the prospects for the future. Hospice professionals, armed with thorough professional training and years of experience, often fear that correctional health care providers will only parody superficial aspects of the hospice approach. Continual nudging and nurturing by local and state hospice professionals is required in order to bring about this change in the first place and to sustain it through time. Prison hospice workers need not only initial training, but also ongoing education and personal contact with experienced hospice professionals. While the interest of the big national organizations is necessary, the real action happens when local hospices work with nearby prisons to attend to the needs of dying inmates.

Prison Nursing: Formation of a Stable Professional Identity.

Science.gov (United States)

Choudhry, Khurshid; Armstrong, David; Dregan, Alexandru

The aim of this study was to analyze how working within prison environments can influence the self-identity and professional identity of nurses. The prison environment can be a difficult environment for nurses to deliver care within, with nurses having to carry out activities that seem to go against their professional role, while at the same time providing care to prisoners who have greater health needs than the general population. There is a lack of theoretical consideration of how prison nurses carry out their role in the face of such challenges. This study used a review of literature published over the last 11 years exploring nurses' beliefs, thoughts, and feelings toward delivering care within prison environment. With time, nurses working within prison environments develop specific skills to be able to deliver appropriate care to their patients. These skills include adapting to both the prison environment and the prison culture. Ultimately, adaptations lead to a change in identity allowing nurses to work effectively within prison. Providers of prison healthcare should ensure that induction (orientation) processes for new nurses are designed to address specific challenges that nurses face including the potential for cognitive dissonance. They should ensure that nurses receive training to develop and acquire the skills highlighted in this review. Ensuring that this training is in place may increase nurse retention.

RISK FACTORS ASSOCIATED WITH CARDIOVASCULAR DISEASE IN PRISON POPULATION

Directory of Open Access Journals (Sweden)

Ricardo Soares de OliveiraI

2014-02-01

Full Text Available This work aimed to make a reflection about the risk factors associated with cardiovascular disease in the prison population, as well as the performance of the health care team in these spaces. It is a reflective approach, literature that included e-journal articles, published in the year 2003 to 2011, indexed at LILACS, Scielo, MEDLINE, and available in full. Textbooks were also consulted and ordinances of Ministry of health and Justice of Brazil. Used the descriptors "risk factors," "cardiovascular disease" and "Prisoners". It was noted that the current situation of overcrowding in prisons is, with unhealthy environment, which imposes risks the health of prisoners. The living habits, such as use of alcohol and drugs (cocaine, marijuana, tranquillizers and tobacco, increases the risk for cardiovascular disease. In addition, the authors emphasize, a priori, the low level of schooling of the detainees. The performance of the health care team must be based on educational practices for promoting and monitoring the health, with multidisciplinary support. Further studies need to be done in order to investigate the incidence of cardiovascular diseases, as well as evidence of the effectiveness of health care for this population.

Transgendered Prisoners in the United States: A Progression of Laws

Directory of Open Access Journals (Sweden)

Rudolph Alexander

2013-11-01

Full Text Available In 1976, prisoners acquired the right to medical treatment from the U.S. Supreme Court through the Eighth Amendment to the United States Constitution, which forbade, in part, cruel and unusual punishment. The following year, a Fourth Circuit Court of Appeals ruled that medical treatment included psychiatric or mental health treatment. These rulings applied to general prisoners, but not initially prisoners who suffered from gender identity disorder. Courts ruled then that gender identity disorder was not a serious mental disorder—a critical component of the right to medical care and mental health treatment. Later, a few appeals courts ruled that gender identity disorder was a serious mental disorder, triggering a prisoner’s right to medical care and mental health treatment for this disorder. Prisoners with gender identity disorder have litigated for sex realignment surgery as part of their treatment, which prison administrators have balked. The latest ruling unequivocally ordered the Massachusetts Department of Corrections to give a prisoner suffering from gender identity disorder sex reassignment surgery, but the prison system has appealed. This ruling, and previous rulings, has furthered policy towards transsexual prisoners.

Oral Health of Lipjan Convicts: Kosovo Prison House

Directory of Open Access Journals (Sweden)

Luljeta Zajmi

2018-01-01

Full Text Available Objectives. The oral health services of the prison population are considered more complex than those of the general population. The aim of this study was to examine the oral health status (the DMFT index and OHI index and to evaluate the relation between the oral health and risk factors of inmates of this population, thus identifying the dental health status of inmates by gender, age, and the duration of their sentence. Materials and Methods. Our study has included a total number of 150 inmates, of both genders, from Lipjan prison house in Kosovo. Results. Oral health condition of inmates in Lipjan prison house is severe; the average value of DMFT is 8.44: for minors 6.22, while for adults 9.55. The assessment of DMFT index within the recruited inmates in our study shows that the mean rate of oral cure was 3.21, while the mean extraction value and caries were 3.55 and 3.58, respectively. The mean plaque test value was 1.44. Conclusion. Based on this research, we have concluded that the oral health condition of the inmates in Lipjan prison is not good, due to the presence of different risk factors among them.

Availability of behavioral health treatment for women in prison.

Science.gov (United States)

Blitz, Cynthia L; Wolff, Nancy; Paap, Kris

2006-03-01

This study examined whether women with behavioral health needs are more likely to receive treatment for these problems in prison or in the community and to what extent prison disrupts or establishes involvement in treatment for these women. Data were collected in August 2004 as part of a population survey of female inmates in the only state correctional facility for women in New Jersey. A total of 908 women were surveyed. Fifty-six percent of the women surveyed reported needing behavioral health treatment before incarceration, but only 62 percent of this group reported receiving such treatment in the community. The rate at which treatment matched need within this population before incarceration varied by type of treatment needed: it was the highest (58 percent) for women who needed treatment for mental health problems, lower (52 percent) for those who needed substance abuse treatment, and lowest (44 percent) for those who needed treatment for comorbid mental health and substance abuse problems. In comparison, the rate of match between need for and receipt of treatment in prison was higher for all three types of behavioral health treatment (78 percent, 57 percent, and 65 percent, respectively). Additionally, the findings suggest that prison did not disrupt the type of behavioral health treatment that inmates had previously received in the community. At least in New Jersey, prison appears to improve access to behavioral health treatment among female inmates. Although this conclusion is consistent with the rehabilitation goals of incarceration, it also suggests that some women may have been able to avoid prison if treatment had been provided in the community, especially for substance-related problems.

[Guidelines for substitution treatments in prison populations].

Science.gov (United States)

Michel, L; Maguet, O

2005-01-01

drug addicts for heroin of 160,000). There are however considerable variations (from 0 to 16.2%) of the proportion of substituted of one establishment for the other according to the type of prison, of its size, its localization and the type of medical device present. If a consensus exists for methadone (daily delivery with sanitary control), the organization of the care relating to the buprenorphine is extremely variable from one establishment to another, often putting in difficulty as well the medical teams as the prisoners. One recommendation is essential: the formulation of an individualized therapeutic project. Thirteen other recommendations are made in the following fields: renewal of substitution treatments, initiation of substitution treatments, urinary controls, methods of prescription, methods of delivery, co-prescriptions, global care, confidentiality, files, exits and transfers, extractions, formation, accompaniment of the teams. These recommendations being formulated, many medical concerns remain present and several questions open. The report of joint mission IGAS/IGSJ of June 2001 on the health of the prisoners underlines the principal persistent gaps: hygiene and public health, treatment of the mental disorders, the follow-up of the sexual delinquents, handling ageing, handicap and the end of lifetime. In the same way, the difficulties listed in prison environment concerning substitution are only the exacerbation of those existing outside: the misuses and traffics are common in free environment, risk reduction in prison, as outside, handle with obstacles related to the penalization of the drug use and can hardly evolve except questioning the law of 1970. The prison practice opens also questions: that of the "duration" of the substitution, frequently posed by the prisoners; concern to see the prison becoming a privileged place of access to the care, combining sanction and care whereas the law of 1970 allows the alternative (care or sanction); that of the

Mental health in-reach in an urban UK remand prison.

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Forrester, Andrew; Singh, Jagmohan; Slade, Karen; Exworthy, Tim; Sen, Piyal

2014-01-01

Prison mental health in-reach teams (MHITs) have developed in England and Wales over the last decade. Services have been nationally reviewed, but detailed descriptions of their work have been scarce. The purpose of this paper is to describe the functions of one MHIT in a busy, ethnically diverse, male remand prison in London, UK. Clinical and demographic data were collected for prisoners referred to the MHIT using a retrospective design over an 18-week period in 2008/2009 (n=111). Foreign national prisoners and sentenced prisoners were significantly under-referred. Most referrals were already known to community mental health services, although around a quarter accessed services for the first time in prison. Around a third presented with self-harm/suicide risks. Substance misuse problems were common. Although the MHIT had evolved systems to promote service access, prisoner self-referrals were limited. Foreign national prisoners require enhanced investment to improve service access. MHITs identify people with mental disorders for the first time in prisons, but better screening arrangements are needed across systems. An evaluation of multiple MHIT models could inform a wider delivery template. Originality/value - One of the first ground-level evaluations of MHITs in England and Wales.

HIV and tuberculosis in prisons in sub-Saharan Africa.

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Telisinghe, Lilanganee; Charalambous, Salome; Topp, Stephanie M; Herce, Michael E; Hoffmann, Christopher J; Barron, Peter; Schouten, Erik J; Jahn, Andreas; Zachariah, Rony; Harries, Anthony D; Beyrer, Chris; Amon, Joseph J

2016-09-17

Given the dual epidemics of HIV and tuberculosis in sub-Saharan Africa and evidence suggesting a disproportionate burden of these diseases among detainees in the region, we aimed to investigate the epidemiology of HIV and tuberculosis in prison populations, describe services available and challenges to service delivery, and identify priority areas for programmatically relevant research in sub-Saharan African prisons. To this end, we reviewed literature on HIV and tuberculosis in sub-Saharan African prisons published between 2011 and 2015, and identified data from only 24 of the 49 countries in the region. Where data were available, they were frequently of poor quality and rarely nationally representative. Prevalence of HIV infection ranged from 2·3% to 34·9%, and of tuberculosis from 0·4 to 16·3%; detainees nearly always had a higher prevalence of both diseases than did the non-incarcerated population in the same country. We identified barriers to prevention, treatment, and care services in published work and through five case studies of prison health policies and services in Zambia, South Africa, Malawi, Nigeria, and Benin. These barriers included severe financial and human-resource limitations and fragmented referral systems that prevent continuity of care when detainees cycle into and out of prison, or move between prisons. These challenges are set against the backdrop of weak health and criminal-justice systems, high rates of pre-trial detention, and overcrowding. A few examples of promising practices exist, including routine voluntary testing for HIV and screening for tuberculosis upon entry to South African and the largest Zambian prisons, reforms to pre-trial detention in South Africa, integration of mental health services into a health package in selected Malawian prisons, and task sharing to include detainees in care provision through peer-educator programmes in Rwanda, Zimbabwe, Zambia, and South Africa. However, substantial additional investments are

Sexual Health of Prison Inmates: A Case Study of Kano Central ...

African Journals Online (AJOL)

Sexual and reproductive health of prison inmates suffers from serious neglect in Nigeria. This mixed method study examined prison officials and 160 inmates on prison law and administration, and sexual health of inmates. Most of the inmates examined (82.5%) reported having frequent sexual desire. Wet dreams (46.2%) ...

Provider Experiences with Prison Care and Aftercare for Women with Co-occurring Mental Health and Substance Use Disorders: Treatment, Resource, and Systems Integration Challenges.

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Johnson, Jennifer E; Schonbrun, Yael Chatav; Peabody, Marlanea E; Shefner, Ruth T; Fernandes, Karen M; Rosen, Rochelle K; Zlotnick, Caron

2015-10-01

Incarcerated women with co-occurring mental health and substance use disorders (COD) face complex psychosocial challenges at community reentry. This study used qualitative methods to evaluate the perspectives of 14 prison and aftercare providers about service delivery challenges and treatment needs of reentering women with COD. Providers viewed the needs of women prisoners with COD as distinct from those of women with substance use alone and from men with COD. Providers described optimal aftercare for women with COD as including contact with the same provider before and after release, access to services within 24-72 hours after release, assistance with managing multiple social service agencies, assistance with relationship issues, and long-term follow-up. Providers also described larger service system and societal issues, including systems integration and ways in which a lack of prison and community aftercare resources impacted quality of care and reentry outcomes. Practice and policy implications are provided.

[Comprehensive care program for the mentally ill in Spanish prisons (PAIEM): assessment after four years operation].

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Sanz, J; Gómez-Pintado, P; Ruiz, A; Pozuelo, F; Arroyo, J M

2014-01-01

To assess the comprehensive care program for the mentally ill in prison (PAIEM), which has been implemented for 3 years in Spanish prisons with the aim of improving processes and results. Descriptive study of the data gathered from an anonymous questionnaire completed by members of the PAIEM team in prisons. Frequency distributions were obtained of all the variables relating to facts, attitudes, opinions, experiences, situations and processes of the PAIEM. 91.2% of the PAIEM teams responded. Psychologists, educators, doctors and social workers were the professionals that collaborated most actively in the PAIEM (73%-84%) and were the ones to act most frequently as tutors. The mentally ill are usually located in ordinary modules (80%). The most commonly used activities for their psycho-social rehabilitation are self care (73%), education for health, preparation for daily life and social skills (more than 60%). Interventions with families are basically by telephone (79%). Bivariate analysis showed that the PAIEMs that operate most effectively are those that coordinate well with other technical teams, that prepare referral more than six months prior to release and ones where the NGOs process the referrals. Over 71% of the professionals observed improvements of disabilities and needs in over half the patients more than half of the professionals involved are satisfied (3.4/5) with their participation, although they acknowledge that there is a greater work load. The activities of the PAIEM are adequate, especially in the phases of early detection, stabilisation and rehabilitation and less so in the social incorporation phase, which improves when the third sector intervenes in referrals of patients to the social health care network outside prison.

Transitions to Care in the Community for Prison Releasees with HIV: a Qualitative Study of Facilitators and Challenges in Two States.

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Hammett, Theodore M; Donahue, Sara; LeRoy, Lisa; Montague, Brian T; Rosen, David L; Solomon, Liza; Costa, Michael; Wohl, David; Rich, Josiah D

2015-08-01

One in seven people living with HIV in the USA passes through a prison or jail each year, and almost all will return to the community. Discharge planning and transitional programs are critical but challenging elements in ensuring continuity of care, maintaining treatment outcomes achieved in prison, and preventing further viral transmission. This paper describes facilitators and challenges of in-prison care, transitional interventions, and access to and continuity of care in the community in Rhode Island and North Carolina based on qualitative data gathered as part of the mixed-methods Link Into Care Study of prisoners and releasees with HIV. We conducted 65 interviews with correctional and community-based providers and administrators and analyzed the transcripts using NVivo 10 to identify major themes. Facilitators of effective transitional systems in both states included the following: health providers affiliated with academic institutions or other entities independent of the corrections department; organizational philosophy emphasizing a patient-centered, personal, and holistic approach; strong leadership with effective "champions"; a team approach with coordination, collaboration and integration throughout the system, mutual respect and learning between corrections and health providers, staff dedicated to transitional services, and effective communication and information sharing among providers; comprehensive transitional activities and services including HIV, mental health and substance use services in prisons, timely and comprehensive discharge planning with specific linkages/appointments, supplies of medications on release, access to benefits and entitlements, case management and proactive follow-up on missed appointments; and releasees' commitment to transitional plans. These elements were generally present in both study states but their absence, which also sometimes occurred, represent ongoing challenges to success. The qualitative findings on the

Provider Experiences with Prison Care and Aftercare for Women with Co-occurring Mental Health and Substance Use Disorders: Treatment, Resource, and Systems Integration Challenges

Science.gov (United States)

Johnson, Jennifer E.; Schonbrun, Yael Chatav; Peabody, Marlanea E.; Shefner, Ruth T.; Fernandes, Karen M.; Rosen, Rochelle K.; Zlotnick, Caron

2014-01-01

Incarcerated women with co-occurring mental health and substance use disorders (COD) face complex psychosocial challenges at community reentry. This study used qualitative methods to evaluate the perspectives of 14 prison and aftercare providers about service delivery challenges and treatment needs of reentering women with COD. Providers viewed the needs of women prisoners with COD as distinct from those of women with substance use alone and from men with COD. Providers described optimal aftercare for women with COD as including contact with the same provider before and after release, access to services within 24–72 hours after release, assistance with managing multiple social service agencies, assistance with relationship issues, and long-term follow-up. Providers also described larger service system and societal issues, including systems integration and ways in which a lack of prison and community aftercare resources impacted quality of care and reentry outcomes. Practice and policy implications are provided. PMID:24595815

Mental health consultations in a prison population: a descriptive study

Directory of Open Access Journals (Sweden)

Rustad Aase-Bente

2006-06-01

Full Text Available Abstract Background The psychiatric morbidity among prison inmates is substantially higher than in the general population. We do, however, have insufficient knowledge about the extent of psychiatric treatment provided in our prisons. The aim of the present study was to give a comprehensive description of all non-pharmacological interventions provided by the psychiatric health services to a stratified sample of prison inmates. Methods Six medium/large prisons (n = 928 representing 1/3 of the Norwegian prison population and with female and preventive detention inmates over-sampled, were investigated cross-sectionally. All non-pharmacological psychiatric interventions, excluding pure correctional programs, were recorded. Those receiving interventions were investigated further and compared to the remaining prison population. Results A total of 230 of the 928 inmates (25 % had some form of psychiatric intervention: 184 (20 % were in individual psychotherapy, in addition 40 (4 % received ad hoc interventions during the registration week. Group therapy was infrequent (1 %. The psychotherapies were most often of a supportive (62 % or behavioural-cognitive (26 % nature. Dynamic, insight-oriented psychotherapies were infrequent (8 %. Concurrent psychopharmacological treatment was prevalent (52 %. Gender and age did not correlate with psychiatric interventions, whereas prisoner category (remanded, sentenced, or preventive detention did (p Conclusion Our results pertain only to prisons with adequate primary and mental health services and effective diversion from prison of individuals with serious mental disorders. Given these important limitations, we do propose that the service estimates found may serve as a rough guideline to the minimum number of sessions a prison's psychiatric health services should be able to fulfil in order to serve the inmates psychiatric needs. The results rely on the specialist services' own estimates only. Future studies should

Prison life: television, sports, work, stress and insomnia in a remand prison.

Science.gov (United States)

Elger, Bernice S

2009-01-01

To compare how prisoners complaining of insomnia and prisoners without sleep problems describe their daily activities, stress factors and the perceived reasons for their sleep quality in prison. 102 randomly chosen remanded prisoners complaining of insomnia and 61 randomly chosen prisoners who did not complain of insomnia. Prisoners complaining of insomnia and those reporting good sleep differed significantly in their lifestyle in prison. A significantly higher percentage of the former than of the latter reported writing letters, diaries or a book in prison, as well as doing "arts-related" activities such as painting and listening to music. A significantly higher percentage of non insomniac prisoners than of prisoners complaining of insomnia practiced sports in prison, watched television, and spent their day discussing and meeting other detainees. PSQI and GHQ scores were significantly different between insomniac and non insomniac prisoners. Insomniac prisoners complained significantly more often than non-insomniac prisoners about sleep disturbances, in the first place by roommates, but also by guards. Activities in prison and stressful events were significant factors associated with the variable "insomnia versus no insomnia" Worries about medical problems (odds ratio: 12.9), being separated or divorced (odds ratio: 8.8), having experienced stressful events during the past week (odds ratio: 8.7), "art" activity (odds ratio: 8.6), and having a GHQ score>10 (odds ratio: 7.7) had the highest odds ratios among the tested covariates. No sports in prison and some activities were also predictors of insomnia when entered separately or conditionally. Our study provides arguments on how to alleviate insomnia in prison: changing conditions of imprisonment is of public health benefit. Increased opportunities to practice sports in prison as well as adequate care for medical problems and psychological support to reduce context related stress should be routinely offered to

An assessment of health related quality of life in a male prison population in Greece associations with health related characteristics and characteristics of detention.

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Togas, Constantinos; Raikou, Maria; Niakas, Dimitris

2014-01-01

Prisoners constitute a group with increased health and social care needs. Although implementing policies that aim at improving outcomes within this population should be a priority area, studies that attempt to assess health outcomes and health related quality of life (HRQoL) in this population are limited. To assess HRQoL in a prison population in Greece and to explore the relationship between HRQoL and a set of individual sociodemographic and health related characteristics and characteristics of detention. A cross-sectional study involving 100 male prisoners was conducted in the prison of Corinth in Greece. HRQoL was assessed through the use of the SF-36 and the EQ-5D. The mean physical and mental summary scores of the SF-36 were 55.33 and 46.82, respectively. The EQ-VAS mean score was 76.41%, while the EQ-5D index was 0.72. Multivariate analysis identified a statistical relationship between HRQoL and the conditions of detention, controlling for the effect of sociodemographic characteristics, morbidity, and mental problems. The use of narcotics in particular is significantly associated with lower HRQoL. Implementation of policies that aim at preventing the use of narcotics within the prison environment is expected to contribute to improved HRQoL in this population.

Symptoms and treatment of mental illness among prisoners: a study of Michigan state prisons.

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Fries, Brant E; Schmorrow, Angela; Lang, Sylvia W; Margolis, Philip M; Heany, Julia; Brown, Greg P; Barbaree, Howard E; Hirdes, John P

2013-01-01

This study reports on a representative sample of prisoners in Michigan correctional facilities to determine the prevalence of psychiatric illness and the delivery of mental health (MH) services. Mental health assessments were conducted with 618 incarcerated subjects using the interRAI Correctional Facilities (interRAI CF). Subjects were randomly sampled based on four strata: males in the general population, males in administrative segregation, males in special units, and females. The interRAI CF assessments were merged with secondary data provided by the Michigan Department of Corrections (MDOC) containing information on MH diagnoses or services that the subjects were receiving within the facilities, demographics, and sentencing. Study results show that 20.1% of men and 24.8% of women in Michigan prisons have a substantial level of MH symptoms and that 16.5% and 28.9%, respectively, are receiving MH services. However, when compared with Michigan Department of Corrections MH care records, 65.0% of prisoners who are experiencing symptoms of mental illness are not currently receiving any psychiatric services. The mis-match between symptoms and service delivery suggests the need for improved procedures for identifying and measuring psychiatric symptoms within Michigan correctional facilities to ensure that appropriate individuals receive needed care. It is recommended that a standardized assessment process be implemented and conducted at regular intervals for targeting and improving psychiatric care in the prison system. Copyright © 2013 Elsevier Ltd. All rights reserved.

Evaluation of a health system strengthening initiative in the Zambian prison system

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Sharma, Anjali; Moonga, Clement N; Chileshe, Chisele; Magwende, George; Henostroza, German

2018-01-01

Introduction In 2013, the Zambian Correctional Service (ZCS) partnered with the Centre for Infectious Disease Research in Zambia on the Zambian Prisons Health System Strengthening project, seeking to tackle structural, organisational and cultural weaknesses within the prison health system. We present findings from a nested evaluation of the project impact on high, mid-level and facility-level health governance and health service arrangements in the Zambian Correctional Service. Methods Mixed methods were used, including document review, indepth interviews with ministry (11) and prison facility (6) officials, focus group discussions (12) with male and female inmates in six of the eleven intervention prisons, and participant observation during project workshops and meetings. Ethical clearance and verbal informed consent were obtained for all activities. Analysis incorporated deductive and iterative inductive coding. Results Outcomes: Improved knowledge of the prison health system strengthened political and bureaucratic will to materially address prison health needs. This found expression in a tripartite Memorandum of Understanding between the Ministry of Home Affairs, Ministry of Health (MOH) and Ministry of Community Development, and in the appointment of a permanent liaison between MOH and ZCS. Capacity-building workshops for ZCS Command resulted in strengthened health planning and management outcomes, including doubling ZCS health professional workforce (from 37 to78 between 2014 and 2016), new preservice basic health training for incoming ZCS officers and formation of facility-based prison health committees with a mandate for health promotion and protection. Mechanisms: continuous and facilitated communication among major stakeholders and the emergence of interorganisational trust were critical. Enabling contextual factors included a permissive political environment, a shift within ZCS from a ‘punitive’ to ‘correctional’ organisational culture, and

Examining relationships between receiving mental health services in the Pennsylvania prison system and time served.

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Metraux, Stephen

2008-07-01

This study examined a cohort of 7,046 men who were released from the Pennsylvania State prison system between 1999 and 2002 to Philadelphia County to assess the relationships between receipt of mental health services in prison and prison exit. Administrative data on prison stays for 7,046 men released from Pennsylvania prisons to Philadelphia locations were analyzed. Of the 7,046 men, 8.7% received ongoing or intensive mental health services and 25.9% received mental health services while incarcerated. Multivariate analyses indicate that use of mental health services was positively associated with increased odds of serving the full prison sentence (as opposed to receiving parole), although the relationship between mental health services received and length of prison episode was inconclusive. Dynamics related to prison release warrant further attention in efforts to reduce the prevalence of mental illness in prisons and to facilitate community reentry for persons so diagnosed.

Improving health in prisons - from evidence to policy to implementation - experiences from the UK.

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Leaman, Jane; Richards, Anna Amelia; Emslie, Lynn; O'Moore, Eamonn Joseph

2017-09-11

Purpose The purpose of this paper is to understand the components of a high-quality prison healthcare system and the impact, ten-years on, of the transfer of accountability in England, from a justice ministry to a health ministry. Design/methodology/approach A rapid the evidence review was undertaken, which included a review of 82 papers and qualitative interviews with key informants. The concepts and themes identified were summarised and analysed through a framework analysis, designed to improve population outcomes and address health inequalities. The use of a rapid evidence assessment, rather than a systematic review methodology, the use of abstracts (rather than full-text articles) to extract the data, and limiting the search strategy to articles published in the English language only might mean that some relevant research papers and themes were not identified. The need for the evidence to be produced within a limited time frame and with limited resources determined these pragmatic approaches. Findings The review found that English prison healthcare has undergone "transformation" during this period, leading to increased quality of care through organisational engagement, professionalisation of the healthcare workforce, transparency, use of evidence-based guidance and responsiveness of services. The review also highlighted that there is still room for improvement, for example, relating to the prison regime and the lack of focus on early/preventive interventions, as well as specific challenges from limited resources. Research limitations/implications Time and resource constraints meant a rapid evidence review of papers in the English language was undertaken, rather than a systematic review. This might mean relevant papers have been missed. The review also only covered small number of countries, which may limit the transferability of findings. The lack of qualitative data necessitated the use of quantitative data gathered from key informants. However, this enabled a

Does dental indifference influence the oral health-related quality of life of prisoners?

Science.gov (United States)

Marshman, Zoe; Baker, Sarah R; Robinson, Peter G

2014-10-01

Prisoners have worse oral health and greater unmet dental treatment needs than the general population. However, little is known about the impact of the mouth, or attitudes such as dental indifference and consequent patterns of dental service use in this disadvantaged group. The aim was to determine whether dental indifference was associated with the oral health-related quality of life (OHQoL) of prisoners using Andersen's behavioural model of service utilization as the theoretical framework. The sample was male prisoners aged 20-35 years attending three prisons in the north of England. Participants took part in interviews and oral examinations. The variables were selected to populate Andersen's model including: predisposing characteristics (socioeconomic status), enabling resources (dental indifference and dental attendance patterns before prison), perceived need (perceived treatment need, satisfaction with appearance of teeth, global rating of oral health), evaluated need (number of decayed teeth), health behaviours (use of dental services while in prison) and health outcomes (OHQoL). Structural equation modelling was used to estimate direct and indirect pathways between variables. Of the 700 men approached, 659 completed the interview and clinical examination. Worse OHQoL was associated with less dental indifference (i.e. greater interest in oral health), previous regular use of dental services, perceived need for treatment and use of prison dental services. The number of decayed teeth and predisposing factors such as qualifications and employment did not predict OHQoL. Dental indifference was related to the OHQoL of prisoners in addition to previous regular use of dental services, a perceived need for treatment and use of dental services while in prison. Dental services in prisons might incorporate methods to address dental indifference in their attempts to improve oral health. The findings also have general implications for the assessment of population oral

Emergence of a Policy, closure of a sector: regarding the management of penitentiary health care in Brazil.

