Adult Prison Population Research Articles

Attention Deficit Hyperactivity Disorder (ADHD): Forensic Issues

ADHD has long been recognised as disproportionately present in both juvenile and adult prison populations. This is so for a number of reasons, including the potential for persons with ADHD to be disinhibited, impulsive, impaired in executive functioning and chaotic in their lifestyle. A major challenge exists, though, to assist courts to understand better how ADHD may have played a role in criminal offending and thus to be relevant to evaluations of criminal culpability or even responsibility. Another issue that arises for expert assessment is how ADHD may make the experience of custodial detention especially burdensome and be relevant in this respect also for sentencing. This article considers the overall forensic context of ADHD in criminal litigation and reviews a selection of illustrative decisions from Canada, Australia, New Zealand and the United Kingdom to identify principles on the basis of which courts can make nuanced decisions that are suitably informed by expert mental health evidence about the forensic ramifications of ADHD.

IT’S ALL IN THE ACTION

CASE SETTING The prevalence of metabolic syndrome in patients with serious mental illness is almost double the prevalence reported for the general population of Australia. Cardiometabolic disease and mental illness are overrepresented in adult prison populations, with people in custody significantly more likely to have cardiovascular disease and Type 2 diabetes. The Forensic Hospital, is a mental health facility with 140 beds that sits within Justice Health NSW. It is specifically designed for people who have mental illness and have been involved with the criminal justice system, as well as those who are considered to be at high risk in the community. The Ministry of Health and Justice Health NSW have several documents that make reference to the importance of screening for Metabolic Syndrome however barriers exist at the patient, staff, and organisational level to implementing the recommended physical health guidelines in a high secure forensic mental health setting. TREATMENT It’s All In The Action is a Quality Improvement project led by the Forensic Hospital’s Senior Exercise Physiologist and Rehabilitation Coordinator. The initiative focused on embedding physical health intervention for Forensic Hospital patients at risk of or diagnosed with metabolic syndrome through the establishment of the Metabolic Care Team. RESULTS A defined physical health pathway to intervention within the Forensic Hospital in the form of a physical health MDT, atypical in the Forensic Mental Health setting. REFLECTIONS/LEARNINGS The presentation will outline the steps taken in a ground up approach to address the growing concern of systemic neglect and achieve service level change. It will demonstrate translation of best practice research as well as State and National policy and guidelines into tangible action for a significantly marginalised population group. Finally, it will reflect on the sustainability of this initiative, the integration of partnerships, and recommendations for prospective next steps.

Adolescence as a “Radical” Age and Prevention of Violent Radicalisation: A Qualitative Study of Operators of a Juvenile Penal Circuit in Italy

In the scientific community, the topic of the risk of violent radicalisation within the juvenile penal circuit is infrequently explored compared to the attention devoted to the adult prison population or to other areas of social and educational intervention. This article presents some results of a study conducted, within the framework of a European project led by the Italian Ministry of Justice, at some institutions of the juvenile penal circuit in Italy, with the involvement of staff working at the Offices of Social Services for Minors (USSM), the Juvenile Penal Institutes (IPM), and the reception communities of two Italian regions (North and South). The article aims to explore the viewpoint of the professionals working in these facilities, analysing their perceptions and experiences regarding the radicalisation of young people in the penal circuit. This concept is understood both in a broader sense, evoking the characteristics of adolescence, as experienced by the population in their charge, and also in the more specific sense of religious radicalisation and its possible violent outcomes. The article shows how, when referring to the task of detecting possible signs of (violent) radicalisation in the behaviour of young people, penal-circuit professionals highlight the difficulties and risks they encounter in the attempt to reconcile educational and supervisory tasks. The personal and social characteristics of the population under their care and the more specific characteristics of the adolescent phase, in fact, seem to constitute factors that make the process of the detection of radicalisation more complex, with the risk of increasing the labelling and stigmatisation of these young offenders, thus, paradoxically, favouring outcomes that would be desirable to prevent.

