County Detention Research Articles

Sustainability of Treatment Programs Utilizing Medications for Opioid Use Disorders in Incarcerated Young Adults.

The epidemic of opioid overdose brought a major health crisis to the front line of public health in the United States. Early efforts have focused on the prevention of production, distribution, and consumption of the drugs. However, there is little information about youth populations at risk for opioid overdose and their response to targeted treatment plans. The San Bernardino County Youth Opioid Response (SBCYOR) coalition in collaboration with the San Bernadino County (SBC) Probation Department organized a safety net system for at-risk youth by improving communication among county resources. This program mainly focused on individuals aged 12 to 24 years in the county's detention centers along with educational and prevention projects such as naloxone programs for first responders in the region. To describe the impact of the SBCYOR program on at-risk youth, we compare the frequencies of patients referred and treated with medications for opioid use disorder (MOUD) at the SBC Probation Department, which was responsible for individuals from age 12 to less than 18 years, with those from the West Valley Detention Center (WVDC), which was responsible for adults (18 to 24 years of age), from September 2020 through June 2022. Similar proportions of youths were referred for treatment of opioid use disorder (OUD) at the respective sites (3.7% SBC Probation Department, 3.6% WVDC). Of these, however, 78.0% were treated with MOUD at SBC Probation Department compared with only 7.1% at WVDC. SBCYOR coalition partners were able to transform their services into a comprehensive medical and behavioral health program for the incarcerated youth population at risk for OUD.

Primary care need and engagement by people with criminal legal involvement: Descriptive and associational analysis using retrospective data on the entire population ever detained in one southeastern U.S. county jail 2014-2020.

More than 7 million people are released each year from U.S. jails or prisons, many with chronic diseases that would benefit from primary care in their returning communities. The objective of this study was to provide an in-depth, payer-agnostic description and associational analysis of primary care need and utilization by all individuals ever detained in one county detention facility over a 7-year period. Detention records 2014-2020 were merged with data from an electronic health record with excellent coverage of local primary care, emergency, and hospital services. We found low primary care participation for the group as a whole, with under three quarters of those with serious chronic diseases ever seeing a primary care provider over a 7-year period and less than half ever having a year with more than one visit. Multivariable regression models estimated associations between individual characteristics (demographic, detention-related, and clinical) and ever having access to primary care (logistic) and the number of primary care visits (zero-inflated negative binomial). We found that having more jail bookings was associated with fewer primary care visits, but not one-time access, even controlling for time out of community, age, insurance, and other demographic characteristics. This finding was driven by subgroups with chronic disease such as hypertension, obstructive lung disease, and diabetes, who most need regular primary care. Being Black retained an independent effect, even controlling for bookings and other variables, and was also associated with fewer primary care visits, though not one-time access. To promote primary care utilization among individuals who have the combined challenges of repeated jail involvement and chronic disease, it is crucial to focus on engagement, as much as formal access. Access to health insurance alone will not resolve the problem; Medicaid expansion should be coupled with specialized, tailored support to promote engagement in primary care.

Key criteria within DSM-5 substance use disorder diagnoses: evidence from a correctional sample

Nearly 9 million adults are processed into U.S. jails annually and the majority present indications of substance use disorder, yet little research has been conducted to examine how certain DSM-5 criteria specify levels of severity in this institutionalized population. Clinical interviews were conducted with 718 adults (M age = 34.3 years, SD = 10.3) detained in four county detention centers using the Comprehensive Addiction and Psychological Evaluation-5 (CAAPE-5). Prevalence rates were examined by severity levels to identify prominent criteria within methamphetamine, opioid, alcohol, and cannabis use disorders. Item response theory models were estimated to determine which criteria effectively identified the most severe conditions. A subset of key criteria, consisting of withdrawal, sacrificed activities, craving, role failure, and failure to cut down on substance use, was clearly observed. These five items identified significant proportions of severe substance use disorders, but the greatest accuracy was among cases of methamphetamine and opioid use. A reduced set of five DSM criteria can detect certain severe substance use disorders efficiently. This information can be applied to diagnostic and clinical service delivery procedures in correctional settings, paying particular attention to the special circumstances found among adults who are incarcerated in local detention centers.

A Prospective Study of Injection Drug Use and Jail Readmission in Two Western North Carolina Counties.