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Batista E Silva, Martinho Braga

2016-06-01

The aim of this study is to understand recent transformations in penitentiary health care management in Brazil, during the implementation of the National Policy for Comprehensive Health Care for People Deprived of Liberty in the Prison System, and the closure of the National Sector for Penitentiary Health Care. The scientific problem investigated is the language of penitentiary health care policy. The theoretical-methodological framework adopted is Pierre Bourdieu's genetic structuralism. In this manner, we carry out an analysis of documents and public statements in search of State categories and classifications. We note the consolidation of a state classification that separates the 'penitentiary' domain from the 'prison' domain, as well as the creation of the State category of 'person deprived of liberty in the prison system'. Penitentiary health care management constitutes itself as a question of primary care.

HIV in Indian prisons: Risk behaviour, prevalence, prevention & treatment

OpenAIRE

Dolan, Kate; Larney, Sarah

2010-01-01

Background & Objectives: HIV is a major health challenge for prison authorities. HIV in prisons has implications for HIV in the general community. The aim of this paper was to gather information on HIV risk, prevalence, prevention and treatment in prisons in India. Methods: Relevant published and unpublished reports and information were sought in order to provide a coherent picture of the current situation relating to HIV prevention, treatment and care in prisons in India. Information covered...

Counterintuitive findings from a qualitative study of mental health in English women's prisons.

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Caulfield, Laura S

2016-12-19

Purpose Large numbers of women in prison report significant emotional and mental health problems, and there is evidence to suggest that the prison environment may exacerbate the incidence and severity of these issues (Armour, 2012). However, there has been limited exploration of the extent to which women's mental health problems exist prior to incarceration, whether symptoms first occur in incarceration, and how incarceration affects this. The paper aims to discuss these issues. Design/methodology/approach In-depth interviews were conducted with 43 women incarcerated in three English prisons and a thematic analysis of the data was conducted. Review of official prison records provided a form of data triangulation. Findings Analysis of the data revealed that while many women who experienced mental health issues in prison had experienced these issues in the past, a number of women reported first experiencing mental health and emotional problems only after entering prison. Although these problems often recede, this demonstrates the significant impact that entering prison can have upon the mental health of women. Unusually, the data highlighted many positive experiences of support within prison. However, there was some lack of consistency in the treatment and support offered to women. Originality/value The data presented here are in many ways more positive than previous research and - as opposed to much of the existing literature that simply states the prevalence women's issues in prison - provides insight into the lived experiences of women in prison. This paper documents how prison can present an opportunity for women to engage with treatment, but there is a need for a clearer understanding of women's needs and consistent and appropriate support.

[Participatory design guide for mental health promotion in prisons].

Science.gov (United States)

Bustamante Navarro, R; Paredes-Carbonell, J J; Aviñó Juan-Ulpiano, D; González Rubio, J; Pitarch Monzó, C; Martínez Martínez, L; Arroyo-Cobo, J M

2013-01-01

[corrected] The main aim was to describe the issues and the participatory process required to design a Guide to promotemental health in prison through group activities. We reviewed the bibliography, the mental health policies, the workshops about healthy mental habits, and a video about protection and risk factors. We identified the stakeholders and sought their points of view about the topics included in the Guide. We decided on the contents of the Guide and the incorporation of the health assets model and the perspectives provided by gender and cultural diversity. After the initial design of the modules and sessions, we started a pilot in the Prison of Valencia and the Prison of Zaragoza with women and men from different cultures, incorporating the suggested improvements, unifying contents and the discursive style. The guide is formed by: a preface, introduction, description, modules, sessions and evaluation. It has 6 modules and 19 sessions on: health and motivation; self-esteem; health and emotions; more assets to improve health: relax, positive thinking, keeping calm, communication and problem resolution; progress is possible: resiliency and starring in my own change. Each session consists of: activities (objectives, material, allocated time and development), theoretical material and tabbed sheets for activities. The guide is available in print and online versions. A guide has been elaborated with involved stakeholders and the opinion of the prison population.

[Beyond bars and punishments: a systematic review of prison health].

Science.gov (United States)

Gois, Swyanne Macêdo; Santos Junior, Hudson Pires de Oliveira; Silveira, Maria de Fátima de Araújo; Gaudêncio, Mércia Maria de Paiva

2012-05-01

A systematic review of scientific production on Prison Health was conducted, seeking to verify how the subject matter has been dealt with, establishing which is the most exploited focus and identifying possible gaps. The search was carried out in the Virtual Health Library. 1160 articles were located: 1104 on MEDLINE, 19 on LILACS and 37 on SciELO, published from 1993 to 2010. As MEDLINE and LILACS do not show the entire articles, the places, dates and languages of the texts were charted. In-depth analysis was restricted to works which were shown in their entirety and free of charge hosted on SciELO. It revealed that scientific production is present all over the world with a predominantly quantitative approach. It focuses on identifying the socio-demographic profile and health conditions of prisoners, the incidence of tuberculosis, Human Immunodeficiency and Hepatitis C virus infections. There is a predominance of studies carried out with male prisoners, in comparison with the female sex. It is clear that prisoner health is a public health problem on the rise, which demands research that can orient health policies and strategies.

Improving public health by respecting autonomy: using social science research to enfranchise vulnerable prison populations.

Science.gov (United States)

Shaw, David; Elger, Bernice

2015-05-01

It is widely recognised that prisoners constitute a vulnerable population that is subject to numerous health inequalities and merits special protection. Improving prisoners' access to healthcare by ensuring adherence to the principle of equivalence has been the main focus of efforts to ensure that their health is not jeopardised. However, another means of respecting prisoners' autonomy and improving their health is to involve them (and prison staff) in social science research within prisons. Such research not only produces valuable data which can be used to assess whether the principle of equivalence is being respected; it also enfranchises prisoners by allowing them to air concerns about perceived ill-treatment and influence their environment. If prison authorities enable such research and adjust policy accordingly, both they and prisoners will benefit from the increased level of respect for prisoners' autonomy, and the improvements in individual and public health that flow from this. Conducting social science research in prisons enables the creation of a virtuous cycle of respect that makes prisons safer and healthier places. Copyright © 2015 Elsevier Inc. All rights reserved.

Long-term prisoner in prison isolation

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Karolina Grudzińska

2013-06-01

Full Text Available Long-term prisoner belongs to a particular category of people who are imprisoned in prisons. On the one hand in this group are often heavily demoralized people who committed the most serious crimes, on the other hand it is a group of prisoners, who should be well thought out and programmed the impact of rehabilitation. The situation of man trapped for years poses in a complicated situation not only the prisoners, but also the entire prison staff. They have to take care of the fact that the prison isolation did not cause the state in which convicts form itself in learned helplessness and lack of skills for self-planning and decision-making. In addition, planning the rehabilitation impact of long-term prisoners should not be forgotten that these prisoners in the short or the long term will return to the libertarian environment therefore, should prevent any negative effects of long-term imprisonment. This article presents the main issues related to the execution of imprisonment against long-term prisoners. It is an attempt to systematize the knowledge of this category of people living in prison isolation.

Physicians in US Prisons in the Era of Mass Incarceration.

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Allen, Scott A; Wakeman, Sarah E; Cohen, Robert L; Rich, Josiah D

2010-12-01

The United States leads the world in creating prisoners, incarcerating one in 100 adults and housing 25% of the world's prisoners. Since the 1976, the US Supreme Court ruling that mandated health care for inmates, doctors have been an integral part of the correctional system. Yet conditions within corrections are not infrequently in direct conflict with optimal patient care, particularly for those suffering from mental illness and addiction. In addition to providing and working to improve clinical care for prisoners, physicians have an opportunity and an obligation to advocate for reform in the system of corrections when it conflicts with patient well-being.

The impact of prisons on the mental health of prisoners in the state of Rio de Janeiro, Brazil.

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Constantino, Patricia; Assis, Simone Gonçalves de; Pinto, Liana Wernersbach

2016-06-01

The aim of this article is to assess the mental health status of inmates and people in custody in the state of Rio de Janeiro and the association between mental health and imprisonment using the Beck Depression Inventory and the Lipp Stress Symptom Inventory for Adults. 1,573 individuals, via stratified sampling with probability proportional to size. more than half have up to 29 years old; 70.6% were black/brown; 77.4% had strong family ties; 42.9% had been incarcerated for under a year; and 22,9% performed work tasks in prison. Stress: 35.8% of men and 57.9% of women. Factors associated with stress among men: length of time in prison and family ties. Male prisoners who had been in prison for between 1 and 9 years are 0.55 times less likely to experience stress symptoms than those who had been in prison for less than a year; those with regular/weak family ties are more likely to experience stress than those with strong ties. Women with only regular/weak family ties are more likely to experience stress; work tasks performed in prison was a protective factor. Depression: 7.5% of women and 6.3% of men. Among men, practicing a religion, maintaining strong family ties, and performing prison work tasks are protective factors. Among women, an association was found between depression and family ties.

An Assessment of Health Related Quality of Life in a Male Prison Population in Greece Associations with Health Related Characteristics and Characteristics of Detention

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Constantinos Togas

2014-01-01

Full Text Available Background. Prisoners constitute a group with increased health and social care needs. Although implementing policies that aim at improving outcomes within this population should be a priority area, studies that attempt to assess health outcomes and health related quality of life (HRQoL in this population are limited. Aim. To assess HRQoL in a prison population in Greece and to explore the relationship between HRQoL and a set of individual sociodemographic and health related characteristics and characteristics of detention. Methods. A cross-sectional study involving 100 male prisoners was conducted in the prison of Corinth in Greece. HRQoL was assessed through the use of the SF-36 and the EQ-5D. Results. The mean physical and mental summary scores of the SF-36 were 55.33 and 46.82, respectively. The EQ-VAS mean score was 76.41%, while the EQ-5D index was 0.72. Multivariate analysis identified a statistical relationship between HRQoL and the conditions of detention, controlling for the effect of sociodemographic characteristics, morbidity, and mental problems. The use of narcotics in particular is significantly associated with lower HRQoL. Conclusions. Implementation of policies that aim at preventing the use of narcotics within the prison environment is expected to contribute to improved HRQoL in this population.

Clinical work in prison: Which areas of therapeutic interventions

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Francesca Campostrini

2014-09-01

Full Text Available Working in prison is a stressful situation for a clinical psychologist, given the contextual constraints. The psychologist is supposed to build caring relationships with psychiatric patients restricted in a iatrogenic context as the prison is. The authoridentifiesthree clustersof constraints at work in the prison context: legislative, institutional and cultural. Within this framework, the prison is faced to a conflict between custody and rehabilitation. The clinical psychologist has to manage this conflict and must build clinical settings similar to those outside the prison. The paper is based on the authors experience with short-time groups, of which a short description is givenKeywords:Prison; Prison and mental health; Custody; Rehabilitation; Clinical practice 

Job demands, resources and mental health in UK prison officers.

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Kinman, G; Clements, A J; Hart, J

2017-08-01

Research findings indicate that working as a prison officer can be highly stressful, but the aspects of work that predict their mental health status are largely unknown. To examine, using elements of the demands-resources model, the extent to which work pressure and several potential resources (i.e. control, support from managers and co-workers, role clarity, effective working relationships and positive change management) predict mental health in a sample of UK prison officers. The Health and Safety Executive Management Standards Indicator Tool was used to measure job demands and resources. Mental health was assessed by the General Health Questionnaire-28. The effects of demands and resources on mental health were examined via linear regression analysis with GHQ score as the outcome. The study sample comprised 1267 prison officers (86% male). Seventy-four per cent met 'caseness' criteria for mental health problems. Job demands, poor interpersonal relationships, role ambiguity and, to a lesser extent, low job control and poor management of change were key predictors of mental health status. The findings of this study can help occupational health practitioners and psychologists develop structured interventions to improve well-being among prison officers. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

HIV treatment in US prisons.

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Wakeman, Sarah E; Rich, Josiah D

2010-09-03

Arguably one of the most marginalized populations in our society, prisoners bear a disproportionate burden of infectious diseases, particularly HIV. In addition, groups known to be at an inordinately higher risk of HIV, including minorities, the addicted, the mentally ill and the impoverished are overrepresented among incarcerated populations. This concentration of HIV among groups that have been historically difficult to reach, with limited intersections with healthcare, provides an opportunity for testing, diagnosis, treatment, linkage to care and prevention. Providing HIV care within correctional facilities poses unique challenges. Barriers to confidentiality, access to medication and prior records, and lack of comprehensive discharge planning can serve as obstacles to providing optimal care. This article discusses the public health implications and importance of providing HIV care to prisoners, and also discusses the practicalities of working within an environment that poses particular barriers to care.

Health Promotion in a Prison Setting: Experience in Villabona Prison

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Muro, Pilar; Enjuanes, Jordi; Morata, Txus; Palasí, Eva

2016-01-01

Aim: The aim of this study was to analyse experiences of a health promotion intervention implemented by the Therapeutic and Educational Unit at Villabona prison in Spain, which aimed to create drug-free spaces as part of a model of social rehabilitation. Design: As part of a larger participatory evaluation study concerning the efficacy of…

The mental health and substance misuse needs of male ex-armed forces personnel in prison.

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Wainwright, Verity; Lennox, Charlotte; McDonnell, Sharon; Shaw, Jenny; Senior, Jane

2018-01-01

Ex-armed forces personnel constitute the largest known occupational group in prison but there is little evidence regarding their mental health, or substance misuse, needs. A total of 105 participants were interviewed and measures assessing symptoms of common mental health (CMH) problems and substance misuse were completed along with a review of their health care records. Forty (38%) participants screened for current CMH problems (CCMH) and high levels of dual symptomology and alcohol misuse were assessed. Thirty-nine (37%) had a mental health diagnosis recorded, most commonly for post-traumatic stress disorder (PTSD), depression and personality disorder. Those who screened for a CCMH problem were more likely to have pre-service vulnerability to negative health outcomes and those with dual symptomology were more likely to have experienced deployment during their service. Findings suggest the mental health needs of this group are similar to the general prison population. Potentially higher prevalences of PTSD and alcohol misuse may direct service provision.

Mental health/illness and prisons as place: frontline clinicians׳ perspectives of mental health work in a penal setting.

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Wright, Nicola; Jordan, Melanie; Kane, Eddie

2014-09-01

This article takes mental health and prisons as its two foci. It explores the links between social and structural aspects of the penal setting, the provision of mental healthcare in prisons, and mental health work in this environment. This analysis utilises qualitative interview data from prison-based fieldwork undertaken in Her Majesty׳s Prison Service, England. Two themes are discussed: (1) the desire and practicalities of doing mental health work and (2) prison staff as mental health work allies. Concepts covered include equivalence, training, ownership, informal communication, mental health knowledge, service gatekeepers, case identification, and unmet need. Implications for practice are (1) the mental health knowledge and understanding of prison wing staff could be appraised and developed to improve mental healthcare and address unmet need. Their role as observers and gatekeepers could be considered. (2) The realities of frontline mental health work for clinicians in the penal environment should be embraced and used to produce and implement improved policy and practice guidance, which is in better accord with the actuality of the context - both socially and structurally. Copyright © 2014 Elsevier Ltd. All rights reserved.

HIV in Indian prisons: risk behaviour, prevalence, prevention & treatment.

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Dolan, Kate; Larney, Sarah

2010-12-01

HIV is a major health challenge for prison authorities. HIV in prisons has implications for HIV in the general community. The aim of this paper was to gather information on HIV risk, prevalence, prevention and treatment in prisons in India. Relevant published and unpublished reports and information were sought in order to provide a coherent picture of the current situation relating to HIV prevention, treatment and care in prisons in India. Information covered prison management and population statistics, general conditions in prisons, provision of general medical care and the HIV situation in prison. No data on drug injection in prison were identified. Sex between men was reported to be common in some Indian prisons. A national study found that 1.7 per cent of inmates were HIV positive. Some prisons provided HIV education. Condom provision was considered illegal. A few prisoners received drug treatment for drug use, HIV infection or co-infection with sexually transmitted infections (STIs). HIV prevalence in prisons in India was higher than that in the general community. Regular monitoring of information on HIV risk behaviours and prevalence in Indian prisons is strongly recommended. Evidence based treatment for drug injectors and nation-wide provision of HIV prevention strategies are urgently required. Voluntary counselling, testing and treatment for HIV and STIs should be provided.

Playwork in Prison as a Mechanism to Support Family Health and Well-Being

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Woodall, James; Kinsella, Karina

2017-01-01

Objective: The health of the prison population is of increasing concern, given the disproportionate rates of ill health in this population. Moreover, the challenges faced by prisoners' families and their children are also becoming more apparent, with prisoners' children being more likely than other children to experience mental and emotional…

Connectivity, prison environment and mental health among first-time male inmates in Mexico City.

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Albertie, Ariel; Bourey, Christine; Stephenson, Rob; Bautista-Arredondo, Sergio

2017-02-01

Research from high-income countries suggests that prison populations are affected disproportionately by mental illness. However, little research has examined mental health among prisoners in low- and middle-income countries or associations between mental health and contextual factors surrounding the prison experience among susceptible first-time inmates in these settings. The current study examines associations between connectivity, prison environment and mental health (major depression and substance use) among novice male inmates (n = 593) in three Mexico City prisons. Severe depression (46.2%), any substance use (53.8%) and heavy substance use (45.7%) were prevalent. Among key co-variates, recent visitors were protective for severe depression, conjugal visits for any substance use and prison employment for heavy substance use. Physical attacks were associated with increased prevalence of depression, sentence time served with both any and heavy substance use and overcrowding with any substance use. These findings suggest the need for routine health assessments to improve identification and treatment programmes to minimise mental health burden. Addressing demographic risk factors as well as contextual determinants, by decreasing physical violence and overcrowding and supporting outside connections for prisoners, may help improve inmate mental health.

Insomnia management in prisons in England and Wales: a mixed-methods study.

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Dewa, Lindsay H; Hassan, Lamiece; Shaw, Jenny J; Senior, Jane

2017-06-01

Insomnia in prison is common; however, research is limited regarding the management strategies that prison establishments employ. To address this knowledge gap, we conducted a survey to identify how insomnia is detected, diagnosed and treated in adult prisons in England and Wales. Telephone interviews with a purposive sample of health-care managers were then conducted. The survey was sent to all establishments holding adult prisoners, covering screening and assessment methods to detect insomnia; treatment options, both pharmacological and non-pharmacological; the importance of insomnia as a treatable condition; and staff training available. Eighty-four (73%) prisons completed the survey. Few had a stepped approach to insomnia management, as recommended by National Institute for Health and Care Excellence (NICE) guidelines. The most common treatments available were sleep hygiene education and medication, offered by 94 and 88% of respondents, respectively. Analysis of telephone interviews revealed four main themes: insomnia as a normal occurrence in prison; the problem of medication in prison; the negative impact of the prison environment; and effective management of insomnia in prison. The current findings suggest that logistical, ethical and security barriers and a lack of staff knowledge and training impact negatively on the management of insomnia in prison. © 2017 European Sleep Research Society.

Dental triage Hydebank Wood Prison and young offenders centre, Belfast.

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Gray, R; Fawcett, T

2014-05-01

The aim of this study was to devise and test a triage protocol to prioritise patients' dental needs in a prison environment. Secondary aims were to include in the triage process oral health promotion and information about accessing prison dental services. Also to work collaboratively with the prison staff to improve referrals to the dental services. The triage system was devised to have three strands: (1) an oral health assessment conducted by the dental nurse during the induction process for each new prisoner; (2) a simple oral health examination conducted in monthly screening clinics; (3) the prioritisation of referrals from prison landing staff using the prisons computer system PRISM. The triage was evaluated by assessing the first 100 patients' records with regard to the prioritisation of the triage category at the time of the clinical dental examination. Of the 100 patients triaged 95% were prioritised into the correct triage category. Seventy-two percent of patients were seen in the appropriate timeframe. Referral patterns from prison landing staff were improved along with interdisciplinary working in the prison. All new prisoners were seen within 72 hours of committal and received oral health advice and information on accessing dental services. This is the first triage system to be introduced into Hydebank Wood Prison, facilitating a targeted approach to dental care. It has improved access to the prison dental services; introduced oral health advice and information into the regular prison healthcare structure; and improved the efficiency of the clinical dental sessions. It is hoped to strategically address problems with waiting times and inequity in service utilisation.

Prevalence of Mental Health problems in sentenced men in prisons from Andalucía (Spain).

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López, M; Saavedra, F J; López, A; Laviana, M

2016-12-01

To estimate the prevalence of different mental health problems in men serving prison sentences in Andalusia. Descriptive, cross-sectional study of a random sample of 472 men interned in two prisons located in Andalusia. We collected socio-demographic and general criminal and penitentiary data, and we identified mental health problems with two validated instruments for epidemiological research in mental health: the SCID-I interview to diagnose Axis 1 disorders of the DSM-IV and the self-applied questionnaire IPDE to estimate personality disorders. We analyzed the data (proportions and confidence intervals) with the SPSS-18 statistical package. 82.6% of the sample had a history of having suffered some type of mental health problem throughout their life (prevalence-life) and 25.8 have suffered from them in the past month (month prevalence). The most common disorders of the Axis I (DSM-IV) are related to abuse of and dependence on psychoactive substances (prevalence life of 65.9% and month prevalence of 6.6%), with an important but less frequent presence of affective (31.4%-9.3%), anxiety (30.9%-10, 4%) and psychotic disorders (9.5%-3, 4%). As regards personality disorders, the estimated probable prevalence lies between the 56.6% ("5" cutoff point) and the 79.9 ("4" cut-off point). The male inmate population in prisons in Andalucía shows a high prevalence of mental health problems, similar to that found in other Spanish and international prisons, but their care needs should take into account the different pathologies that they present.

Prevalence of Mental Health problems in sentenced men in prisons from Andalucía (Spain

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M. López

Full Text Available Objectives: To estimate the prevalence of different mental health problems in men serving prison sentences in Andalusia. Methods: Descriptive, cross-sectional study of a random sample of 472 men interned in two prisons located in Andalusia. We collected socio-demographic and general criminal and penitentiary data, and we identified mental health problems with two validated instruments for epidemiological research in mental health: the SCID-I interview to diagnose Axis 1 disorders of the DSM-IV and the self-applied questionnaire IPDE to estimate personality disorders. We analyzed the data (proportions and confidence intervals with the SPSS-18 statistical package. Results: 82.6% of the sample had a history of having suffered some type of mental health problem throughout their life (prevalence-life and 25.8 have suffered from them in the past month (month prevalence. The most common disorders of the Axis I (DSM-IV are related to abuse of and dependence on psychoactive substances (prevalence life of 65.9% and month prevalence of 6.6%, with an important but less frequent presence of affective (31.4%-9.3%, anxiety (30.9%-10, 4% and psychotic disorders (9.5%-3, 4%. As regards personality disorders, the estimated probable prevalence lies between the 56.6% ("5" cutoff point and the 79.9 ("4" cut-off point. Conclusions: The male inmate population in prisons in Andalucía shows a high prevalence of mental health problems, similar to that found in other Spanish and international prisons, but their care needs should take into account the different pathologies that they present.

An audit of tuberculosis health services in prisons and immigration removal centres.

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Mehay, Anita; Raj, Thara; Altass, Lynn; Newton, Autilia; O'Moore, Eamonn; Railton, Cathie; Tan, Hong; Story, Al; Frater, Alison

2017-06-01

Tuberculosis (TB) is the second leading cause of death worldwide due to a single infectious agent. Rates of active TB in places of prescribed detention (PPD), which include Prisons, Young Offender Institutions and Immigration Removal Centres, are high compared with the general population. PPD therefore present an opportunity to develop targeted health programmes for TB control. This audit aims to assess current service provisions and identify barriers to achieving best practice standards in PPD across London. Twelve healthcare teams within PPD commissioned by NHS England (London Region) were included in the audit. Services were evaluated against the National Institute for Health and Care Excellence standards for TB best practice. None of the health providers with a digital X-ray machine were conducting active case finding in new prisoners and no health providers routinely conduct Latent TB infection testing and preventative treatment. Barriers to implementing standards include the lack of staff skills and staff skills mix, structural and technical barriers, and demands of custodial and health services. This audit restates the importance of national public health TB strategies to consider healthcare provisions across PPD. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The prison setting as a place of enforced residence, its mental health effects, and the mental healthcare implications.

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Jordan, Melanie

2011-09-01

The subject of place is salient certainly when deliberating the health of prisoners as a social group. This paper provides an overview and assessment of health and place in relation to mental health and the prison locale. Particular attention is devoted to prison culture, both staff and inmate. The incarceration experience (i.e. the nature of enforced residence in the prison environment) can affect negatively prisoners' mental health. The mental health of the prison population is poor, and mental health services in the prison setting have need of further improvement. However, the provision of mental healthcare and the pursuit of good mental health in the prison milieu are challenging. The prison-based-exceedingly complex-three-way relationship between culture-mental and health-mental healthcare is debated. Copyright © 2011 Elsevier Ltd. All rights reserved.

Key successes and challenges in providing mental health care in an urban male remand prison: a qualitative study

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Samele, Chiara; Forrester, Andrew; Urqu?a, Norman; Hopkin, Gareth

2016-01-01

Purpose This study aimed to describe the workings of an urban male remand prison mental health service exploring the key challenges and successes, levels of integration and collaboration with other services. Method A purposive sampling was used to recruit key prison and healthcare professionals for in-depth interviews. A thematic analysis was used to analyse transcripts based on an initial coding frame of several predefined themes. Other key themes were also identified. Results Twenty-eight i...

Conducting Research as a Visiting Scientist in a Women’s Prison

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Byrne, Mary Woods

2006-01-01

Incarcerated populations have disparities in health risks and illness conditions meriting study, but the history of prison research is marred by unethical conduct. Ethical participation strategies are discussed in the context of studies implemented by the author in a state prison system. This study used ethnographic approaches, observed adherence to federal and institutional review board regulations and corrections department directives, and maintained continuous communication with vested interests to provide entry and long-term access for studies on female prisoners and their civilian infants. A culture clash between the punitive restrictive environment that serves the custody–control–care mission of corrections systems and the open inquiry environment needed for conduct of health research exists. Federal regulations protect prisoners as human subjects but additional vigilance and communication by researchers are required. Gaining and maintaining access to prison inmates for nursing research are leadership challenges that can be met within the caring and collaborative paradigm of nursing. PMID:16061169

The principle of equivalence reconsidered: assessing the relevance of the principle of equivalence in prison medicine.

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Jotterand, Fabrice; Wangmo, Tenzin

2014-01-01

In this article we critically examine the principle of equivalence of care in prison medicine. First, we provide an overview of how the principle of equivalence is utilized in various national and international guidelines on health care provision to prisoners. Second, we outline some of the problems associated with its applications, and argue that the principle of equivalence should go beyond equivalence to access and include equivalence of outcomes. However, because of the particular context of the prison environment, third, we contend that the concept of "health" in equivalence of health outcomes needs conceptual clarity; otherwise, it fails to provide a threshold for healthy states among inmates. We accomplish this by examining common understandings of the concepts of health and disease. We conclude our article by showing why the conceptualization of diseases as clinical problems provides a helpful approach in the delivery of health care in prison.

Attitudes and beliefs towards methadone maintenance treatment among Australian prison health staff.

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Gjersing, Linn R; Butler, Tony; Caplehorn, John R M; Belcher, Josephine M; Matthews, Richard

2007-09-01

Justice Health NSW has one of the most extensive prison-based methadone programmes in the world. We examine prison health staff attitudes towards methadone treatment and compare these with community methadone staff. A cross-sectional survey of 202 staff employed by Justice Health New South Wales was undertaken in 2003. Results. The mean scores on the various sub-scales were: abstinence-orientation (AO) 2.9 (95% CI 2.8 - 3.0); disapproval of drug use (DDU) 3.3 (95% CI 3.2 - 3.4); knowledge (Know) 2.7 (95% CI 2.4 - 2.9); and toxicity 4.6 (95% CI 4.2 - 5.0). Both the AO and DDU score were correlated negatively with the Know score (r = -0.37 and r = -0.13, respectively). Prison health staff had higher AO (2.9 vs. 2.6, p US community methadone staff about the toxicity of methadone (4.6 vs. 0.0, p prison health staff attitudes to methadone treatment. Correctional health staff tend to be more abstinence-orientated, more likely to disapprove of drug use, and less knowledgeable about the risks and benefits of methadone than Australian community methadone staff. The findings have important implications for training health staff working in the prison environment with regard to client retention on methadone treatment.

