Health Of Inmates Research Articles

Policy Recommendations to Improve Mental Health in Polish Prisons

Context: Mental health is a central aspect of public health and social development, as such it corresponds to target 3.4 of the Sustainable Development Goals. This target aims to promote mental health and well-being, making it especially necessary to address this matter in environments such as prisons where exposure to risk factors is high. Incarceration itself is a cause of mental illness. Central and Eastern European countries hold some of the highest prison populations in the region and Poland numbers in this regard are 50% higher than the average in the European Union (EU) (about 179 inmates per 100,000 inhabitants). In Polish prisons, the chance of receiving adequate psychiatric and psychological care is limited due to a shortage of trained personnel and scarce infrastructure. However, data on mental health in Polish prisons is not routinely reported from official sources. Article 150 of the Polish Penal Code attempts to protect the mental health of inmates; yet, in reality, there is no legal enforcement to apply these measures, a feature shared with most of its neighbouring countries. The aim of this policy brief is to offer recommendations to lower recidivism rates, up-scale prison staff and create spill-over effects on (mental) healthcare and security in Polish prisons.Policy Options: The World Health Organization (WHO) European Framework for Action on Mental Health 2021-2025 should be adapted to the Polish Prison System. Best practices focus on a collaborative approach centred on healthcare services, labour policies, well-being and rehabilitation. Ideally, incarceration provides inmates with the possibility to be included and active, to see their relatives, to vote, to be engaged and maintain contact with the outside society. These best practices statistically reduce mental illnesses, lower recidivism and promote inclusion and rehabilitation. Recommendations: To tackle mental health challenges that prisoners in Poland experience, it is recommended to adapt a new approach with the following components: improving methodological quality of data collection as well as routine reporting to enable good governance structures, promoting collaborative efforts among stakeholders, and strengthening existing resources through capacity building which has been convincingly demonstrated as the most cost-effective type of interventions.

Co-designing a conceptual controlled environment agriculture (CEA) model inside an Australian maximum-security prison: A research framework

This research paper presents the framework for a research study that aims to define and evaluate the design requirements and the related feasibility of a controlled environment agriculture (CEA) system concept within a maximum-security prison in Australia. A co-design methodology will guide the study so that the views of a broad range of stakeholders can contribute to the conceptualization of a CEA farm system that is appropriately suited to correctional settings. The unique aspect of this research lies in the application of a bottom-up consultative process involving both prison administrators and inmates. Stakeholders will initially be asked to consider what CEA typology would be most suitable for a prison environment and then use this as a basis for developing a more extensive system design. As open-field agriculture represents a lower-cost alternative to CEA, this will also be considered to complement CEA. The co-design sessions will run in tandem with current growth trials of lettuce within the prison environment using different growing environments. The research is aimed at assisting to reduce the impacts of climate change, by growing produce locally. Growing produce within the prison walls reduces food miles and improves the nutritional quality of produce, which benefits longer-term inmate health. Growth trials that complement the co-design study are aimed at evaluating the ease of use for each of type growing environment. This research contributes significant new knowledge for the application of co-design in prisons, aimed at developing implementation guidelines for a CEA ecosystem that would supply fresh vegetables to pre-cooked inmate meals. The researcher has a unique perspective as an inmate. Outside community groups wishing to try CEA may also benefit from this study.

