Adults In Prison Research Articles

Older Adults' perspectives on death and dying in prison

PurposeIncarcerated people often have extensive health needs compared to their community-dwelling peers. This is especially the case among older adults, who represent a sizeable and growing portion of the U.S. prison population with a concomitant health burden. While research has expanded in recent years regarding health-related experiences among older adults in prisons, research surrounding their perceptions of death and dying in these settings remains limited. MethodsWe gathered qualitative data from 193 interviews with older men incarcerated across three U.S. prisons. ResultsExperiences related to dying and death were normative among the sample and both secondary and primary accounts of dying and death were described. Descriptions of death were most often framed with reference to health conditions versus violence. Further, respondents' perceptions of death and dying were also linked to fears in three areas: dying while imprisoned, dying due to distrust of the prison health care system, and what happens to their personal effects and persons after death in prison. ConclusionsFindings reinforce the importance of addressing carceral medical neglect, the potential role of hospice, and the need for correctional policy and practice to be attentive to disenfranchised grief.

The health impacts of the COVID-19 pandemic on adults who experience imprisonment globally: A mixed methods systematic review.

The prison setting and health status of people who experience imprisonment increase the risks of COVID-19 infection and sequelae, and other health impacts of the COVID-19 pandemic. To conduct a mixed methods systematic review on the impacts of the COVID-19 pandemic on the health of people who experience imprisonment. We searched Medline, PsycINFO, Embase, the Cochrane Library, Social Sciences Abstracts, CINAHL, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Sociology Database, Coronavirus Research Database, ERIC, Proquest Dissertations and Theses, Web of Science, and Scopus in October 2021. We reviewed reference lists for included studies. Original research conducted in or after December 2019 on health impacts of the COVID-19 pandemic on adults in prisons or within three months of release. We used the Joanna Briggs Institute's Critical Appraisal Checklist for Qualitative Research for qualitative studies and the Joanna Briggs Institute's Critical Appraisal Checklist for Studies Reporting Prevalence Data for quantitative studies. We qualitized quantitative data and extracted qualitative data, coded data, and collated similar data into categories. We identified 62 studies. People in prisons had disproportionately high rates of COVID-19 infection and COVID-19 mortality. During the pandemic, all-cause mortality worsened, access to health care and other services worsened, and there were major impacts on mental wellbeing and on relationships with family and staff. There was limited evidence regarding key primary and secondary prevention strategies. Our search was limited to databases. As the COVID-19 pandemic is ongoing, more evidence will emerge. Prisons and people who experience imprisonment should be prioritized for COVID-19 response and recovery efforts, and an explicit focus on prisons is needed for ongoing public health work including emergency preparedness. 239324.

What Older Prisoners Teach Us About Care and Justice in An Aging World

Over the last two decades, there has been a rapid rise in the proportion of older adults in prisons across the world. While the cause for this trend depends on local demographic, legal and social circumstances, ethnographic attention to this issue remains sparse. This commentary examines the contributions of two recent books on older adults in prisons in order to highlight key questions and findings that might provide a foundation for future research for the anthropology of aging and the life course. Despite focusing on different national contexts, both works reveal the disproportionate harm to older adults as a result of incarceration, as well as the ways individuals cope, even in very restrictive institutional environments. I conclude by stressing the need for more ethnographic attention to the growing overlap between aging and the carceral (in and out of prisons), and the importance of this research for questioning our broader assumptions about aging, care, crime and justice.

The older prisoner health and social care assessment and plan (OHSCAP) versus treatment as usual: a randomised controlled trial