Preparing linked population data for research: cohort study of prisoner perinatal health outcomes

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Lisa Hilder

2016-06-01

Full Text Available Abstract Background A study of pregnancy outcomes related to pregnancy in prison in New South Wales, Australia, designed a two stage linkage to add maternal history of incarceration and serious mental health morbidity, neonatal hospital admission and infant congenital anomaly diagnosis to birth data. Linkage was performed by a dedicated state-wide data linkage authority. This paper describes use of the linked data to determine pregnancy prison exposure pregnancy for a representative population of mothers. Methods Researchers assessed the quality of linked records; resolved multiple-matched identities; transformed event-based incarceration records into person-based prisoner records and birth records into maternity records. Inconsistent or incomplete records were censored. Interrogation of the temporal relationships of all incarceration periods from the prisoner record with pregnancies from birth records identified prisoner maternities. Interrogation of maternities for each mother distinguished prisoner mothers who were incarcerated during pregnancy, from prisoner control mothers with pregnancies wholly in the community and a subset of prisoner mothers with maternities both types of maternity. Standard descriptive statistics are used to provide population prevalence of exposures and compare data quality across study populations stratified by mental health morbidity. Results Women incarcerated between 1998 and 2006 accounted for less than 1 % of the 404,000 women who gave birth in NSW between 2000 and 2006, while women with serious mental health morbidity accounted for 7 % overall and 68 % of prisoners. Rates of false positive linkage were within the predicted limits set by the linkage authority for non-prisoners, but were tenfold higher among prisoners (RR 9.9; 95%CI 8.2, 11.9 and twice as high for women with serious mental health morbidity (RR 2.2; 95%CI 1.9, 2.6. This case series of 597 maternities for 558 prisoners pregnant while in prison

Preparing linked population data for research: cohort study of prisoner perinatal health outcomes.

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Hilder, Lisa; Walker, Jane R; Levy, Michael H; Sullivan, Elizabeth A

2016-06-16

A study of pregnancy outcomes related to pregnancy in prison in New South Wales, Australia, designed a two stage linkage to add maternal history of incarceration and serious mental health morbidity, neonatal hospital admission and infant congenital anomaly diagnosis to birth data. Linkage was performed by a dedicated state-wide data linkage authority. This paper describes use of the linked data to determine pregnancy prison exposure pregnancy for a representative population of mothers. Researchers assessed the quality of linked records; resolved multiple-matched identities; transformed event-based incarceration records into person-based prisoner records and birth records into maternity records. Inconsistent or incomplete records were censored. Interrogation of the temporal relationships of all incarceration periods from the prisoner record with pregnancies from birth records identified prisoner maternities. Interrogation of maternities for each mother distinguished prisoner mothers who were incarcerated during pregnancy, from prisoner control mothers with pregnancies wholly in the community and a subset of prisoner mothers with maternities both types of maternity. Standard descriptive statistics are used to provide population prevalence of exposures and compare data quality across study populations stratified by mental health morbidity. Women incarcerated between 1998 and 2006 accounted for less than 1 % of the 404,000 women who gave birth in NSW between 2000 and 2006, while women with serious mental health morbidity accounted for 7 % overall and 68 % of prisoners. Rates of false positive linkage were within the predicted limits set by the linkage authority for non-prisoners, but were tenfold higher among prisoners (RR 9.9; 95%CI 8.2, 11.9) and twice as high for women with serious mental health morbidity (RR 2.2; 95%CI 1.9, 2.6). This case series of 597 maternities for 558 prisoners pregnant while in prison (of whom 128 gave birth in prison); and 2

Ethical issues of prison nursing: A qualitative study in Northern Italy.

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Sasso, Loredana; Delogu, Barbara; Carrozzino, Roberto; Aleo, Giuseppe; Bagnasco, Annamaria

2018-05-01

Prisons are contexts where nurses are required to have specific skills to ensure that, in a setting designed for the expiation of crime, prisoners receive the same type of care as anyone else. But this is not always the case, giving rise to ethical issues. 'How do correctional nurses describe their working experience in prisons? What issues emerged?' This is a qualitative descriptive study. Following purposive sampling, we conducted five focus groups. Thematic analysis was used to analyse the data. Participants and research context: Our sample included 31 correctional nurses in seven prisons in Northern Italy. Ethical considerations: The scientific merit of this study was recognized by the Academic Board of the University of Genoa. Approval to conduct the study was obtained from the Liguria Regional Government that funded this study and from the Local Health Authority that was the prison nurses' employer. Formal consent was obtained from all the nurses who volunteered to participate in this study. Five themes emerged from the focus groups: (1) prisoners' healthcare needs, (2) negotiation between custody and care, (3) satisfaction of working in prisons, (4) obstacles to quality care and (5) safety. 'Manipulation' was a transversal theme that emerged from all the focus groups. The problems generated by the clash between prison security and nursing care priorities did not enable nurses to practice autonomously and provide the best possible to care prisoners, giving rise to ethical issues and moral distress. This in turn causes high nursing turnover rates that negatively impact continuum of care. In Italy, correctional nurses urgently require specific education interventions with the participation of all those who work in prisons. Interventions based on the post-modern concept of restorative nursing could offer prison nurses the opportunity to both resolve ethical issues and reduce moral distress.

Why has the health promoting prison concept failed to translate to the US?

OpenAIRE

Woodall, JR

2016-01-01

Two decades since the World Health Organization Regional Office for Europe published a report on health promotion in prison that stimulated further debate on the concept of the “health-promoting prison,” this article discusses the extent to which the concept has translated to the United States. One predicted indicator of success for the health-promoting prison movement was the expansion of activity beyond European borders; yet 2 decades since the European model was put forward, there has been...

Reducing the use of seclusion for mental disorder in a prison: implementing a high support unit in a prison using participant action research

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2012-01-01

Background Vulnerable prisoners and mentally disordered offenders who present with risk of harm to self or others were accommodated in Special Observation Cells (SOCs) isolated from others for considerable periods of time. This practice has been criticised by the Council of Europe Committee for the Prevention of Torture. The objective of this initiative was to reduce the use of seclusion within the prison and to improve the care of vulnerable and mentally ill prisoners within the prison. Results The prison studied is a committal centre for sentenced prisoners with an official bed capacity of 630. The forensic mental health in-reach team, in co-operation with the prison health service followed the 'spiral' of planning, action and fact finding about the results of the action. In December 2010 a 10 bed High Support Unit (HSU) was established within the prison. During the first year, 96 prisoners were admitted. A third (35%) reported psychotic symptoms, 28% were referred due to the immediate risk of self-harm, 17% were accommodated for medical treatments and increased observation, 13% received specialised treatment by the Addiction Psychiatry team, 6% presented with emotional distress. One prisoner was accommodated on the HSU due to the acute risk he posed to others. A major mental illness was diagnosed in 29%, 20% required short-term increased support for crisis intervention and were found not to have a mental illness. A further 10% were deemed to be feigning symptoms of mental illness to seek refuge in the HSU. 7% had personality disorder as their primary diagnosis and 4% had a learning disability. Stratifying risk within the prison population through the provision of the HSU decreased the total episodes of seclusion in the prison by 59% (p prison. Pathways between the prison and the forensic psychiatric hospital saw no change in activity but improved continuity of care. Conclusions The next step is to further stratify risk by establishing a low support unit to serve

Alternatives to current HIV/AIDS policies and practices in South African prisons.

Science.gov (United States)

Goyer, K C; Gow, Jeff

2002-01-01

Prisoners in South Africa face problems of overcrowding, violence and poor nutrition. Added to this burden in recent times is the increased threat from HIV. The HIV epidemic has been relatively late in coming to South Africa but infection rates are now 20% in the adult population. However, there is no data available on the level of HIV infection in the prison population. Overseas studies suggest that the characteristics of prisoners place them at much greater risk of HIV infection. Factors which contribute to increased levels of HIV infection include poor health care facilities, lack of condoms and lack of disinfectants. Current policies and practices on HIV in prison attempt to balance the constraints of limited resources with the need to preserve prisoner human rights. The outcomes include: mass testing not freely available, HIV education is limited, and early release of prisoners with advanced AIDS is not allowed. Constraints on the implementation of effective HIV prevention strategies include: bureaucratic inefficiency, lack of resources, and a reluctance by prison authorities to address the issue of HIV in prison. These problems can possibly be overcome by addressing the issue from both management and prisoner perspectives. On the management side, increased resources, increased training of prison officials, and increased political commitment to address the issue are required. Outside partnerships are probably required for an effective response. Prisoners require better nutrition, better living conditions, better health care, freely available condoms and disinfectants.

Tuberculosis in prisons in sub-Saharan Africa--the need for improved health services, surveillance and control.

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O'Grady, Justin; Hoelscher, Michael; Atun, Rifat; Bates, Matthew; Mwaba, Peter; Kapata, Nathan; Ferrara, Giovanni; Maeurer, Markus; Zumla, Alimuddin

2011-03-01

Prisons have long been associated with rapid transmission of infectious diseases. The HIV/AIDS epidemic in sub-Saharan Africa (SSA) has fuelled the spread of TB and HIV in prisons. The poor living conditions and ineffective health services in prisons in SSA are a major breeding ground of Mycobacterium tuberculosis (Mtb). The spread of TB between prisoners, prison staff and visitors and the emergence of drug-resistant TB in prisons now poses a threat to control efforts of national TB programmes in SSA. Accurate data required to develop appropriate interventions to tackle the ominous problem of TB in African prisons are scanty and unreliable. The health of prisoners is by default a neglected political issue. This article reviews the available literature on TB and drug-resistant TB in prisons from SSA countries, discusses the risk factors for acquiring TB and highlights the priorities for further translational research in prisons. Ethical issues pertaining to research on captive African populations are discussed. Scientific, political and funder attention is required urgently to improve prison health services. Copyright © 2010. Published by Elsevier Ltd.

Climbing the walls: prison mental health and community engagement.

Science.gov (United States)

Caie, Jude

Until recently, treatment for mental health conditions has focused on medical and psychological therapy. The role and significance of social and community interventions and initiatives in fostering recovery, resilience and a sense of 'flourishing' is now being recognised. This paper seeks to explore how these principles, which are usually community-based, can be successfully applied within a prison setting, and how such interventions may have a positive effect on the mental health of prisoners through successfully engaging them with the communities they are set to return to after release while still in custody.

Epidemiological Criminology: Contextualization of HIV/AIDS Health Care for Female Inmates.

Science.gov (United States)

Lanier, Mark M; Zaitzow, Barbara H; Farrell, C Thomas

2015-04-01

Worldwide, women are increasingly being incarcerated. One unintended consequence is the increase in unhealthy female offenders. Among the more serious health concerns are HIV and AIDS. Challenges associated with caring for women with HIV/AIDS impacts not only disease management and infection control within correctional facilities but also the prisoners' home communities where they will need health care, drug and alcohol rehabilitation, housing assistance, and employment opportunities. No bridging theory has been presented that links prison and community health concerns with criminal justice policy. This article not only presents recommendations for effective HIV/AIDS policy but also suggests epidemiological criminology as a means of explicit merging of health with justice issues and consequently provides a bridging framework. © The Author(s) 2015.

Recidivism after release from a prison nursery program.

Science.gov (United States)

Goshin, Lorie S; Byrne, Mary W; Henninger, Alana M

2014-01-01

To analyze 3-year recidivism after release from a prison nursery, a secure unit that allows imprisoned women to care for their infants. Descriptive study of 139 women who co-resided with their infants between 2001 and 2007 in a New York State prison nursery. Administrative criminal justice data were analyzed along with prospective study data on demographic, mental health, and prison nursery policy-related factors. Results reflect a sample of young women of color with histories of clinically significant depressive symptoms and substance dependence, who were convicted of nonviolent crimes and had multiple prior arrests. Three years after release 86.3% remained in the community. Only 4% of women returned to prison for new crimes. Survival modeling indicated that women who had previously violated parole had a significantly shorter mean return to prison time than those who were in the nursery for a new crime. Women released from a prison nursery have a low likelihood of recidivism. Innovative interventions are needed to address incarceration's public health effects. Nurses can partner with criminal justice organizations to develop, implement, and evaluate programs to ensure the health needs of criminal justice involved people and their families are met. © 2013 Wiley Periodicals, Inc.

Standards for the mental health care of people with severe ...

African Journals Online (AJOL)

Adele

health policy, human rights and rehabilitation. .... Health Policy staff covering Psycho-social rehabilitation ... They outline the essential aspects of care for the treatment and ..... within the criminal justice system (e.g. prisons and Places of Safety).

Prevalence of Eye Disease among Inmates of Ilesa Prison ...

African Journals Online (AJOL)

Introduction: In Nigeria, like many other developing countries where prisoners have restricted access to health care including eye health care, severe untreated eye disorders are common causes of ocular morbidity and blindness. This study was carried out to determine the prevalence and pattern of eye disease among ...

Improving the care of older persons in Australian prisons using the Policy Delphi method.

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Patterson, Karen; Newman, Claire; Doona, Katherine

2016-09-01

There are currently no internationally recognised and approved processes relating to the care of older persons with dementia in prison. This research aimed to develop tools and procedures related to managing the care of, including the identification and assessment of, older persons with dementia who are imprisoned in New South Wales, Australia. A modified approach to the Policy Delphi method, using both surveys and facilitated discussion groups, enabled experts to come together to discuss improving the quality of care provision for older persons with dementia in prison and achieve research aims. © The Author(s) 2014.

[Planning a Health Residence for Prison Security Measures, Tuscany (Italy)].

Science.gov (United States)

Porfido, Eugenio; Colombai, Renato; Scarpa, Franco; Totaro, Michele; Tani, Luca; Baldini, Claudio; Baggiani, Angelo

2016-01-01

Health Residences for Prison Security Measures are facilities hosting psychotic persons who have committed crimes and providing them with personalized rehabilitation and treatment plans to promote their reinstatement in society. The aim of this study was to describe the criteria for planning and designing a prison health residence in the Tuscany region (Italy), to be managed by the regional healthcare service, in line with current regulations, with dedicated staff for providing specific treatment plans and programmes.

Mental health treatment patterns following screening at intake to prison.

Science.gov (United States)

Martin, Michael S; Potter, Beth K; Crocker, Anne G; Wells, George A; Grace, Rebecca M; Colman, Ian

2018-01-01

While there is general consensus about the need to increase access to mental health treatment, it is debated whether screening is an effective solution. We examined treatment use by inmates in a prison system that offers universal mental health screening. We conducted an observational study of 7,965 consecutive admissions to Canadian prisons. We described patterns of mental health treatment from admission until first release, death, or March, 2015 (median 14-month follow-up). We explored the association between screening results and time of first treatment contact duration of first treatment episode, and total number of treatment episodes. Forty-three percent of inmates received at least some treatment, although this was often of short duration; 8% received treatment for at least half of their incarceration. Screening results were predictive of initiation of treatment and recurrent episodes, with stronger associations among those who did not report a history prior to incarceration. Half of all inmates with a known mental health need prior to incarceration had at least 1 interruption in care, and only 46% of inmates with a diagnosable mental illness received treatment for more than 10% of their incarceration. Screening results were associated with treatment use during incarceration. However, mental health screening may have diverted resources from the already known highest need cases toward newly identified cases who often received brief treatment suggestive of lower needs. Further work is needed to determine the most cost-effective responses to positive screens, or alternatives to screening that increase uptake of services. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The Prevalence of Mental Disorders in Male Prisoners of Qasr Prison in Tehran

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O. Yahyazadeh

2006-07-01

Full Text Available Background: Mental health of prisoners, as a high risk group, is of considerable importance. Unfortunately limited data is currently available about psychiatric morbidity of this group in Iran. This study was designed to determine the prevalence of axis I disorders in prisoners and their correlation with the type of offense. Methods: Using stratified random sampling 351 prisoners from five offense categories (54 from financial, 71 from violent, 74 from nonviolent, 72 from drug related and 80 from immoral acts subgroup were recruited into the study, and examined by Structured Clinical Interview for DSM-IV. Results: Eighty- eight percent of the prisoners had experienced at least one axis I disorder throughout their lives, and 46.9% met the criteria for current disorders. Substance related (78% and mood disorders (48.7% were the most prevalent of lifetime disorders. However, mood (30.7% and adjustment (12.6% disorders had the highest amounts in current diagnoses. The total number of disorders was lowest in the financial subgroup. The drug related subgroup had lower rate of anxiety and higher rate of substance related disorders. Conclusion: Compared to western studies, the prevalence of axis I disorders in this study is among the highest. The fact that about half of all prisoners at the time of study suffered from at least one axis I disorder shows the emergent need of this group for more mental health care and services.

Cost-effectiveness of hepatitis B vaccination of prison inmates.

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Pisu, Maria; Meltzer, Martin Isaac; Lyerla, Rob

2002-12-13

The purpose of this paper is to determine the cost-effectiveness of vaccinating inmates against hepatitis B. From the prison perspective, vaccinating inmates at intake is not cost-saving. It could be economically beneficial when the cost of a vaccine dose is US dollars 30 per dose, or there is no prevalence of infection upon intake, or the costs of treating acute or chronic disease are about 70% higher than baseline costs, or the incidence of infection during and after custody were >1.6 and 50%, respectively. The health care system realizes net savings even when there is no incidence in prison, or there is no cost of chronic liver disease, or when only one dose of vaccine is administered. Thus, while prisons might not have economic incentives to implement hepatitis B vaccination programs, the health care system would benefit from allocating resources to them.

Assaults by Mentally Disordered Offenders in Prison: Equity and Equivalence.

Science.gov (United States)

Hales, Heidi; Dixon, Amy; Newton, Zoe; Bartlett, Annie

2016-06-01

Managing the violent behaviour of mentally disordered offenders (MDO) is challenging in all jurisdictions. We describe the ethical framework and practical management of MDOs in England and Wales in the context of the move to equivalence of healthcare between hospital and prison. We consider the similarities and differences between prison and hospital management of the violent and challenging behaviours of MDOs. We argue that both types of institution can learn from each other and that equivalence of care should extend to equivalence of criminal proceedings in court and prisons for MDOs. We argue that any adjudication process in prison for MDOs is enhanced by the relevant involvement of mental health professionals and the articulation of the ethical principles underpinning health and criminal justice practices.

Physicians in US Prisons in the Era of Mass Incarceration

OpenAIRE

Allen, Scott A.; Wakeman, Sarah E.; Cohen, Robert L.; Rich, Josiah D.

2010-01-01

The United States leads the world in creating prisoners, incarcerating one in 100 adults and housing 25% of the world’s prisoners. Since the 1976, the US Supreme Court ruling that mandated health care for inmates, doctors have been an integral part of the correctional system. Yet conditions within corrections are not infrequently in direct conflict with optimal patient care, particularly for those suffering from mental illness and addiction. In addition to providing and working to improve cli...

Assessing the Quality and Value of Psychological Health Care in Civilian Health Plans: Lessons and Implications for the Military Health System

Science.gov (United States)

2015-01-01

such as primary care practices, therapist 2 offices, prisons, schools , and community organizations. Providers working in these various settings have...ment, follow-up care for children prescribed attention deficit hyperactivity disorder ( ADHD ) medication, and mental health utilization (among other

Mental disorder and victimisation in prison: Examining the role of mental health treatment.

Science.gov (United States)

Daquin, Jane C; Daigle, Leah E

2018-04-01

There is evidence that people with mental disorders are at increased risk of victimisation in prison. It is unclear whether this risk of victimisation varies across types of disorders or symptoms and what role mental health treatment has on victimisation risk in this context. To examine the relationship between specific mental disorders, psychiatric symptoms, and victimisation in prison and the effect of treatment for the disorders on victimisation risk. Using a nationally-representative sample of prisoners, path analyses were conducted to examine the relationship between mental disorder and victimisation. The analyses also examined whether receiving mental health treatment in prison affected any such relationship. Victimisation risk varied with the type of mental disorder or symptoms. Depression, personality disorder, hopelessness, paranoia, and hallucinations were associated with increased victimisation risk. Psychotic illnesses were otherwise negatively associated with victimisation. Receiving mental health treatment in prison was associated with greater risk of victimisation there. Receiving treatment appeared to mediate the relationship between mental disorders, symptoms, and victimisation. The findings suggest that not all inmates with mental disorders are at an increased risk of victimisation. Further, mental health treatment in prison also appears to be a risk factor of victimisation. More research is needed to further elucidate the relationship between mental disorders, treatment, and victimisation. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Enhancing Care of Aged and Dying Prisoners: Is e-Learning a Feasible Approach?

Science.gov (United States)

Loeb, Susan J; Penrod, Janice; Myers, Valerie H; Baney, Brenda L; Strickfaden, Sophia M; Kitt-Lewis, Erin; Wion, Rachel K

Prisons and jails are facing sharply increased demands in caring for aged and dying inmates. Our Toolkit for Enhancing End-of-life Care in Prisons effectively addressed end-of-life (EOL) care; however, geriatric content was limited, and the product was not formatted for broad dissemination. Prior research adapted best practices in EOL care and aging; but, delivery methods lacked emerging technology-focused learning and interactivity. Our purposes were to uncover current training approaches and preferences and to ascertain the technological capacity of correctional settings to deliver computer-based and other e-learning training. An environmental scan was conducted with 11 participants from U.S. prisons and jails to ensure proper fit, in terms of content and technology capacity, between an envisioned computer-based training product and correctional settings. Environmental scan findings focused on content of training, desirable qualities of training, prominence of "homegrown" products, and feasibility of commercial e-learning. This study identified qualities of training programs to adopt and pitfalls to avoid and revealed technology-related issues to be mindful of when designing computer-based training for correctional settings, and participants spontaneously expressed an interest in geriatrics and EOL training using this learning modality as long as training allowed for tailoring of materials.

Participatory communication for tuberculosis control in prisons in Bolivia, Ecuador, and Paraguay.

Science.gov (United States)

Waisbord, Silvio

2010-03-01

To assess the challenges in reducing tuberculosis (TB) in prisons in Bolivia, Ecuador, and Paraguay and propose ways to address them through communication interventions. Challenges to two central goals of TB control--early diagnosis of positive cases and successful application of the directly observed treatment, short course (DOTS) strategy--were examined. Data were gathered (through in-depth, structured interviews) and focus groups were conducted in the prisons that housed the largest number of male inmates in each country. Interviewees and focus group participants included program directors, administrative personnel, correctional health and security staff, and incarcerated people who were or had been under treatment for TB and had participated as 'peers' in health services. The findings showed a range of entrenched obstacles for adequate TB control. Stigmatizing attitudes and low knowledge about TB among inmates and key prison personnel discouraged people living in prisons from seeking diagnosis and treatment. Systemic problems in prison health services, along with squalid living conditions, lack of coordination between national TB programs and prison health systems, and insufficient allocation of resources to health prevented the provision of adequate TB prevention and care. In addressing the barriers to effective TB control in prison systems in Bolivia, Ecuador, and Paraguay, a participatory approach to communication is necessary.

THE EFFECT OF HEALTH EDUCATION PROGRAM ON THE AIDS PREVENTIVE BEHAVIORS OF PRISONERS AGED UNDER 25 YEARS OLD (GHEZALHESAR PRISON-TEHRAN

Directory of Open Access Journals (Sweden)

K TARBIAT MODARES

2003-09-01

Full Text Available Introduction: Today's, prisons are one of the cetain centers of HIV in allover the world. This matter must be seriously noticed that the most of the prisoners after a short time of jail return to the society. In fact, prisoners are notonly susceptible to exposure infection of HIV, but also they are a reservoir for beginning and development of the HIV in the society. The rate of HIV infection among the prisoners is higher of general population. This study is a quasi-experimental one. It has been aimed to evaluate The Effect of health education program on the AIDS preventive behaviors of prisoners aged under 25 years old (Ghezalhesar Prison-Tehran. Methods: A questionnaire was developed in four sections: demographic factors, knowledge, attitude and practice and it were used after taking reliability and validity. The level of KAP toward AIDS was practice and it was used after taking reliability and validity. The level of KAP toward AIDS was evaluated first by using a questionnaire (pretest. The educational needs were recognized, and then the educational plan was designed. Educational methods in this study were lecturing group discussion, fact to face, answer question, poster, leaflet, pamphlet and video film. Results: After 2 month performing educational program, KAP determined (posttest and then compared with pretest information. Collected data analyzed by parametric and non-paramedic statistic tests. The results of the study show that 22% of prisoners in prison had Druge Injection, 8% of them had sexual intercourse, 38% of them had A Razor shared and 60% of them had tattooed. Also 82% of prisoners were in using syring for drugs and 48% were witness for sexual intercourse of other prisoners. Analysis of the data, before and after the educational program showed that is significant difference between knowledge, attitude and practice. The results of the study indicated that health education program has effected on increase of KAP. Discussion: The

Why Has the Health-Promoting Prison Concept Failed to Translate to the United States?

Science.gov (United States)

Woodall, James

2018-05-01

Two decades since the World Health Organization Regional Office for Europe published a report on health promotion in prison that stimulated further debate on the concept of the "health-promoting prison," this article discusses the extent to which the concept has translated to the United States. One predicted indicator of success for the health-promoting prison movement was the expansion of activity beyond European borders; yet 2 decades since the European model was put forward, there has been very limited activity in the United States. This "Critical Issues and Trends" article suggests reasons why this translation has failed to occur.

Some Ruminations about Prison Mental Health Work.

Science.gov (United States)

Toch, Hans

1995-01-01

Describes incidents involving mental health services in prison facilities that illustrate "Catch-22" situations, in many of which inmates perceive clinicians as people who "come to watch you drown instead of throwing you a rope." Proposes a supplementation of "administrative clinical" thinking with nonbureaucratic,…

Social identity and the prison health worker: Implications for practitioner satisfaction and turnover intentions.

Science.gov (United States)

Stephenson, Amber L; Bell, Nicolette

2017-08-23

Delivering health care within the prison walls poses distinct and arduous challenges to the practitioner. Correctional health workers regularly face issues of overcrowding, increased prevalence of infectious disease, advancing age, deteriorating conditions, and patients with an inclination for violence. Still, regardless of the sizeable workforce, costs, and impact on community well-being, correctional health is often overlooked in health services delivery research. The aim of this study was to better understand the unique nature of delivering services in the prison context through the lens of social identity theory and further explore practitioner satisfaction and retention. A survey design was used in this study, sampling clinicians in a state department of corrections in the United States. Using the data from 317 respondents, the study explored the relationship between professional identification and perceived organizational support as they impact job satisfaction and turnover intention and while controlling for burnout. Using nested ordinary least squares regression and nested logistic regression, the results showed that professional identification and perceived organizational support were positively associated with job satisfaction. Perceived organizational support was negatively and significantly related to turnover intentions. This article adds originality and value to the literature by using social identity theory to address the occupational perceptions of a large, yet often underrepresented and underexplored, subsector of the health workforce. The results highlight several areas where health care managers, whether from correctional or noncorrectional environments, could implement policy and procedure changes to further engage and retain the clinical workforce. To engage and retain the health worker population, managers must consider identification-reinforcing interventions that align with the self-concept and visibly display gestures of organizational

Actividad clínica en la consulta médica a demanda de un Centro Penitenciario frente a la de un Centro de Salud Comparisons between clinical practice consultation in a prison and in community health centres: differences and repercussions

Directory of Open Access Journals (Sweden)

C. Chérrez

2007-02-01

y de la conflictividad, sugiere un papel más relevante del médico general en un CP que en el conjunto del SPS y puede ser un dato a tener en cuenta en la planificación de la anunciada integración de la SP en el SPS.Objectives: To describe and quantify clinical practice consultancy in a prison health care unit so as to evaluate likely differences from a community Health Care Centre. To identify possible training needs when transferring health care staff from one system to another in the light of probable integration of Prison Health Care into the Public Health System. Methods: A transversal descriptive study was used for three Primary Health Care teams: an urban health centre with a high work load, a rural health centre with a low work load, and the health care unit of a provincial prison (not a mega-prison. Ransom sequential sampling was used to include all the medical activity generated in the consultancy. All activity programmed by the health professional and administrative consultancy was excluded, while efforts were made to locate troubled consultations. Comparisons were made by contrasting differences in proportions. Results: The Prison Health Care Unit showed higher statistically significant clinical activity in mental health, drug abuse, HIV and HCV infection management and specific Primary Health Care problems (biopsychosocial integration is a therapeutic priority. In both community Health Centres there is more statistically significant activity in Internal Medicine and Geriatrics. In the prison environment there is significantly higher troubled consultation. Conclusions: In a future context of integration of prison health care services into the Public Health Service, training in mental health care (especially addictive disorders and in HIV-HCV infection management may be necessary for community health centre professionals wishing to transfer to prison health care units. The prison health care professional who wants to work in a public health centre may

Bruxism and health related quality of life in southern Italy's prison inmates.