Attitudes toward elderly inmates in correctional facilities

Objective: Psychological well-being and mental health of elderly inmates are investigated by international organization, committees and researchers. One of the main factors that influence their quality of life, daily mood and well-being is interpersonal relationship. Numerous empirical data confirm the importance of interpersonal relationship and attitudes toward aging. An attitude can be defined as an evaluation of a stimulus as reflected in our cognitive, emotional and behavioral responses to the problem (Fiske &Taylor, 1991). In the field of geriatric psychology, research has focused on the problem of interpersonal relationship between elderly people and workers in prison environment. Prison officers are responsible for the safety and security of the prison facility (Bezerra et al., 2016), for supporting offender rehabilitation efforts and for managing organizational demands (Schaufeli & Peeters, 2000). Despite their importance to the running of the prison system, the health and wellbeing of prison officers remains poor. Hypotheses: H0: There isn’t any correlation between the social support inmates have, and their quality of life H1: The more social support correlate the higher level of inmates’ quality of life Methods: The systematic review of research and policy papers, articles that published on interpersonal relationship between elderly inmates and officers in correctional facilities, also effective programs outcomes were conducted. The main symptoms of the problem were measured with special checklist and questionnaires. Results: The elderly inmates experience emotional instability; tendency to self-accusations; anxiety-depressive response; low tolerance for frustration; mistrust and heightened criticism of others; intra and interpersonal conflict. A systematic approach in psychological work with elderly prisoners, also officers allows for the transition from a symptomatic to a personality-oriented level of psychological impact. Psychological emotional support can renew their hope on life, influence positive outcomes of the support program. According to the results of repeated psychological research, the patient's condition was characterized by positive dynamics: the level of psychological distress and the intensity of psychological distress significantly decreased, the general internality of the personality increased, as well as the subjective assessment of personal well-being. Conclusion: It is necessary to focus the attention of specialists on the advisability of using psycho-educational programs in a prison environment, providing information about the aging dynamically. Such programs, used at the initial stages of work with patients, contribute to the creation of motivation for personal psychotherapy and significantly increase its effectiveness.

Attitudes toward elderly inmates in correctional facilities

Objective: Psychological well-being and mental health of elderly inmates are investigated by international organization, committees and researchers. One of the main factors that influence their quality of life, daily mood and well-being is interpersonal relationship. Numerous empirical data confirm the importance of interpersonal relationship and attitudes toward aging. An attitude can be defined as an evaluation of a stimulus as reflected in our cognitive, emotional and behavioral responses to the problem (Fiske &Taylor, 1991). In the field of geriatric psychology, research has focused on the problem of interpersonal relationship between elderly people and workers in prison environment. Prison officers are responsible for the safety and security of the prison facility (Bezerra et al., 2016), for supporting offender rehabilitation efforts and for managing organizational demands (Schaufeli & Peeters, 2000). Despite their importance to the running of the prison system, the health and wellbeing of prison officers remains poor. Hypotheses: H0: There isn’t any correlation between the social support inmates have, and their quality of life H1: The more social support correlate the higher level of inmates’ quality of life Methods: The systematic review of research and policy papers, articles that published on interpersonal relationship between elderly inmates and officers in correctional facilities, also effective programs outcomes were conducted. The main symptoms of the problem were measured with special checklist and questionnaires. Results: The elderly inmates experience emotional instability; tendency to self-accusations; anxiety-depressive response; low tolerance for frustration; mistrust and heightened criticism of others; intra and interpersonal conflict. A systematic approach in psychological work with elderly prisoners, also officers allows for the transition from a symptomatic to a personality-oriented level of psychological impact. Psychological emotional support can renew their hope on life, influence positive outcomes of the support program. According to the results of repeated psychological research, the patient's condition was characterized by positive dynamics: the level of psychological distress and the intensity of psychological distress significantly decreased, the general internality of the personality increased, as well as the subjective assessment of personal well-being. Conclusion: It is necessary to focus the attention of specialists on the advisability of using psycho-educational programs in a prison environment, providing information about the aging dynamically. Such programs, used at the initial stages of work with patients, contribute to the creation of motivation for personal psychotherapy and significantly increase its effectiveness.

Depression and its associated factors among prisoners in East Gojjam Zone prisons, Northwest Ethiopia: a multi-centered cross-sectional study

BackgroundLittle is known about the prevalence and risk factors for depression in this vulnerable population around the world, including Ethiopia. Furthermore, information on the health of inmates is limited. The study sought to assess the prevalence and associated factors for depression among prisoners in the East Gojjam Zone of Northwest Ethiopia.MethodsInstitution-based cross-sectional study was conducted in East Gojjam Zone prisons. Data were gathered from 462 eligible prisoners who were chosen using a computer-generated simple random sampling technique. The patient health questionnaire nine was used to assess an individual's depression level. The information was entered into Epi-Data Version 4.2 and exported to STATA Version 14.1 for further analysis. Variables with a P < 0.05 in the multivariable binary logistics regression were considered significant.ResultsIn this study the prevalence of depression among prisoners was 50.43% (95% CI 46–55%). Having work inside prison (AOR 0.6, CI 0.37–0.96), have no history of mental illness (AOR 0.37, 95% CI 0.16–0.85), had monthly income greater than 1500 birr (AOR 0.16, CI 0.05–0.5), Not thinking about the life after prison (AOR 0.4, 95% CI 0.27–0.64), and Prisoners who are sentenced for more than 5 years (AOR 2.2, CI 1.2–4), were significantly associated with depression.ConclusionsAccording to this study, half of the prisoners in East Gojjam Zone prisons had depressive symptoms. Prisons should place a greater emphasis on the mental health of prisoners who have been sentenced for a long time, those who have a history of mental illness, and those who have no work in the prison.