Access to justice in prisons or the limitations of prison defense

This article sought to understand the adequacy of criminal defense services within prisons. By analyzing secondary data and interviews, it describes the justiciable problems and legal needs, the lines of action, and the obstacles that the adult prison population encounters. The results show that the experience and needs that arise in prison surpass the institutional capabilities of the chilean Public Defender’s Office. Therefore, a new institutional framework must be created to meet the justice claims of prisoners.

Desconexión Moral y Delincuencia en Población Penitenciaria Adulta: una Revisión Metaanalítica

Research on moral disengagement associated with adult criminal profiles is recent a recent issue and, therefore, has been less evaluated. This meta-analytic study aims to determine the strength of the relationship between moral disengagement and crime in the adult prison population. The results showed a moderate relationship between moral disengagement and crime, with an effect size of r = .26 (p .001). The analysis of moderating variables (i.e., type of offence, gender, age, and instrument measuring moral disengagement) do not show statistically significant results in this association. Finally, it is concluded that moral disengagement is a risk factor for criminal behaviour commission, and future lines of research are proposed.

The prevalence of comorbid serious mental illnesses and substance use disorders in prison populations: a systematic review and meta-analysis

SummaryBackgroundComorbid mental illnesses and substance use disorders are associated with adverse criminal, social, and health outcomes. Yet, their burden is not reliably known among prison populations. We therefore aimed to estimate the prevalence of comorbid serious mental illnesses and substance use disorders (dual disorders) among people in prison worldwide.MethodsIn this systematic review and meta-analysis, we searched 15 electronic databases (ASSIA, CAB s, Criminal Justice Database, Embase, Global Health, Global Index Medicus, IBSS, MEDLINE, NCJRS, PAIS Index, PsycINFO, Russian Science Citation Index, Scielo, Social Services s, and Web of Science) and the grey literature (Open Grey and ProQuest Dissertations & Theses Global) for studies reporting the prevalence of serious mental illnesses and substance use disorders in prison populations published between Jan 1, 1980, and Sept 25, 2021, and contacted the authors of relevant studies. Empirical studies among unselected adult prison populations that applied representative sampling strategies and validated diagnostic instruments, and either reported the prevalence of dual disorders or had authors who could provide prevalence data in correspondence, were included. Two reviewers (GB and SDL) independently extracted data from the eligible studies; both current (up to 1 year) and lifetime prevalence were extracted, if available. We sought summary estimates. Our primary outcomes were comorbid non-affective psychosis with substance use disorders and comorbid major depression with substance use disorders. We conducted a random-effects meta-analysis, explored between-sample heterogeneity with meta-regression, and calculated odds ratios (ORs) to assess bidirectional relationships between mental and substance use disorders. Risk of bias was assessed by use of a standard tool. The study protocol was registered with PROSPERO, CRD42020207301.FindingsOf 11 346 records screened, we identified 34 studies reporting the prevalence of dual disorders among individuals in prison and received unpublished prevalence data for 16 studies, totalling 50 eligible studies and 24 915 people. The mean quality score of included studies was 7·8 (SD 1·2). We found that 3·5% (95% CI 2·2–5·0) had current non-affective psychosis with any comorbid substance use disorder, representing 443 (49·2%) of 900 people with non-affective psychosis, and 9·1% (5·6–13·3) had current major depression and comorbid substance use disorders, representing 1105 (51·6%) of 2143 people with major depression. Between-sample heterogeneity was high (I2>80%). People in prison with current non-affective psychosis were significantly more likely to have substance use disorders compared with those without (OR 1·7, 95% CI 1·4–2·2). People with major depression had higher odds of substance use disorders than those without (1·6, 1·3–2·0).InterpretationAround half of the prison population with non-affective psychosis or major depression have a comorbid substance use disorder. Consideration should be given to screening for dual disorders and implementing integrated and scalable treatments.FundingEconomic and Social Research Council, Agencia Nacional de Investigación y Desarrollo (Chile), and the Wellcome Trust.