Science.gov (United States)

Cavallo, P; Savarese, G; Carpinelli, L

2014-06-01

The aim of this study was to determine the prevalence of self-assessed bruxism, the level of Health Related Quality of Life (HRQoL) and their relationship in a group of male inmates. BASIC RESEARCH DESIGN, SETTING: The present study was cross-sectional, its setting was two penal institutions in Italy. A sample of 280 male prisoners (mean age 39.7 years). Due to the very small number of female prisoners, it was not possible to study both genders. Subjects were administered a questionnaire with items investigating demographic data, self-assessed bruxism and HRQoL using EuroQoL EQ-5D instrument. Bruxism was present in 29.7% of inmates. Results for EQ-5D (in brackets are data for the general population age and gender matched) were: EQ-index 1.3 (0.8), EQ-VAS 62 (80). Percentage reporting a problem for each dimension: Mobility (MO): 7.5 (9.6), Self Care (SC): 6.1 (4.3), Usual Activities (UA): 17.9 (10.1), Pain/discomfort (PD): 43.9 (40.8), Anxiety/depression (AD): 54.6 (31.9). There was a strong correlation between bruxism and EQ-index, showing concordance and dependence and, as expected, discordance and dependence between bruxism and EQ-VAS. Bruxism prevalence is higher and HRQoL is worse in the prison population than in the general population; the presence of bruxism is correlated with lower HRQoL levels, and correlation is stronger for subjects at first prison experience and for higher education levels, thus suggesting higher effect of stress on these subjects.

A longitudinal study of mental health symptoms in young prisoners: exploring the influence of personal factors and the correctional climate.

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Gonçalves, Leonel C; Endrass, Jérôme; Rossegger, Astrid; Dirkzwager, Anja J E

2016-04-06

Despite the high prevalence rate of mental health problems among young prisoners, little is known about the longitudinal course and covariates of their mental health symptoms during incarceration, especially the influence of the correctional climate. The current study aimed: (1) to examine changes in young prisoners' mental health symptoms during incarceration, (2) to identify personal factors associated with their mental health symptoms and perceptions of the correctional climate, and (3) to test the incremental effect of perceptions of the correctional climate on mental health symptoms. Data were obtained from a sample of 75 youths (aged 17 to 22 years) detained in a Portuguese young offender prison. Data were gathered 1, 3, and 6 months after their admission in this facility. Socio-demographic, clinical and criminological variables were collected. Mental health symptoms and perceptions of the correctional climate were assessed through self-report assessment tools. Linear and logistic (multi-level) regressions and tests for differences between means were performed to analyze the data. Overall, mental health symptoms marginally declined by the sixth month in prison. Prisoners with a history of mental health treatment were more likely to have increased symptoms. Higher levels of mental health symptoms were associated with a history of mental health treatment, remand status, and a lower educational level. Better perceptions of the correctional climate were associated with Black race and participation in prison activities. A negative perception of the correctional climate was the strongest covariate of young prisoners' mental health symptoms and had incremental validity over that of personal variables. The results highlight that both characteristics of the prisoners and of the prison environment influence young prisoners' mental health. Prison management can try to reduce young prisoners' mental health problems by developing scientific procedures for their mental

[Study of the prevalence of severe mental disorder in the penitentiaries Puerto I, II and III of Puerto de Santa María (Cádiz): new strategies of psychiatric care in prison].

Science.gov (United States)

Marín-Basallote, N; Navarro-Repiso, C

2012-02-01

In recent years it has been observed that there is a high level of severe mental disorder within the Spanish prison system. A one year descriptive and transversal study of the psychiatric health care demand in the prisons Puerto I, II and III of Puerto de Santa Maria (Cádiz). Of the 128 patients studied, the psychiatric diagnostics with highest prevalence were personality disorders (F60-69) at 35.16%, the next group was psychosis (F20-29) at 25.78%, and in third place mental and behaviour disorders due to use of psychotropic substances (F10-19) at 16.41%. 46.09% suffered conditions which are categorised as severe mental disorders. This study confirms the high levels of severe mental disorder in prisons located in the area of the Puerto Real Hospital. We are making efforts to improve on psychiatric health care provided to these patients by working closely with the Prison system.

Health-state utilities in a prisoner population: a cross-sectional survey

Directory of Open Access Journals (Sweden)

Levy Michael H

2009-08-01

Full Text Available Abstract Background Health-state utilities for prisoners have not been described. Methods We used data from a 1996 cross-sectional survey of Australian prisoners (n = 734. Respondent-level SF-36 data was transformed into utility scores by both the SF-6D and Nichol's method. Socio-demographic and clinical predictors of SF-6D utility were assessed in univariate analyses and a multivariate general linear model. Results The overall mean SF-6D utility was 0.725 (SD 0.119. When subdivided by various medical conditions, prisoner SF-6D utilities ranged from 0.620 for angina to 0.764 for those with none/mild depressive symptoms. Utilities derived by the Nichol's method were higher than SF-6D scores, often by more than 0.1. In multivariate analysis, significant independent predictors of worse utility included female gender, increasing age, increasing number of comorbidities and more severe depressive symptoms. Conclusion The utilities presented may prove useful for future economic and decision models evaluating prison-based health programs.

Correlation Investigation as to the Mental Health of the Prison Guard in Xi'an Police Station

Institute of Scientific and Technical Information of China (English)

Feng Xue

2005-01-01

Based on the symptom check list 90,EPQ scale and the simplified coping style questionaire,the author made a relative study on psychological health,personality character and coping style of 267 prison guard of police bureau in Xi'an city .The study shows this: 　　①The mental health,personality character and coping style could be effected by many factors,such as gender,age,educational background,income,origin,satisfactory degree of working enviroment and some others.The mental health,personality character and coping style could effect each other.②The psychological health state of 267 prison guard is much worse than that of domestic common people.③The personality character of 267 prison guard shows much higher hostility and lower nervous than that of domestic common people.④The coping style of 267 prison guard often take positive coping styles.⑤Psychological health,personality character and coping style of prison guard are closely related.

Determining intestinal parasitic infections (IPIs) in inmates from Kajang Prison, Selangor, Malaysia for improved prison management.

Science.gov (United States)

Angal, Lorainne; Mahmud, Rohela; Samin, Sajideh; Yap, Nan-Jiun; Ngui, Romano; Amir, Amirah; Ithoi, Init; Kamarulzaman, Adeeba; Lim, Yvonne A L

2015-10-29

The prison management in Malaysia is proactively seeking to improve the health status of the prison inmates. Intestinal parasitic infections (IPIs) are widely distributed throughout the world and are still gaining great concern due to their significant morbidity and mortality among infected humans. In Malaysia, there is a paucity of information on IPIs among prison inmates. In order to further enhance the current health strategies employed, the present study aims to establish firm data on the prevalence and diversity of IPIs among HIV-infected and non-HIV-infected individuals in a prison, an area in which informed knowledge is still very limited. Samples were subjected to microscopy examination and serological test (only for Strongyloides). Speciation for parasites on microscopy-positive samples and seropositive samples for Strongyloides were further determined via polymerase chain reaction. SPSS was used for statistical analysis. A total of 294 stool and blood samples each were successfully collected, involving 131 HIV positive and 163 HIV negative adult male inmates whose age ranged from 21 to 69-years-old. Overall prevalence showed 26.5% was positive for various IPIs. The IPIs detected included Blastocystis sp., Strongyloides stercoralis, Entamoeba spp., Cryptosporidium spp., Giardia spp., and Trichuris trichiura. Comparatively, the rate of IPIs was slightly higher among the HIV positive inmates (27.5%) than HIV negative inmates (25.8%). Interestingly, seropositivity for S. stercoralis was more predominant in HIV negative inmates (10.4%) compared to HIV-infected inmates (6.9%), however these findings were not statistically significant. Polymerase chain reaction (PCR) confirmed the presence of Blastocystis, Strongyloides, Entamoeba histolytica and E. dispar. These data will enable the health care providers and prison management staff to understand the trend and epidemiological situations in HIV/parasitic co-infections in a prison. This information will further

Trends in state prison admission of offenders with serious mental illness.

Science.gov (United States)

Bradley-Engen, Mindy S; Cuddeback, Gary S; Gayman, Mathew D; Morrissey, Joseph P; Mancuso, David

2010-12-01

This study examined whether the proportion as well as the number of prisoners with behavioral health disorders have increased in recent years. Among 41,440 persons admitted to Washington State prisons from 1998 through 2006, this study estimated numbers and proportions of behavioral health disorders diagnosed while persons were in the community or in prison. There was a 44% increase in persons admitted with a diagnosed co-occurring substance use disorder between 1998 (N=477) and 2005 (N=686); this increase dropped to 27% by 2006 (N=604). Ratewise, increases in the annual proportion of persons admitted with co-occurring disorders were much smaller, ranging from approximately .2% to 2.6%. The growth in the numbers of prisoners with serious mental illness and co-occurring substance use disorders was not due primarily to increases in admission base rates. Nevertheless, more treatment resources will be needed in prisons to meet growing mental health care needs, and more community-based resources will be needed to ensure continuity of treatment and successful community reentry.

A Descriptive Model of Patient Readiness, Motivators, and Hepatitis C Treatment Uptake among Australian Prisoners

Science.gov (United States)

Yap, Lorraine; Carruthers, Susan; Thompson, Sandra; Cheng, Wendy; Jones, Jocelyn; Simpson, Paul; Richards, Alun; Thein, Hla-Hla; Haber, Paul; Lloyd, Andrew; Butler, Tony

2014-01-01

Background Hepatitis C virus infection (HCV) has a significant global health burden with an estimated 2%–3% of the world's population infected, and more than 350,000 dying annually from HCV-related conditions including liver failure and liver cancer. Prisons potentially offer a relatively stable environment in which to commence treatment as they usually provide good access to health care providers, and are organised around routine and structure. Uptake of treatment of HCV, however, remains low in the community and in prisons. In this study, we explored factors affecting treatment uptake inside prisons and hypothesised that prisoners have unique issues influencing HCV treatment uptake as a consequence of their incarceration which are not experienced in other populations. Method and Findings We undertook a qualitative study exploring prisoners' accounts of why they refused, deferred, delayed or discontinued HCV treatment in prison. Between 2010 and 2013, 116 Australian inmates were interviewed from prisons in New South Wales, Queensland, and Western Australia. Prisoners experienced many factors similar to those which influence treatment uptake of those living with HCV infection in the community. Incarceration, however, provides different circumstances of how these factors are experienced which need to be better understood if the number of prisoners receiving treatment is to be increased. We developed a descriptive model of patient readiness and motivators for HCV treatment inside prisons and discussed how we can improve treatment uptake among prisoners. Conclusion This study identified a broad and unique range of challenges to treatment of HCV in prison. Some of these are likely to be diminished by improving treatment options and improved models of health care delivery. Other barriers relate to inmate understanding of their illness and stigmatisation by other inmates and custodial staff and generally appear less amenable to change although there is potential for

A descriptive model of patient readiness, motivators, and hepatitis C treatment uptake among Australian prisoners.

Directory of Open Access Journals (Sweden)

Lorraine Yap

Full Text Available BACKGROUND: Hepatitis C virus infection (HCV has a significant global health burden with an estimated 2%-3% of the world's population infected, and more than 350,000 dying annually from HCV-related conditions including liver failure and liver cancer. Prisons potentially offer a relatively stable environment in which to commence treatment as they usually provide good access to health care providers, and are organised around routine and structure. Uptake of treatment of HCV, however, remains low in the community and in prisons. In this study, we explored factors affecting treatment uptake inside prisons and hypothesised that prisoners have unique issues influencing HCV treatment uptake as a consequence of their incarceration which are not experienced in other populations. METHOD AND FINDINGS: We undertook a qualitative study exploring prisoners' accounts of why they refused, deferred, delayed or discontinued HCV treatment in prison. Between 2010 and 2013, 116 Australian inmates were interviewed from prisons in New South Wales, Queensland, and Western Australia. Prisoners experienced many factors similar to those which influence treatment uptake of those living with HCV infection in the community. Incarceration, however, provides different circumstances of how these factors are experienced which need to be better understood if the number of prisoners receiving treatment is to be increased. We developed a descriptive model of patient readiness and motivators for HCV treatment inside prisons and discussed how we can improve treatment uptake among prisoners. CONCLUSION: This study identified a broad and unique range of challenges to treatment of HCV in prison. Some of these are likely to be diminished by improving treatment options and improved models of health care delivery. Other barriers relate to inmate understanding of their illness and stigmatisation by other inmates and custodial staff and generally appear less amenable to change although there

[Evaluation of the need for periodontal treatment in prisons near Dakar, Senegal].

Science.gov (United States)

Diouf, M; Cissé, D; Lo, C M M; Faye, D; Faye, B; Benoist, H M; Souaré, N

2009-12-01

Oral diseases qualify as major public health problems due to their high prevalence and incidence. They usually affect poor and marginal segments of the population. This study focused on the prison population that is characterized by poor living conditions and malnutrition. The aim of study was to assess the need for periodontal care in prisoners serving time in the Dakar region of Senegal. This cross-sectional study included 375 prisoners serving in three facilities, i.e. the penal camp, Liberte VI prison for women, and Rufisque prison for women. Data were collected using a modified WHO information sheet. The community periodontal index of treatment needs (CPITN) was used for scoring. Statistical analysis with stratification by sex and age was performed and tests were considered as significant for p prison time was 39.29 months +/- 17.73. The proportion of prisoners needing periodontal treatment increased gradually according to prison time with significant differences (p prison time would reduce the need for periodontal treatment in prisons in Dakar.

An Outbreak of Syphilis in Alabama Prisons: Correctional Health Policy and Communicable Disease Control

Science.gov (United States)

Wolfe, Mitchell I.; Xu, Fujie; Patel, Priti; O'Cain, Michael; Schillinger, Julia A.; St. Louis, Michael E.; Finelli, Lyn

2001-01-01

Objectives. After syphilis outbreaks were reported at 3 Alabama State men's prisons in early 1999, we conducted an investigation to evaluate risk factors for syphilis infection and describe patterns of syphilis transmission. Methods. We reviewed medical, patient interview, and prison transfer records and documented sexual networks. Presumptive source cases were identified. Odds of exposure to unscreened jail populations and transfer from other prisons were calculated for case patients at 1 prison. Results. Thirty-nine case patients with early syphilis were identified from 3 prisons. Recent jail exposure (odds ratio [OR] = 8.0, 95% confidence interval [CI] = 0.3, 158.7, P = .14) and prison transfer (OR = 32.0, 95% CI = 1.6, 1668.1, P prisons included mixing of prisoners with unscreened jail populations, transfer of infected inmates between prisons, and multiple concurrent sexual partnerships. Reducing sexual transmission of disease in correctional settings is a public health priority and will require innovative prevention strategies. PMID:11499107

Prevalence and correlates of depression and anxiety disorder in a sample of inmates in a Nigerian prison.

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Osasona, Samuel O; Koleoso, Olaide N

2015-01-01

Prisoners tend to be marginalized and deprived of the rights and privileges that other citizens in the community enjoy. Their separation from families, adverse effects on health of prison environment, and the uncertainty about the future place a great psychological burden on them which can lead to the development of mental illness. The aim of this study was to determine the prevalence of psychiatric morbidity (depression and anxiety) and the associated factors among a sample of the prison inmates. The study was descriptive and cross-sectional in design; it was conducted in a medium security prison in Benin City, Nigeria. Participants were interviewed with the Self-Reporting Questionnaire-20, the Hospital Anxiety and Depression Scale, and a socio-demographic questionnaire. Two hundred and fifty-two prisoners who were selected by systematic sampling techniques participated in the study and the data were analyzed using the 16th version of the SPSS with the statistical level of significance set at p anxiety symptoms respectively on the HADS. Overall, 84.5% of the respondents had at least one type of psychiatric morbidity. Age, marital status, self-reported physical and mental health, previous mental illness, imprisonment status, prison accommodation, prison meal, and health care services were found to be significantly associated with depression, anxiety or general psychiatric morbidity. Self-reported poor current mental health was the only variable that predicted all the three types of psychiatric morbidity. Prisoners in this study, and as in previous reports, had high prevalence rates of psychiatric morbidity. Thus, prisoners have a need for regular psychiatric screening and treatment. The consequences of untreated psychiatric morbidity and the need for improved health care services and infrastructure in the prison were discussed. © The Author(s) 2015.

Medical student experiences in prison health services and social cognitive career choice: a qualitative study.

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Brooker, Ron; Hu, Wendy; Reath, Jennifer; Abbott, Penelope

2018-01-02

One of the purposes of undergraduate medical education is to assist students to consider their future career paths in medicine, alongside the needs of the societies in which they will serve. Amongst the most medically underserved groups of society are people in prison and those with a history of incarceration. In this study we examined the experiences of medical students undertaking General Practice placements in a prison health service. We used the theoretical framework of the Social Cognitive Career Theory (SCCT) to explore the potential of these placements to influence the career choices of medical students. Questionnaire and interview data were collected from final year students, comprising pre and post placement questionnaire free text responses and post placement semi-structured interviews. Data were analysed using inductive thematic analysis, with reference to concepts from the SCCT Interest Model to further develop the findings. Clinical education delivered in a prison setting can provide learning that includes exposure to a wide variety of physical and mental health conditions and also has the potential to stimulate career interest in an under-served area. While students identified many challenges in the work of a prison doctor, increased confidence (SCCT- Self-Efficacy) occurred through performance success within challenging consultations and growth in a professional approach to prisoners and people with a history of incarceration. Positive expectations (SCCT- Outcome Expectations) of fulfilling personal values and social justice aims and of achieving public health outcomes, and a greater awareness of work as a prison doctor, including stereotype rejection, promoted student interest in working with people in contact with the criminal justice system. Placements in prison health services can stimulate student interest in working with prisoners and ex-prisoners by either consolidating pre-existing interest or expanding interest into a field they had not

Examining the Role of Familial Support During Prison and After Release on Post-Incarceration Mental Health.

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Wallace, Danielle; Fahmy, Chantal; Cotton, Lindsy; Jimmons, Charis; McKay, Rachel; Stoffer, Sidney; Syed, Sarah

2016-01-01

A significant number of prisoners experience mental health problems, and adequate social support is one way that facilitates better mental health. Yet, by being incarcerated, social support, particularly family support, is likely to be strained or even negative. In this study, we examine whether familial support--either positive or negative--in-prison and after release affects mental health outcomes post-release. Using the Serious and Violent Offender Reentry Initiative (SVORI) dataset, we regress post-release mental health on in-prison familial support, post-incarceration familial support, and changes in familial support. We find that while in-prison family support does not affect mental health, post-release familial support does. Also, experiencing an increase in negative familial support is associated with lower post-incarceration mental health. We conclude with a discussion of policies which may facilitate better familial support environments. © The Author(s) 2014.

[Addiction problems behind prison walls--view of the prison administration].

Science.gov (United States)

Preusker, H

2000-04-01

As Head of the Prison Administration of Saxony, the author describes the difficulties and problems that exist in the care and treatment of prisoners who are addicted to drugs or alcohol. Up to now, these problems have been dealt with in a manner that was too much concentrated on ideas and aspects of security by using systems of control and restrictions. Social contacts inside and outside of the prison and a sense of freedom are, however, the requirements of the legal concept of resettling prisoners. There is a great need for more counselling and therapy. It should also be attempted to improve the conditions for the individual prisoners, e.g. by setting up drug-free units and, thus, provide a environment to the addicts that enables them to live their lives without the daily struggle for drugs and alcohol.

Forget Me Not: Dementia in Prison

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Maschi, Tina; Kwak, Jung; Ko, Eunjeong; Morrissey, Mary B.

2012-01-01

The number of older adults with dementia in U.S. prisons is rapidly rising. Yet, the vast majority of this marginalized subgroup of the aging population is left neglected behind bars without access to adequate medical and mental health care services. We assert that proactive, interdisciplinary collaborative efforts to improve practice, policy, and…

Impact of family-friendly prison policies on health, justice and child protection outcomes for incarcerated mothers and their dependent children: a cohort study protocol.

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Myers, Helen; Segal, Leonie; Lopez, Derrick; Li, Ian W; Preen, David B

2017-08-23

Female imprisonment has numerous health and social sequelae for both women prisoners and their children. Examples of comprehensive family-friendly prison policies that seek to improve the health and social functioning of women prisoners and their children exist but have not been evaluated. This study will determine the impact of exposure to a family-friendly prison environment on health, child protection and justice outcomes for incarcerated mothers and their dependent children. A longitudinal retrospective cohort design will be used to compare outcomes for mothers incarcerated at Boronia Pre-release Centre, a women's prison with a dedicated family-friendly environment, and their dependent children, with outcomes for mothers incarcerated at other prisons in Western Australia (that do not offer this environment) and their dependent children. Routinely collected administrative data from 1985 to 2013 will be used to determine child and mother outcomes such as hospital admissions, emergency department presentations, custodial sentences, community service orders and placement in out-of home care. The sample consists of all children born in Western Australia between 1 January 1985 and 31 December 2011 who had a mother in a West Australian prison between 1990 and 2012 and their mothers. Children are included if they were alive and aged less than 18 years at the time of their mother's incarceration. The sample comprises an exposed group of 665 women incarcerated at Boronia and their 1714 dependent children and a non-exposed comparison sample of 2976 women incarcerated at other West Australian prisons and their 7186 dependent children, creating a total study sample of 3641 women and 8900 children. This project received ethics approval from the Western Australian Department of Health Human Research Ethics Committee, the Western Australian Aboriginal Health Ethics Committee and the University of Western Australia Human Research Ethics Committee. © Article author(s) (or their

Systematic review of health and behavioural outcomes of smoking cessation interventions in prisons.

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de Andrade, Dominique; Kinner, Stuart A

2016-09-01

We conducted a systematic review to examine the impact of smoking cessation interventions, including smoking bans, on prisoners and prison staff. We systematically searched health and criminal justice databases for relevant studies. Search strings were used to combine terms related to smoking cessation interventions with terms related to incarceration. We used forward and backward snowballing to capture additional studies. Studies were included if: they were published between 1 January 1994 and 23 May 2016; the population was incarcerated adults and/or prison staff; they had a quantitative component; they were published in English; and they reported outcomes of a smoking cessation programme/ban with regard to reported change in smoking behaviour and/or behavioural outcomes. Studies were reviewed for methodological rigour using the Effective Public Health Practice Project's Quality Assessment Tool for Quantitative Studies. Data were independently reviewed for methodological quality by 1 author and a research assistant. Cessation programmes, including free nicotine replacement therapy and/or behavioural counselling can significantly increase the likelihood of quitting in prison and increase abstinence postrelease. Indoor bans have little impact on prisoner smoking behaviour. Prisoners who experience a complete smoking ban typically resume smoking shortly after release from prison. Bans may result in adverse behavioural outcomes, but these are generally minimal and short-lived. While there is limited evidence to inform tobacco control policies in custodial settings, outcomes of this review suggest that cessation programmes/bans can be an effective mechanism to interrupt prisoner smoking behaviour when properly enforced. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Psychiatric morbidity in prisoners

Science.gov (United States)

Kumar, Vinod; Daria, Usha

2013-01-01

Background: Prisoners are having high percentage of psychiatric disorders. Majority of studies done so far on prisoners are from Western countries and very limited studies from India. Aim: Study socio-demographic profile of prisoners of a central jail and to find out current prevalence of psychiatric disorders in them. Materials and Methods: 118 prisoners were selected by random sampling and interviewed to obtain socio-demographic data and assessed on Indian Psychiatric Interview Schedule (IPIS) with additional required questions to diagnose psychiatric disorders in prisoners. Results: Mean age of prisoners was 33.7 years with 97.5% males, 57.6% from rural areas and 65.3% were married. Average education in studied years was 6.6 years and 50.8% were unskilled workers. 47.4% were murderers while 20.3% of drugs related crimes. 47.5% were convicted and history of criminal behavior in family was in 32.2% prisoners. Current prevalence of psychiatric disorders was 33%. Psychotic, depressive, and anxiety disorders were seen in 6.7%, 16.1%, and 8.5% prisoners respectively. 58.8% had history of drug abuse/dependence prior to imprisonment. Conclusion: One prison of Hadoti region of Rajasthan is full of people with mental-health problems who collectively generate significant levels of unmet psychiatric treatment need. Prisons are detrimental to mental-health. Beginning of reforms is the immediate need. PMID:24459308

Manifestations of HIV stigma and their impact on retention in care for people transitioning from prisons to communities

OpenAIRE

Kemnitz, Rebecca; Kuehl, Theresa C.; Hochstatter, Karli R.; Barker, Emily; Corey, Anna; Jacobs, Elizabeth A.; Repplinger, Michael D.; Ehlenbach, William J.; Seal, David W.; Sosman, James M.; Westergaard, Ryan P.

2017-01-01

Background While most people living with HIV who are incarcerated in United States receive appropriate HIV care while they are in prison, interruptions in antiretroviral therapy and virologic failure are extremely common after they are released. The purpose of this study was to describe whether and how HIV stigma influences continuity of care for people living with HIV while they transition from prison to community settings. Methods We conducted semi-structured, telephone-based interviews wit...

Using a Delphi process to define priorities for prison health research in Canada.

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Kouyoumdjian, Fiona G; Schuler, Andrée; McIsaac, Kathryn E; Pivnick, Lucie; Matheson, Flora I; Brown, Glenn; Kiefer, Lori; Silva, Diego; Hwang, Stephen W

2016-01-14

A large number of Canadians spend time in correctional facilities each year, and they are likely to have poor health compared to the general population. Relatively little health research has been conducted in Canada with a focus on people who experience detention or incarceration. We aimed to conduct a Delphi process with key stakeholders to define priorities for research in prison health in Canada for the next 10 years. We conducted a Delphi process using an online survey with two rounds in 2014 and 2015. We invited key stakeholders in prison health research in Canada to participate, which we defined as persons who had published research on prison health in Canada since 1994 and persons in the investigators' professional networks. We invited 143 persons to participate in the first round and 59 participated. We invited 137 persons to participate in the second round and 67 participated. Participants suggested topics in the first round, and these topics were collated by investigators. We measured the level of agreement among participants that each collated topic was a priority for prison health research in Canada for the next 10 years, and defined priorities based on the level of agreement. In the first round, participants suggested 71 topics. In the second round, consensus was achieved that a large number of suggested topics were research priorities. Top priorities were diversion and alternatives to incarceration, social and community re-integration, creating healthy environments in prisons, healthcare in custody, continuity of healthcare, substance use disorders and the health of Aboriginal persons in custody. Generated in an inclusive and systematic process, these findings should inform future research efforts to improve the health and healthcare of people who experience detention and incarceration in Canada. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Psychiatric needs of male prison inmates in Italy.

