Inmates In Correctional Facilities Research Articles

Methicillin-Resistant Staphylococcus aureus Infection in the Texas Prison System

Recent reports indicate that correctional facility inmates may be at elevated risk for contracting methicillin-resistant Staphylococcus aureus (MRSA) infection because of overcrowding, poor hygiene, and high rates of diseases causing immunosuppression. The present study of 299,179 Texas inmates who were incarcerated between 1999-2001 indicated an incidence of 12 MRSA infections/1000 person-years. Inmates with circulatory disease, cardiovascular disease, diabetes, end-stage liver disease, end-stage renal disease, human immunodeficiency virus infection or acquired immunodeficiency syndrome, and skin diseases all exhibited elevated rates of MRSA infection.

HIV prevention with jail and prison inmates: Maryland's Prevention Case Management program.

Prevalence of HIV infection and AIDS cases is higher among inmates of correctional facilities than among the general population, especially for female inmates. This creates a strong need for effective HIV prevention with this population. Maryland's Prevention Case Management (PCM) program provides individual or group counseling to inmates nearing release to promote changes in risk behavior. Pretest and posttest surveys assess changes in perceived risk, condom attitudes, condom use self-efficacy, self-efficacy to reduce injection drug risk and other substance use risk, and behavioral intentions during participation in the program. Client contact logs, kept by counselors, document the number and duration of sessions, and the specific modules, completed by participants. Over a 4-year period, PCM records identified 2,610 participants in the program. Pre-intervention and postintervention data were available for 745 participants, with client contact log records available for 529 (71%) of these individuals. Significant, positive changes were found in self-reported condom attitudes, self-efficacy for condom use, self-efficacy for injection drug use risk, self-efficacy for other substance use risk, and intentions to practice safer sex post-release. Inmate populations are a crucial audience for HIV/AIDS testing, treatment, and prevention efforts. The Maryland PCM program has documented positive changes in participants' attitudes, self-efficacy, and intentions related to HIV risk, over a 4-year period.

From Jail to Community: Innovative Strategies to Enhance Continuity Of HIV/AIDS Care

Persons of color incarcerated in prisons and jails in the United States continue to be disproportionately affected by the HIV epidemic. Several state and city departments of health have received federal funding to develop and implement or to expand innovative strategies or models of HIV prevention, case management, and discharge planning services for racial/ethnic minority inmates in correctional facilities. This article provides an overview of service models for county jails and emphasizes the need for strategies to improve the health of the inmate and the community to which he or she will return.

Medical education about the care of addicted incarcerated persons: A national survey of residency programs

In June 1998, there were 1.8 million inmates in correctional facilities for adults; 1.2 million in state and federal prisons and 600,000 in municipal/county jails (668 persons per 100,000 U.S. population). Rates of TB, AIDS, mental illness, and substance abuse are 2–13 times higher in persons living in jails and prisons. This study was designed to assess the level of training offered to residents in seven medical specialties in the care of addicted incarcerated persons. The study design involved two stages. The first entailed a mailed survey to 1,831 residency directors in family medicine, internal medicine, osteopathic medicine, pediatrics, obstetrics and gynecology, psychiatry, and emergency medicine. The second stage was a telephone interview, about substance use disorders, of faculty listed by the residency directors as teaching residents. The mailed survey was completed by 1,205 residency directors (66%). The 769 faculty from those identified programs, who participated in the telephone interview, reported that only 14% of their residency programs offered lectures or conferences on the care of incarcerated persons, yet 44% of the programs had residents caring for incarcerated persons with substance abuse problems, in a clinical setting. Only 22% offered clinical experiences for residents in a correctional facility. We recognize that our survey of correctional health and substance abuse training is limited, but as such, a greater number of respondents to our survey do not teach residents addiction medicine topics pertaining to prevention, evaluation, intervention, and management of the addicted criminal offender/patient in a correctional setting or give adequate clinical exposure to this special population. The data suggests a need to develop and implement educational programs on medical care for this high‐risk and expanding population.

Fifty years of prison suicide in Austria: does legislation have an impact?

The absolute and relative frequency of suicides in jails and prisons in Austria over the 50 years from 1947 to 1996 is described. Important legislational changes regarding the criminal justice system are discussed with regard to possible consequences for the incidence of prisoners' suicides. Within the five decades a significant increase in the absolute numbers of jail and prison suicides was evident in spite of the considerable decrease in the total inmate population. Therefore, the suicide rate of inmates of correctional facilities increased significantly. Possible reasons for this phenomenon are discussed in relation to changes of the criminal law.

Issues Regarding Antiretroviral Treatment for Patients With HIV-1 Infection

To the Editor. —In their 1991 report, HIV Disease in Correc- tional Facilities , the Presidential National Commission on AIDS recommends that and treatment available to HIV-infected inmates in correctional facilities should be equal to that available to HIV-infected individuals in the general community. Dr Carpenter and colleagues 2 and Dr Quinn 3 recommend treatment of acute primary HIV infections with combination antiretroviral regimens that include 2 nucleoside reverse transcriptase inhibitors and a protease inhibitor. Incarcerated populations have higher prevalence rates of HIV infection than the general nonincarcerated population. As unprotected sexual intercourse and sharing of syringes and needles for injection continue to occur within correctional facilities, new cases of HIV infection among inmates most certainly will take place. A considerable number of these newly infected inmates will present with symptomatic primary HIV infections, also referred to as the acute retroviral syndrome. Therefore we believe that primary care clinicians in correctional facilities have

Organized Aerobic Exercise and Depression in Male County Jail Inmates

Depression in inmates of correctional facilities is well-documented. However, the efficacy of any specific, non-pharmacologic intervention for depression in this population was not located in the l...