Effect of 6 month-yoga training on mental health of Indian jail inmates

Introduction: Prisoners are vulnerable to mental health-related problems. The present study was conducted to determine the effect of 6 months Yoga practice on the mental health of jail inmates. The study's main objective was to assess the impact of 6 months of Yoga practice on the mental health of Jail inmates. Materials and Methods: A total of 37 Tihar Jail inmates (27 males and 10 females) participated in the study. With the help of questionnaires, anxiety, depression, stress, aggression, physical health, psychological health, and general well-being of the jail inmates were assessed. The study employed a Single Group Repeated Measures design. Pre and posttest methods were adopted in the study. Results: Significant reduction in stress and aggression and improvement in physical health, psychological health, and general well-being were found after 6 months Yoga-training; however, there was no significant reduction in anxiety and depression in the combined group. In male inmates, anxiety, depression, stress, and aggression were reduced significantly, and their physical health, psychological health, and general well-being significantly improved after 6 months of Yoga training. In female inmates, aggression got reduced after 6 months of regular Yoga practice; but no significant changes were found in other parameters. Conclusion: Regular Yoga practice for 6 months significantly improved the mental health of Tihar Jail inmates, especially male inmates. However, there is a need to conduct more studies to confirm the results.

A complex increase in hepatitis C virus in a correctional facility: bumps in the road

ObjectiveThe prevalence of hepatitis C virus (HCV) in correctional facilities in Australia among people who inject drugs is 60%, with disproportionate effects observed in Aboriginal and Torres Strait Islander people. Following the micro‐elimination of HCV in a Queensland correctional facility (QCF), newly acquired cases began to increase in mid‐2019. Here we discuss the public health response to increasing HCV in a QCF. MethodsEnhanced surveillance was performed to obtain contextual outbreak data on risk factors including injecting drug use, sharing of personal hygiene equipment and do‐it‐yourself‐tattooing. ResultsIn the sixteen months, there were 250 notifications of new and re‐infected HCV infections in prisoners in the QCF. Qualitative data revealed the leading factor in transmission to be injecting drug use. ConclusionsDrivers for increased HCV transmission in correctional facilities include boredom, waiting lists for opioid substitution programs, changes in injecting behaviours and sharing of injecting paraphernalia. Point‐of‐care testing combined with education and the development of a needle and syringe program may be promising ways forward for managing HCV in correctional facilities. Implications for public healthCorrectional facilities are key locations to target sexually transmitted infection (STI) and blood‐borne virus (BBV) testing and treatment as well as health promotion to improve the health of inmates and the communities they return to.