Science.gov (United States)

Piselli, Massimiliano; Attademo, Luigi; Garinella, Raffaele; Rella, Angelo; Antinarelli, Simonetta; Tamantini, Antonia; Quartesan, Roberto; Stracci, Fabrizio; Abram, Karen M

2015-01-01

This paper presents data on the mental health needs of men in an Italian prison and examines if mental health needs of inmates differ across key correctional subpopulations. Interviewers conducted semi-structured clinical interviews with 526 convicted males incarcerated in the Spoleto Prison from October 2010 through September 2011. Nearly two thirds (65.0%) of inmates had an Axis I or Axis II disorder. About half (52.7%) had an Axis I disorder. Personality disorders were the most common disorders (51.9%), followed by anxiety (25.3%) and substance use disorders (24.9%). Over one third of inmates (36.6%) had comorbid types of disorder. The most common comorbid types of disorders were substance use disorders plus personality disorders (20.1%) and anxiety disorders plus personality disorders (18.0%). Findings underscore a significant need for specialized mental health services for men in Italian prisons. Moreover, as inmates return to the community, their care becomes the responsibility of the community health system. Service systems must be equipped to provide integrated services for those with both psychiatric and substance use disorders and be prepared for challenges posed by patients with personality disorders. Copyright © 2015 Elsevier Ltd. All rights reserved.

Medical devices made into weapons by prisoners: an unrecognized risk.

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Hayden, J W; Laney, C; Kellermann, A L

1995-12-01

The alteration of a knee immobilizer into a sharp weapon by a prisoner prompted us to survey neighboring penal institutions to determine the frequency of such events. We mailed a nine-item survey to all detention facilities in Tennessee, Arkansas, and Mississippi. A second survey was sent to nonresponding institutions 6 weeks after the initial mailing. The Regional Medical Center at Memphis, the designated facility for evaluation and treatment of prisoners from the county jail and state penitentiary. Survey respondents included 25 state penitentiaries, 31 county jails, 1 state minimum-security facility, 1 state maximum-security facility, 1 work-release center, 1 county detention center for drunken-driving offenders, and 1 federal penitentiary. Of the 81 institutions surveyed, 77% responded to one of the two mailings. Forty percent responded in the affirmative when asked whether stolen or unauthorized medical equipment from outside their institutions had been discovered among inmates. When respondents were questioned as to whether medical equipment, prescribed or not, had been used or altered in a criminal manner, 34% responded "yes." Medications and medical appliances were listed in the responses. A survey of 81 local and neighboring penal institutions in a three-state area revealed that the illicit use of medicine and medical devices by prisoners is a legitimate safety concern of prison personnel and health care workers when medical care for inmates must be sought outside the security of their institutions. The modification of medical equipment into weapons by incarcerated patients, although clearly recognized as a security and safety problem by police authorities, appears to be unappreciated by health care workers providing episodic care to inmates.

Oral Health Status of a Sample of Prisoners in Enugu: A ...

African Journals Online (AJOL)

health. Subjects and Methods: The study involved 230 inmates of the Federal Prison in. Enugu. .... the study participants had unhealthy periodontal tissues, this finding is consistent with .... disease, and other stress‑related illnesses. J Health ...

Inside the nation's largest mental health institution: a prevalence study in a state prison system.

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Al-Rousan, Tala; Rubenstein, Linda; Sieleni, Bruce; Deol, Harbans; Wallace, Robert B

2017-04-20

The United States has the highest incarceration rate in the world which has created a public health crisis. Correctional facilities have become a front line for mental health care. Public health research in this setting could inform criminal justice reform. We determined prevalence rates for mental illnesses and related comorbidities among all inmates in a state prison system. Cross-sectional study using the Iowa Corrections Offender Network which contains health records of all inmates in Iowa. The point prevalence of both ICD-9 and DSM-IV codes for mental illnesses, timing of diagnosis and interval between incarceration and mental illness diagnosis were determined. The average inmate (N = 8574) age was 36.7 ± 12.4 years; 17% were ≥50 years. The majority of inmates were men (91%) and white (65%).Obesity was prevalent in 38% of inmates, and 51% had a history of smoking. Almost half of inmates were diagnosed with a mental illness (48%), of whom, 29% had a serious mental illness (41% of all females and 27% of all males), and 26% had a history of a substance use disorder. Females had higher odds of having both a mental illness and substance use disorder. Almost all mental illness diagnoses were first made during incarceration (99%). The mean interval to diagnosis of depression, anxiety, PTSD and personality disorders were 26, 24, 21 and 29 months respectively. Almost 90% of mental illnesses were recognized by the 6 th year of incarceration. The mean interval from incarceration to first diagnosis (recognition) of a substance abuse history was 11 months. There is a substantial burden of mental illness among inmates. Racial, age and gender disparities in mental health care are coupled with a general delay in diagnosis and treatment. A large part of understanding the mental health problem in this country starts at prisons.

Reducing the use of seclusion for mental disorder in a prison: implementing a high support unit in a prison using participant action research

Directory of Open Access Journals (Sweden)

Giblin Yvette

2012-04-01

Full Text Available Abstract Background Vulnerable prisoners and mentally disordered offenders who present with risk of harm to self or others were accommodated in Special Observation Cells (SOCs isolated from others for considerable periods of time. This practice has been criticised by the Council of Europe Committee for the Prevention of Torture. The objective of this initiative was to reduce the use of seclusion within the prison and to improve the care of vulnerable and mentally ill prisoners within the prison. Results The prison studied is a committal centre for sentenced prisoners with an official bed capacity of 630. The forensic mental health in-reach team, in co-operation with the prison health service followed the 'spiral' of planning, action and fact finding about the results of the action. In December 2010 a 10 bed High Support Unit (HSU was established within the prison. During the first year, 96 prisoners were admitted. A third (35% reported psychotic symptoms, 28% were referred due to the immediate risk of self-harm, 17% were accommodated for medical treatments and increased observation, 13% received specialised treatment by the Addiction Psychiatry team, 6% presented with emotional distress. One prisoner was accommodated on the HSU due to the acute risk he posed to others. A major mental illness was diagnosed in 29%, 20% required short-term increased support for crisis intervention and were found not to have a mental illness. A further 10% were deemed to be feigning symptoms of mental illness to seek refuge in the HSU. 7% had personality disorder as their primary diagnosis and 4% had a learning disability. Stratifying risk within the prison population through the provision of the HSU decreased the total episodes of seclusion in the prison by 59% (p Conclusions The next step is to further stratify risk by establishing a low support unit to serve as a step-down from the high support unit.

Music therapy for prisoners: pilot randomised controlled trial and implications for evaluating psychosocial interventions.

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Gold, Christian; Assmus, Jörg; Hjørnevik, Kjetil; Qvale, Liv Gunnhild; Brown, Fiona Kirkwood; Hansen, Anita Lill; Waage, Leif; Stige, Brynjulf

2014-12-01

Mental health problems are common among prison inmates. Music therapy has been shown to reduce mental health problems. It may also be beneficial in the rehabilitation of prisoners, but rigorous outcome research is lacking. We compared group music therapy with standard care for prisoners in a pilot randomised controlled trial that started with the establishment of music therapy services in a prison near Bergen in 2008. In all, 113 prisoners agreed to participate. Anxiety (STAI-State [State-Trait Anxiety Inventory], STAI-Trait), depression (HADS-D [Hospital Anxiety and Depression Scale]), and social relationships (Quality of Life Enjoyment and Satisfaction Questionnaire [Q-LES-Q]) were assessed at baseline; every 2 weeks in the experimental group; after 1, 3, and 6 months in the control group; and at release. No restrictions were placed on the frequency, duration, or contents of music therapy. Duration of stay in the institution was short (62% stayed less than 1 month). Only a minority reached clinical cutoffs for anxiety and depression at baseline. Between-group analyses of effects were not possible. Music therapy was well accepted and attractive among the prisoners. Post hoc analysis of within-group changes suggested a reduction of state anxiety after 2 weeks of music therapy (d = 0.33, p = .025). Short sentences and low baseline levels of psychological disturbance impeded the examination of effects in this study. Recommendations for planning future studies are given, concerning the careful choice of participants, interventions and settings, comparison condition and design aspects, choice of outcomes, and integration of research approaches. Thus, the present study has important implications for future studies evaluating interventions for improving prisoners' mental health. ISRCTN22518605. © The Author(s) 2013.

The impact of prison staff responses on self-harming behaviours: prisoners' perspectives.

Science.gov (United States)

Marzano, Lisa; Ciclitira, Karen; Adler, Joanna

2012-03-01

To further understanding of how health and correctional staff responses to self-harming behaviours influence prisoners and their subsequent actions. Participant-centred, qualitative methods were used to explore the complex and under-researched perspectives of self-harming male prisoners. Semi-structured interviews were conducted with 20 adult male prisoners who had engaged in repetitive, non-suicidal self-harm during their current prison sentence, or considered doing so. The interviews were analyzed drawing on principles of thematic analysis and discourse analysis. With some exceptions, prison officers, nurses, and doctors are portrayed by prisoners as being ill-prepared to deal with repetitive self-harm, often displaying actively hostile attitudes and behaviours. These findings underscore the need for appropriate training, support and supervision for staff working with self-harming prisoners. ©2011 The British Psychological Society.

The Relation between the Type of Crime Committed and the Mental Health Status of the Female Prisoners in Urmia

Directory of Open Access Journals (Sweden)

Morad Ali Zareipour

2017-05-01

Full Text Available Background: The mental health of female prisoners as a high-risk group is very important. Evaluating their health needs has been neglected in most societies. The purpose of this research is to evaluate the relation between the type of crime committed and the mental health status of the female prisoners in Urmia province, Iran. Methods: This descriptive-analytical study was conducted on 150 female prisoners in 2016. The standard questionnaire of general health with 28 questions and also a questionnaire including demographic information, the type of crime, and the conviction period were used in order to evaluate the mental health status. The collected information was analysed through SPSS16 and by using chi-square test, Fisher’s exact test and one-way ANOVA. Results: The results showed that 74% of the female prisoners were suspected to have mental disorder and the least of it was depression with 20.4 per cent being affected by it and the most severe mental disorder pertaining to social function with 78% being affected. Also, the prisoner who had committed murder or had been accomplices for murder, and those sentenced to death had the worst mental health. The statistical relation between mental health and the type of crime and the length of the sentence was significant and the odds ratio of mental disorders among women who were sentenced for murder and for being accomplices to murder was 2.4 times that of women who were convicted for crimes related to drugs. Conclusion: Considering the poor mental health of female prisoners and its relationship with the severity of the crime and the conviction period, it is necessary to make policies to promote mental health in prisoners in order to promote the other aspects of prisoners’ health and also to prevent the recurrence of crime after the discharge from prison. 

Reflections on researcher departure: Closure of prison relationships in ethnographic research.

Science.gov (United States)

Abbott, Laura; Scott, Tricia

2018-01-01

Offender Management Services through the Health Research Authority Integrated Research Application System and permission to proceed was granted by the University of Hertfordshire, UK. Thematic analysis enabled the identification of themes associated with the experience of prison pregnancy illuminating how prison life continues with little consideration for their unique physical needs, coping tactics adopted and the way women negotiate entitlements. On researcher departure from the field, the complex feelings of loss and sadness were experienced by both participants and researcher. To leave the participant with a sense of abandonment following closure of fieldwork, due to the very nature of the closed environment, risks re-enactment of previous emotional pain of separation. Although not an ethical requirement, the researcher sought out psychotherapeutic supervision during the fieldwork phase with 'Janet', a forensic psychotherapist, which helped to highlight the need for careful closure of research/participant relationships with a vulnerable population. This article brings to the consciousness of prison researchers the need to minimise potential harm by carefully negotiating how to exit the field. Reflections of the researcher are interlinked with utterances from some participants to illustrate the types of departure behaviours. Closure of fieldwork and subsequent researcher departure involving pregnant women in prison requires careful handling to uphold the ethical research principle 'do no harm'.

Evaluation of a comedy intervention to improve coping and help-seeking for mental health problems in a women's prison.

Science.gov (United States)

Wright, Steve; Twardzicki, Maya; Gomez, Fabio; Henderson, Claire

2014-08-01

Rates of mental illness and self-harm are very high among women prisoners. Questionnaires assessed prisoners' knowledge of and attitudes towards mental health problems, and relevant behavioural intentions before and after the intervention, to evaluate the effectiveness of a comedy show in a women's prison to reduce mental health stigma and improve coping and help-seeking for mental health problems. The intervention appeared to have been successful in improving some aspects of prisoners' knowledge about the effectiveness of psychotherapy (Z = - 2.304, p = 0.021) and likelihood of recovery from mental health problems (Z = - 2.699, p = 0.007). There were significant post-intervention increases in the proportion who stated they would discuss or disclose mental health problems with all but one of the sources of help in the questionnaire, which was consistent with the increases in the number of prisoners who rated themselves as likely to start using different sources of help or prison activities. There was no improvement in intentions to associate with people with a mental health problem. The intervention appeared effective in improving factors that might increase help-seeking and improve coping, but not those that would change behaviour towards others with a mental health problem.

Should we use a direct regulation to implement the Healthy Prisons Agenda in England? A qualitative study among prison key policy makers.

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Ismail, N; de Viggiani, N

2017-08-31

The Healthy Prisons Agenda seeks to reduce prisoners' health risks, balance prisoners' rights with a security regime, ensure equivalent prison health service provisions to community health services, and facilitate the whole-prison approach. There is an established assumption that legislation will ensure better implementation of health promotion programmes. This study aimed to examine whether a legislative framework, via a direct regulation, could lead to enhanced implementation of the Healthy Prisons Agenda in England. A qualitative study design was conducted using semi-structured interviews with 30 key prison policy makers in England. Our findings contradict the established assumption that legislation improves the implementation of health promotion programmes. A direct regulation was perceived as restrictive, manifesting excessive compliance and encouraging a risk-averse culture, whilst preoccupation with security, order and discipline amongst prison governors and custody staff was deemed an internal institutional barrier to implementing the Healthy Prisons Agenda. External barriers included diminishing resources, lengthier or delayed sentencing, and an unsympathetic public and political stance towards prisoner rehabilitation. A direct regulation should not be used to operationalize the Healthy Prisons Agenda. Rather, self-regulation, along with proactive solutions for the identified barriers to implementing the Agenda, is the most appropriate path forward. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Women's health situation in prison: Sexual and reproductive rights

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Arianna Oliveira Santana Lopes

2014-10-01

Full Text Available The article discusses issues associated to women's health, since search what are the sexual and reproductive rights for women in situations of incarceration, highlighting the essentiality of these and if they are applied in Brazilian prisons. Therefore, was realized a literature review to assess the situation of the Brazilian women's prisons with regular year 2003 to 2012. When examined there was a wide disparity of reality experienced by these women by numerous factors, ranging from the barriers imposed by the prison as restriction on conjugal visits, the very attempt to play a role of motherhood and, of course, which drew more attention: the discrimination based on gender, since man reassembles his relationships more easily and generally leaves the companion incarcerated for cultural and social arising male sex. Concludes with the emerging need for change this situation in order to provide a better way to live in such a hostile environment to women incarcerated, where the same have their rights violated and nothing is done to such default.

Incremental conditions of isolation as a predictor of suicide in prisoners.

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Roma, Paolo; Pompili, Maurizio; Lester, David; Girardi, Paolo; Ferracuti, Stefano

2013-12-10

In a study of the incidence of suicide in jails and prisons under increasing conditions of deprivation in Italy from 2004 to 2008, imprisonment involving greater levels of isolation was found to be associated with a higher rate of suicide. Greater care should be taken to ensure that prisoners in isolation do not commit suicide by limiting this option when possible or providing mental health services when isolation is necessary. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Changes in the provision of institutionalized mental health care in post-communist countries.

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Adrian P Mundt

Full Text Available General psychiatric and forensic psychiatric beds, supported housing and the prison population have been suggested as indicators of institutionalized mental health care. According to the Penrose hypothesis, decreasing psychiatric bed numbers may lead to increasing prison populations. The study aimed to assess indicators of institutionalized mental health care in post-communist countries during the two decades following the political change, and to explore whether the data are consistent with the Penrose hypothesis in that historical context.General psychiatric and forensic psychiatric bed numbers, supported housing capacities and the prison population rates were collected in Azerbaijan, Belarus, Croatia, Czech Republic, East Germany, Hungary, Kazakhstan, Latvia, Poland, Romania, Russia and Slovenia. Percentage change of indicators over the decades 1989-1999, 1999-2009 and the whole period of 1989-2009 and correlations between changes of different indicators were calculated. Between 1989 and 2009, the number of general psychiatric beds was reduced in all countries. The decrease ranged from -11% in Croatia to -51% in East Germany. In 2009, the bed numbers per 100,000 population ranged from 44.7 in Azerbaijan to 134.4 in Latvia. Forensic psychiatric bed numbers and supported housing capacities increased in most countries. From 1989-2009, trends in the prison population ranged from a decrease of -58% in East Germany to an increase of 43% in Belarus and Poland. Trends in different indicators of institutionalised care did not show statistically significant associations.After the political changes in 1989, post-communist countries experienced a substantial reduction in general psychiatric hospital beds, which in some countries may have partly been compensated by an increase in supported housing capacities and more forensic psychiatric beds. Changes in the prison population are inconsistent. The findings do not support the Penrose hypothesis in that

Changes in the provision of institutionalized mental health care in post-communist countries.

Science.gov (United States)

Mundt, Adrian P; Frančišković, Tanja; Gurovich, Isaac; Heinz, Andreas; Ignatyev, Yuriy; Ismayilov, Fouad; Kalapos, Miklós Péter; Krasnov, Valery; Mihai, Adriana; Mir, Jan; Padruchny, Dzianis; Potočan, Matej; Raboch, Jiří; Taube, Māris; Welbel, Marta; Priebe, Stefan

2012-01-01

General psychiatric and forensic psychiatric beds, supported housing and the prison population have been suggested as indicators of institutionalized mental health care. According to the Penrose hypothesis, decreasing psychiatric bed numbers may lead to increasing prison populations. The study aimed to assess indicators of institutionalized mental health care in post-communist countries during the two decades following the political change, and to explore whether the data are consistent with the Penrose hypothesis in that historical context. General psychiatric and forensic psychiatric bed numbers, supported housing capacities and the prison population rates were collected in Azerbaijan, Belarus, Croatia, Czech Republic, East Germany, Hungary, Kazakhstan, Latvia, Poland, Romania, Russia and Slovenia. Percentage change of indicators over the decades 1989-1999, 1999-2009 and the whole period of 1989-2009 and correlations between changes of different indicators were calculated. Between 1989 and 2009, the number of general psychiatric beds was reduced in all countries. The decrease ranged from -11% in Croatia to -51% in East Germany. In 2009, the bed numbers per 100,000 population ranged from 44.7 in Azerbaijan to 134.4 in Latvia. Forensic psychiatric bed numbers and supported housing capacities increased in most countries. From 1989-2009, trends in the prison population ranged from a decrease of -58% in East Germany to an increase of 43% in Belarus and Poland. Trends in different indicators of institutionalised care did not show statistically significant associations. After the political changes in 1989, post-communist countries experienced a substantial reduction in general psychiatric hospital beds, which in some countries may have partly been compensated by an increase in supported housing capacities and more forensic psychiatric beds. Changes in the prison population are inconsistent. The findings do not support the Penrose hypothesis in that historical context as

Dealing food: female drug users' narratives about food in a prison place and implications for their health.

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Smoyer, Amy B; Blankenship, Kim M

2014-05-01

Prison is a major "place" for drug users in the US, yet remarkably little is known about the lived experience of incarceration. More information about prison life is needed to improve health outcomes for incarcerated and formerly incarcerated people. Thirty (30) formerly incarcerated women were interviewed about prison food. All interviews were digitally recorded and transcribed. Qualitative data analysis software was used to code and organize the data using thematic analysis. As described in these participants' narratives, prison food systems contributed to the construction of boundaries that distinguished the prison place from places and life outside the institution's walls. Participants also described boundaries within the prison that resulted in a patchwork of interior places, each with their own unique structure, meaning, and food system. These places, constructed by physical location, movement, and power, or lack thereof, included various micro-geographies that further defined women's individual prison experience. The boundaries that separated these places were not fixed: Women shifted and diminished internal and external borders by resisting food policies and reproducing their outside lives inside. These findings call for public policy officials and prison administrators to reexamine the prison place in order to facilitate healthier eating behaviors and lay the groundwork for more positive communication between inmates and correctional staff and administration. More research is needed to measure how these types of changes to the prison food environment impact nutritional, mental health, substance abuse, and criminal justice outcomes. Copyright © 2013 Elsevier B.V. All rights reserved.

Dealing food: Female drug users’ narratives about food in a prison place and implications for their health

Science.gov (United States)

Smoyer, Amy B.; Blankenship, Kim M.

2015-01-01

Background Prison is a major “place” for drug users in the US, yet remarkably little is known about the lived experience of incarceration. More information about prison life is needed to improve health outcomes for incarcerated and formerly incarcerated people. Methods Thirty (30) formerly incarcerated women were interviewed about prison food. All interviews were digitally recorded and transcribed. Qualitative data analysis software was used to code and organize the data using thematic analysis. Results As described in these participants’ narratives, prison food systems contributed to the construction of boundaries that distinguished the prison place from places and life outside the institution's walls. Participants also described boundaries within the prison that resulted in a patchwork of interior places, each with their own unique structure, meaning, and food system. These places, constructed by physical location, movement, and power, or lack thereof, included various micro-geographies that further defined women's individual prison experience. The boundaries that separated these places were not fixed: Women shifted and diminished internal and external borders by resisting food policies and reproducing their outside lives inside. Conclusion These findings call for public policy officials and prison administrators to reexamine the prison place in order to facilitate healthier eating behaviors and lay the groundwork for more positive communication between inmates and correctional staff and administration. More research is needed to measure how these types of changes to the prison food environment impact nutritional, mental health, substance abuse, and criminal justice outcomes. PMID:24412007

28 CFR 16.97 - Exemption of Bureau of Prisons Systems-limited access.

Science.gov (United States)

2010-07-01

... the health care of the inmates and the safety and security of the prisons and the public. (p) The... Mental Health Record System (JUSTICE/BOP-007). (7) Inmate Safety and Accident Compensation Record System... Mental Health Records System, (Justice/BOP-007). (o) These exemptions apply only to the extent that...

Counterintuitive findings from a qualitative study of mental health in English women’s prisons

OpenAIRE

Caulfield, L.S

2016-01-01

Purpose:- Large numbers of women in prison report significant emotional and mental health problems, and there is evidence to suggest that the prison environment may exacerbate the incidence and severity of these issues (Armour, 2012). However, there has been limited exploration of the extent to which women’s mental health problems exist prior to incarceration, whether symptoms first occur in incarceration, and how incarceration affects this. The paper aims to discuss these issues.\\ud \\ud Desi...

The efficacy of exercise referral as an intervention for Irish male prisoners presenting with mental health symptoms.

Science.gov (United States)

O'Toole, Shay; Maguire, Jim; Murphy, Pearse

2018-06-11

Purpose The use of exercise as an intervention to improve health in the general population is well documented. The purpose of this paper is to explore whether an exercise referral scheme can be an effective health promotion tool for male prisoners in Ireland, presenting with mental health symptoms. Design/methodology/approach This mixed methods study with a pre- and post-intervention design was conducted in Mountjoy Prison, Dublin, which has a capacity for approximately 790 prisoners. Reliable and validated symptom assessment scales were used to assess levels of depression, anxiety, stress, self-esteem and anger amongst a sample of 40 prisoners pre- and post-intervention. The scales used were the Depression, Anxiety and Stress scale or DASS-42 (Lovibond and Lovibond, 1995), the Novaco Anger Scale (Novaco, 1994), the Rosenberg Self-Esteem Scale ( Rosenberg, 1965 ) and the Zung Self-Rated Anxiety Scale (Zung, 1971). Semi-structured interviews were also conducted with a subset of the participants post-intervention to further test and contextualise the symptom ratings. The data gathered from the self-rating scales were imported into SPSS 22 for statistical testing for significance. Wilcoxon's signed-rank test was then used to measure significance of changes. Thematic analysis was performed on the qualitative data. Findings In the post-intervention, significant levels of improvement were achieved in the levels of depression, anxiety (DASS), anxiety (Zung), stress, anger, and self-esteem for 29 of the 30 prisoners who completed the study. The incidence of normal mood scores rose from 33 to 90 per cent after the intervention; the incidence of extremely severe scores for anxiety changed from 40 to 7 per cent, severe stress scores changed from 27 to 3 per cent, normal stress levels rose from 17 to 73 per cent, marked anger ratings reduced from 40 to 3 per cent and low self-esteem levels reduced from 20 per cent of participants pre-intervention to 7 per cent post

Forensic mental health services: Current service provision and planning for a prison mental health service in the Eastern Cape

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Kiran Sukeri

2016-05-01

Full Text Available Objectives: No research data exists on forensic psychiatric service provision in the Eastern Cape, Republic of South Africa. The objective of this research was to assess current forensic psychiatric service provision and utilisation rates at Fort England Hospital. This is important in improving and strengthening the service. A related objective was to develop a model for a provincial prison mental health service. Methodology: This study is a situational analysis of an existing forensic psychiatric service in the Eastern Cape. The design of the study was cross sectional. An audit questionnaire was utilised to collate quantitative data, which was submitted to Fort England Hospital, Grahamstown. A proposed prison mental health service was developed utilising prevalence rates of mental illness among prisoners to calculate bed and staff requirements for an ambulatory and in-patient service. Results: During the study period a total of 403 remand detainees were admitted to the forensic psychiatry division of Fort England Hospital. The average length of stay was 494 days and the bed utilisation rate was determined at 203.54%. We estimate that to provide a provincial prison mental health service to treat psychotic illnesses and major depression the province requires a 52 bedded facility and a total staff complement of approximately 31. Conclusions: Forensic psychiatric services include the assessment, management and treatment of mentally disordered persons in conflict with the law and prisoners requiring psychiatric assessments. The Eastern Cape Province does not have plans or policies to assess and manage mentally ill offenders, resulting in an increased load on available services. We recommend that an inter-departmental task team, which includes Health, Justice and Constitutional Development and Correctional Services, should be established in the province, to develop a strategy to assist in the development of an effective and efficient forensic

AIDS in Mexican prisons.

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Olivero, J M; Roberts, J B

1995-01-01

The human rights organization Americas Watch, which toured Mexican prisons, reported in 1991 that all prisoners with HIV infection in the Mexico City area were housed in a single AIDS ward in Santa Marta Prison. In 1991, the 16-bed facility had 15 patients; in 1993, this number had increased by 5. In Mexico City, with 3 prisons holding over 2000 male adults each, there were only 20 known infected prisoners in the AIDS ward at Santa Marta. In 1991, authorities at Matamoros, in the state of Tamaulipas, insisted that none of their inmates had ever been diagnosed as infected with HIV. The prison physician at Reynosa indicated that only 2 inmates since 1985 had ever been diagnosed as infected. In 1992, the prison in Saltillo, in the state of Coahuila, reported that here had yet to be a single positive test for HIV. The prison at Reynosa held 1500 people and only 2 inmates were diagnosed as having AIDS between 1985 and 1991. Prisons at Matamoros and Saltillo held similar numbers but had no experience of infected inmates. A survey of 2 prisons in the state of Tamaulipas indicates that around 12% of the population may use IV drugs, and 9% indicate sharing needles. It is possible for prisoners to die of diseases like pneumonia, associated with AIDS, without the connection to AIDS being diagnosed. Each state, and possibly each prison in Mexico, has its own particular AIDS policies. Santa Marta was the single facility in Mexico City used to house AIDS-infected prisoners, who were segregated. Finally, the prison at Saltillo required all women entering the facility to have a medical examination, including a test for HIV. High-level prison personnel have demonstrated ignorance and fear of AIDS and intolerance of infected prisoners. Mexico must reassess the need to provide adequate medical care to offenders who are sick and dying behind bars.