Injection drug use among people admitted to rural jails has significant implications for both infectious disease transmission and incarceration patterns. This study examines the relationship between injection drug use, jail readmission, and detention duration to inform interventions designed specifically for this understudied correctional setting. The Comprehensive Addiction and Psychological Evaluation-5 (CAAPE-5) was administered to a random sample of adults admitted to two county detention centers in Western North Carolina. Data regarding readmission and the length of detention were obtained for the 12-month study period. Participants included 420 adults, aged 18-66 years. Nearly three-quarters (70.9%) met criteria for at least one substance use disorder (SUD) and almost half (45.7%) met criteria for multiple SUDs. Approximately half (45.2%) reported injecting drugs, with the majority (71.6%) reporting injecting methamphetamine, followed by 51.1% who injected opioids. People who injected drugs were 1.83 times more likely (95% CI = 1.17-2.87) than those who did not inject to be admitted on multiple occasions and also spent a significantly longer amount of time detained (IRR = 1.34, 95% CI = 1.02-1.77) during the 12-month follow-up period. The study was limited to jails in two counties and injection-related factors may vary from other facilities. The association between drug injection and longer detention periods presents an opportunity to engage people with infectious disease screening and substance use services in jails. Connection to stable primary and behavioral health care after release is a high priority in enhancing community health.

Relationships between substance use disorders, 'severe mental illness' and re-arrest in a county detention facility: A 4-year follow-up cohort study.

A growing body of literature demonstrates strong association between poor mental health and criminal recidivism, but research from county jails is limited. Our aim was to examine the relationship between re-arrest and severe mental illnesses-schizophrenia, bipolar disorder and major depressive disorder-together and separately and with substance use disorders, separately and as comorbid conditions, in a mid-sized county jail cohort in the southeastern United States. We examined the full cohort of 8097 individuals who were booked into the County Detention Facility between 31 January 2014 and 31 January 2015. Their incarceration data were merged with data from the local health system to investigate the presence of severe mental illness and substance use disorder diagnoses. Re-arrest data were tracked for 4years after the index arrest. Approximately 60% of the cohort was re-arrested within 4years. People with substance use disorders, with or without severe mental illness, had higher re-arrest rates than those with severe mental illness alone or neither diagnosis. Drug-associated arrests did not explain this finding. Using detailed mental illness diagnosis data with a complete cohort of detained arrestees, we have shown the wide range of need among such individuals. By demonstrating that drug-associated crimes per se do not drive repeated arrest, we underscore a need to examine other factors that promote the cycle of repeated arrest in this population. Each individual requires treatment tailored to their personal psychiatric and criminogenic needs.

An inside view: Reflections of a jail chaplain

Reflecting on my 35 years as a chaplain in a large county detention facility, serving as a chaplain was my call, my passion, my frustration, and my pain. I am struck by the importance of respect in the lives of those who are incarcerated. Respect, both personal and systemic, is essential for facilitating healthy relationships and spiritual development among prisoners. When respect is lacking, prisoners are subjected to dehumanizing conditions, physical and mental health problems, and an ongoing environment of violence. Staff members also experience the negative effects of a disrespectful environment, leading to job dissatisfaction and burnout. Our communities’ responses to crime often focus on humiliation, isolation, and punishment, which perpetuates desperate coping mechanisms such as substance abuse, poverty, and violence. This approach only serves to further dehumanize people who are incarcerated. Providing opportunities for prisoners to form healthy relationships while in custody is essential for their rehabilitation and reentry into society. It also allows local faith communities to practice their faith principles of mercy, forgiveness, and compassion by reaching out to those people who are often forgotten and marginalized.

Barriers and facilitators to attending and being physically active during recreation time among women incarcerated

BackgroundMost women incarcerated in jail are not physically active and do not attend recreation time (rec-time), a time dedicated to being physically active, outside. The purpose of this study was to determine barriers and facilitators to attending and being physically active during rec-time among women incarcerated in jail.MethodsWe recruited and distributed a cross-sectional questionnaire to 100 women incarcerated at the Coconino County Detention Facility (CCDF) in Flagstaff, Arizona from March to July 2020. Women were asked about their experience with rec-time at CCDF, including if they had ever attended, how often they attended, if they exercised at rec-time, activities they participated in, and facilitators, barriers, and benefits to attend rec-time.ResultsAmong 99 women who completed the questionnaire, 89% had ever attended rec-time. Most women identified environmental- and health-related facilitators to attending rec-time including enjoying natural light (74%), getting fresh air (83%), a change in environment (62%), and to move around and exercise (72%). Many women indicated environmental-, equipment-, clothing, and motivation-related barriers to attending rec-time. Specifically, women believed there was a lack of equipment (56%) and limited access to proper footwear (49%).ConclusionsAs health and environment are important facilitators and barriers to being physically active among women incarcerated in jail, it is important to identify appropriate environmental and policy interventions to increase the use of rec-time and physical activity. If a correctional facility does not offer rec-time or a similar alternative, one should be established, accessible, and welcoming.