BackgroundOlder people are the fastest-growing demographic group among prisoners in England and Wales and they have complex health and social care needs. Their care is frequently ad hoc and uncoordinated. No previous research has explored how to identify and appropriately address the needs of older adults in prison. We hypothesised that the Older prisoner Health and Social Care Assessment and Plan (OHSCAP) would significantly increase the proportion of met health and social care needs 3 months after prison entry, compared to treatment as usual (TAU).MethodsThe study was a parallel randomised controlled trial (RCT) recruiting male prisoners aged 50 and over from 10 prisons in northern England. Participants received the OHSCAP or TAU. A clinical trials unit used minimisation with a random element as the allocation procedure. Data analysis was conducted blind to allocation status. The intervention group had their needs assessed using the OHSCAP tool and care plans were devised; processes that lasted approximately 30 min in total per prisoner. TAU included the standard prison health assessment and care. The intention to treat principle was followed. The trial was registered with the UK Clinical Research Network Portfolio (ISRCTN ID: 11841493) and was closed on 30 November 2016.ResultsData were collected between 28 January 2014 and 06 April 2016. Two hundred and forty nine older prisoners were assigned TAU of which 32 transferred prison; 12 were released; 2 withdrew and 1 was deemed unsafe to interview. Two hundred and fifty three 3 prisoners were assigned the OHSCAP of which 33 transferred prison; 11 were released; 6 withdrew and 1 was deemed unsafe to interview. Consequently, data from 202 participants were analysed in each of the two groups. There were no significant differences in the number of unmet needs as measured by the Camberwell Assessment of Needs – Forensic Short Version (CANFOR-S). The mean number of unmet needs for the OHSCAP group at follow-up was 2.03 (SD = 2.07) and 2.06 (SD = 2.11) for the TAU group (mean difference = 0.088; 95% CI − 0.276 to 0.449, p = 0.621).No adverse events were reported.ConclusionThe OHSCAP was fundamentally not implemented as planned, partly due to the national prison staffing crisis that ensued during the study period. Therefore, those receiving the OHSCAP did not experience improved outcomes compared to those who received TAU.Trial registrationCurrent Controlled Trials: ISRCTN11841493, 25/10/2012.

Caring, sharing, preparing and declaring: how do hospices support prisons to provide palliative and end of life care? A qualitative descriptive study using telephone interviews

Background: Older adults in prison have complex healthcare needs, and many will need palliative care before their sentence ends. Compared with prison-based hospices, little is known about the role played by community-based hospices in providing palliative care to people in prison Aim: To describe the roles Scottish hospices have adopted to support prisons to provide palliative care, and to discuss the international relevance of these findings in addressing the knowledge gap around community hospices supporting people in prison. Design: A qualitative descriptive study using semi-structured telephone interviews. Setting/participants: Representatives from all Scottish adult hospices were invited to take part in a short telephone interview and all (N = 17) participated. Results: Four roles were identified: caring, sharing, preparing and declaring. Most hospices employed different combinations of roles. Five (30%) hospices were engaged in caring (providing direct care at the prison or the hospice). Eleven (65%) hospices were engaged in sharing (supporting the prison by sharing knowledge and expertise). Eleven (65%) hospices were engaged in preparing (making preparations to support prisons). All seventeen hospices were described as declaring (expressing a willingness to engage with prisons to provide care). Conclusions: There are differences and similarities in the way countries provide palliative care to people in prison: many are similar to Scotland in that they do not operate prison-based hospices. Variations exist in the level of support hospices provide. Ensuring that all people in prison have equitable access to palliative care will require close collaboration between prisons and hospices on a national level.

Wasted Lives: Aging as an Incentive for Reconstruction of Desistance Intentions Among Older Adults in Prison

There is growing scholarly interest in older adults involved in crime and their lives in prison. However, the specific group of older adults who persistently offend (OAPO) and their desistance intentions has received little attention. The present study aims to explore the lived experiences of OAPO who intend to desist from crime. Seventeen OAPO were interviewed, and an interpretive phenomenological analysis approach was used to analyze the narratives they presented. Participants’ interviews revealed four superordinate themes: (1) insight and change in the lives of OAPO; (2) a series of losses lead to disillusionment with a life of crime; (3) desistance as the only alternative; and (4) fear of death in prison as a catalyst for desistance. The findings suggest that desistance intention among older adults in prison is an individualized process deeply affected by age-related motivations and dynamics.

Older adults incarcerated in state prison: health and quality of life disparities between age cohorts

Objectives This research sought to describe the physical and psychological health and quality of life among older adult men incarcerated in a state prison and to examine the role of age and historical time between age cohorts. Methods Survey responses from male respondents incarcerated in a medium-security prison (N = 186) were described using frequencies and descriptive statistics; chi-square and analysis of variance analyses were used to examine differences between age cohorts. Results The average number of chronic health conditions for the sample was higher than those in similar samples; the proportion of older adults with four or more chronic conditions was 10% higher than the national average for adults age 65 or older. Depression and post-traumatic stress (PTS) symptom severity scores were higher than those found in community-based samples. Significant differences were identified between cohorts regarding physical (number of chronic conditions, F = 12.48, p < .01); functional impairment, F = 4.28, p < .05) and psychological health (PTS symptom severity, F = 3.16, p < .05). Conclusion Policy and practice implications are discussed including the expansion of on- and off-site services for older adults in prisons, enhanced accessibility, and the use of grief counseling and stress management strategies.