Intellectual disability and the prison setting

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V. Tort

2016-06-01

Full Text Available Introduction: The prevalence of intellectual disability (ID in the prison setting has scarcely been studied. Although some approximations or estimates regarding people with intellectual disabilities have been performed in Spain, there is little in the way of reliable data. Objectives: 1 To determine the prevalence of ID in a sample population in the residential modules of a Spanish prison, 2 Obtain data on the prevalence of ID in prison psychiatric units and hospitals. Methods: 1 A TONI II test was performed on a sub-sample (n = 398 of a prevalence study in Spanish prisons33 to identify inmates with intellectual disabilities. 2 We reviewed the reports of the psychiatric department of Parc Sanitari Sant Joan de Deu to establish the diagnosis at discharge of patients with a primary diagnosis of intellectual disability 3 Data from the Directorate General of Prisons on the prevalence of ID in Prison Psychiatric Hospitals was reviewed. Results: The data obtained from the TONI II test found 3.77% of the study population has an IQ below 70, and 7.54 % has a borderline IQ rate. Assessment of penitentiary psychiatric hospitalization data showed these figures to be higher. Conclusions: The data from a Spanish prison population showed that ID levels were higher than those in the community, especially amongst prisoners requiring specialized psychiatric care. What is also evident is that adequate resources are required in prisons and in the community to provide better care for people with intellectual disabilities who are in the pathway of the criminal justice system.

Interventions at the Transition from Prison to the Community for Prisoners with Mental Illness: A Systematic Review.

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Hopkin, G; Evans-Lacko, S; Forrester, A; Shaw, J; Thornicroft, G

2018-01-23

Prisoners have high rates of mental illness and the transition from prison to the community is a problematic time for the provision of mental health services and a range of negative outcomes have been identified in this period. A systematic review was conducted to identify interventions for prisoners with diagnosed mental health conditions that targeted this transition period. Fourteen papers from 13 research studies were included. The interventions identified in this review were targeted at different stages of release from prison and their content differed, ranging from Medicaid enrolment schemes to assertive community treatment. It was found that insurance coverage, and contact with mental health and other services can be improved by interventions in this period but the impact on reoffending and reincarceration is complex and interventions may lead to increased return to prison. There is a developing evidence base that suggests targeting this period can improve contact with community mental health and other health services but further high quality evidence with comparable outcomes is needed to provide more definitive conclusions. The impact of programmes on return to prison should be evaluated further to establish the effect of interventions on clinical outcomes and to clarify the role of interventions on reincarceration.

Teaching Health versus Treating Illness: The Efficacy of Three Principles Correctional Counseling with People in an English Prison.

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Kelley, Thomas M; Hollows, Jacqueline; Lambert, Eric G; Savard, Dennis M; Pransky, Jack

2017-11-01

Three principles correctional counseling (3PCC) posits that people in prison have inner mental health they have obscured to varying degrees with their own thinking. 3PCC further posits that people in prison can rekindle and sustain this inner health via understanding how three psychospiritual principles-Universal Mind, consciousness, and thought-coalesce to form people's psychological experience. We review the three principles and explain how exposure to these principles can lead to improved mental health and improved behavior. Then, we describe 3PCC and distinguish it from prevailing correctional counseling methods. Finally, we present a preliminary study that examines the efficacy of 3PCC for improving the mental health and behavior of people in an English prison. Our findings show that participants exposed to 3PCC showed a significant improvement in mental well-being and purpose in life, significant reductions in anxiety and anger, and improved behavior in the prison community.

WOMEN'S HEALTH SITUATION IN PRISON: SEXUAL AND REPRODUCTIVE RIGHTS

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Arianna Oliveira Santana Lopes

2014-12-01

Full Text Available The article discusses issues associated to women's health, since search what are the sexual and reproductive rights for women in situations of incarceration, highlighting the essentiality of these and if they are applied in Brazilian prisons. Therefore, was realized a literature review to assess the situation of the Brazilian women's prisons with regular year 2003 to 2012. When examined there was a wide disparity of reality experienced by these women by Saúde da mulher em situação de prisão: direitos sexuais e reprodutivos numerous factors, ranging from the barriers imposed by the prison as restriction on conjugal visits, the very attempt to play a role of motherhood and, of course, which drew more attention: the discrimination based on gender, since man reassembles his relationships more easily and generally leaves the companion incarcerated for cultural and social arising male sex. Concludes with the emerging need for change this situation in order to provide a better way to live in such a hostile environment to women incarcerated, where the same have their rights violated and nothing is done to such default.

Sexual Health of Prison Inmates: A Case Study of Kano Central ...

African Journals Online (AJOL)

AJRH Managing Editor

Sexual and reproductive health of prison inmates suffers from serious neglect in Nigeria. This mixed method study .... inmates using a pretested semi structured self- administered ..... Lwanga SK, Lemeshow S. Sample Size Determination in.

Systematic review of health and behavioural outcomes of smoking cessation interventions in prisons

OpenAIRE

de Andrade, Dominique; Kinner, Stuart A

2016-01-01

Objective We conducted a systematic review to examine the impact of smoking cessation interventions, including smoking bans, on prisoners and prison staff. Data sources We systematically searched health and criminal justice databases for relevant studies. Search strings were used to combine terms related to smoking cessation interventions with terms related to incarceration. We used forward and backward snowballing to capture additional studies. Study selection Studies were included if: they ...

Tobacco use, Alcohol Consumption and Self-rated Oral Health among Nigerian Prison Officials

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Clement Chinedu Azodo

2014-01-01

Conclusions: Data from this survey revealed that the majority of the participants rated their oral health as good/excellent. The prevalence of tobacco use and alcohol consumption among prison officials was higher than reported values among the general population in Nigeria. This indicates that more surveillance and intervention studies are needed to evaluate the best way to control tobacco use and alcohol consumption among prison officials in Nigeria.

Use of psychoactive substances in prison: Results of a study in the Lyon-Corbas prison, France.

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Sahajian, F; Berger-Vergiat, A; Pot, E

2017-09-01

In prison, in 2012, according to various sources, from 4 to 56% of the European inmate population used psychoactive substances (PAS). The aim of our study was to describe PAS consumption during incarceration in the prison of Lyon-Corbas, France. A transversal descriptive study was conducted between September 23rd and September 27th 2013 among all inmates of this prison. We used an anonymous self-administered questionnaire, distributed at lunchtime and collected, the same day, at dinnertime, by the mental health service personnel. Among 785 inmates present at the time of the study in the prison of Lyon-Corbas, 710 were included and the response rate was 64.4% (95% CI [60.8-67.8]). Among 457 responding inmates, 16.4% (95% CI [13.2-20.0]) reported no PAS consumption. Among 382 consumers, 74.4% (95% CI [69.8-78.5]) used tobacco, 36.8% (95% CI [32.2-41.8]) cannabis, 30.4% (95% CI [25.9-35.1]) alcohol, 7.7% (95% CI [5.2-10.6]) heroin and 10.3% (95% CI [7.5-13.6]) cocaine. Furthermore, 15% of consumers had started PAS consumption during their incarceration. Among consumers of at least one PAS other than tobacco, cannabis and alcohol, the way of consumption was sniff for 60.0% (95% CI [48.5-70.2]) and injection for 31.0% (95% CI [21.6-42.1]). Use of several PAS at the same time and sharing sniffing and/or injection paraphernalia were other risky behaviors observed; 12% (95% CI [5.8-20.4]) of drug injectors declared using chlorine to sterilize their injection paraphernalia. Our study provides worrying data about PAS consumption in prison. The measures of prohibition do not prevent this consumption. There is even an initiation of consumption of PAS for 15% of the first-time incarcerated inmates. This finding should encourage public authorities to facilitate access of inmates to the care structures in prisons, to improve drug use prevention and care programs and to develop activities (sports, cultural, educational and vocational). Copyright © 2017 Elsevier Masson SAS

On the role of correctional officers in prison mental health.

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Dvoskin, Joel A; Spiers, Erin M

2004-01-01

This article discusses the role of correctional line staff in treatment of prison inmates with serious mental illness. The authors assert that many roles and duties traditionally attributed to clinicians can and often should be performed not only by mental health professionals, but by line staff such as correctional officers and nurses. Moreover, the optimal climate for effective treatment is one in which mental health professionals and line staff work collaboratively, especially since line staff alone are in contact with inmates 24 hours per day. The specific activities which comprise mental health treatment in prison are described as: 1) counseling and psychotherapy-talking with inmates, 2) consultation-talking about inmates, 3) special housing, activities, and behavioral programs, and 4) medication. Case examples demonstrate how correctional officers, nurses, and other line staff perform each of these activities. Recognition and nurturance of these activities will improve the quality of services and reduce stress on staff and inmates alike. Consultation with line staff, joint training, and use of multi-disciplinary treatment teams are advocated as methods of reaching these goals.

[Treatment of offenders with mental disorders: focusing on prison psychiatry].

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Nakatani, Yoji

2011-01-01

Forensic mental health services exist in a nebulous space at the intersection of two different systems-criminal justice and mental health-and the entanglement of these systems poses intricate problems for psychiatrists. This article discusses the present circumstances of forensic mental health services in Japan, focusing on trends in prison psychiatry. In the traditional Japanese system, offenders with mental disorders were treated within general psychiatry as involuntarily admitted patients, or within the prison system as mentally ill inmates. As a consequence of recent legal reform, however, this situation has radically changed. The Medical Treatment and Supervision Act of 2005 aimed to provide intensive psychiatric treatment to offenders with mental disorders, attaching great importance to their reintegration into society. Under the new system, a person who commits a serious criminal offense in a state of insanity or diminished capacity shall be referred by the public prosecutor to the district court; following a treatment order of the court, the person shall be treated in psychiatric facilities established by the law. While the new system is expected to play a role in the context of specialist forensic psychiatry, its distinction from general psychiatry remains unclear. For example, persons who commit serious crimes, such as assault, in an acute psychotic state are occasionally admitted to general psychiatric hospitals, even if they meet the criteria for a treatment order under the Medical Treatment and Supervision Act. The relationship between prison psychiatry and specialist forensic psychiatry is still more problematic. Compared to the intensive, rehabilitation-oriented care provided under the Medical Treatment and Supervision Act, mental health services in penal institutions have a number of disadvantages, and it is unlikely that mentally ill prisoners have benefited from the recent progress in forensic psychiatry. Statistics show that the number of

Discharges to prison from medium secure psychiatric units in England and Wales.

Science.gov (United States)

Doyle, Michael; Coid, Jeremy; Archer-Power, Laura; Dewa, Lindsay; Hunter-Didrichsen, Alice; Stevenson, Rachel; Wainwright, Verity; Kallis, Costas; Ullrich, Simone; Shaw, Jenny

2014-09-01

Early findings from a national study of discharges from 32 National Health Service medium secure units revealed that nearly twice as many patients than expected were discharged back to prison. To compare the characteristics of those discharged back to prison with those discharged to the community, and consider the implications for ongoing care and risk. Prospective cohort follow-up design. All forensic patients discharged from 32 medium secure units across England and Wales over a 12-month period were identified. Those discharged to prison were compared with those who were discharged to the community. Nearly half of the individuals discharged to prison were diagnosed with a serious mental illness and over a third with schizophrenia. They were a higher risk, more likely to have a personality disorder, more symptomatic and less motivated than those discharged to the community. Findings suggest that alternative models of prison mental healthcare should be considered to reduce risks to the patient and the public. Royal College of Psychiatrists.

Field study of the indoor environment in a Danish prison

DEFF Research Database (Denmark)

Dogbeh, Audrey; Jomaas, Grunde; Bjarløv, Søren Peter

2015-01-01

The indoor environment in a Danish prison was evaluated based on measurements made during the summer season of temperature, relative humidity and carbon dioxide, as well as through carefully conducted surveys among the inmates. The temperatures in the cells were high and well beyond common levels...... a compromise must be found to ensure that the building can comply with minimum health and comfort standards. The findings of this study can be used as background for recommendations for renovation of prison buildings.......The indoor environment in a Danish prison was evaluated based on measurements made during the summer season of temperature, relative humidity and carbon dioxide, as well as through carefully conducted surveys among the inmates. The temperatures in the cells were high and well beyond common levels...... in Danish buildings. The mean CO2 concentrations were generally low, but reached high maximum levels up to 5000 ppm. Thirty-one inmates responded to the questionnaire. They spent on average 19 h in the cell per day (range 12–23 h). Sixty-nine percent of the inmates expressed dissatisfaction...

Implementing two nurse practitioner models of service at an Australian male prison: A quality assurance study.

Science.gov (United States)

Wong, Ides; Wright, Eryn; Santomauro, Damian; How, Raquel; Leary, Christopher; Harris, Meredith

2018-01-01

To examine the quality and safety of nurse practitioner services of two newly implemented nurse practitioner models of care at a correctional facility. Nurse practitioners could help to meet the physical and mental health needs of Australia's growing prison population; however, the nurse practitioner role has not previously been evaluated in this context. A quality assurance study conducted in an Australian prison where a primary health nurse practitioner and a mental health nurse practitioner were incorporated into an existing primary healthcare service. The study was guided by Donabedian's structure, processes and outcomes framework. Routinely collected information included surveys of staff attitudes to the implementation of the nurse practitioner models (n = 21 staff), consultation records describing clinical processes and time use (n = 289 consultations), and a patient satisfaction survey (n = 29 patients). Data were analysed descriptively and compared to external benchmarks where available. Over the two-month period, the nurse practitioners provided 289 consultations to 208 prisoners. The presenting problems treated indicated that most referrals were appropriate. A significant proportion of consultations involved medication review and management. Both nurse practitioners spent more than half of their time on individual patient-related care. Overall, multidisciplinary team staff agreed that the nurse practitioner services were necessary, safe, met patient need and reduced treatment delays. Findings suggest that the implementation of nurse practitioners into Australian correctional facilities is acceptable and feasible and has the potential to improve prisoners' access to health services. Structural factors (e.g., room availability and limited access to prisoners) may have reduced the efficiency of the nurse practitioners' clinical processes and service implementation. Results suggest that nurse practitioner models can be successfully integrated into a

Challenges for Canada in meeting the needs of persons with serious mental illness in prison.

Science.gov (United States)

Simpson, Alexander I F; McMaster, Jeffry J; Cohen, Steven N

2013-01-01

The number of prison inmates is predicted to rise in Canada, as is concern about those among them with mental illness. This article is a selective literature review of the epidemiology of serious mental illness (SMI) in prisons and how people with SMI respond to imprisonment. We review the required service components with a particular focus on care models for people with SMI in the Canadian correctional system. An estimated 15 to 20 percent of prison inmates have SMI, and this proportion may be increasing. The rate of incarceration of aboriginal people is rising. Although treatment in prison is effective, it is often unavailable or refused. Many of those with SMI are lost to follow-up within months of re-entering the community. There is much policy and service development aimed at improving services in Canada. However, the multijurisdictional organization of health care and the heterogeneity of the SMI population complicate these developments.

A randomized controlled trial of prison-initiated buprenorphine: prison outcomes and community treatment entry.

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Gordon, Michael S; Kinlock, Timothy W; Schwartz, Robert P; Fitzgerald, Terrence T; O'Grady, Kevin E; Vocci, Frank J

2014-09-01

Buprenorphine is a promising treatment for heroin addiction. However, little is known regarding its provision to pre-release prisoners with heroin dependence histories who were not opioid-tolerant, the relative effectiveness of the post-release setting in which it is provided, and gender differences in treatment outcome in this population. This is the first randomized clinical trial of prison-initiated buprenorphine provided to male and female inmates in the US who were previously heroin-dependent prior to incarceration. A total of 211 participants with 3-9 months remaining in prison were randomized to one of four conditions formed by crossing In-Prison Treatment Condition (received buprenorphine vs. counseling only) and Post-release Service Setting (at an opioid treatment center vs. a community health center). Outcome measures were: entered prison treatment; completed prison treatment; and entered community treatment 10 days post-release. There was a significant main effect (p=.006) for entering prison treatment favoring the In-Prison buprenorphine Treatment Condition (99.0% vs. 80.4%). Regarding completing prison treatment, the only significant effect was Gender, with women significantly (pPrison buprenorphine Treatment Condition (47.5% vs. 33.7%). Buprenorphine appears feasible and acceptable to prisoners who were not opioid-tolerant and can facilitate community treatment entry. However, concerns remain with in-prison treatment termination due to attempted diversion of medication. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Changes in the Provision of Institutionalized Mental Health Care in Post-Communist Countries

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Mundt, Adrian P.; Frančišković, Tanja; Gurovich, Isaac; Heinz, Andreas; Ignatyev, Yuriy; Ismayilov, Fouad; Kalapos, Miklós Péter; Krasnov, Valery; Mihai, Adriana; Mir, Jan; Padruchny, Dzianis; Potočan, Matej; Raboch, Jiří; Taube, Māris; Welbel, Marta; Priebe, Stefan

2012-01-01

Background General psychiatric and forensic psychiatric beds, supported housing and the prison population have been suggested as indicators of institutionalized mental health care. According to the Penrose hypothesis, decreasing psychiatric bed numbers may lead to increasing prison populations. The study aimed to assess indicators of institutionalized mental health care in post-communist countries during the two decades following the political change, and to explore whether the data are consistent with the Penrose hypothesis in that historical context. Methodology/Principal Findings General psychiatric and forensic psychiatric bed numbers, supported housing capacities and the prison population rates were collected in Azerbaijan, Belarus, Croatia, Czech Republic, East Germany, Hungary, Kazakhstan, Latvia, Poland, Romania, Russia and Slovenia. Percentage change of indicators over the decades 1989–1999, 1999–2009 and the whole period of 1989–2009 and correlations between changes of different indicators were calculated. Between 1989 and 2009, the number of general psychiatric beds was reduced in all countries. The decrease ranged from −11% in Croatia to −51% in East Germany. In 2009, the bed numbers per 100,000 population ranged from 44.7 in Azerbaijan to 134.4 in Latvia. Forensic psychiatric bed numbers and supported housing capacities increased in most countries. From 1989–2009, trends in the prison population ranged from a decrease of −58% in East Germany to an increase of 43% in Belarus and Poland. Trends in different indicators of institutionalised care did not show statistically significant associations. Conclusions/Significance After the political changes in 1989, post-communist countries experienced a substantial reduction in general psychiatric hospital beds, which in some countries may have partly been compensated by an increase in supported housing capacities and more forensic psychiatric beds. Changes in the prison population are inconsistent

Nurses' experience of caring for inmate patients.

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Weiskopf, Constance S

2005-02-01

The aim of this paper is to report the findings of a study of the experience of caring for prisoners through examining the everyday experience of nurses' delivering health care to inmate patients in a correctional setting. Prisons are most often viewed as places for punishment, while the goals of health and healing, and prevention of diseases in correctional facilities are often neglected. Nurses who deliver health care to prisoners are challenged to do so in a caring relationship that will facilitate their health and healing. The literature on the nature of prison nursing indicates that delivering health care to inmates must be carefully balanced against the need for security, and is affected by factors such as custody staff values, staff education, nursing management, and organizational practices. In-depth interviews were carried out with nine Registered Nurses who had been employed in a variety of correctional institutions throughout their careers, and analysed thematically using Colaizzi's phenomenological method. Findings. Nurses' caring was experienced as an attempt to negotiate the boundaries between the cultures of custody and caring. Facing complex challenges and a number of limitations on the nurse-patient relationship, nurses strived to find a way to care for their inmate patients. Environmental risk meant that caution and vigilance were essential and these nurses demonstrated courage and persevered for the sake of their inmate patients. The findings make clear the challenging and frustrating experience of nurses' caring for inmate patients in restrictive settings. As a result, there are implications for nursing practice, education, and research to assure the best possible health outcomes for inmate patients, the integrity of caring nursing practice, and the safety of both nurses and patients.

Prisoners' Perception of Legitimacy of the Prison Staff: A Qualitative Study in Slovene Prisons.

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Hacin, Rok; Meško, Gorazd

2018-02-01

The purpose of this article is to explore prisoners' perception of legitimacy of prison staff and examine the compliance of prisoners with the authority of prison staff to highlight the differences between instrumental and normative compliance of prisoners. This study draws on data collected from a random sample of 193 prisoners in all Slovene prisons. Using a qualitative approach based on structured interviews, our findings suggest that distributive justice, procedural justice, the quality of relations with prison staff, and the effectiveness of prison staff influence prisoners' perception of legitimacy in a prison environment. Several prisoners comply with prison rules because they fear sanctions, which indicates their instrumental compliance, while normative compliance was reported by prisoners who perceived the legitimacy of prison staff in a more positive manner. Overall findings indicate that both instrumental and normative compliance of prisoners can be observed in Slovene prisons.

Prison staff and prisoner views on a prison smoking ban: evidence from the Tobacco in Prisons Study.

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Brown, Ashley; Sweeting, Helen; Logan, Greig; Demou, Evangelia; Hunt, Kate

2018-05-15

In jurisdictions permitting prisoner smoking, rates are high (c75%), with smoking embedded in prison culture, leading to secondhand smoke exposures among staff and prisoners and challenges for smoking cessation. Momentum is building to ban smoking in prisons, but research on staff and prisoner views is lacking. We address this gap, providing evidence on staff and prisoner views throughout all Scottish prisons. Data were collected prior to announcement of a (November 2018) prison smoking ban throughout Scotland. Mixed methods were used: surveys of staff (online, N=1,271, ~27%) and prisoners (questionnaire, N=2,512, ~34%); 17 focus groups and two paired interviews with staff in 14 prisons. Staff were more positive than prisoners about bans and increased smoking restrictions, although prisoner views were more favourable should e-cigarettes be permitted. Non-smokers were more positive than smokers. Whilst 74% staff and 22% prisoners agreed bans were a good idea, both groups acknowledged implementation and enforcement challenges. Staff views were influenced by beliefs about: acceptability of the policy in principle; and whether/how bans could be achieved. Although some voiced doubts about smoke-free policies, staff likened a ban to other operational challenges. Staff raised concerns around needs for appropriate measures, resources and support, adequate lead-in time, and effective communication prior to a ban. We recommend that regular and open opportunities for dialogue within and between different stakeholder groups are created when preparing for prison smoking bans, and that specific measures to address staff and prisoner concerns are incorporated into plans to create and maintain smoke-free environments. To our knowledge, this study is the first to research staff and prisoner views across a whole prison system prior to implementation of smoke-free policies. The results highlight potential challenges and suggest measures which might help to maximise the success of

Forcible feeding in English prisons. 1910.

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Dock, Lavinia L

2014-11-01

Editor's note: From its first issue in 1900 through to the present day, AJN has unparalleled archives detailing nurses' work and lives for more than a century. These articles not only chronicle nursing's growth as a profession within the context of the events of the day, but they also reveal prevailing societal attitudes about women, health care, and human rights. Today's nursing school curricula rarely include nursing's history, but it's a history worth knowing. To this end, From the AJN Archives will be a frequent column, containing articles selected to fit today's topics and times. This month's article, from the March 1910 issue, addresses the force-feeding of female political prisoners in Great Britain. It was written by nurse and social activist Lavinia Dock, a cofounder of the Nurses Associated Alumnae (which later became the American Nurses Association) and the International Council of Nurses and a contributing editor to AJN. Dock wrote, "Among the prisoners thus cruelly treated have been several nurses." She shared physicians' outrage that the Home Office ordered the force-feeding but tried to place responsibility for the practice entirely on prison physicians. More than a century later, the force-feeding of political prisoners continues to raise ethical and legal issues within the nursing and medical communities (see "Ethical Issues for Nurses in Force-Feeding Guantánamo Bay Detainees" in this issue).

Smoking-Related Behaviors and Effectiveness of Smoking Cessation Therapy Among Prisoners and Prison Staff.

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Turan, Onur; Turan, Pakize Ayse

2016-04-01

Smoking is a serious problem in prisons. This work aimed to assess smoking-related behaviors and the effectiveness of tobacco cessation therapy in prison. This study includes four visits to a prison in Bolvadin-Afyon, Turkey. Pharmacologic options for tobacco cessation were offered to the participants who wanted to quit smoking. One hundred seventy-nine subjects (109 prisoners and 70 prison staff) with 68.7% current smokers were included. There was an increase of cigarette smoking in 41.8% (the most common reason was stress) and decrease in 18.7% (the most common reason was health problems) of the participants after incarceration. Fifty-nine participants accepted the offered tobacco cessation treatment. Only 2 participants started their planned medications, but they could not quit smoking. The most common reason for failed attempts to quit was the high prices of cessation therapies. Factors like stress and being in prison may provoke smoking. A smoking ban does not seem to be a total solution for preventing tobacco use in prisons. Tobacco cessation programs may be a better option. Cost-free cessation medications may increase quitting rates among prisoners and prison staff. Copyright © 2016 by Daedalus Enterprises.

Prison officers' views about hepatitis C testing and treatment: a qualitative enquiry.

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Jack, Kathryn; Islip, Natalie; Linsley, Paul; Thomson, Brian; Patterson, Anne

2017-07-01

To explore the views of prison officers in an English category B male prison about people in prison being tested and treated for hepatitis C. Hepatitis C testing and treatment in English prisons remain low with the reasons being poorly understood. Prison officers are in continuous contact with prisoners so might observe factors that may influence people in prisons' choice in whether to accept hepatitis C testing and treatment. A qualitative design within an interpretative framework was employed. Semistructured interviews were conducted with 10 prison officers at an English male category B prison. The interviews were audiorecorded and transcribed at the prison. Four themes emerged Safeguarding, Stigma, Confidentiality and Education. Hepatitis C testing and treatment were supported in principle but if a person in prison poses a threat to the overall security of a prison, any health issues that are not immediately life threatening will be overridden, irrespective of the financial or health consequences. The prison officers respected people in prisons' confidentiality regarding health matters, but this could be compromised during violent incidents. All of the prison officers displayed limited knowledge about hepatitis C. This qualitative enquiry illustrates that prison security transcends health. This suggests that health providers may need to offer greater flexibility and collaboration across the network of National Health Service hospitals to maintain continuity in treatment if a prisoner is moved to a different establishment or liberated. This study introduces the notion that prison security staff may have a potential role in promoting or discouraging hepatitis C testing and treatment by the ways in which their knowledge impacts on their interactions with people in prison. Engaging this staff group in educational opportunities should be a component of commissioned hepatitis service delivery in prisons. © 2016 John Wiley & Sons Ltd.

Inside the nation’s largest mental health institution: a prevalence study in a state prison system

Directory of Open Access Journals (Sweden)

Tala Al-Rousan

2017-04-01

Full Text Available Abstract Background The United States has the highest incarceration rate in the world which has created a public health crisis. Correctional facilities have become a front line for mental health care. Public health research in this setting could inform criminal justice reform. We determined prevalence rates for mental illnesses and related comorbidities among all inmates in a state prison system. Methods Cross-sectional study using the Iowa Corrections Offender Network which contains health records of all inmates in Iowa. The point prevalence of both ICD-9 and DSM-IV codes for mental illnesses, timing of diagnosis and interval between incarceration and mental illness diagnosis were determined. Results The average inmate (N = 8574 age was 36.7 ± 12.4 years; 17% were ≥50 years. The majority of inmates were men (91% and white (65%.Obesity was prevalent in 38% of inmates, and 51% had a history of smoking. Almost half of inmates were diagnosed with a mental illness (48%, of whom, 29% had a serious mental illness (41% of all females and 27% of all males, and 26% had a history of a substance use disorder. Females had higher odds of having both a mental illness and substance use disorder. Almost all mental illness diagnoses were first made during incarceration (99%. The mean interval to diagnosis of depression, anxiety, PTSD and personality disorders were 26, 24, 21 and 29 months respectively. Almost 90% of mental illnesses were recognized by the 6th year of incarceration. The mean interval from incarceration to first diagnosis (recognition of a substance abuse history was 11 months. Conclusions There is a substantial burden of mental illness among inmates. Racial, age and gender disparities in mental health care are coupled with a general delay in diagnosis and treatment. A large part of understanding the mental health problem in this country starts at prisons.

The HIV Prison Paradox: Agency and HIV-Positive Women's Experiences in Jail and Prison in Alabama.