Reproductive Injustice at the Southern Border and Beyond: An Analysis of Current Events and Hope for the Future.

Reproductive Injustice at the Southern Border and Beyond: An Analysis of Current Events and Hope for the Future.

The Infiltrators

Reviewed by: The Infiltrators by Cristina Ibarra and Alex Rivera J. Felix Gallion (bio) The Infiltrators. Cristina Ibarra and Alex Rivera, 2019. Baked Studios. 95 mins. Having been described as a “docufiction” and “docu-thriller” on last year’s film festival circuit, and even as a riff on the heist film genre by the filmmakers themselves, The Infiltrators is an eclectic mix of cinematic forms that bucks conventional description within established varieties of documentary. The film follows a group of DREAMer activists and members of the National Immigrant Youth Alliance (NIYA) who in 2012 purposely surrendered themselves to Customs and Border Patrol in order to gain access to the Broward County Detention Facility in South Florida. Their original goal was to “infiltrate” the facility in order to contact Claudio Rojas, an undocumented individual from Argentina who was suddenly detained and threatened with deportation, and try to secure his release. Once inside, however, they soon discover that their advocacy and connections to the outside world could help countless more detained within Broward. [End Page 189] The film’s main action—dealing with armed guards, smuggling things in and out of what is essentially a prison, stopping government planes on the tarmac— is the stuff of blockbuster movies, and, visually, directors Rivera and Ibarra use a few scripted, big-budget tropes to emphasize the danger and drama of the whole infiltration endeavor, such as opening the film with shots of the US-Mexico border as seen from a high-tech night-vision camera and scripting a smuggling scene that’s as nailbiting as anything in a Hollywood production. But The Infiltrators is not so much a thriller or heist film as a kind of ghost story. Millions haunt this film—particularly the nearly 1.3 million Deferred Action for Childhood Arrivals (DACA) recipients awaiting the Supreme Court’s ruling on whether or not the Trump administration can end the program and the estimated 10.7 million undocumented individuals who live with a constant fear of arrest, confinement, and deportation. It is the relationship and solidarity between these groups that the film’s genre-bending tries so valiantly to represent. The titular “infiltrators,” Marco Saavedra and Viridiana Martinez, represent the former and the particular relationship DREAMers have to media representation and to the law leading up to the implementation of the DACA program. The film makes it clear that the thought of surrendering to immigration officials is only made possible by the limited protections from deportation Saavedra and Martinez achieved due to the media coverage of their activism with NIYA. For Saavedra and Martinez, it is the paradox of being able to live and advocate for themselves and others because they are openly undocumented that necessitates an action like gaining access to a detention center. Once inside Broward, Saavedra and Martinez’s experiences are implicitly compared to those of other non-DREAMer detainees, including the aforementioned Claudio Rojas, arrested and detained without warning; Maria Soledad, a Venezuelan political asylum seeker; Neema Mukun, a Congolese woman whose attempt to flee an abusive husband lands her in detention for three years; and Ashan, a Sri Lankan migrant detained for more than two years. These individual stories give us glimpses into the scope of the Obama-era deportation apparatus, but Rivera and Ibarra also use them to demonstrate the complex relationship detained migrants have to both legal and media representation. In transporting us to the heart of a detention center, Rivera and Ibarra show us how these spaces are designed to function as representational “black boxes.” With the media and general public denied access to these privately run centers, and with migrants often being moved between them with no notice given to their families or loved ones, detained migrants are depicted as living specters with few ways to communicate with the greater public and government officials on the outside. For NIYA and the directors, the terrible irony of all this is that they are trapped in a system that denies them basic legal rights yet invokes classical liberalism’s “right to privacy” as a means [End Page 190] of blocking access to anyone with interest. Saavedra describes this liminal position best: “You see, because none of...