Comparing the predictive capability of self-report and medically-verified non-fatal overdose in adults released from prison: A prospective data linkage study

BackgroundSelf-reported non-fatal overdose (NFOD) is a predictor of future overdose and is often used to target overdose prevention for people released from prison. However, the level of agreement between self-reported and medically-verified NFOD history remains unknown. This study aimed to determine the agreement between, and predictive value of, self-reported and medically-verified history of NFOD in people recently released from prison. MethodsPre-release baseline survey data from 1307 adults in prison surveyed from 2008 to 2010 in Queensland, Australia were linked to ambulance, emergency department, and hospital records. We compared the agreement of self-reported NFOD history in the baseline survey and medically-verified NFOD ascertained through linked medical data. Unadjusted and adjusted regression models were used to determine the association between self-reported and medically verified NFOD history and medically-verified NFOD after release from prison. Results224 (19 %) participants self-reported NFOD history only, 75 (5 %) had medically-verified NFOD history only, and 56 (4 %) both self-reported and had medically-verified NFOD history. Compared to those with no NFOD history, those who self-reported and had a medical history of NFOD (adjusted hazard ratio (AHR) 6.1, 95 %CI 3.1–11.9), those with a medical history only (AHR 3.4, 95 %CI 1.7–7.0), and those who self-reported only (AHR 1.8, 95 %CI 1.0–3.5) were at increased risk of medically-verified NFOD after release from prison. ConclusionsRelying on self-report of NFOD is likely to miss people at increased risk of future NFOD, many of whom could be identified through medical records. Wherever possible, data related to NFOD should be triangulated from multiple sources.

A systematic review of interventions for older adults living in jails and prisons

Objectives: The population of older adults in prison is the fastest growing demographic. Older inmates are more likely to have chronic medical conditions and cognitive decline, but these conditions occur earlier and may be more complex for older inmates. Specialized interventions to manage the unique health and mental health needs of older inmates are important to improve health and reduce burden on criminal justice systems. The aim of this research is to conduct a systematic review of empirically-tested interventions to improve the health or mental health of older adults living in jail or prison.Method: We conducted a systematic review of the literature to answer two research questions: (1) what interventions designed to improve the health or mental health of older adults living in jail or prison have been empirically tested? and (2) what are the effects of the interventions on inmates’ physical or mental health?Results: Twenty-four articles were identified; seven met inclusion criteria. Several manuscripts discussed the same intervention, so the review identified five unique interventions for incarcerated older adults. The interventions are discussed including their main findings and limitations.Conclusion: Results support the need for research on interventions for incarcerated older adults. Intervention during incarceration can have a great impact on older adults’ health and mental health during incarceration and upon reentry to the community. Directions for future research suggest the need for collaboration between practitioners and researchers in order to increase knowledge of what types of intervention work for older inmates living in jails and prisons.

Management of Facial Trauma in the Prisoner Population

More than 10 million people are imprisoned worldwide, and the prevalence of all investigated mental disorders is higher in prisoners than in the general population. Although the extent to which prison increases the incidence of mental disorders is uncertain, considerable evidence suggests low rates of identification and treatment of psychiatric disorders. Prisoners are also at increased risk of all-cause mortality, suicide, self-harm, violence, and victimisation, and research has outlined some modifiable risk factors. Few high quality treatment trials have been done on psychiatric disorders in prisoners. Despite this lack of evidence, trial data have shown that opiate substitution treatments reduce substance misuse relapse and possibly reoffending. The mental health needs of women and older adults in prison are distinct, and national policies should be developed to meet these. In this Review, we present clinical, research, and policy recommendations to improve mental health care in prisons. National attempts to meet these recommendations should be annually surveyed.

Prison Break. Education of young adults in closed prisons—building a bridge from prison to civil society?