Childism: A Review of Falih Koksal’s Article on “Needs, Habits and Children’s Wellbeing” Alongside an Exploration of the Film “System Crasher”

Abstract In this review I will focus on societies mistreating children in order to fulfil certain needs through them, to project internal conflicts and self-hatred outward, or to assert themselves when they feel their authority has been questioned. Regardless of their individual motivations, they all rely upon a societal prejudice against children to justify themselves and legitimate their behaviour. We are all familiar of prejudice against people of colour, women, LGBTQ in Western society. Sadly, prejudice against children – “childism” (Young-Bruehl, 2012) is not acknowledged. Incarcerating children, sending victims of abuse and neglect to juvenile detention centers (juvies) is unethical and unacceptable. We all know that many children who have spent years of their lives in and out of juvies will join the adult prison population. The word “childism” is not in the political discourse or our dictionaries, and no subfield of Prejudice Studies has been dedicated to it. In this review I invite readers to understand how our (Western) society is failing to support the development and well-being of its children to combat such a prejudice. Childism is a prejudice that rationalizes and legitimates the maltreatment of children and as professionals we have a responsibility to fight it. We (all of us) must learn not to project our self hatred onto our children in the form of a prejudice. With psychoanalytic understanding and guidance an abusing system can give up abusing. The “intergenerational transmission of trauma” can be interrupted.

Disorders of Language and Literacy in the Prison Population: A Scoping Review

Language and literacy skills are essential for education, school achievements, work and social conditions. Some studies indicate an elevated incidence of problems with language and literacy in the prison population, potentially contributing to increased risks of maladjustment and recidivism. In general, the bulk of research on language and literacy has been directed towards children and adolescents. This study aimed to map the extent of the literature on language and literacy disorders in the adult prison population over the past 20 years, and what it reveals about the prevalence and nature of these disorders in prisoners. In total, 18 studies were identified. Of these, the majority (15) investigated literacy. The three studies investigating language all reported an elevated prevalence in the population. The literacy studies were altogether less clear, due to differences in theoretical approach and methods. In terms of the nature of the disorders, many studies assessed the behavioral level only. Results are discussed in terms of theoretical approaches, as well as recommendations for research, assessment, and intervention.

Understanding and supporting the health literacy of young men in prison: a mixed-methods study

PurposePrisons offer a public health opportunity to access a group with multiple and complex needs and return them to the community with improved health. However, prisons are not conducive to optimal health and there are few frameworks to guide efforts. This study aims to generate insights into health literacy across a young adult prison population, specifically examining the level of limitations, barriers and characteristics associated with these limitations.Design/methodology/approachThe study took place in a single prison in England for young adult men aged 18–21 years old. A mixed-methods design was adopted with 104 young men completing a quantitative survey and qualitative semi-structured interviews with 37 young men.Findings72% (n = 75) of young men scored as limited in their health literacy. Barriers included structural restrictions, limited access to formal support and social and natural disruptions. No demographic characteristics or smoking intentions/behaviours predicted limited health literacy, but characteristics of the prison were predictive. Physical problems (sleep, nausea, tiredness and headaches), mental health and well-being (anxiety, depression and affect) and somatisation problems were also predictive of limitations.Practical implicationsPrison healthcare services and commissioners should undertake regular health literacy needs assessments to support developments in reducing barriers to healthcare and increasing health improvement efforts. Action also requires greater political will and investment to consider broader action on the wider determinants of (prison) health.Originality/valueThe study provides a framework to understand and guide prison health efforts and highlights attention needed at the level of governments, prison leaders and their health systems.

Completion Rates, Adverse Effects, and Costs of a 3-Month and 9-Month Treatment Regimen for Latent Tuberculosis Infection in California Inmates, 2011-2014.