Civil Detainees' Rights to In-Custody Care

In Charles v. Orange County , 925 F.3d 73 (2d Cir. 2019), the plaintiffs appealed a Southern District of New York decision to dismiss all claims against the Orange County detention facility that alleged constitutional violations for failing to provide discharge planning for the plaintiffs upon

A Pilot Study of a Meditation and Mindfulness Program with Detained Juveniles: An Adaptation of Inner Resources for Teens (IRT)

ABSTRACTThis study examined the clinical utility of a meditation, mindfulness, and mantra intervention for youth experiencing serious mental illness while incarcerated. Participants were 17 adolescent males, aged 16 to 18, from two units of a county detention center in the San Francisco Bay Area. Eleven (64.7%) participants were Latino-American, one (5.9 %) was Black/African American, three (17.6 %) were Caucasian-American, one (5.9%) was Asian-American and one (5.9%) self-identified as “other/mixed race.” The intervention consisted of a four-session adaptation of the Inner Resources for Teens (IRT) manualized intervention, designed to teach and practice skills for developing sustained mindfulness. Participants completed the intervention over a four-week period, attending one hour per week. They were asked to practice the techniques for ten minutes a day. Participants were assessed using the Child Acceptance and Mindfulness Measure (CAMM) and the Brief Symptom Inventory (BSI) at pre-treatment, mid-treatment, and immediate post-treatment. Intent-to-treat analyzes found statistically significant reductions in global severity (d = − 0.44), positive symptoms distress (d = − 0.54), obsessive compulsive symptoms (d = − 0.65), paranoid ideation (d = − 0.49), and psychoticism (d = − 0.71). Positive symptoms, somatization, depression, hostility, and mindfulness non-significantly improved with small effect sizes. These findings suggest that IRT may improve symptoms of mental illness among youth in detention facilities.

Overcoming Institutional, Scientific, and Cross-disciplinary Barriers for Healthcare and Disease Transmission Research in County Jail Settings: Integrating Genomics, Survey Data, and Biological Data Collection Strategies

More than 20 million Americans are currently or have been previously incarcerated and 12 million cycle in and out of the criminal justice system each year. Despite the importance of the jail populations, there are a number of barriers to conducting research in this setting. Challenges in recruiting jail inmates without undue coercion while ensuring proper consent are significant. Even simple things like participant compensation are complicated in an environment when participants do not have direct access to cash or choices for places to spend it. Finally, simply carrying out surveys and biological specimen collection is complicated by the requirement of not introducing contraband into a controlled jail environment. Over the last two years, we have designed and carried out a study within a county detention facility in Arizona. We have successfully enrolled, surveyed, and collected bio-specimens from 200 currently incarcerated individuals, facing and resolving the challenges outlined above. Our solutions to these can be of great benefit to other researchers attempting cross-disciplinary analyses in jail settings.

Epidemiology of Incarceration: Characterizing Jail Incarceration for Public Health Research.

Each year, 9 million individuals cycle in and out of jails. The under-characterization of incarceration as an exposure poses substantial challenges to understanding how varying levels of exposure to jail may affect health. Thus, we characterized levels of jail incarceration including recidivism, number of incarcerations, total and average number of days incarcerated, and time to reincarceration. We created a cohort of 75,203 individuals incarcerated at the Coconino County Detention Facility in Flagstaff, Arizona, from 2001 to 2018 from jail intake and release records. The median number of incarcerations during the study period was one (interquartile range [IQR] = 1-2). Forty percent of individuals had >1 incarceration. The median length of stay for first observed incarcerations was 1 day (IQR = 0-5). The median total days incarcerated was 3 (IQR = 1-23). Average length of stay increased by number of incarcerations. By 18 months, 27% of our sample had been reincarcerated. Characteristics of jail incarceration have been largely left out of public health research. A better understanding of jail incarcerations can help design analyses to assess health outcomes of individuals incarcerated in jail. Our study is an early step in shaping an understanding of jail incarceration as an exposure for future epidemiologic research. See video abstract at, http://links.lww.com/EDE/B536.

Transformative and Social Justice Dimensions of a Jail-based College Course

Research consistently demonstrates the benefits associated with the provision of education in correctional facilities. These examinations typically focus on prison-based education, enhanced employment opportunities, and recidivism reduction. There is considerably less attention afforded to jail-based education and other benefits associated with institutional education opportunities. This study focuses on a criminal justice college course based on the Inside-Out Prison Exchange Model taught at the Washoe County (Nevada) Detention Center in the spring 2016 semester. This course brought together outside students (i.e., college students) and inside students (i.e., incarcerated men) for a semester-long course held once per week in the jail. The results highlight the transformative aspects of a single course that may generate the foundation for functional changes among people who are incarcerated and the value of experiential education for college students.

Health Disparities and Converging Epidemics in Jail Populations: Protocol for a Mixed-Methods Study.