ABSTRACTPrison education is seen in both criminal and education policies as a way of assimilating inmates ‘back into society’. In spite of the policy emphasis on education, the practices in prison education vary from prison to prison. The stated aim of prison education in EU and in Finnish national level policies is to teach inmates the skills and knowledge that they can use in life after release and thus reduce recidivism. In this paper, we analyse policies and practices related to education programmes in closed prisons in Finland with discourses of employability and therapisation of education. International and national policy documents and ethnographic data and interviews with young people and teachers have been use as data sources. Our aim is to draw a picture of multiple and complex power relations that shape the young adults in prison as flexible subjects that are able to make the transition from prison ‘back’ to civil society.

Mental health among young adults in prison: the importance of childhood-onset conduct disorder.

BackgroundThe psychiatric health burden of prisoners is substantial. However, there is a lack of high-quality studies of psychiatric disorders among young adults with a high risk of reoffending.AimsTo investigate the lifetime prevalence of psychiatric disorders and use of mental health services among young male violent offenders and the impact of childhood-onset conduct disorder (COCD).MethodA nationally representative cohort (n = 270, age 18–25) of male offenders was followed back in medical records and clinically assessed by gold standard methods. Lifetime prevalences are presented together with odds ratios (ORs) as risk estimates in relation to COCD.ResultsPrevious use of psychiatric services among the participants was high but their lifetime psychiatric morbidity was even higher, with 93% meeting criteria for at least one Axis I disorder. The COCD group was overrepresented in most clinical categories and carried five times higher odds (OR = 5.1, 95% CI 2.0–12.8) of a psychotic disorder, three times higher odds (OR = 3.2, 95% CI 1.2–8.5) of a substance use disorder and two times higher odds of a mood disorder (OR = 2.3, 95% CI 1.3–4.0) or anxiety disorder (OR = 2.0, 95% CI 1.1–3.5).ConclusionsThe mental health burden is substantial among young violent offenders, and COCD is an important indicator of future mental health problems which must be a priority for public health efforts.Declaration of interestNone.Copyright and usage© The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.

Trauma, stress, and coping among older adults in prison: Towards a human rights and intergenerational family justice action agenda.

Although there is a growing body of research on older adults and coping in prison, many inquiries about areas of concern remain unanswered. Specifically, what are the primary traumatic experiences and stressors of the incarceration experience and how do incarcerated older adults, many of whom have s

Staff Sexual Misconduct

This is a study of female staff sexual misconduct, drawing on reports of victims identified in large-scale national surveys of adults in prison and jails and youth in juvenile facilities. Past research has often emphasized the inmate roles and staff member vulnerabilities. More recent scholarship has moved beyond the traditional conception of sexual abuse by female correctional workers as the consequence of manipulative and predatory actions by male inmates and placed greater responsibility on the women for their actions. Although the surveys conducted by the Bureau of Justice Statistics over the last decade in response to the 2003 Prison Rape Elimination Act are unable to speak to the motivations of the victims or the perpetrators, they provide an assessment of the magnitude of the problem and offer extensive detail on the circumstances surrounding female staff sexual misconduct. The findings indicate that female staff members are overrepresented among perpetrators of staff sexual misconduct in prisons, jails, and juvenile facilities. The data reveal a high level of staff misconduct, involving abuse of power, trading in favors, offers of special privileges and protection, and offers of alcohol and drugs, which co-occurs with female staff sexual misconduct.

Living conditions, nutritional status and morbidity in children in prisons and detention centers in Burkina Faso

In Burkina Faso, although children are sometimes separated from adults in prisons, they still live in the same conditions of overcrowding, which can reach 180% of the capacity. The aim of our study was to describe living conditions, nutritional status, and morbidity of children in detention centers of Burkina Faso. The objective of this cross-sectional descriptive study is to describe the social and health conditions of children held in 20 detention centers in Burkina Faso. During the study period, 109 children, with a mean age of 16.3 years, were examined in 20 correction centers. The main reason for incarceration was theft (66% cases, n = 72). Detention exceeded more than one month for 76 children (70%), and 59% (N = 46) had had fewer than one visit per month since their incarceration. Of these 20 facilities, 6 had no separate quarters for children. The main symptoms and diseases encountered in these children were fever in 19% of the cases (N = 16), macroscopic hematuria in 13% (N = 11), urinary tract infection in 12% (N = 10) and diarrhea in 12% (N = 10). These results show that there is a need to take preventive measures to protect these children's health, especially by improving the quality of living conditions in detention center.