Attitudes Toward Elderly Inmates in Correctional Facilities

Psychological well-being and mental health of elderly inmates are investigated by the international organizations, committees, and researchers. One of the main factors that influence their quality of life, daily mood, and well-being is interpersonal relationship. Numerous empirical data confirm the importance of interpersonal relationship, and attitudes toward aging. A definition of attitude item can be explained as an evaluation of a stimulus as reflected in our cognitive, emotional and behavioral responses to the problem (Fiske &amp;Taylor, 1991). In the field of geriatric psychology, research has focused on the problem of interpersonal relationship between elderly people and workers in prison environments. Prison officers are in interpersonal relationship with inmates and have responsibility for the safety, and security of the prison facility, and also for managing organizational demands (Schaufeli &amp; Peeters, 2000). Some researchers have shown that the health, and wellbeing of prison officers remain poor, and risk of being affected by different mental health problems, as depression, post-traumatic stress disorder (Viotti, 2016). A systematic review of research and policy papers, articles that published on interpersonal relationship between elderly inmates and officers in correctional facilities, also effective programs outcomes were conducted. The main symptoms of the problem were measured with a special checklist and questionnaires. The quality of life was measured QOL survey that was made based on WHO (World Health Organization) QOL questionnaire. 200 elderly prisoners have been involved in the research from different prison regimes of Azerbaijan correctional facilities between 2019-2020. A systematic approach in psychological work with elderly prisoners, also officers allows for the transition from a symptomatic to a personality-oriented level of psychological impact. Psychological emotional support can renew their hope on life, influence positive outcomes of the support program. According to the results of repeated psychological research, the patient's condition was characterized by positive dynamics: the level of psychological distress and the intensity of psychological distress significantly decreased, the general internality of the personality increased, as well as the subjective assessment of personal well-being. It is necessary to focus the attention of specialists on the advisability of using psycho-educational programs in a prison environment, providing information about the aging dynamically. Such programs, used at the initial stages of work with patients, contribute to the creation of motivation for personal psychotherapy and significantly increase its effectiveness.

Jailhouse rock: health status, patterns of use, and subjective benefits of cannabis use in a sample of inmates in Spanish prisons.

ObjectivesTo assess the perceived health and quality of life, perceived social support, prison life, and cannabis use among a sample of inmates in Spanish prisons. Material and methods We hosted a discussion with inmates in order to learn their reasons for using cannabis (phase 1). Then, a questionnaire was prepared specifically for this study (phase 2), containing indicators from the Catalan Health Survey and other items regarding patterns of cannabis use and life in prison. The questionnaire was administered by the authors to a sample of Catalan inmates. Results and discussion A sample of 63 inmates completed the questionnaire. Cannabis was used mainly for therapeutic purposes, which can be interpreted as a coping strategy related to the stress associated with prison life. Nearly half of the subjects used cannabis as a substitute for prescription medications and illicit drugs. It was found that the only variable that predicted self-perceived health status was the number of visits inmates received. This suggests that social support is a key factor for improving the health and well-being of inmates. Cannabis use in prison seems to be related to coping with a challenging context. The benefits and risks of this practice need to be further researched.

Outcome Measure Epidemiological of Female Inmates in West Amazon, Brazil

Introduction: the prison system in the Brazilian state of Acre, located in the Western region of the Amazon, is a branch of the criminal justice system that has been suffering from issues such as overcrowding and growth in internal organized crime. The prevalence of these matters directly affects the resocialization of prisoners and inhibits the successful re-engineering of their social values and beliefs. Objective: to analyze the epidemiological profile of jailed women in the State of Acre, Brazil. Methods: in a cross-sectional descriptive study, 129 participants were recruited from female penitentiaries in the state of Acre. Conducted between August and December of 2017, data was collected through a validated questionnaire, divided into modules, using both open and closed-ended items. Results: we found that most women who participated in the study were single (n = 86, 66.7%), had brown skin (n = 93, 72.1%), had children (n=102, 79.1%), resided in the state of Acre (n=117, 90.5%). The mean age of the sample was 27.69 years. Among those participants who reported having partners (n = 40, 31%), we found that half had partners who were also incarcerated (n = 20, 50%). The study results also indicate that drug trafficking (n = 86, 66.7%) was the major cause for female incarceration, followed by homicide crime (n = 16, 12.4%). Over half of the participants were in prison for the first time (n = 75, 58.1%), with a high recidivism rate observed in the total sample (n = 54, 41.9%). A majority of the participants (n = 97, 75.2%) kept in touch with members of their families and a smaller portion (n = 15, 11.6%) received conjugal visits. With regard to social activities, slightly more than half (n = 75, 58.1%) worked and the majority (n = 114, 88.4%) did not study while jailed. Conclusion: the difficulties associated with accessing inmate data and the lack of peer-reviewed studies on inmate health in Brazil suggests that the public policies recommended by the PNSSP and the National Policy for Comprehensive Health Care for Women should be reevaluated.

Health Management in Italian Prisons during COVID-19 Outbreak: A Focus on the Second and Third Wave.