In California, about 80% of tuberculosis disease is caused by untreated latent tuberculosis infection (LTBI), and the rate of LTBI is higher among incarcerated persons (16%) than among nonincarcerated persons (6%). We compared 2 regimens to treat LTBI in an adult prison population in California: 9 months of twice-weekly isoniazid (9H; previous standard of care) and 12 once-weekly doses of isoniazid and rifapentine (3HP; introduced in 2011). We evaluated the rates of completion and discontinuation caused by hepatotoxicity among randomly selected patients with LTBI prescribed the 9H regimen in 2011 and among patients with LTBI prescribed the 3HP regimen who entered California prisons during September 2013-March 2014. We compared the cost per fully treated patient for the 2 regimens. Of 92 patients treated with the 9H regimen, the treatment completion rate was 42% and discontinuation due to hepatotoxicity was 14%. Of 122 patients who accepted the 3HP regimen, the completion rate was 90% and discontinuation due to hepatotoxicity was 2%. The cost per fully treated patient for the 9H regimen was $981 and for 3HP was $652. In an incarcerated population, the 3HP regimen had a higher completion rate, lower hepatotoxicity, and lower cost per fully treated patient than the 9H regimen. If coupled with a high treatment initiation rate, the high rate of LTBI treatment completion with 3HP may contribute to reducing tuberculosis morbidity in California.

Murderers or thieves at risk? Offence-related suicide rates in adolescent and adult prison populations

PurposePrisoners have a higher risk of suicide compared to non-incarcerated individuals. One aim of suicide prevention for prisoners is to identify risk factors in order to put stronger support mechanisms in place for the more vulnerable detainees. This study investigates the suicide risk (SR) in offence-related sub-populations in a representative German sample and differentiates between SR for adolescent and adult prisoners.MethodsConducting a national study with data from public German records on the entire prison population from 2000 to 2016 and suicide numbers in German prisons in the same period, SR was calculated for the total male prison population as well as for both subgroups, adolescent and adult male prisoners.ResultsIn the study period, male prisoners spent 959.584 life years (LY) in German criminal detention. Among those, 524 prisoners died of suicide. SR was higher for detainees imprisoned for an offence resulting in extensive physical harm for another person, e.g. homicide (suicide rate = 134,8 suicides per 100.000 LY; OR = 2,47; CI95%: 1,98–3,08), bodily injury (suicide rate = 87,3; OR = 1,60; CI95%: 1,29–1,99), and sexual offences (suicide rate = 84,2; OR = 1,54; CI95%: 1,18–2,01) compared with the SR of the total prison population (suicide rate = 54.6). Age differences between offence-related SR were found for theft, with adolescents (suicide rate = 69,3; OR = 1,25; CI95%: 0,85–1,84) showing higher SR than adults (suicide rate = 38,2; OR = 0,7; CI95%: 0,54–0,92).ConclusionThe index offence of detainees is associated with SR and age-related differences exist. Suicide prevention in prisons should take both into account to determine populations at risk.

Bitches, Fishes, and Monsters: Prison Slang and Nonhuman Animal Terminology

AbstractThe adult prison population in the U.S. is one of the most important, marginalized, yet misunderstood groups within the country. Not only is the population larger than those of other industrialized nations, but the prisons themselves also tend to be more punitive in nature. While there have been many proposed reasons for this, ranging from differences in the “American Character” to the increasing severity of mandatory sentencing guidelines, explanations of the American prisoner setting remain thin. One area that has relevance to this topic but in which there has been little research is the language used to describe prisoners. This language is replete with images of nonhuman animals. Examples and explanations of this phenomenon are provided through the inspection of the lexicons and argots (“prison slang”) for animal themes, and implications regarding implicit power relationships and the effects on both prisoners and nonhuman animals stemming from this language are explored.

