Federal Correctional Institutions Research Articles

Canada's Aging Federal Prison Population: Health Disparity, Risk, and Compassionate Release for Persons Convicted of Sexual Offenses.

The Canadian federal prison population is increasingly aging within institutions that were never intended or designed to meet the complex medical and mental health needs of older incarcerated persons. Increasing numbers of incarcerated persons are "aging in place," and many are dying within federal correctional institutions. Persons convicted of sexual offenses comprise a large-and growing-proportion of this aging population. The Correctional Investigator Canada has recently called for an expansion of access to compassionate release for the aging federal prison population, yet little progress has been made. In this article, we explore the significant challenges faced by the aging population in federal institutions, including insufficient access to appropriate care, challenges in application for compassionate release, and how questions of risk may affect the potential for community transfer. Questions of risk overshadow decisions on early release of incarcerated persons, especially those convicted of sexual offenses. Nurses play a central role in the provision of care to aging incarcerated persons and in advocacy for better access to services when a patient's needs cannot be met within the institution. This article presents a call to action for forensic nurses in Canada (and beyond) to advocate for both improved services within federal correctional institutions and for expedited access to compassionate release of aging incarcerated persons, especially those nearing end of life. The significant disparity in access to health care for aging incarcerated persons compared with their nonincarcerated counterparts represents a significant concern.

An Exploratory Factor Analysis of a Prison Rape Elimination Act Survey in a Women's Prison

Even with the dramatic increase in the number of female inmates in state and federal correctional institutions in recent decades, the criminal justice system continues to develop policies based on empirical research from male inmate programming. A shift in focus toward gender-responsive programming is challenging corrections to address women's needs. This study's data are a result of a settlement agreement between the United States Department of Justice (USDOJ) and a state Department of Corrections (DOC) to explore female inmates’ perceptions of sexual and physical safety in the state's largest correctional faculty. The Prison Rape Elimination Act Survey Instrument (PSI) was designed with 15 categories and 76 questions, including demographic data, sexual and physical safety factors, and items related to programs. Results of the exploratory factor analysis (EFA) indicate that the instrument has four factors detecting 41% of the variance explained. Recommendations are to conduct a confirmatory factor analysis (CFA) to assure that the instrument is psychometrically sound and the factors are verified.

The Mental Health and Wellness of Correctional Officers in Canada: Programs and Practices

ABSTRACT Correctional work includes dealing with numerous stressors that compromise mental health. Yet, correctional scholars have dedicated limited attention to assessing the mental health support available to correctional officers at work. Therefore, we explore how officers view mental health programs, especially the Employee Assistant Program (EAP) and the Critical Incident Stress Management Program (CISM). Our findings derive from 44 semi-structured interviews with officers from 15 federal correctional institutions in Canada. Most participants found the mental health programs available at their institutions “helpful.” However, they still regretted some of the program’s characteristics, providing insights into alterations that can increase the effectiveness of the mental health support provided to prison staff. Such alterations comprise changing the mental health approach within correctional services from reactive to proactive and expanding the availability of professionals specialized in correctional mental health within the existing programs.

Intellectual/developmental disabilities among people incarcerated in federal correctional facilities in Ontario, Canada: Examining prevalence, health and correctional characteristics.

There is little research with people who experience intellectual/developmental disabilities and imprisonment. The study linked health and correctional data to examine prevalence of intellectual/developmental disabilities and health and correctional characteristics among adults experiencing their first federal incarceration between 1 January 2002 and 31 December 2011 (n= 9278) and two non-incarcerated groups (n= 10,086,802). The prevalence of intellectual/developmental disabilities was 2.1% in the incarcerated group and 0.9% in the non-incarcerated group. Before incarceration, those with, versus without, intellectual/developmental disabilities were at greater risk of traumatic brain injury, mental illness, and substance use disorders. While incarcerated, those with intellectual/developmental disabilities were more likely to incur serious institutional disciplinary charges. Post-incarceration, persons with intellectual/developmental disabilities were at greater risk of emergency department visits, and psychiatric and acute hospitalizations, than the non-incarcerated groups. People with intellectual/developmental disabilities are overrepresented in Canadian federal correctional institutions. The authors offer strategies to support people prior to, during, and post-incarceration.