The SARS-CoV-2 spread is a threatening and challenging issue for correctional systems worldwide because of many factors, particularly overcrowding and of the intrinsic characteristics of the population. The prevention measures adopted by the Italian Government were aimed to protect and preserve both inmates’ and prison workers’ health. The present study aimed to evaluate the efficacy of the adopted strategies. Methods: Data regarding Italian prisons’ occupation and prisoners’ population from January 2019 to June 2021, as well as the cumulative weekly increase of confirmed cases and the number of doses of vaccine administered among the population of inmates, the prison workers, and Italian population from November 2020 to the end of June 2021, were collected. Results: Prisons’ occupation dropped from 120% to 106% after the beginning of the pandemics. The confirmed cases between inmates were consistently lower than among the Italian population and prison workers. A time-series chart showed a time lag of one week between the peaks of the different population. Conclusions: The containing strategies adopted by the Italian correctional system have proved their effectiveness in terms of the prevention and protection of both inmate and staff health.

Reliability of prisoners\u2019 survey responses: comparison of self-reported health and biomedical data from an australian prisoner cohort

ObjectivePrisoner health surveys primarily rely on self-report data. However, it is unclear whether prisoners are reliable health survey respondents. This paper aimed to determine the level of agreement between self-report and biomedical tests for a number of chronic health conditions.MethodThis study was a secondary analysis of existing data from three waves (1996, 2001, 2009) of the New South Wales (NSW) Inmate Health Survey. The health surveys were cross-sectional in nature and included a stratified random sample of men (n=2,114) from all NSW prisons. Self-reported histories of hepatitis, sexually transmissible infections, and diabetes were compared to objective biomedical measures of these conditions.ResultsOverall, the sensitivity (i.e., the respondents who self-reported having the condition also had markers indicative of the condition using biomedical tests) was high for hepatitis C (96%) and hepatitis B (83%), but low for all other assessed conditions (ranging from 9.1% for syphilis using RPR to 64% for diabetes). However, Kappa scores indicated substantial agreement only for hepatitis C. That is, there were false positives and false negatives which occurred outside of chance leading to poor agreement for all other assessed conditions.ConclusionsPrisoners may have been exposed to serious health conditions while failing to report a history of infection. It may be possible that prisoners do not get tested given the asymptomatic presentation of some conditions, were unaware of their health status, have limited health-service usage preventing the opportunity for detection, or are subject to forgetting or misunderstanding prior test results. These findings demonstrate the importance of the custodial environment in screening for health conditions and referral for treatment should this be needed. Testing on entry, periodically during incarceration, and prior to release is recommended.

Male Prisoners’ Perspectives of Access to Quality Health Care at a Prison Infirmary in Ghana

This study assessed factors that influence access to quality health care among a prison population nearing its release in Ghana. A structured quantitative questionnaire was administered to 200 inmates using a total population sampling. Gap analysis was performed between inmate expectations and perceptions of health provider factors to determine quality. There was an overall negative gap due to expectations exceeding perceptions. This article recommends that a policy document on the health and welfare of inmates be developed and implemented to improve their access to quality health care.

Incarceration and COVID-19: Recommendations to Curb COVID-19 Disease Transmission in Prison Facilities and Surrounding Communities.

Overcrowding can increase the risk of disease transmission, such as that of SARS-CoV-2 (COVID-19), within United States prisons. The number of COVID-19 cases among prisoners is higher than that among the general public, and this disparity is further increased for prisoners of color. This report uses the example case of the COVID-19 pandemic to observe prison conditions and preventive efforts, address racial disparities for people of color, and guide structural improvements for sustaining inmate health during a pandemic in four select states: California, New York, Illinois, and Florida. To curb the further spread of COVID-19 among prisoners and their communities, safe public health practices must be implemented including providing personal protective equipment (PPE) and testing of staff and inmates, disseminating culturally and language appropriate information regarding the pandemic and preventive precautions, introducing social distancing measures, and ensuring adequate resources to safely reintegrate released prisoners into their communities.

Impacts of Incarceration on Health Focusing on Minority Males: Considerations for COVID-19 and Future Pandemics

Long-standing health and social inequalities associated with minorities have increased their risk for infection, hospitalization, and death related to COVID-19. This disparity is further exacerbated with incarcerated individuals, yet little attention, both prepandemic and presently, has been devoted to collecting up-to-date data. This study uses the 2004 Survey of Inmates in State Correctional Facilities (SISCF), the most recent data, to explore the general offender population and self-reported chronic and medical health conditions to highlight how COVID-19 will impact marginalized populations. Results from the four binary regression models found that minority males are more likely to have chronic illnesses which increase in probability with longer sentences, number of incarcerations, and advancement in age. Our findings advocate for the development of recent data sets on inmate health, particularly minority individuals, as well as the construction of more precise health measures to address these health disparities, including COVID-19.