Tracking the Gendered Life Courses of Care Leavers in 19th-Century Britain

The adult outcomes of children raised in care are a matter of much concern in Britain today. Care leavers account for a quarter of the adult prison population, a tenth of the young homeless population, and over two thirds of sex workers (Centre for Social Justice, 2015: 4). This article argues that, by contrast, the first generation of boys and girls passing through the early care system were more likely to have experienced a modest improvement in their life chances. It explores three key questions. First, what mechanisms shaped adult outcomes of care in the past? Second, did these vary by gender? Third, what might life course approaches to these issues gain from engaging both with historical- and gender-inflected analysis? The article draws on our wider analysis of the life courses and life chances of 400 adults who passed through the early youth justice and care systems as children in the northwest of England from the 1860s to the 1920s. These systems were closely interlinked. Within that, the article focuses on the experiences of a subgroup sent to a more care-oriented institution. It compares their collective outcomes with those of the wider group and within-group by gender. It offers a selection of case studies of women’s lives before and after care to highlight the value of, and challenges involved in, undertaking gender analysis in life course research of this kind.

Intelligence Assessment Instruments in Adult Prison Populations: A Systematic Review.

Detection of intellectual disability (ID) in the penitentiary system is important for the following reasons: (a) to provide assistance to people with ID in understanding their legal rights and court proceedings; (b) to facilitate rehabilitation programs tailored to ID patients, which improves the enhancement of their quality of life and reduces their risk of reoffending; and (c) to provide a reliable estimate of the risk of offence recidivism. It requires a short assessment instrument that provides a reliable estimation of a person's intellectual functioning at the earliest possible stage of this process. The aim of this systematic review is (a) to provide an overview of recent short assessment instruments that provide a full-scale IQ score in adult prison populations and (b) to achieve a quality measurement of the validation studies regarding these instruments to determine which tests are most feasible in this target population. The Preferred Reporting Items for Systematic reviews and Meta-Analyses Statement is used to ensure reliability. The Satz-Mögel, an item-reduction short form of the Wechsler Adult Intelligence Scale, shows the highest correlation with the golden standard and is described to be most reliable. Nevertheless, when it comes to applicability in prison populations, the shorter and less verbal Quick Test can be preferred over others. Without affecting these conclusions, major limitations emerge from the present systematic review, which give rise to several important recommendations for further research.

Prevalence of Traumatic Brain Injury in a Male Adult Prison Population and Its Association with the Offence Type

Background: The prevalence of traumatic brain injury (TBI) in prison populations has been found to vary considerably. This study aimed to determine the prevalence of TBI in a prison population in New Zealand and to identify whether age, ethnicity, offence type, security classification and sentence length were linked to TBI prevalence. Methods: All offenders admitted to a new Corrections Facility over a 6-month period (May-November 2015) were screened to understand their history of TBI. Data was merged with demographic information, details of the offence type, sentence length and security classification from the prison database. Binary logistic regression was used to identify the contribution of predictors on TBI history. Results: Of the 1,061 eligible male prisoners, 1,054 (99.3%) completed a TBI history screen. Out of the 672 (63.7%) who had sustained at least one TBI in their lifetime, 343 (32.5%) had experienced multiple injuries. One in 5 participants experienced their first TBI injury before the age of 15 years. A regression model was able to correctly classify 66.9% of cases and revealed that belonging to Māori ethnicity or being imprisoned for violent, sexual or burglary offences were independently predictive of TBI (χ² = 9.86, p = 0.28). Conclusions: The high prevalence of TBI within male prisoners and a high proportion of injuries sustained in childhood suggest the need for routine screening for TBI to identify prisoners at risk of persistent difficulties. Interventions to support those experiencing persistent difficulties post-TBI are needed to optimise functioning and prevent reoffending.