Opioid agonist treatment (OAT) experiences and release plans among federally incarcerated individuals with opioid use disorder (OUD) in Ontario, Canada: a mixed-methods study

BackgroundIncarcerated populations experience an elevated prevalence of opioid use disorder (OUD). Federal correctional institutions in Canada have increasingly treated OUD among correctional populations via opioid agonist treatment (OAT) – an evidence based pharmacotherapy that works to reduce drug use and related health harms. However, there is limited evidence regarding incarcerated individuals’ experiences with institutional-based OAT, as well potential OAT-related community release prospects. This information is important for optimal treatment retention and improved health. To address this knowledge gap, we conducted a longitudinal follow-up study examining OAT-related experiences among federally incarcerated individuals before and after community release. This article focuses on the baseline (pre-release) data.MethodsThis mixed-methods study examined OAT-related experiences and release prospects among n = 46 individuals scheduled for community release, recruited from seven federal prisons located in Ontario, Canada. Participants underwent a comprehensive interviewer-administered on-site assessment, including quantitative and qualitative items. Assessment data was furthermore linked to administrative correctional data. Data were analyzed using thematic qualitative and descriptive quantitative approaches.ResultsParticipants had complex histories with opioid use including related negative health outcomes. Experiences with institutional OAT were divergent and provision was not standardized; those with OAT engagement pre-admission did not experience many challenges, whereas those initiating OAT during incarceration experienced barriers such as treatment waitlists and adverse process experiences. Most participants expressed a preference for buprenorphine-naloxone over methadone, but described difficulties accessing it. Participants were keen to transition into community-based treatment, yet envisaged prospective barriers and facilitators concerning successful reintegration and treatment continuity.ConclusionsMajor barriers towards the current administration of OAT in federal correctional systems in Canada exist, including extensive waitlists, non-standardized practices, and challenges accessing preferred OAT formulations; this contributes to sub-optimal treatment. Eliminating waitlists, standardizing OAT provision, providing additional OAT options, and more comprehensive release planning may be essential for treatment retention and positive outcomes.

Comparing characteristics and outcomes of different opioid agonist treatment modalities among opioid-dependent federal men correctional populations in Canada.

Limited evidence exists in Canada on outcomes related to Opioid Agonist Treatment (OAT) and/or differences between OAT modalities among persons in correctional institutions. This study addresses this knowledge gap by examining key characteristics and outcomes of men in Canadian federal correctional institutions across treatment modalities. A retrospective cohort of men incarcerated in federal correctional institutions (N=2833) were classified into four groups - three OAT participant groups: prescribed methadone (M-OAT), prescribed buprenorphine/naloxone (Suboxone®; S-OAT) and those who switched between the two OAT modalities at least once (X-OAT). The fourth group was a non-treatment comparison group (Non-OAT). Two-thirds of study participants were released and examined for post-release outcomes. Descriptive statistics and multi-variate Cox proportional hazards regression were used. The X-OAT group was more likely than the other study groups to have positive urinalysis tests, disciplinary charges, or institutional security or behavioral incidents. Survival analysis indicated that the X-OAT had an adjusted hazard of a return to custody that was 57% greater than the other groups. This study indicates that individuals switching OAT modalities are a more complex group needing additional supports, especially for community reintegration. Although few of the returns to custody were due to new offences, a third of participants in the OAT groups had their release revoked, indicating a high need population mostly due to their substance use.

203 - Decisional capacity and advance care planning in older people who are incarcerated

AbstractThere is a growing number of older people incarcerated across the United States. With a population of greater than 300 million, the US has 5% of the world’s population, yet incarcerates 25% of the world’s prisoners. From 2000 to 2005, the percentage of prisoners in federal and state correctional institutions who were 55 and older increased by 33%. According to the American Civil Liberties Union older prison population has climbed 1300% since the 1980s, with 125,000 inmates aged 55 or older incarcerated.Correctional facilities are the largest mental health institutions with 1 out of 5 individuals with serious mental health or substance use disorders. These facilities lack the capacity to provide long-term care for those with severe physical or mental health disorders even in the most ideal circumstances.Individuals within the criminal justice system have a higher burden of chronic physical and health disorders and have a lower life expectancy.Health care decision making is one area where patients in custody have autonomy in discussing advance directives, substitute decision makers and medical decision making. However, prisoners are at risk of suboptimal care, unmet palliative and end of life care needs, and lacking or inappropriate surrogates. Without documentation of advance directives or surrogates there are bureaucratic, practical, and legal barriers particularly for those without family or friends. In addition, some individuals involved in the correctional system’s only surviving family members may also be their victims, thus have a conflict of interest.This presentation will explore capacity and substitute decision making for individuals involved in the criminal justice system who have severe mental and physical health disorders. A case description will be used to illustrate a decision-making tree for patients who are incarcerated. As the world population continues to age, the number of older people who are incarcerated and unable to make healthcare decisions will continue to increase. In this special population, correctional system clinicians and providers need to be familiar with strategies to address the need for advance care planning before older people lose decisional capacity.