Nutritional Status of Inmates in the Central Prison of Mbuji-Mayi, Democratic Republic of Congo

Background The nutritional situation in prisons of developing countries and the health status of inmates remain a major human rights concern. The objective of the study was to assess the nutritional status of inmates jailed in a prison of the Democratic Republic of Congo (DRC). Methods This cross-sectional study was conducted over a 4-month period in the Central Prison of Mbuji-Mayi, DRC. Three hundred inmates were selected according to the Malnutrition Universal Screening Tool (MUST). Severe malnutrition was defined according to Buzby index and Nutritional Risk Index (NRI). Data were analyzed by Stata™ (version12.0). Results The inmates were aged between 18 and 70 years and primarily males (88.7%). Of them, 24% were suffering from severe malnutrition and 62% of moderate malnutrition as based on the NRI. At the time of study, 88% of inmates were incarcerated for more than 6 months. Multivariate logistic regression analysis showed that factors independently associated with severe malnutrition were incarceration of more than 6 months (OR=5.1; 95% CI (1.5-17.4)), origin of food (prison vs. family or NGO) (OR=4.7; 95% CI (1.6-13.8)) presence of tuberculosis, human immunodeficiency virus and/or intestinal infections (OR=2.6; 95% CI (1.4-4.7)). Conclusions The nutritional situation in the Central Prison of Mbuji-Mayi is precarious. There is urgent need to supply enough nutrient-rich food to improve health of inmates.

Prison health priorities in Burkina Faso: a cross-sectional study in the two largest detention environments in Burkina Faso

PurposeThe purpose of this paper is to study the factors associated with the occurrence of diseases and beriberi among prisoners incarcerated in the two largest Remand and Correctional Facilities (RCF).Design/methodology/approachThis was a cross-sectional descriptive and analytical study carried out from April 20 to May 19, 2017, in the RCFs of Ouagadougou and Bobo-Dioulasso. All prisoners who consulted and those referred to the health center by the health-care team were included in the study. Complaints and diagnosed diseases information were collected using the second version of the International Classification of Primary Care (ICPC-2). The authors used a logistic regression model to perform univariate and multivariate analyses.FindingsOf the 1,004 prisoners from the two RCFs included in the study (32.6%), 966 (96%) were male. The median age was 31.6 years. The distribution of diseases diagnosed using the ICPC-2 showed a predominance of gastrointestinal tract, skin and respiratory tract diseases among 206 (19.3%), 188 (17.6%) and 184 (17.2%) prisoners, respectively. A total of 302 prisoners (30.1%) had clinical beriberi, and 80 prisoners (8%) were underweight. Being incarcerated for more than nine months was independently associated with a high risk of digestive and respiratory diseases as well as beriberi.Research limitations/implicationsThis study highlighted higher frequencies of digestive, skin and respiratory complaints and diseases in the two largest detention centers in Burkina Faso. These diseases are variously related to age, penal status and length of incarceration. In addition, underweight and thiamin vitamin deficiency responsible for beriberi are more frequent in adult prisoners, those not attending school, convicted prisoners and those with a length of stay in detention of more than nine months. These concrete results should help define a strategy and priority actions needed to reduce morbidity in prisons.Practical implicationsThe actions should include the intervention of specialists in the field of common diseases in prisons, the improvement of individual hygiene conditions and environment, the improvement of the quality and quantity of the food ration, a strategy to reduce prison overcrowding. Other actions must be planned to allow specific groups such as women and minors to have access to health care that is adapted to them. Beyond the central concern of promoting the rights of prisoners and humanizing prisons, actions to improve the health of prisoners are part of an overall public health approach with its socio-economic and environmental implications.Social implicationsThere is a need for a strong commitment from the State to develop a prison health policy that prioritizes the prevention of communicable and non-communicable diseases that are particularly prevalent in this context, without forgetting mental health and nutrition. This requires a collaboration of stakeholders based on better intersectorial communication, the implementation of a monitoring and evaluation system for the health of prisoners, an enhancement of the status of health-care providers working in prisons and an increase in the funding allocated to the health of prisoners with the mobilization of the necessary funds.Originality/valueThis study uses a primary health care classification to assess the health of inmates in a prison in Africa. It contributes to the weak evidence around prison health surveillance and health profiling of prisoners in Africa.