Trouble sleeping inside: a cross-sectional study of the prevalence and associated risk factors of insomnia in adult prison populations in England

ObjectiveTo investigate the prevalence of insomnia and identify associated demographic, clinical and forensic risk factors in adult prisoners in England. MethodsA cross-sectional study of 237 prisoners aged 18–72 years, across two male prisons and one female prison in North England. We used the Sleep Condition Indicator to measure probable DSM-V insomnia disorder (ID) and the Pittsburgh Sleep Quality Index to examine sleep quality. Multiple demographic, sleep, clinical and forensic self-reported measures were recorded to identify any associations with insomnia. ResultsOverall, the prevalence of possible DSM-V ID was 61.6% (95% CI, 55.5%–67.8%). Subjective poor sleep quality was reported by 88.2% (95% CI, 84.1%–92.3%). Seven in ten (70.6%) female prisoners had possible DSM-V ID (95% CI, 64.8%–76.4%). Multivariable logistic regression analysis, adjusting for gender and age, indicated odds of having possible ID in prison were increased for the following factors: history of physical ill-health (OR = 3.62, 95% CI, 1.31–9.98); suicidality (OR = 2.79, 95% CI, 1.01.7.66), previously asked for help for insomnia (OR = 2.58, 95% CI, 1.21–5.47), depression (OR = 2.06, 95% CI 1.31–3.24), greater endorsement of dysfunctional beliefs about sleep (OR = 1.50, 95% CI, 1.21–1.87), poor sleep hygiene (OR = 1.11, 95% CI, 1.04–1.19), and problematic prison environment (eg, noise, light or temperature) (OR = 1.07, 95% CI, 1.02–1.12). ConclusionsFor the first time we have established the prevalence and associated factors of insomnia in a large sample of adult English prisoners. ID and poor sleep quality are common, especially in female prisoners. These findings emphasize/amplify the need for dedicated treatment pathways to improve screening, assessment and treatment of insomnia in prison.

Self-Esteem in Adult Prison Population: The Development and Validation of the Self-Esteem Measure for Prisoners (SEM-P)

ABSTRACTThe main aim of the current study was to develop and validate the Self-Esteem Measure for Prisoners (SEM-P), composed of personal and prison self-esteem, among a systematically selected sample of prisoners (N = 1,794). Confirmatory factor analyses revealed that the SEM-P was best captured with the bifactor conceptualization reflecting two grouping factors (personal and prison self-esteem) and one general factor. Although factor loadings were stronger for the general factor, the two grouping factors evidenced good differential predictive validity. The SEM-P is a reliable and valid measure of self-esteem among inmates because it considers the importance of prison culture for self-evaluations.

Challenging spiralling remand in custody rates: what legal and procedural changes can address the trend?

PurposeThe purpose of this paper is to draw to the attention of parliamentarians and policy-makers the specific vulnerabilities of applicants for bail that need to be addressed if there are to be any answers to the current malaise.Design/methodology/approachAlmost a quarter of the adult prison population in Australia is made up of persons imprisoned awaiting trial. By looking at current data and recent research findings, the paper reveals that there persists in Australia great unevenness in remand distributions by jurisdiction.FindingsThe paper explains why there are differences in remand rates across Australia and why they are rising and draws from more recent snapshots that complement these findings from comprehensive studies conducted a decade ago.Practical implicationsFurthermore it examines ideas floated in the last decade by academics and practitioners keen to lower remand rates and to bring some uniformity to the process while keeping intact the two key (yet potentially contradictory) aims of the remand in custody system: the safety of the community and the presumption of innocence.Originality/valueThe paper’s findings will appeal to parliamentarians and policy-makers tasked with bringing about law reform in the field, as well as police leaders, correctional advisors and students of the legal process.

English

English

To Learn or Not to Learn—This Is the Question

This research explores the rate of learning disabilities (LD) within the Hebrew-speaking adult prison population in Israel, examining the relationship between LD and dropping out of school with criminal behavior. The study finds that the frequency of LD is very high among Israeli inmates (69.6%) and that a gap exists between LD inmates’ awareness of their scholastic weakness in school and the educational system’s ignorance. Implications of these results are discussed.