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Sprague, Courtenay; Scanlon, Michael L; Radhakrishnan, Bharathi; Pantalone, David W

2017-08-01

Incarcerated women face significant barriers to achieve continuous HIV care. We employed a descriptive, exploratory design using qualitative methods and the theoretical construct of agency to investigate participants' self-reported experiences accessing HIV services in jail, in prison, and post-release in two Alabama cities. During January 2014, we conducted in-depth interviews with 25 formerly incarcerated HIV-positive women. Two researchers completed independent coding, producing preliminary codes from transcripts using content analysis. Themes were developed iteratively, verified, and refined. They encompassed (a) special rules for HIV-positive women: isolation, segregation, insults, food rationing, and forced disclosure; (b) absence of counseling following initial HIV diagnosis; and (c) HIV treatment impediments: delays, interruption, and denial. Participants deployed agentic strategies of accommodation, resistance, and care-seeking to navigate the social world of prison and HIV services. Findings illuminate the "HIV prison paradox": the chief opportunities that remain unexploited to engage and re-engage justice-involved women in the HIV care continuum.

Ethics in research involving prisoners.

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Pont, Jörg

2008-01-01

Research involving prisoners repeatedly went astray during the last century, culminating in the cruel medical experiments inside the Nazi concentration camps that gave rise to the Nuremberg Code. However, prisoners continued to become victims of scientific exploitation by the rapidly evolving biomedical research industry. The common roots of these abuses were the flawed philosophy that the needs of the society outweigh the needs of the individual and the researchers' view that prisoners are cheap, easy to motivate and stable research subjects. Prisoners are vulnerable to exploitation and abuse by research because their freedom for consent can easily be undermined, and because of learning disabilities, illiteracy and language barriers prevailing within prisoner populations. Therefore, penal laws of some countries supported by a number of internationally agreed documents prohibit research involving prisoners completely. However, prisoners must also be regarded as vulnerable to the specific health problems in prisons, e.g. transmissible diseases, mental disorders and suicide - problems that need to be addressed by research involving prisoners. Additionally, the participation of prisoner patients in research they directly can benefit from should be provided. Hence, it must be a common objective to find the right balance between protection from exploitation and access to research beneficial to prisoners.

"Up yours": smuggling illicit drugs into prison.

Science.gov (United States)

George, Sanju; Clayton, Steve; Namboodiri, Vasudevan; Boulay, Sylvie

2009-01-01

A significant proportion of patients who are heroin-dependant and receiving treatment in the community serve prison sentences at some point in their lives, meaning their treatment continues "on the inside". Although prison inmates are promised the same quality of care as they would get "on the outside", this is not always the case. Some drawbacks of the drug treatments offered in prisons can lead to people smuggling drugs into prisons. The present work describes how a patient, who is heroin dependant and attending a community drug and alcohol team for methadone maintenance treatment, smuggled methadone and heroin into prison, his reasons for doing that, his personal description of the extent of drug use in prisons and finally what can be done to stop it from treatment and policy perspectives. Drug misuse is common in prisons. Much more can be done at treatment and policy levels to prevent people smuggling drugs into prison.

Accounting for psychotropic medication changes in prisons: patient and doctor perspectives.

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Hassan, Lamiece; Edge, Dawn; Senior, Jane; Shaw, Jenny

2015-07-01

Psychotropic medicines are widely used to treat mental illness; however, people entering prison commonly report that prescribed psychotropic medicines are changed or withdrawn, adding to their distress in difficult times. Drawing on three extracts from a larger qualitative dataset in which patients and doctors were interviewed about psychotropic medication use in English prisons, we combined discursive psychological and Foucauldian discourse analysis techniques to examine how individuals accounted for medication changes. Patients used four discursive strategies to organize descriptions of medication changes: they established entitlement to psychotropic medication, questioned the clinical judgment of prison doctors; highlighted communication problems; and attributed negative health outcomes to medication regime changes. In contrast, we examined an effective defense by a general practitioner, which showed how clinical needs were prioritized over previously held prescriptions when making prescribing decisions. Wider implications for continuity and equivalence of care between prisons and the wider community are discussed. © The Author(s) 2014.

Is it morally permissible for hospital nurses to access prisoner-patients' criminal histories?

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Neiman, Paul

2016-01-01

In the United States, information about a person's criminal history is accessible with a name and date of birth. Ruth Crampton has studied nurses' care for prisoner-patients in hospital settings and found care to be perfunctory and reactive. This article examines whether it is morally permissible for nurses in hospital settings to access information about prisoner-patients' criminal histories. Nurses may argue for a right to such information based on the right to personal safety at work or the obligation to provide prisoner-patients with the care that they deserve. These two arguments are considered and rejected. It is further argued that accessing information about a prisoner-patient's criminal history violates nurses' duty to care. Care, understood through Sarah Ruddick's account as work and relationship, requires nurses to be open and unbiased in order to do their part in forming a caring relationship with patients. Knowledge of a prisoner-patient's criminal history inhibits the formation of this relationship and thus violates nurses' duty to care.

Exploring differences in healthcare utilization of prisoners in the Canton of Vaud, Switzerland.

Directory of Open Access Journals (Sweden)

Karine Moschetti

Full Text Available Prison healthcare is an important public health concern given the increasing healthcare needs of a growing and aging prison population, which accumulates vulnerability factors and suffers from higher disease prevalence than the general population. This study identifies the key factors associated with outpatient general practitioner (GP, nursing or psychiatric healthcare utilization (HCU within prisons. Cross-sectional data systematically collected by the prison medical staff were obtained for a sample of 1664 adult prisoners of the Canton of Vaud, Switzerland, for the year 2011. They contain detailed information on demographics (predisposing factors, diagnosed chronic somatic and psychiatric disorders (needs factors, as well as prison stay characteristics (contextual factors. For GP, nurse and psychiatric care, two-part regressions are used to model separately the probability and the volume of HCU. Predisposing factors are generally not associated with the probability to use healthcare services after controlling for needs factors. However, female inmates use higher volumes of care, and the volume of GP consultations increases with age. Chronic somatic and psychiatric conditions are the most important predictors of the probability of HCU, but associations with volumes differ in their magnitude and significance across disease groups. Infectious, musculoskeletal, nervous and circulatory diseases actively mobilize GP and nursing staff. Schizophrenia, illicit drug and pharmaceuticals abuse are strongly positively associated with psychiatric and nurse HCU. The occupancy rate displays positive associations among contextual factors. Prison healthcare systems face increasingly complex organizational, budgetary and ethical challenges. This study provides relevant insights into the HCU patterns of a marginalized and understudied population.

Old and dangerous: Prison and dementia.

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Cipriani, Gabriele; Danti, Sabrina; Carlesi, Cecilia; Di Fiorino, Mario

2017-10-01

Older prisoners are the fastest growing group of prisoners in many countries. The purpose of this study is to explore the phenomenon of detention of persons suffering from dementia. Medline searches were conducted for relevant articles, chapters and books published until August 2016. Search terms included dementia, elderly, prison and criminal. Publications found through this indexed search were reviewed for further relevant references. As results, there is a lack of data about elderly with dementia in prisons. Given the rise in the average age, it is reasonable to hypothesize that the number of older prisoners is growing. Moreover, some elderly are imprisoned with a concomitant cognitive impairment or psychiatric disorder while others will develop such diseases once incarcerated. At the present time, legal and social systems seem unprepared to handle the phenomenon of dementia in prison. As proposal, health assessments for older first time offenders should become a practice inside the correctional facilities and include an evaluation for specific health issues, such as psychiatric comorbidity and cognitive impairment. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Sex in prisons--a management guide.

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Awofeso, Niyi; Naoum, Raymond

2002-01-01

Prisons are invariably unisex institutions where, besides many deprivations, heterosexual expression in its normal sense is absent. It is this characteristic that make prisons settings potentially fertile grounds for sexual aberrations. Since definite and accurate data concerning sexual activities among prison inmates are difficult to obtain, the phenomenon of sexual practices in prisons has traditionally been a topic of much speculation. However, the descriptions and explanations of most authors on the subject are often contradictory, and some of the best information are from unpublished sources. This article is an attempt to subsume many fragmented explanations about seven main types of sexual issues in prisons (i.e. consensual homosexuality, masturbation, transsexualism, prostitution, conjugal visits, sex between prisoners and prison staff, and rape among prison inmates) under more general criminological and management concepts. Suggestions for prison administrators on how to manage these complex issues in the best interests of security and inmates' health are also provided.

Tuberculosis and HIV control in sub-Saharan African prisons: "thinking outside the prison cell".

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Reid, Stewart E; Topp, Stephanie M; Turnbull, Eleanor R; Hatwiinda, Sisa; Harris, Jennifer B; Maggard, Katie R; Roberts, Sarah T; Krüüner, Annika; Morse, Jill C; Kapata, Nathan; Chisela, Chileshe; Henostroza, German

2012-05-15

Tuberculosis is one of the fastest-growing epidemics in prison populations in sub-Saharan Africa (SSA), constituting a threat to both inmates and the wider community. Various factors have contributed to the breakdown of tuberculosis control in prison facilities in SSA, including slow and insensitive diagnostics, failing prison infrastructure, inadequate funding, and weak prevention and treatment interventions for human immunodeficiency virus (HIV). In this article, we describe the challenges inherent in current approaches to tuberculosis control in prisons and consider the alternatives. We argue that although improved implementation of conventional tuberculosis control activities is necessary, considerable investment in a broader range of public health interventions, including infrastructure and staffing upgrades, cutting-edge tuberculosis diagnostics, and combination prevention for HIV, will be equally critical. This combination response to tuberculosis in prisons will be essential for tackling existing and nascent prison tuberculosis epidemics and will require high-level political support and financing.

Protecting prisoners' autonomy with advance directives: ethical dilemmas and policy issues.

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Andorno, Roberto; Shaw, David M; Elger, Bernice

2015-02-01

Over the last decade, several European countries and the Council of Europe itself have strongly supported the use of advance directives as a means of protecting patients' autonomy, and adopted specific norms to regulate this matter. However, it remains unclear under which conditions those regulations should apply to people who are placed in correctional settings. The issue is becoming more significant due to the increasing numbers of inmates of old age or at risk of suffering from mental disorders, all of whom might benefit from using advance directives. At the same time, the closed nature of prisons and the disparate power relationships that characterise them mean that great caution must be exercised to prevent care being withdrawn or withheld from inmates who actually want to receive it. This paper explores the issue of prisoners' advance directives in the European context, starting with the position enshrined in international and European law that prisoners retain all their human rights, except the right to liberty, and are therefore entitled to self-determination regarding health care decisions.

A Study of Prisonization among Danish Prisoners

DEFF Research Database (Denmark)

Kjær Minke, Linda

2012-01-01

It is well documented that imprisonment implies socialization to prison culture. This particular kind of socialization to prison culture is defined as prisonization. This article shed lights on how this process of prisonization occur and in which way does it affect the prisoner and if anything...... could be done to avoid prisonization....

The role of the physician: Eugene Sanger and a standard of care at the Elmira prison camp.

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Waggoner, Jesse

2008-01-01

The conduct of American military physicians in prisoner of war (POW) camps has been called into question by the abuse scandals at Abu Ghraib and Guantánamo Bay. This essay explores the experiences of the first U.S. military physicians to confront POW patients in large numbers-events that occurred during the American Civil War. While POWs received sub-standard care in camps north and south, the war also saw the issuance of the first document to outline the rights of POWs. This ambivalence toward the proper care and treatment of the POW is evident in the career of Dr. Eugene Sanger, the first Union surgeon at the prison camp in Elmira, New York. Sanger demonstrated both concern about the sanitary condition of the camp and pride in the deaths of POWs as furthering the overall war aims. His cruelty attracted some censure, but Sanger never faced disciplinary action. He was honorably discharged and went on to become the Surgeon General of his home state. This article places his actions at Elmira in the context of medical ethics, Army orders, and Northern opinion in 1864, and it will argue that the lack of Federal response to Eugene Sanger's poor record while serving at the prison set a precedent for inferior medical care of POWs by American military physicians.

Health at work and coping with stress of prison officers

Directory of Open Access Journals (Sweden)

Ewa Sygit–Kowalkowska

2017-02-01

Full Text Available Background The aim of the study was to assess the state of mental and physical health and the expressed strategies for coping with stress of prison officers which are a group that is relatively unknown and seldom subjected to the tests. Among the coping strategies, the authors also identified those that were predictors of mental and physical well-being at work men working professionally in penitentiary institutions. Material and Methods The sample consisted of 90 prison officers working in the security department who are in direct contact with inmates. The control group consisted of 85 men working in services and trade in the Kujawsko-Pomorskie Voivodeship (Poland, chosen by the authors as a result of intentional selection. The study used the following tools: "Psychosocial Working Conditions" Questionnaire by R. Cieślak, M. Widerszal – Bazyl, Mini-COPE Questionnaire by C.S. Carver, adapted to Poland by Z. Juczyński and N. Ogińska-Bulik. Socio-demographic data were also collected. The results were compared with a group of men working outside the uniformed services. Results In the group of prison officers, longer seniority was associated with a statistically significant deterioration of mental and physical well-being. Based on higher level of seeking support in stressful situations as well as a lower level of helplessness, one could predict a higher general level of physical and mental well-being. Conclusions Due to the character of the work and the risk of negative phenomena is important broad-based health promotion in this occupational group.

Assisted suicide for prisoners? Stakeholder and prisoner perspectives.

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Shaw, David M; Elger, Bernice S

2016-09-01

For a wider project on aging in prison, the authors interviewed 35 older prisoners and 24 stakeholders (prison staff, prison healthcare professionals, and policy makers) about healthcare for prisoners. In all, 6 prisoners and 3 stakeholders spontaneously expressed their attitudes concerning assisted suicide. Some prisoners seek assisted suicide for medical reasons and others because they regard spending the rest of their lives in prison as undignified. However, stakeholders identified several ethical and practical challenges in providing assisted suicide to prisoners. This article presents these perspectives on assisted suicide in prison and provides an ethical analysis of the issues raised.

HIV and infectious disease care in jails and prisons: breaking down the walls with the help of academic medicine.

Science.gov (United States)

Flanigan, Timothy P; Zaller, Nickolas; Taylor, Lynn; Beckwith, Curt; Kuester, Landon; Rich, Josiah; Carpenter, Charles C J

2009-01-01

Health care within correctional facilities has traditionally been marginalized from excellence in academic medicine. The armamentarium of a medical school, which includes excellence in research, teaching and clinical care, can be successfully applied to the correctional setting both in the United States and internationally. At any one time, there are over 2 million people incarcerated in the US who are disproportionately poor and from communities of color. Rates of human immunodeficiency virus (HIV) and hepatitis C virus infection (HCV) in prisons are 5 and 17-28-times higher than in the general population, respectively. The correctional setting provides an excellent opportunity to screen for and treat sexually transmitted infections (STIs), HIV, HCV, chronic hepatitis B virus (HBV) infections and tuberculosis (TB) and to develop effective prevention programs.

Interventions to increase testing, linkage to care and treatment of hepatitis C virus (HCV) infection among people in prisons: A systematic review.

Science.gov (United States)

Kronfli, Nadine; Linthwaite, Blake; Kouyoumdjian, Fiona; Klein, Marina B; Lebouché, Bertrand; Sebastiani, Giada; Cox, Joseph

2018-04-28

While the burden of chronic hepatitis C virus (HCV) infection is significantly higher among people in prisons compared to the general population, testing and treatment uptake remain suboptimal. The aim of this systematic review was to synthesize evidence on the effectiveness of interventions to increase HCV testing, linkage to care and treatment uptake among people in prisons. We searched Medline (Ovid 1996-present), Embase (Ovid 1996-present), and the Cochrane Central Register of Controlled Trials for English language articles published between January 2007 and November 2017. Studies evaluating interventions to enhance HCV testing, linkage to care and treatment uptake for people in prison were included. Two independent reviewers evaluated articles selected for full-text review. Disagreements were resolved by consensus. A total of 475 unique articles were identified, 29 were eligible for full text review, and six studies were included. All but one study was conducted in the pre-direct-acting antiviral (DAA) era; no studies were conducted in low- or middle-income countries. Of the six studies, all but one focused on testing. Only two were randomised controlled trials; the remaining were single arm studies. Interventions to enhance HCV testing in prison settings included combination risk-based and birth-cohort screening strategies, on-site nurse-led opt-in screening clinics with pre-test counselling and education, and systematic dried blood spot testing. All interventions increased HCV testing, but risk of study bias was high in all studies. Interventions to enhance linkage to care included facilitated referral for HCV assessment and scheduling of specialist appointments; however, risk of study bias was critical. There is a lack of recent data on interventions to improve the HCV care cascade in people in prisons. With the introduction of short-course, well-tolerated DAAs, rigorous controlled studies evaluating interventions to improve testing, linkage and treatment

“Up yours”: smuggling illicit drugs into prison

Science.gov (United States)

George, Sanju; Clayton, Steve; Namboodiri, Vasudevan; Boulay, Sylvie

2009-01-01

A significant proportion of patients who are heroin-dependant and receiving treatment in the community serve prison sentences at some point in their lives, meaning their treatment continues “on the inside”. Although prison inmates are promised the same quality of care as they would get “on the outside”, this is not always the case. Some drawbacks of the drug treatments offered in prisons can lead to people smuggling drugs into prisons. The present work describes how a patient, who is heroin dependant and attending a community drug and alcohol team for methadone maintenance treatment, smuggled methadone and heroin into prison, his reasons for doing that, his personal description of the extent of drug use in prisons and finally what can be done to stop it from treatment and policy perspectives. Drug misuse is common in prisons. Much more can be done at treatment and policy levels to prevent people smuggling drugs into prison. PMID:21954402

What do prisoners eat? Nutrient intakes and food practices in a high-secure prison.

Science.gov (United States)

Hannan-Jones, Mary; Capra, Sandra

2016-04-01

There are limited studies on the adequacy of prisoner diet and food practices, yet understanding these are important to inform food provision and assure duty of care for this group. The aim of this study was to assess the dietary intakes of prisoners to inform food and nutrition policy in this setting. This research used a cross-sectional design with convenience sampling in a 945-bed male high-secure prison. Multiple methods were used to assess food available at the group level, including verification of food portion, quality and practices. A pictorial tool supported the diet history method. Of 276 eligible prisoners, 120 dietary interviews were conducted and verified against prison records, with 106 deemed plausible. The results showed the planned food to be nutritionally adequate, with the exception of vitamin D for older males and long-chain fatty acids, with Na above upper limits. The Australian dietary targets for chronic disease risk were not achieved. High energy intakes were reported with median 13·8 (se 0·3) MJ. Probability estimates of inadequate intake varied with age groups: Mg 8 % (>30 years), 2·9 % (70 years), 1·5 % (food provision in the prison environment and also poses questions for population-level dietary guidance in delivering appropriate nutrients within energy limits.

Reducing the use of seclusion for mental disorder in a prison: implementing a high support unit in a prison using participant action research.

LENUS (Irish Health Repository)

Giblin, Yvette

2012-01-01

Vulnerable prisoners and mentally disordered offenders who present with risk of harm to self or others were accommodated in Special Observation Cells (SOCs) isolated from others for considerable periods of time. This practice has been criticised by the Council of Europe Committee for the Prevention of Torture. The objective of this initiative was to reduce the use of seclusion within the prison and to improve the care of vulnerable and mentally ill prisoners within the prison.

Breves consideraciones sobre la asistencia médica forzosa a los internos en los centros penitenciarios Some brief commentaries about enforced medical care for prison inmates

Directory of Open Access Journals (Sweden)

J.E. Arribas López

2009-10-01

Full Text Available En una sentencia de octubre de 2005 la Audiencia Nacional, declara la responsabilidad patrimonial del Ministerio del Interior (Dirección General de Instituciones Penitenciarias, por apreciar una concurrencia de culpas entre un interno fallecido en prisión y la Administración, ya que, aunque observa que fue correcta la actuación de los servicios médicos penitenciarios en el reconocimiento, diagnóstico y seguimiento de las enfermedades que padecía, antes y durante su internamiento, sin embargo tuvieron que adoptar, ante las reiteradas negativas de aquél a someterse a la medicación prescrita, las medidas reglamentarias oportunas con la correspondiente autorización de la dirección del centro penitenciario, a fin de que se cumpliera el tratamiento indicado. Sentada la indiscutible responsabilidad de la Administración de actuar, velando por la vida, integridad y salud de los internos cuando se observa un riesgo directo e inmediato utilizando la fuerza si es preciso, cuando se trata de procesos patológicos de curso prolongado, que puede llevar a una limitación de los derechos del interno más allá de lo necesario y someterlo a la aplicación habitual de unas medidas de fuerza que están concebidas y reguladas sólo para situaciones excepcionales.A decision by the National Court in October 2005 declared that the Ministry of the Interior (General Directorate of Prisons held pecuniary liability as a result of a concurrence of guilt between a deceased prison inmate and the prison Administration. It was observed that the prison health care staff had acted correctly when checking, diagnosing and monitoring the illness of the patient before and during admission. However, when faced with repeated refusals by the inmate to accept the prescribed treatment, they had to take suitable regulatory measures to comply with the terms of the indicated treatment with authorisation from the prison director. The Administration has a clearly established and

Prevalence of chronic medical conditions among inmates in the Texas prison system.

Science.gov (United States)

Harzke, Amy J; Baillargeon, Jacques G; Pruitt, Sandi L; Pulvino, John S; Paar, David P; Kelley, Michael F

2010-05-01

Given the rapid growth and aging of the US prison population in recent years, the disease profile and health care needs of inmates portend to have far-reaching public health implications. Although numerous studies have examined infectious disease prevalence and treatment in incarcerated populations, little is known about the prevalence of non-infectious chronic medical conditions in US prison populations. The purpose of this study was to estimate the prevalence of selected non-infectious chronic medical conditions among inmates in the Texas prison system. The study population consisted of the total census of inmates who were incarcerated in the Texas Department of Criminal Justice for any duration from September 1, 2006 through August 31, 2007 (N=234,031). Information on medical diagnoses was obtained from a system-wide electronic medical record system. Overall crude prevalence estimates for the selected conditions were as follows: hypertension, 18.8%; asthma, 5.4%; diabetes, 4.2%; ischemic heart disease, 1.7%; chronic obstructive pulmonary disease, 0.96%; and cerebrovascular disease, 0.23%. Nearly one quarter (24.5%) of the study population had at least one of the selected conditions. Except for asthma, crude prevalence estimates of the selected conditions increased monotonically with age. Nearly two thirds (64.6%) of inmates who were >or=55 years of age had at least one of the selected conditions. Except for diabetes, crude prevalence estimates for the selected conditions were lower among Hispanic inmates than among non-Hispanic White inmates and African American inmates. Although age-standardized prevalence estimates for the selected conditions did not appear to exceed age-standardized estimates from the US general population, a large number of inmates were affected by one or more of these conditions. As the prison population continues to grow and to age, the burden of these conditions on correctional and community health care systems can be expected to increase.

Motivation to Reduce Risk Behaviors While in Prison: Qualitative Analysis of Interviews with Current and Formerly Incarcerated Women.

Science.gov (United States)

Abad, Neetu; Carry, Monique; Herbst, Jeffrey H; Fogel, Catherine I

2013-10-01

Prison is an environment in which programs can be implemented to change harmful behaviors among high-risk populations. Incarcerated women experience high rates of HIV and other sexually transmitted diseases (STDs), yet little research has examined women's motivation to reduce risky behaviors during incarceration. In-depth individual interviews were conducted with former and current women prisoners in two North Carolina correctional facilities and analyzed to identify barriers and facilitators of behavior change while in prison. Analyses revealed key motivators of behavior change: Viewing prison as a place to recover from past trauma, removing oneself from negative social networks, gaining access to needed mental and physical health services, and engaging in self-care and self-reflection. Barriers to behavior change include fear of recidivism, stigma of being in prison, and return to undesirable social networks post-release. Moreover, women noted that the provision of mental health services, educational enhancement and housing assistance could help them reduce engagement in high-risk behaviors after their incarceration. These findings can be incorporated into HIV/STD risk reduction interventions to facilitate positive behavior change among incarcerated women prisoners. Prison itself is a tremendous education in the need for patience and perseverance. It is above all a test of one's commitment.-Nelson Mandela, 1995.

Preventing Suicide in Prisons, Part I Recommendations fromthe International Association for Suicide Prevention Task Force on Suicide in Prisons

NARCIS (Netherlands)

Konrad, N.; Daigle, M.S.; Daniel, A.E.; Dear, G.E.; Frottier, P.; Hayes, L.M.; Kerkhof, A.J.F.M.; Liebling, A.; Sarchiapone, M.

2007-01-01

In 2000 the Department of Mental Health of the World Health Organization (WHO) published a guide named Preventing Suicide. A Resource for Prison Officers as part of the WHO worldwide initiative for the prevention of suicide. In 2007 there are new epidemiological data on prison suicide, a more

The Study of Personality Traits and Demographic Characteristics of Prisoners with Psychopathic Personality Disorder in Comparison with Ordinary Prisoners in Sample of Tehran Prisoners, Tehran, Iran.

Directory of Open Access Journals (Sweden)

D Ghaderi

2012-07-01

Full Text Available

Background and Objectives: Most conducted research about psychopathy has been done among Western countries' prisoners and it has remained unclear whether these findings are applicable in other contexts. The aim of this is to survey personality traits and demographic characteristics of prisoners with psychopathic personality disorder in comparison with ordinary prisoners in sample of Tehran prisoners.

Methods: This study was done based on descriptive method. 202 prisoners were selected among Ray City prisoners in Tehran and the applied method was sample available. All prisoners completed Hare (PCL-SV psychopathic personality disorder checklist and five personality traits Questionnaire, McCare and Costa (Neo-FFI. Data were analyzed by Pearson correlation, Regression, and T student for independent groups.

Results: The prevalence of psychopathy disorder among prisoners of this group was reported 10.89. Statistical analysis by Pearson correlation test, regression analysis and T student independent groups, represent a significant positive relationship between Psychopaty and extraversion (p=1% and a significant negative relationship between openness and Psychopaty (p=5%, agreeableness and conscientiousness (p=1%, respectively. No relationship was found between psychopathy, and neurosis. Furthermore, results indicated that, in comparison with non-psychopathic prisoners, psychopathic prisoners were more neurosis and extraversion, however, they showed low level of openness, agreeableness and conscientiousness.

Conclusion: According to the findings, psychopathic disorder and five personality traits are related. Therefore, futher studies in the field of examined variables can provide more information.

The environment in prison: the care provided to the women prisioners and intramural relations

Directory of Open Access Journals (Sweden)

Mª del Mar García-Vita

2013-04-01

Full Text Available The daily life of prison deserves studies that investigate the diversity of interactions that take placewithin itswalls. These interactions largely determine the climate that governs the centers and the possibilities offered by the prison of the treatment of inmates of both sexes.In our research on women prisoners and reintegration processes, we have noticed some peculiarities thatmay be useful in treatment. This is a national research, with a stratified sample of 599 inmates in second and third degree of compliance (we have obtained 538 valid questionnaires and 61 interviews and 36 professionals. The informationwas collected in 2011 using a questionnaire and semi-structured interviews of inmates, along with a questionnaire for professionals of prisons.The analysis of the information gathered has caused us to observe the influence of the organization of prison personnel, their relationship with women prisoners, alongwith the relationships formed in prison, in the existing environment in prisons and the re-education process itself of prisons. It likewise shows howand inwhatways the stay in prison can be a positive factor, enhancing the social, personal and emotional conditions thatwill facilitatethereintegration of prisoners and their return to life in freedom.

US: developments in the treatment of HIV-positive prisoners in two states.

Science.gov (United States)

Gibson, Katie

2005-08-01

Legal actions have been launched in Alabama and Mississippi to address living conditions and medical care of HIV-positive prisoners in state prisons. These were the only two states to allow complete segregation of HIV-positive prisoners in state prisons into the 1990s. The two cases highlight the ways in which the courts have been involved in supervising prison conditions in the United States.

Sobreocupación en los Centros Penitenciarios y su impacto en la salud Overcrowding in prisons and its impact on health

Directory of Open Access Journals (Sweden)

J. García-Guerrero

2012-02-01

about the issue in the international community and prison administrations and above all, assigning specific economic resources, are key elements in preventing this deficit in social welfare and health care.

[International visibility and impact of the Spanish research on prison health (2002-2011)].