BackgroundIncarcerated populations have increased in the last 20 years and >12 million individuals cycle in and out of jails each year. Previous research has predominately focused on the prison population. However, a substantial gap exists in understanding the health, well-being, and health care utilization patterns in jail populations.ObjectiveThis pilot study has 5 main objectives: (1) define recidivists of the jail system, individuals characterized by high incarceration rates; (2) describe and compare the demographic and clinical characteristics of incarcerated individuals; (3) identify jail-associated health disparities; (4) estimate associations between incarceration and health; and (5) describe model patterns in health care and jail utilization.MethodsThe project has two processes—a secondary data analysis and primary data collection—which includes a cross-sectional health survey and biological sample collection to investigate infectious disease characteristics of the jail population. This protocol contains pilot elements in four areas: (1) instrument validity and reliability; (2) individual item assessment; (3) proof of concept of content and database accessibility; and (4) pilot test of the “honest broker” system. Secondary data analysis includes the analysis of 6 distinct databases, each covered by a formal memorandum of agreement between Northern Arizona University and the designated institution: (1) the Superior Court of Arizona Public Case Finder database; (2) North Country Health Care; (3) Health Choice Integrated Care; (4) Criminal Justice Information Services; (5) Correctional Electronic Medical Records; and (6) iLEADS. We will perform data integration processes using an automated honest broker design. We will administer a cross-sectional health survey, which includes questions about health status, health history, health care utilization, substance use practices, physical activity, adverse childhood events, and behavioral health, among 200 Coconino County Detention Facility inmates. Concurrent with the survey administration, we will collect Methicillin-resistant and Methicillin-sensitive Staphylococcus aureus (samples from the nose) and dental microbiome (Streptococcus sobrinus and Streptococcus mutans samples from the mouth) from consenting participants.ResultsTo date, we have permission to link data across acquired databases. We have initiated data transfer, protection, and initial assessment of the 6 secondary databases. Of 199 inmates consented and enrolled, we have permission from 97.0% (193/199) to access and link electronic medical and incarceration records to their survey responses, and 95.0% (189/199) of interviewed inmates have given nasal and buccal swabs for analysis of S. aureus and the dental microbiome.ConclusionsThis study is designed to increase the understanding of health needs and health care utilization patterns among jail populations, with a special emphasis on frequently incarcerated individuals. Our findings will help identify intervention points throughout the criminal justice and health care systems to improve health and reduce health disparities among jail inmates.International Registered Report Identifier (IRRID)RR1-10.2196/10337

'Above all, be brave'.

What is your job? My new role is director of nursing at Guilford County Detention Centers, North Carolina. I manage three sites across the county, with around 1,300 inmates including men, women and juveniles.

Devolution, not decarceration: The limits of juvenile justice reform in Texas

Across the USA, a number of states have been reducing the number of juveniles sent to state-run corrections institutions. Findings from a case study on juvenile justice in Texas indicate that the effort to reduce the number of juveniles sent to large state institutions and to invest in “community-based corrections” has entrenched rather than challenged the role of the justice system in the lives of thousands of juveniles. Texas has cut the number of juveniles sent to state-run facilities, but has bolstered and expanded county probation and county detention, which is where the vast majority of juveniles have always been handled. Youth who continue to be sent to state-run facilities or who are housed in county-run institutions experience a high level of violence and are routinely subjected to solitary confinement. The popularity of deinstitutionalizing juveniles from state-run corrections institutions and increasing programming and control of offenders at the local level are animating the landscape of criminal justice policy across the country. The Texas case suggests that this narrow approach further consolidates the extensive role of the justice system in U.S. society.

Virginia County Builds Consensus to Keep Mentally Ill Out of Jail

“Slow but steady” is the watchword as one county tackles the problem of too many people with mental illness in jail.

Promoting Health Literacy and Personal Health Management with Inmates in a County Detention Center

Promoting Health Literacy and Personal Health Management with Inmates in a County Detention Center

Library Services to Inmates in the Rural County Jails of Western North Carolina

This paper investigates the current statues of library collections and services in the rural jails in western North Carolina. The authors interviewed the sheriffs and jail administrators in 6 of the 7 western most county detention centers. The benefits of reading and importance of literacy to this underserved population, descriptions the collections and library service policies along with photographs of the actual book collections and the challenges the jails face in maintaining and delivering these services, are presented. This paper advocates that one possible solution to this situation is working towards building partnerships between the public library systems and their local jails and how that can benefits everyone in the community.