Assessing mental disorder in the criminal justice system: Feasibility versus clinical accuracy

A number of investigations have now shown that the rates of mental disorder among inmates in correctional facilities in North America far exceed the rates for these disorders in the general population (Collins & Schlenger, 1983; Daniel, Robins, Reid, & Wilfey, 1988; Hodgins & Ce Hyde & Seiter, 1987; Motiuk & Porporino, 1991; Neighbors et al., 1987; Teplin, 1990a). The rates of major disorders (schizophrenia and major affective disorders) have been found to be up to four times greater than the genera1 population rates matched for sex. These recent studies have further suggested that, in a large majority of cases, the major disorder had been present before the current period of incarceration. Previous estimates of the prevalence of mental disorders among offenders had suggested that only about 5% of inmates suffered from psychosis. However, these estimates were obtained using various diagnostic criteria, reliabilities of the diagnoses were not examined and/or reported, samples were small and biased (usually those referred for treatment), and comparable prevalence rates for the general population were not available (for a review of these older investigations, see, for example, Roth, 1986; Wormith & Borzecki, 1985). The new studies succeeded in correcting many of the methodological weaknesses that characterized the older investigations. They examined representative samples of inmates, all used the DSM-III criteria, and all but one (Hyde & Seiter, 1987) used the same standardized, reliable, and valid diagnostic tool that had been used to obtain prevalence rates of mental disorder in the genera1 population (the Diagnostic Interview Schedule, DIS, Robins, Helzer, Croughan, & Ratcliff, 1981). Interviewers were specifically trained to use the instrument and supervised during the course of the study to ensure that they adhered to the rules of the instrument, and these studies examined and reported inter-rater reliabilities for the diagnoses.

Organized Aerobic Exercise and Depression in Male County Jail Inmates

Depression in inmates of correctional facilities is well-documented. However, the efficacy of any specific, non-pharmacologic intervention for depression in this population was not located in the literature. This study examined the influence of an exercise program on depression in male county jail inmates. Twenty-five subjects from one jail received three hours of organized aerobic exercise weekly for 12 weeks; 20 inmates from another facility constituted the control group. Both groups completed the Beck Depression Inventory (BDI) twice, with a 12-week interval between tests. Decreased BDI scores for the treatment group suggest that organized aerobic exercise could be an effective primary or adjunct intervention for depression in this population.

The Convicted Rapist

The issue addressed in this article concerns the characteristics of “official rapists,” that is, males who have been processed by the criminal justice system. Presently available research findings are inadequate for developing a definitive portrait of the rapist since the study populations most often consist of rapists only. In the research for this article, incarcerated rapists were compared with other sex offenders, and with other serious property and violent offenders. A sample of 965 males was drawn from a national survey of inmates in correctional facilities. While a few differences were found (most notably rapists were more likely to be black than other offenders), in general, rapists were most often similar to both serious property and violent offenders. Rapists differed most often from other sex offenders. However, both rapists and other sex offenders were less likely to have previously served time than other serious offenders.

Changes in due process of law

Joseph J. Senna, MSW, JD, is Associate Pro fessor, College of Criminal Justice, Northeastern University, Boston, Massachusetts. Today the concept of due process of law is being applied increasingly to protect in dividual rights when the government seeks to deprive a person of life, liberty, or prop erty.1 The trend toward a wider use of due process to prevent abuse of power has spread to many fields in the human ser vices, especially public welfare, juvenile delinquency, and corrections. More than ever before, due process of law has been used in these settings to challenge various types of arbitrary action such as the termi nation of aid by welfare officials or the imposition of punishment on prison in mates. Perhaps because consistent judicial intervention has called attention to grave infringements of human rights in the fields mentioned and in mental health—particu larly over the past decade—these fields have become open to severe criticism and change by those providing or receiving services. Prior to the 1960s the judicial system usually refused to become involved in arbi trary administrative practices in human services. Today the courts have discarded the traditional hands-off doctrine and they readily review grievances of individuals in order to insure equal protection and due process of law. The judicial system has begun to recognize that persons on welfare, patients in mental hospitals, juveniles be fore a court, and inmates in correctional facilities have basic rights. Those who are planning and carrying out programs and services are now ques tioning procedures followed for many years because these procedures may vio late the constitutional rights of those in volved. Social work practitioners and other professionals who are in the field of human services and who are providing the services ought to be aware of the extent of judicial intervention, which is occurring increasingly when basic human rights are violated. Also, judicial solutions to human service problems have an impact on overall agency administration, types of programs, and eligibility requirements, as well as pro fessional education.