The Impact of Privatization on Minority Faith Prison Chaplains in Canada.

Canadian federal prison chaplaincy underwent a major shift in 2013 when the provision of its services was privatized and outsourced to a single for-profit company. This article presents a summary of the experiences and concerns expressed by minority faith chaplains serving in federal correctional institutions following privatization. It is based on ten in-depth, semi-structured interviews with minority faith prison chaplains. The results show that minority faith federal prison chaplains are concerned about increased levels of bureaucratization that have compromised the quality of spiritual care available to prisoners, reductions in resources for chaplains, and increased levels of emotional exhaustion and frustration among themselves and fellow minority faith chaplains serving in Canadian correctional facilities.

ПРОБЛЕМЫ ИСПОЛНЕНИЯ НАКАЗАНИЙ В ОТНОШЕНИИ ЖЕНЩИН, СОВЕРШИВШИХ ПРЕСТУПЛЕНИЯ ТЕРРОРИСТИЧЕСКОЙ НАПРАВЛЕННОСТИ

The article is devoted to the problem of execution of assignments against women who committed terrorist crimes. The relevance of the study is due to the trend of increasing terrorist crimes among women, despite the decrease in crime in this category according to official statistics. The article points out the danger of the presence of "sleeper cells" on the territory of the republics of the North Caucasus from the number of supporters of international terrorist organizations, previously not recorded by law enforcement agencies, the number of which is growing due to information extremism. «Sleeper cells» have a negative impact on young people who directly or indirectly sympathize with the so-called «forest brothers», contribute to the development of terrorist activities among women. The article shows the preventive role of criminal legislation in the suppression of terrorist crime, including the terrorist activities of women. This hypothesis determined the purpose of the study – to establish ways to improve the system of execution of sentences for women who have committed terrorist crimes. Based on the study of the characteristics of terrorist crime among women, some directions for improving the system of execution of punishment for female terrorists are proposed. The results of the study can be used in the activities of the Federal penitentiary service and correctional institutions for women.

Dialectics Associated with implementation of dialectical Behavior Therapy in canadian federal Correctional Institutions for Women

This article describes implementation of Dialectical BehaviourTherapy [DBT] in Correctional Service of Canada [CSC]’s institutionsfor women. A brief overview of the targeted population, outcomesof research studies pertaining to the effectiveness of DBT withinthe CSC context as well as a description of its current model willbe presented. Prominent dialectics and challenges encountered inimplementing DBT within this correctional setting will be discussed.

Government reports versus offenders' experiences: toward the resolution of discrepancies in healthcare and healthcare delivery.

- Canadian literature on federal correctional institutions and prison living indicate a shortage inadequate and available healthcare services to meet the needs of the prison population, despite prisoners higher rates of health challenges (e.g. mental health, addictions, HIV/AIDS) in comparison to the general population. With fewer resources, concerns arise about the delivery, quantity, and quality of penal healthcare provision. Thus, the authors examines former prisoners' experiences of, in comparison to government reports on, wait-times, and request processes for healthcare services, as well as issues of access, quality of interactions with healthcare professionals and the regulations and policies governing healthcare provision. The paper aims to discuss these issues. - The authors compare data gathered from interviews with 56 former-federal prisoners with publicly available Correctional Services Canada reports on healthcare delivery, staff-prisoner interactions, programmes and services, and overall physical and mental health to identify consistencies and inconsistencies between the government's and former prisoners' understandings of penal healthcare. - Discrepancies exist between prisoners reported experiences of healthcare provision and government reports. Prisoners are dissatisfied with healthcare provision in more secure facilities or when they feel their healthcare needs are not met yet become more satisfied in less secure institutions or when their needs are eventually met. - Theories of administrative control frame the analyses, including discrepancies between parolee experiences and Correctional Service Canada reports. Policy recommendations to improve healthcare provision are highlighted.