New Directions for the Study of Incarcerated Older Adults: Using Social Capital Theory

As the population of older adults continues to rise, so, too, does the population of older adults in prison. The body of literature on older adults in corrections is scant, particularly with regard to health and social functioning. Past studies of aging inmates primarily focus on health care and related costs. The purpose of this article is twofold: (a) outline and synthesize the research on older adults living in prison; and (b) propose a framework for future research and intervention development based on social capital theory. Recommendations for social work practice, programs, and research are discussed.

Deliberate self-harm among adults in prisons

This article explores barriers that prevent or interfere with the implementation of policies for reducing deliberate self-harm in adults in prisons and the levers that aid implementation. An integrative literature review was conducted of 12 studies of deliberate self-harm in the prison service between 2000 and 2012. Data were analysed thematically. Six themes were identified: knowledge; attitudes; emotion; staff skills; environment; and resisting treatment. The authors argue that having identified barriers and levers, the next stage is to address them so that the high levels of self-harm in prison can be reduced.

‘A Delicate Balance…’: Language as a Tool of Identity Expression for Incarcerated Men Pursuing Higher Education

In the course of an initiative to provide higher education to adults in prison, incarcerated men enrolled in an undergraduate degree programme were offered the opportunity to participate in a series of writing workshops. This article examines the products of these workshops, specifically the ways that language chosen by the writers serves as a tool in the process of identity construction and expression. Choices made in discourse, shown to be deliberate, demonstrate the men’s awareness of relationships between language, identity and power, as well as testifying to the significance of these connections for writers.

Bridging community and prison for older adults: invoking human rights and elder and intergenerational family justice.

Older adults in prison present a significant health and human rights challenge for the criminal justice system. To date, there is no known study that provides a comprehensive examination or portrait of older persons in prison. The purpose of this paper is to understand individual, family, system, and community vulnerabilities that can complicate successful community reintegration for these individuals. This study provides a cross-sectional, descriptive analysis of biopsychosocial, spiritual, and prison use characteristics associated with a sample of 677 older prisoners, aged 50+, in a state-wide prison system. Results indicate the extent of diversity within this population based on demographic, clinical, social, legal profiles, prison service use patterns, and professional and personal contacts. Due to the diversity within this population, an interdisciplinary approach is needed to address the complex social and health care needs of an aging prison population and to plan for their reentry. Practical implications - These findings suggest the need for holistic prevention, assessment, and interventions to interrupt the social-structural disparities that foster and support pathways to incarceration and recidivism. The human rights implications for the current treatment of older adults in prison include providing in-prison treatment that promotes safety, well-being, reconciliation, and seamless bridges between prison and community for older adults and their families. The True Grit Program is presented as an example of a humanistic and holistic approach of such an approach.

Reducing Vulnerability to Harm in Adults With Cognitive Disabilities in the Australian Criminal Justice System

AbstractPersons with cognitive disabilities such as intellectual disability, borderline intellectual disability, and acquired brain injury are overrepresented in Australian criminal justice systems both as victims and as offenders. Data obtained in Australia and internationally indicate that up to 12% of the prison population has an intelligence quotient (IQ) of less than 70, with up to 30% having an IQ of between 70 and 80, indicating substantially higher representation of intellectual disability and borderline intellectual disability than in the general population. Indigenous Australian adults in prison are significantly more likely to have intellectual disability than their non‐Indigenous counterparts. Points of intervention throughout individuals' trajectories into and through the criminal justice and human service system are investigated, allowing new ways of understanding how persons with intellectual and other cognitive disabilities are vulnerable to the harms of control‐and‐punishment systems. Using an innovative data‐linking and data‐merging method, the authors compiled longitudinal administrative data from all criminal justice and human service agencies in New South Wales, Australia, to create life‐course pathways for 2,731 persons who had served time in prison in New South Wales and whose mental health and cognitive disability diagnoses were available. Mapping service agency responses and institutional trajectories of these persons from an early age reveal a picture of early police contact and enmeshment in juvenile and adult corrections with high frequency, but often of low duration. Poor recognition of cognitive disability coupled with the presence of mental disorders and substance use disorders is associated with multiple and compounding social disadvantage and vulnerability to harm. This group is subject to multiple, simultaneous, and continuing human service agency interventions, which have only limited impact on their offending and (re)incarceration. Provision of appropriate support before, during, and after imprisonment is likely to reduce these individuals' vulnerability to harm and improve their experiences of community integration.