Self-harm and suicidality among three subgroups of male sex offenders: results from an Australian prisoner cohort

ObjectivePrisoners complete suicide and self-harm more frequently than members of the community. Sex offenders have been found to be at greater risk of engaging in these behaviours. This study examines the characteristics, prevalence, and predictors of self-harm and suicide attempts among: sex offenders that only victimise children (ChildSOs); adults (AdultSOs); or both (age-crossover polymorphous; PolySOs).MethodsData from three waves (1996, 2001, 2009) of the New South Wales (NSW) Inmate Health Survey was linked to the State’s re-offending database to identify men with histories of sexual offending. The health surveys captured self-report data on self-harm and suicidality.ResultsNon-sexual violent offenders (15%) and AdultSOs (14%) had the highest rate of self-harm, significantly more than ChildSOs (11%), non-sexual non-violent offenders (10%), and PolySOs (0%). Several factors significantly predicted self-harm at the bivariate level for both ChildSOs and AdultSOs, with unique predictors for each group. At the multivariate level, manic-depression trended towards significance for ChildSOs and any mental health condition remained a significant predictor for AdultSOs who self-harmed relative to AdultSOs who had not (aOR = 11.989, 95%CI [1.14, 126.66]). Approximately 23% of AdultSOs, 22% of PolySOs, and 19% of ChildSOs reported a suicide attempt throughout their lifetime, whereas only 15% of non-sexual non-violent offenders reported an attempt. At the bivariate level, few factors were significant for ChildSOs while several factors were significant for AdultSOs. At the multivariate level, a diagnosis of depression and treatment with psychiatric medication trended towards being significant predictors of suicide attempts for ChildSOs. In contrast, treatment with psychiatric medication (aOR = 25.732, 95%CI [1.91, 347.19])] remained a significant predictor for AdultSOs who attempted suicide relative to AdultSOs who had not, as well as historical psychiatric hospitalisation (aOR = 6.818, 95%CI [1.04, 44.82]) and self-harm (aOR = 5.825, 95%CI [1.31, 25.99]).ConclusionSex offenders are at significantly higher risk of attempting and completing suicide relative to non-sexual non-violent offenders and warrant special attention. The prevalence rates and predictors of self-harm and suicidality suggest differences between sex offender subgroups may exist. These hold implications for the criminal justice and public health systems for addressing needs and identifying those most at risk of self-harm and suicide.

Does mental health treatment reduce recidivism among offenders with a psychotic illness?

Prison inmate health surveys consistently show high proportions of prisoners have mental health problems; however, scholarly opinion is divided on the contribution of mental illness to offending. Some contend that mental illness is not a cause of offending and that mental health treatment will not reduce offending. Others maintain mental health treatment can reduce the risk of offending among persons with a significant mental illness. In this article we report the results of a rigorous evaluation of the effectiveness of mental health treatment in reducing offending amongst a cohort of defendants with a diagnosis of psychosis. We find evidence that the provision of mental health treatment to defendants with a psychotic illness does significantly reduce the risk of further offending.

Prisoners' perceptions of the healthcare service: A qualitative study.

It is recognized that the health of those in prison is poorer than the general population. The objective of this research is to understand the perceptions of the prisoners of the health care that they received at a district level prison in Thailand. We conducted a qualitative study, using in-depth interviews. Content analysis was used for data analysis. The participants were 13 prisoners. The findings reveal the prisoners have positive attitudes toward health services. They think that they are receiving the same standard of care as the general population. However, they are concerned about getting a communicable disease and accessibility to emergency care. There is limited dental care. The female prisoners have more trouble accessing health care than male prisoners. Suggestions for solving the inequality of care for prisoners includes increasing the collaboration with the community hospitals, using telehealth, adding female health providers, and developing inmate health volunteers among the prisoners.