Non-Suicidal Self-Injury in Women Offenders: Motivations, Emotions, and Precipitating Events

Non-suicidal self-injury (NSSI) poses a serious threat to the safety and well-being of offenders and staff, making it a critical issue for correctional institutions, yet little is known about NSSI adult women offenders. Fifty-six women residing in Canadian federal correctional institutions with a history of NSSI participated in semi-structured interviews to explore their behavior. More than two-thirds of the women interviewed reported engaging in NSSI as a method of coping with negative emotions. The most common emotions reported prior to engaging in NSSI were anger, depression, and anxiety. The most common event that preceded NSSI was interpersonal conflict. After self-injuring, women most commonly reported feelings of relief, followed by regret. Whereas many women described similar experiences with NSSI, this research suggests that NSSI is a complex behavior with many different motivations and precipitating factors, and that effective treatment should consider the individual's unique needs.

The Use of Tobacco as Gambling Currency by Federal Offenders in Canada Before and After a Tobacco Ban

In 2008 tobacco was banned in federal correctional institutions in Canada. In this paper we compare the use of tobacco as currency for gambling in two studies that we conducted, one before and one after the tobacco ban. The data from two studies were compared. The questionnaires were administered to offenders in federal and provincial institutions in Ontario. Study 1 included 254 male offenders and study 2 included 395 male offenders. The focus in this paper is on one questionnaire about the type of wager made while incarcerated. It was found that the use of tobacco as a currency in gambling went from 28.6% of those offenders who gamble to 2.3% of those offenders who gamble. In addition, there was an overall decrease in the number of federal offenders who reported gambling while incarcerated. However, information gained from the questionnaire and from interviews with incarcerated offenders suggests that there has been a shift to money wagers and that gambling inside has become more serious since the tobacco ban. The results suggest that the ban on smoking has resulted in a change in the type of currency used for gambling inside correctional institutions in Ontario Canada.

New APA Resource Addresses Psychiatry in Underserved Areas

New APA Resource Addresses Psychiatry in Underserved Areas

Prisons, sida et divulgation de renseignements médicaux. Analyse juridique et éthique

The article addresses some of the issues raised in federal correctional institutions by the generation and communication of personal medical information pertaining the HIV infection. It examines, first, whether medical information pertaining to federal inmates — information considered confidential between medical staff and an inmate — can be disclosed absent the inmate's consent. It then examines what conditions or criteria determine whether or not such disclosure is ethically and legally justifiable, and if disclosure is justified, what conditions apply to its disclosure. Finally, specific situations in which a claim for disclosure may arise are examined. The article concludes that in federal correctional institutions, the disclosure of personal medical information absent consent of the person is seldom justifiable. In most situations, such disclosure is unnecessary and even appears to be counterproductive or harmful. Measures that can be undertaken to prevent exposure to and infection with HIV have to be undertaken regardless of whether an inmate or staff member is or is not known, to staff, wardens, or inmates, to be infected with HIV.

Canadian Federal Prison Libraries

A nationwide survey of the libraries in Canada’s 51 minimum, medium and maximum security federal correctional institutions was conducted in 2001 through a mailed questionnaire that received a 73 per cent response rate. The questionnaire was directed to the person in charge of the library. The survey gathered information about library staffing, library users, the size and composition of the collection, library funding and limitations on acquisitions and access imposed by the prison administration or the library staff because of subject matter, e.g. violent or sexual material. The results of the survey are set in the context of international prison library history and policy. Overall, the respondents said that their prison libraries were meeting offenders’ needs for recreational, cultural, educational and informative material, but that there was much room for improvement in funding for staff and collections. They also felt that their libraries were undervalued within the prison administration.

Hospice care in prison: general principles and outcomes.

In recent years, tougher sentencing laws have resulted in larger numbers of elder prison inmates and, consequently, more deaths occurring in prisons. In this context, the introduction of prison hospice programs takes on great significance. The purpose of this study is to identify the principle components and outcomes of prison hospice programs based on data gathered from semistructured telephone interviews with prison hospice providers in state and federal correctional institutions and from other sources. The results suggest that there is a growing effort to provide palliative care to dying inmates across the country and that all of the existing programs share common elements and similar structures. Major outcomes of prison hospice programs include cost-effectiveness, enhanced correction, and comfort care.

Substance abuse monitoring by the Correctional Service of Canada.