Science.gov (United States)

Ruíz-Pérez, R; Robinson-García, N

2013-01-01

This paper sets out to analyze the dissemination and impact of Spanish research published in international scientific journals on Prison Health over the last decade. Descriptive, longitudinal and retrospective analysis of scientific output. We used the Medline-Pubmed database as an information resource. We focus on the bibliometric aspects of journals, papers and authors using the indicators offered by the Web of Science, the Journal Citation Reports and the Essential Science Indicators. We identify the output of Spanish researchers, journals in which they are published, authors and main research fields. From 2002 to 2011, Spanish researchers published 159 papers, that is, nearly 2% of the world's share in Prison Health. The publication profile is mainly in international journals with an average impact on JCR. The Revista Española de Sanidad Penitenciaria is the most productive journal (9.09%), although its role is not prominent. Only two authors can be considered as medium-high productive authors with 10 papers in the study time period. The co-authors network shows a dense network with 14 authors along with minor fragmented networks. As regards citations, 6 papers have been cited 15 or more times and only two can be considered as highly cited. Three main research fronts have been identified: infectious diseases, drugs and psychiatric-psychological problems. The Spanish research production on Prison Health represents a similar share of the world output similar to that of other disciplines (1.9%), although slightly lower (General Medicine represents 3.05%; Public Health, 2.38%; Psychiatry, 2.29%; Toxicology, 2.46%). It seems likely that this share will increase as a result of the inclusion of its main journal in Medline along with an increasing number of researchers working on this discipline at an international level. However, inclusion has not yet led to integration into high-impact journals or a larger number of citations. The average Journal Impact Factor is

Involuntary inter-prison transfer of prisoners in Denmark

DEFF Research Database (Denmark)

Kjær Minke, Linda

Involuntary inter prison transfer are for most prisoners very intrusive. In Denmark official record shows in average 669 incidences of involuntary inter prison transfers for disciplinary reasons in the period 2006-2013. Involuntary transfers because of prison capacity are not registered statistic....... A rule in Danish administrative law states that prisoners can be involuntary transferred from one prison to the other without prior notice, statement of reasons or hearing. In a legal protective perspective it is problematic that prisoners can be transferred without apparent reasons....

"Do You Want to Go Forward or Do You Want to Go Under?" Men's Mental Health in and Out of Prison.

Science.gov (United States)

Oliffe, John L; Hanberg, Debra; Hannan-Leith, Madeline N; Bergen, Cara; Martin, Ruth Elwood

2018-03-01

More than 11 million people are currently imprisoned worldwide, with the vast majority of incarcerated individuals being male. Hypermasculine environments in prison are often tied to men's health risks, and gathering information about mental health is fundamental to improving prison as well as community services. The purpose of the current study was to describe the connections between masculinities and men's mental health among prisoners transitioning into and out of a Canadian federal correctional facility. Two focus groups were conducted with a total of 18 men who had recently been released from a federal correctional facility. The focus group interviews were analyzed to inductively derive patterns pertaining to men's mental health challenges and resiliencies "on the inside" and "on the outside." Participant's challenges in prison related to heightened stresses associated with being incarcerated and the negative impact on preexisting mental illness including imposed changes to treatment regimens. Men's resiliencies included relinquishing aggression and connecting to learn from other men "on the inside." Mental health challenges "on the outside" included a lack of work skills and finances which increased the barriers that many men experienced when trying to access community-based mental health services. Mental health resiliencies employed by participants "on the outside" included self-monitoring and management to reduce negative thoughts, avoiding substance use and attaining adequate exercise and sleep. The current study findings offer practice and policy guidance to advance the well-being of this vulnerable subgroup of men in as well as out of prison.

Penile implants among prisoners-a cause for concern?

Directory of Open Access Journals (Sweden)

Lorraine Yap

Full Text Available BACKGROUND: We report the prevalence of penile implants among prisoners and determine the independent predictors for having penile implants. Questions on penile implants were included in the Sexual Health and Attitudes of Australian Prisoners (SHAAP survey following concerns raised by prison health staff that increasing numbers of prisoners reported having penile implants while in prison. METHODS: Computer-Assisted Telephone Interviewing (CATI of a random sample of prisoners was carried out in 41 prisons in New South Wales and Queensland (Australia. Men were asked, "Have you ever inserted or implanted an object under the skin of your penis?" If they responded Yes: "Have you ever done so while you were in prison?" Univariate logistic regression and logistic regression were used to determine the factors associated with penile implants. RESULTS: A total of 2,018 male prisoners were surveyed, aged between 18 and 65 years, and 118 (5.8% reported that they had inserted or implanted an object under the skin of their penis. Of these men, 87 (73% had this done while they were in prison. In the multivariate analysis, a younger age, birth in an Asian country, and prior incarceration were all significantly associated with penile implants (p<0.001. Men with penile implants were also more likely to report being paid for sex (p<0.001, to have had body piercings (p<0.001 or tattoos in prison (p<0.001, and to have taken non-prescription drugs while in prison (p<0.05. CONCLUSIONS: Penile implants appear to be fairly common among prisoners and are associated with risky sexual and drug use practices. As most of these penile implants are inserted in prison, these men are at risk of blood borne viruses and wound infection. Harm reduction and infection control strategies need to be developed to address this potential risk.

A social building? Prison architecture and staff-prisoner relationships

NARCIS (Netherlands)

Beijersbergen, K. A.; Dirkzwager, A. J. E.; van der Laan, P. H.; Nieuwbeerta, P.

2016-01-01

Relationships between correctional officers and prisoners are crucial to life in prison, and affect prison order and prisoners' well-being. Research on factors influencing staff-prisoner relationships is scarce and has not included the design of prison buildings. This study examined the association

Paternalistic breaches of confidentiality in prison: mental health professionals' attitudes and justifications.

Science.gov (United States)

Elger, Bernice Simone; Handtke, Violet; Wangmo, Tenzin

2015-06-01

This manuscript presents mental health practitioners' (MHPs) practice, attitudes and justifications for breaching confidentiality when imprisoned patients disclose suicidal thoughts or abuse by others. 24 MHPs working in Swiss prisons shared their experiences regarding confidentiality practices. The data were analysed qualitatively and MHPs' attitudes and course of action were identified. Analysis revealed paternalistic breaches of confidentiality. When patients reported suicidal thoughts and abuse, MHPs believed that forgoing confidentiality is necessary to protect patients, providing several justifications for it. Patients were informed that such information will be transmitted without their consent to medical and non-medical prison personnel. With reference to suicidal attempts, MHPs resorted to methods that may reduce suicidal attempts such as transfer to hospital or internal changes in living arrangements, which would require provision of certain information to prison guards. In cases of abuse, some MHPs convinced patients to accept intervention or sometimes overrode competent patients' refusals to report. Also in the case of abuse, provision of limited information to other prison personnel was seen as an acceptable method to protect patients from further harm. Breaches of confidentiality, whether limited or full, remain unethical, when used for competent patients based solely on paternalistic justifications. Institutionalising ethical and legal procedures to address suicidal and abuse situations would be helpful. Education and training to help both medical and prison personnel to respond to such situations in an appropriate manner that ensures confidentiality and protects patients from suicide and abuse are necessary. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

HIV and incarceration: prisons and detention.

Science.gov (United States)

Jürgens, Ralf; Nowak, Manfred; Day, Marcus

2011-05-19

The high prevalence of HIV infection among prisoners and pre-trial detainees, combined with overcrowding and sub-standard living conditions sometimes amounting to inhuman or degrading treatment in violation of international law, make prisons and other detention centres a high risk environment for the transmission of HIV. Ultimately, this contributes to HIV epidemics in the communities to which prisoners return upon their release. We reviewed the evidence regarding HIV prevalence, risk behaviours and transmission in prisons. We also reviewed evidence of the effectiveness of interventions and approaches to reduce the risk behaviours and, consequently, HIV transmission in prisons. A large number of studies report high levels of risk behaviour in prisons, and HIV transmission has been documented. There is a large body of evidence from countries around the world of what prison systems can do to prevent HIV transmission. In particular, condom distribution programmes, accompanied by measures to prevent the occurrence of rape and other forms of non-consensual sex, needle and syringe programmes and opioid substitution therapies, have proven effective at reducing HIV risk behaviours in a wide range of prison environments without resulting in negative consequences for the health of prison staff or prisoners.The introduction of these programmes in prisons is therefore warranted as part of comprehensive programmes to address HIV in prisons, including HIV education, voluntary HIV testing and counselling, and provision of antiretroviral treatment for HIV-positive prisoners. In addition, however, action to reduce overcrowding and improve conditions in detention is urgently needed.

Adapting Animal-Assisted Therapy Trials to Prison-Based Animal Programs.

Science.gov (United States)

Allison, Molly; Ramaswamy, Megha

2016-09-01

Prison-based animal programs have shown promise when it comes to increased sociability, responsibility, and levels of patience for inmates who participate in these programs. Yet there remains a dearth of scientific research that demonstrates the impact of prison-based animal programs on inmates' physical and mental health. Trials of animal-assisted therapy interventions, a form of human-animal interaction therapy most often used with populations affected by depression/anxiety, mental illness, and trauma, may provide models of how prison-based animal program research can have widespread implementation in jail and prison settings, whose populations have high rates of mental health problems. This paper reviews the components of prison-based animal programs most commonly practiced in prisons today, presents five animal-assisted therapy case studies, evaluates them based on their adaptability to prison-based animal programs, and discusses the institutional constraints that act as barriers for rigorous prison-based animal program research implementation. This paper can serve to inform the development of a research approach to animal-assisted therapy that nurses and other public health researchers can use in working with correctional populations. © 2016 Wiley Periodicals, Inc.

Emergency department use by released prisoners with HIV: an observational longitudinal study.

Directory of Open Access Journals (Sweden)

Jaimie P Meyer

Full Text Available Many people living with HIV access healthcare systems through the emergency department (ED, and increased ED use may be indicative of disenfranchisement with primary HIV care, under-managed comorbid disease, or coincide with use of other healthcare resources. The goal of this study was to investigate ED use by HIV-infected prisoners transitioning to communities.We evaluated ED use by 151 HIV-infected released prisoners who were enrolled in a randomized controlled trial of directly administered versus self-administered antiretroviral therapy in Connecticut. Primary outcomes were quantity and type of ED visits and correlates of ED use were evaluated with multivariate models by Poisson regression.In the 12 months post-release, there were 227 unique ED contacts made by 85/151 (56% subjects. ED visits were primarily for acute febrile syndromes (32.6% or pain (20.3%, followed by substance use issues (19.4%, trauma (18%, mental illness (11%, and social access issues (4.4%. Compared to those not utilizing the ED, users were more likely to be white, older, and unmarried, with less trust in their physician and poorer perceived physical health but greater social support. In multivariate models, ED use was correlated with moderate to severe depression (IRR = 1.80, being temporarily housed (IRR = 0.54, and alcohol addiction severity (IRR = 0.21 but not any surrogates of HIV severity.EDs are frequent sources of care after prison-release with visits often reflective of social and psychiatric instability. Future interventions should attempt to fill resource gaps, engage released prisoners in continuous HIV care, and address these substantial needs.

A comparison of scoring models for computerised mental health screening for federal prison inmates.

Science.gov (United States)

Martin, Michael S; Wamboldt, Ashley D; O'Connor, Shannon L; Fortier, Julie; Simpson, Alexander I F

2013-02-01

There are high rates of mental disorder in correctional environments, so effective mental health screening is needed. Implementation of the computerised mental health screen of the Correctional Service of Canada has led to improved identification of offenders with mental health needs but with high rates of false positives. The goal of this study is to evaluate the use of an iterative classification tree (ICT) approach to mental health screening compared with a simple binary approach using cut-off scores on screening tools. A total of 504 consecutive admissions to federal prison completed the screen and were also interviewed by a mental health professional. Relationships between screening results and more extended assessment and clinical team discussion were tested. The ICT was more parsimonious in identifying probable 'cases' than standard binary screening. ICT was also highly accurate at detecting mental health needs (AUC=0.87, 95% CI 0.84-0.90). The model identified 118 (23.4%) offenders as likely to need further assessment or treatment, 87% of whom were confirmed cases at clinical interview. Of the 244 (48.4%) offenders who were screened out, only 9% were clinically assessed as requiring further assessment or treatment. Standard binary screening was characterised by more false positives and a comparable false negative rate. The use of ICTs to interpret screening data on the mental health of prisoners needs further evaluation in independent samples in Canada and elsewhere. This first evaluation of the application of such an approach offers the prospect of more effective and efficient use of the scarce resource of mental health services in prisons. Although not required, the use of computers can increase the ease of implementing an ICT model. Copyright © 2013 John Wiley & Sons, Ltd.

Trials and tribulations of conducting bio-behavioral surveys in prisons: implementation science and lessons from Ukraine.

Science.gov (United States)

Azbel, Lyuba; Grishaev, Yevgeny; Wickersham, Jeffrey A; Chernova, Olena; Dvoryak, Sergey; Polonsky, Maxim; Altice, Frederick L

2016-06-13

Purpose - Ukraine is home to Europe's worst HIV epidemic, overwhelmingly fueled by people who inject drugs who face harsh prison sentences. In Ukraine, HIV and other infectious diseases are concentrated in prisons, yet the magnitude of this problem had not been quantified. The purpose of this paper is to evaluate the systematic health survey of prisoners in the former Soviet Union (FSU). Design/methodology/approach - Qualitative interviews were carried out with research and prison administrative staff to assess the barriers and facilitators to conducting a bio-behavioral survey in Ukrainian prisons. Findings - Crucial barriers at the institutional, staff, and participant level require addressing by: first, ensuring Prison Department involvement at every stage; second, tackling pre-conceived attitudes about drug addiction and treatment among staff; and third, guaranteeing confidentiality for participants. Originality/value - The burden of many diseases is higher than expected and much higher than in the community. Notwithstanding the challenges, scientifically rigorous bio-behavioral surveys are attainable in criminal justice systems in the FSU with collaboration and careful consideration of this specific context.

UK news media representations of smoking, smoking policies and tobacco bans in prisons.

Science.gov (United States)

Robinson, Amy; Sweeting, Helen; Hunt, Kate

2018-02-19

Prisoner smoking rates remain high, resulting in secondhand smoke exposures for prison staff and non-smoker prisoners. Several jurisdictions have introduced prison smoking bans with little evidence of resulting disorder. Successful implementation of such bans requires staff support. As news media representations of health and other issues shape public views and as prison smoking bans are being introduced in the UK, we conducted content analysis of UK news media to explore representations of smoking in prisons and smoke-free prisons. We searched 64 national and local newspapers and 5 broadcast media published over 17 months during 2015-2016, and conducted thematic analysis of relevant coverage in 106 articles/broadcasts. Coverage was relatively infrequent and lacked in-depth engagement with the issues. It tended to reinforce a negative view of prisoners, avoid explicit concern for prisoner or prison staff health and largely ignore the health gains of smoke-free policies. Most coverage failed to discuss appropriate responses or support for cessation in the prison context, or factors associated with high prisoner smoking rates. Half the articles/broadcasts included coverage suggesting smoke-free prisons might lead to unrest or instability. Negative news media representations of prisoners and prison smoking bans may impact key stakeholders' views (eg, prison staff, policy-makers) on the introduction of smoke-free prison policies. Policy-makers' communications when engaging in discussion around smoke-free prison policies should draw on the generally smooth transitions to smoke-free prisons to date, and on evidence on health benefits of smoke-free environments and smoking cessation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Implementing change: staff experiences of changes to prison mental healthcare in England and Wales.

Science.gov (United States)

Caulfield, Laura S; Twort, Hannah

2012-01-01

Stemming from substantial criticism during the late twentieth and early twenty-first century, the UK government and HM Prison Service developed a number of policies and protocols aimed at improving the state of prison mental healthcare. While it is difficult to fault the purpose of the government's intentions, criticism has continued relating to problems with the implementation of government led change within the prison system. Existing research leads people to question whether policies are being implemented as intended; and if not, why not? The only clear way to answer these questions is to ask those involved in the actual implementation of these recommendations within the prison service. This paper aims to answer these questions. This paper documents findings from a national survey of senior mental healthcare staff working in prisons in England and Wales. Staff were surveyed about their views on the implementation of recommendations from recent key government documents, their perceptions of prison mental healthcare versus community mental healthcare, and their views on the relationship between HM Prison Service and the National Health Service. While many staff report improvements in prison mental healthcare, many have struggled with the implementation of new ways of working and the findings here suggest there is still some way to go towards providing offenders in prison with effective and appropriate care. Where effective ways of implementing change were identified, these are discussed. Listening to the experiences of the staff involved in prison healthcare has helped identify where implementation of changes could be improved and thus highlights where support might best be targeted in future.

A Social Building? Prison Architecture and Staff–Prisoner Relationships

NARCIS (Netherlands)

Beijersbergen, Karin A.; Dirkzwager, Anja J.E.; van der Laan, Peter H.; Nieuwbeerta, Paul

2016-01-01

Relationships between correctional officers and prisoners are crucial to life in prison, and affect prison order and prisoners’ well-being. Research on factors influencing staff–prisoner relationships is scarce and has not included the design of prison buildings. This study examined the association

Current situation of sexual and reproductive health of men deprived of liberty in the Institutional Care Center of San Jose

Directory of Open Access Journals (Sweden)

Dorita Rivas Fonseca

2013-10-01

Full Text Available The objective of this research was to determine the current status of the issue of sexual and reproductive health ofthe prisoners Institutional Care Center (CAI of San Jose. It is a descriptive study. Through a strategic samplingdetermined the participation of 102 men. The information was obtained by applying a self-administeredquestionnaire with closed and open questions. As a result relevant to your socio-demographic profile, it appearsthat deprived of their liberty is a very heterogeneous group. As regards sexual and reproductive health, the firstconcept they relate to the prevention of disease and the second reproductive aspects, this shows limitations inknowledge on the topics, something that affects the daily life activities and self-care. It is concluded that researchby nurses Gyneco-obstetric in the deprived of liberty is almost null not only in the country but in the world,especially if it comes with the male population. In the case of CAI Prison, health care is not enough for thenumber of inmates who inhabit (overpopulation of almost 50%, this implies a deterioration in health and physicalcondition of these people, as well as sexual and reproductive health

Job Stress among Iranian Prison Employees

OpenAIRE

J Akbari; R Akbari; F Farasati; B Mahaki

2014-01-01

Background: Exposure to job stress causes deleterious effects on physical and mental health of employees and productivity of organizations. Objective: To study work-related stressors among employees of prisons of Ilam, western Iran. Methods: In a cross-sectional study conducted from July to October 2013, 177 employees of Ilam prisons and security-corrective measures organization were enrolled in this study. The UK Health and Safety Executive Organization 35-item questionnaire for asse...

The high burden of tuberculosis (TB) and human immunodeficiency virus (HIV) in a large Zambian prison: a public health alert.

Science.gov (United States)

Henostroza, German; Topp, Stephanie M; Hatwiinda, Sisa; Maggard, Katie R; Phiri, Winifreda; Harris, Jennifer B; Krüüner, Annika; Kapata, Nathan; Ayles, Helen; Chileshe, Chisela; Reid, Stewart E

2013-01-01

Tuberculosis (TB) and human immunodeficiency virus (HIV) represent two of the greatest health threats in African prisons. In 2010, collaboration between the Centre for Infectious Disease Research in Zambia, the Zambia Prisons Service, and the National TB Program established a TB and HIV screening program in six Zambian prisons. We report data on the prevalence of TB and HIV in one of the largest facilities: Lusaka Central Prison. Between November 2010 and April 2011, we assessed the prevalence of TB and HIV amongst inmates entering, residing, and exiting the prison, as well as in the surrounding community. The screening protocol included complete history and physical exam, digital radiography, opt-out HIV counseling and testing, sputum smear and culture. A TB case was defined as either bacteriologically confirmed or clinically diagnosed. A total of 2323 participants completed screening. A majority (88%) were male, median age 31 years and body mass index 21.9. TB symptoms were found in 1430 (62%). TB was diagnosed in 176 (7.6%) individuals and 52 people were already on TB treatment at time of screening. TB was bacteriologically confirmed in 88 cases (3.8%) and clinically diagnosed in 88 cases (3.8%). Confirmed TB at entry and exit interventions were 4.6% and 5.3% respectively. Smear was positive in only 25% (n = 22) of bacteriologically confirmed cases. HIV prevalence among inmates currently residing in prison was 27.4%. Ineffective TB and HIV screening programs deter successful disease control strategies in prison facilities and their surrounding communities. We found rates of TB and HIV in Lusaka Central Prison that are substantially higher than the Zambian average, with a trend towards concentration and potential transmission of both diseases within the facility and to the general population. Investment in institutional and criminal justice reform as well as prison-specific health systems is urgently required.

Changes in mental state associated with prison environments: a systematic review.

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Walker, J; Illingworth, C; Canning, A; Garner, E; Woolley, J; Taylor, P; Amos, T

2014-06-01

To develop an understanding of the stability of mental health during imprisonment through review of existing research evidence relating physical prison environment to mental state changes in prisoners. A systematic literature search was conducted looking at changes in mental state and how this related to various aspects of imprisonment and the prison environment. Fifteen longitudinal studies were found, and from these, three broad themes were delineated: being imprisoned and aspects of the prison regime; stage of imprisonment and duration of sentence; and social density. Reception into prison results in higher levels of psychiatric symptoms that seem to improve over time; otherwise, duration of imprisonment appears to have no significant impact on mental health. Regardless of social density, larger prisons are associated with poorer mental state, as are extremes of social density. There are large gaps in the literature relating prison environments to changes in mental state; in particular, high-quality longitudinal studies are needed. Existing research suggests that although entry to prison may be associated with deterioration in mental state, it tends to improve with time. Furthermore, overcrowding, ever more likely as prison populations rise, is likely to place a particular burden on mental health services. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Limited access to HIV prevention in French prisons (ANRS PRI2DE: implications for public health and drug policy

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Blanche Jerôme

2011-05-01

Full Text Available Abstract Background Overpopulation, poor hygiene and disease prevention conditions in prisons are major structural determinants of increased infectious risk within prison settings but evidence-based national and WHO guidelines provide clear indications on how to reduce this risk. We sought to estimate the level of infectious risk by measuring how French prisons adhere to national and WHO guidelines. Methods A nationwide survey targeting the heads of medical (all French prisons and psychiatric (26 French prisons units was conducted using a postal questionnaire and a phone interview mainly focusing on access to prevention interventions, i.e. bleach, opioid substitution treatment (OST, HBV vaccination and post-exposure prophylaxis (PEP for French prisoners. Two scores were built reflecting adherence to national and WHO international guidelines, ranging from 0 (no adherence to 10 (maximum adherence and 0 to 9 respectively. Results A majority (N = 113 (66% of the 171 prisons answered the questionnaires, representing 74% coverage (46,786 prisoners of the French prison population: 108 were medical units and 12 were psychiatric units. Inmate access to prevention was poor. The median[IQR] score measuring adherence to national guidelines was quite low (4.5[2.5; 5.5] but adherence to WHO guidelines was even lower 2.5[1.5; 3.5]; PEP was absent despite reported risky practices. Unsuitable OST delivery practices were frequently observed. Conclusions A wide gap exists between HIV prevention policies and their application in prisons. Similar assessments in other countries may be needed to guide a global policy reform in prison settings. Adequate funding together with innovative interventions able to remove structural and ideological barriers to HIV prevention are now needed to motivate those in charge of prison health, to improve their working environment and to relieve French prisoners from their currently debilitating conditions.

High variability of TB, HIV, hepatitis C treatment and opioid substitution therapy among prisoners in Germany.

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Müller, Jana; Schmidt, Daniel; Kollan, Christian; Lehmann, Marc; Bremer, Viviane; Zimmermann, Ruth

2017-10-25

In Germany, medical care of prisoners is completely separated from extramural health care. The extent and quality of medical care among prisoners in Germany are therefore largely unknown. We performed a secondary data analysis of pharmacy sales data for tuberculosis (TB), HIV, hepatitis C (HCV) and opioid substitution treatment (OST) delivered to prisons in 11 federal states (FS) in Germany between 01/2012 and 03/2013. The aims of this study were to assess (i) the treatment availability for the selected diseases and OST in German prisons, (ii) the proportion of prisoners treated per FS and overall for TB, HIV, HCV and OST during the study period. Substances unique to or typically used for the treatment of each disease were defined as marker substances with defined daily doses (DDD). For each marker substance we assessed the cumulative number of DDD, the average daily number of DDD (DDD d ) and average treatment prevalence per day in percent (adTP). Accordingly, the DDD d represents one person treated per day and the adTP means the proportion of prisoners treated per day. We compared the adTP of the diseases with previously measured prevalences. We obtained data from pharmacies supplying prisons in 11 of 16 German FS. Of the included prisons, 41% were supplied with medicines for TB, 71% for HIV and 58% for HCV and OST. Twice as many delivered marker substances for TB were indicated for the continuation phase and chemoprevention than the intensive phase. The HIV adTP ranged from 0.06% to 0.94%, HCV adTP ranged from 0.03% to 0.59% and OST adTP ranged from 0% to 7.90%. The overall adTP for the respective treatment was 0.39% for HIV, 0.12% for HCV and 2.18% for OST. According to our findings treatment rates for TB were consistent with the expected TB prevalence, at least in Berlin. HIV treatment seems to be offered to an adequate proportion of estimated infected prisoners. In contrast, the HCV treatment prevalence was low. High variation among FS in provision of all

Socio-economic status and health in a marginalized group: the role of subjective social status among prison inmates.

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Friestad, Christine

2010-12-01

One problem in studies of social inequality in health is that traditional socio-economic indicators are unsuitable for groups finding themselves on the outside of those societal arenas from which measures of education, income and occupation are generated. A measure of subjective social position has accordingly been proposed as an addition to the traditional objective socio-economic measures. The present study investigates this concepts' usefulness as an addition to objective SES markers in a sample of prison inmates, known for their marginalized position in society as well as their poor health. Analyses are based on the male part (n = 225) of a nationally representative sample of prison inmates in Norway. Outcome measures are self-rated health, long-standing illness or disability, mental health problems, perceived change in health status and drug use. Analyses of correlation as well as multivariate logistic regression analyses were performed. Subjective social status was bivariately related to all of the health outcomes, except long-standing illness. Multivariate analyses indicated that subjective social status influenced the odds of experiencing mental health problems, but not any of the other health outcomes when controlling for the other independent variables. Subjective social status may add important information to our understanding of the relationship between social disadvantage and mental health in a marginalized social group such as prison inmates.

Point prevalence of mental disorder in unconvicted male prisoners in England and Wales.

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Brooke, D.; Taylor, C.; Gunn, J.; Maden, A.

1996-01-01

OBJECTIVES: To determine prevalence of mental disorder among male unconvicted prisoners and to assess the treatment needs of this population. DESIGN: Semi-structured interview and case note review of randomly selected cross section of male remand population. Non-attenders were replaced by the next name on prison roll. SETTING: Three young offenders' institutions and 13 adult men's prisons. SUBJECTS: 750 prisoners, representing 9.4% cross sectional sample of male unconvicted population. MAIN OUTCOME MEASURES: Prevalence of ICD-10 diagnoses of mental disorder, and associated treatment needs. RESULTS: Psychiatric disorder was diagnosed in 469 (63%) inmates. The main diagnoses were: substance misuse, 285 (38%); neurotic illness, 192 (26%); personality disorder, 84 (11%); psychosis, 36 (5%); other and uncertain, 36 (0.5%). Subjects could have more than one diagnosis. The average refusal rate was 18%. In total 414 inmates (55%) were judged to have an immediate treatment need: transfer to an NHS bed, 64 (9%); treatment by prison health care services, 131 (17%); motivational interviewing for substance misuse, 115 (15%); and therapeutic community placement, 104 (14%). CONCLUSIONS: Mental disorder was common among male unconvicted prisoners. Psychosis was present at four or five times the level found in the general population. Extrapolation of our results suggests that remand population as a whole probably contains about 680 men who need transfer to hospital for psychiatric treatment, including about 380 prisoners with serious mental illness. PMID:8978228