The Correctional Service of Canada implemented a urine drug-testing program over a decade ago. Offenders residing in federal correctional institutions and living in the community on conditional release were subject to urine drug testing. The objective of this study is to describe this testing program and the extent of drug use by conditional release offenders in 2000. Urine specimens were tested for drugs of abuse and prescription drugs including amphetamines, cannabinoids, cocaine metabolite, opiates, phencyclidine, benzodiazepines, methyl phenidate, meperidine, pentazocine and fluoxetine by immunoassay screening followed by GC-MS confirmation. Ethyl alcohol was analyzed when specifically requested. Alternative screening and confirmation methods with lower cut-off values were used whenever urine specimens were dilute (creatinine <20 mg/dL and specific gravity <or=1.003). Total number of urine specimens analyzed in 2000 was 38,431 (6.7% were dilute). The positive rate for one or more drugs was 27.2% in 2000 in conditional release offenders. In the community setting 28,076 normally concentrated (nondilute) specimens were tested (9.6% were positive for cannabinoids and 3.3% positive for cocaine metabolite). In the 1,270 dilute specimens collected from conditional release offenders in 2000, 12.8% were positive for cannabinoids and 10.6% were positive for cocaine metabolite. The authors conclude that forensic urine drug testing provides an objective measure of drug use when assessing offenders living in the community on conditional release from correctional institutions in Canada.

Experience with urine drug testing by the Correctional Service of Canada

The Correctional Service of Canada implemented a urine drug-screening program over 10 years ago. The objective of this report is to describe the program and drug test results in this program for 1999. Offenders in Canadian federal correctional institutions and those living in the community on conditional release were subject to urine drug testing. Urine specimens were collected at correctional facilities and shipped by courier to MAXXAM Analytics Inc. laboratory. All urine specimens were analyzed for amphetamines, cannabinoids, cocaine metabolite (benzoylecgonine), opiates, phencyclidine, benzodiazepines, methyl phenidate, meperidine, pentazocine and fluoxetine by immunoassay screening (homogeneous EIA and ELISA assays) followed by GC-MS confirmation. Ethyl alcohol was analyzed when specifically requested. Alternative screening and confirmation methods with lower cut-off values were used, whenever urine specimens were dilute (creatinine <20 mg/dl and specific gravity ≤1.003). The number of urine specimens analyzed was 44,722 in 1999 and 6.2% of these specimens were dilute based on creatinine and specific gravity analysis. The positive rate for one or more drugs was 25.5% in 1999. The highest drug positive rates were for cannabinoids (10.7%), morphine (3.2%), cocaine metabolite (3.2%), codeine (2.6%), oxazepam (2.1%), temazepam (1.1%) and ethyl alcohol (1.0%). In correctional institutions (8606 non-dilute specimens analyzed in 1999), 16.4% were positive for cannabinoids, 4.9% positive for codeine and/or morphine and 2.7% positive for oxazepam and/or temazepam. In the 537 dilute specimens collected in institutions, 21% were positive for cannabinoids, 1.3% positive for codeine and/or morphine and 1.3% positive for oxazepam and/or temazepam. In the community setting, 33,928 non-dilute specimens were collected in 1999 (9.0% were positive for cannabinoids and 3.5% positive for cocaine metabolite). In the 1651 dilute specimens collected from offenders in the community in 1999, 12.6% were positive for cannabinoids and 9.5% positive for cocaine metabolite. We conclude that forensic urine drug testing provides an objective measure of drug use by offenders in Canadian federal institutions and those offenders living in the community on conditional release.

PERSONALITY, INTEGRITY, AND WHITE COLLAR CRIME: A CONSTRUCT VALIDITY STUDY

This study examined the construct validity of personality scales, a personality‐based integrity test, and homogenous biodata scales as reflected in their ability to discriminate white collar criminals from other white collar employees. The sample included 365 prison inmates incarcerated in 23 federal correctional institutions for white collar offenses, and 344 individuals employed in upper‐level positions of authority. A cross‐validated linear discriminant function (DF) based on 16 variables selected in the developmental sample produced a large difference (1.83 standard deviation units) between the two sample groups. The pattern of score differences revealed the offenders as having greater tendencies toward irresponsibility, lack of dependability, and disregard of rules and social norms. This study indicates that there are large and measurable psychological differences between white collar offenders and nonoffenders, and that the major construct underlying these differences is “social conscientiousness.” The best measure of this difference was a personality‐based integrity test.