Jail Staff Research Articles

COVID-19 Preventive Measures in Northern California Jails: Perceived Deficiencies, Barriers, and Unintended Harms.

BackgroundCarceral facilities are high-risk settings for COVID-19 transmission. Little is known about the hidden burden of infection or practical barriers to infection control in these settings, especially in jails. There is also limited research on the mental health impacts of the pandemic among people living and working in carceral facilities.MethodsBetween July 8, 2020 and April 30, 2021, we performed SARS-CoV-2 rapid antibody testing and administered a questionnaire among residents and staff of four Northern California jails. We utilized multivariable logistic regression, adjusting for demographic and carceral characteristics, to analyze factors associated with prior infection, including perceived likelihood of prior infection and access to new masks. We additionally assessed the implementation of, perceptions toward, and impacts of COVID-19 policies in practice. We engaged stakeholder representatives, including incarcerated individuals, to guide study design, procedures, and results interpretation.ResultsWe enrolled 788 jail residents and 380 jail staff. Nearly half of residents and two-thirds of staff who were antibody-positive had not previously tested positive for COVID-19. Among residents without a prior COVID-19 diagnosis, antibody positivity was significantly associated with perceived likelihood of prior infection (adjusted OR = 8.9; 95% CI, 3.6–22.0). Residents who had flu-like illness in jail cited inadequate responses to reported illness and deterrents to symptom reporting, including fears of medical isolation and perceptions of medical neglect. Residents also disclosed deficient access to face masks, which was associated with antibody positivity (adjusted OR = 13.8, 95% CI, 1.8–107.0). Worsened mental health was pervasive among residents, attributed not only to fear of COVID-19 and unsanitary jail conditions but also to intensified isolation and deprivation due to pandemic restrictions on in-person visitation, programs, and recreation time.ConclusionCarceral settings present significant challenges to maintaining infection control and human rights. Custody officials should work diligently to transform the conditions of medical isolation, which could mitigate deterrents to symptom reporting. Furthermore, they should minimize use of restrictive measures like lockdowns and suspension of visitation that exacerbate the mental health harms of incarceration. Instead, custody officials should ensure comprehensive implementation of other preventive strategies like masking, testing, and vaccination, in conjunction with multisector efforts to advance decarceration.

Jail-based treatment for opioid use disorder in the era of bail reform: a qualitative study of barriers and facilitators to implementation of a state-wide medication treatment initiative

BackgroundUntil recently, few carceral facilities offered medications for opioid use disorder (MOUD). Although more facilities are adopting MOUD, much remains to be learned about addressing implementation challenges related to expansion of MOUD in carceral settings and linkage to care upon re-entry. This is particularly important in jails, where individuals cycle rapidly in and out of these facilities, especially in jurisdictions beginning to implement bail reform laws (i.e., laws that remove the requirement to pay bail for most individuals). Increasing access to MOUD in these settings is a key unexplored challenge.MethodsIn this qualitative study, we interviewed staff from county jails across New Jersey, a state that has implemented state-wide efforts to increase capacity for MOUD treatment in jails. We analyzed themes related to current practices used to engage individuals in MOUD while in jail and upon re-entry; major challenges to delivering MOUD and re-entry services, particularly under bail reform conditions; and innovative strategies to facilitate delivery of these services.ResultsJail staff from 11 New Jersey county jails participated in a baseline survey and an in-depth qualitative interview from January–September 2020. Responses revealed that practices for delivering MOUD varied substantially across jails. Primary challenges included jails’ limited resources and highly regulated operations, the chaotic nature of short jail stays, and concerns regarding limited MOUD and resources in the community. Still, jail staff identified multiple facilitators and creative solutions for delivering MOUD in the face of these obstacles, including opportunities brought on by the COVID-19 pandemic.ConclusionsDespite challenges to the delivery of MOUD, states can make concerted and sustained efforts to support opioid addiction treatment in jails. Increased use of evidence-based clinical guidelines, greater investment in resources, and increased partnerships with health and social service providers can greatly improve reach of treatment and save lives.

Carceral Amplification of COVID-19: Impacts for Community, Corrections Officer, and Incarcerated Population Risks.

COVID-19 is challenging many societal institutions, including our criminal justice systems. Some have proposed or enacted (e.g., the State of New Jersey) reductions in the jail and/or prison populations. We present a mathematical model to explore the epidemiologic impact of such interventions in jails and contrast them with the consequences of maintaining unaltered practices. We consider infection risk and likely in-custody deaths, and estimate how within-jail dynamics lead to spill-over risks, not only affecting incarcerated people but increasing exposure, infection, and death rates for both corrections officers and the broader community beyond the justice system. We show that, given a typical jail-community dynamic, operating in a business-as-usual way results in substantial, rapid, and ongoing loss of life. Our results are consistent with the hypothesis that large-scale reductions in arrest and speeding of releases are likely to save the lives of incarcerated people, jail staff, and the wider community.

Ask Me Anything”: Lessons learned in implementing a COVID-19 vaccine information initiative in Massachusetts jails

As a group of medical professionals, faith-community leaders, and jail staff, we launched a COVID-19 vaccine Q&A initiative across Massachusetts county jails to increase COVID-19 vaccine confidence and uptake among detained individuals. Here we describe the lessons learned in developing and implementing this initiative.

The Criminal Justice System in Pakistan: A Critical Study

In a country like Pakistan, data is seldom celebrated. A take-off point can be a brief explanation of the Criminal Justice System (CJS), which this layout will endeavor to give ineffectual way. The CJS in Pakistan contains five sections for instance, the police, legitimate chief, confinement offices, arraignment, probation and parole. The degree of the survey was limited to the four regions, be explicit Punjab, Sindh, KPK and Balochistan. Basically, the presentation of CJS isn't at its ideal level in Pakistan as well as mending gauges like improvement and redesign of real establishments as well as cutoff the working of existing police, analysts, judges, specialists, jail staff is required close by revolve around updating the current characteristics of specialists, judges, examiners, remedial offices to additionally foster the usefulness level as well as reason-ability of organization movement by the CJS generally.

Lessons Learned from the Pathways to Community Health Study to Evaluate the Transition of Care from Jail to Community for Men with HIV.

Time spent in jail can provide opportunities to deliver comprehensive medical care, including screening and treatment for HIV; however, engagement in HIV care postrelease is often fragmented. Identifying ways to improve the transition of care from jail to community for people with HIV (PWH) may help with engagement in HIV care postrelease. We evaluated the current HIV care transition processes of one jail in Massachusetts and identified change ideas to facilitate improving the transition of care from the jail to the community for PWH. We conducted qualitative interviews in 2018–2019 with incarcerated men with HIV (n = 17), jail staff (n = 7), and community providers (n = 6) to understand the processes of HIV care prerelease from the jail and engagement in care on release. Data from these interviews and quality improvement tools were used to identify ways to improve the release process for PWH, such as using a release planning checklist, to help ensure that a 30-day supply of HIV medication and an appointment with a community provider within 30 days of release were provided. We identified communication process inefficiencies related to knowing release dates between the HIV care team and case managers that prevented providing HIV medications on release. We worked with jail administrators to find ways to improve the prerelease planning process, which is vital to the continuity of successful HIV care. The use of quality improvement methods generated a list of testable change ideas to improve the release planning process to better align with the Centers for Disease Control and Prevention guidelines, which has implications for PWH and public health.

Surveillance by oral fluid of drugs subject to misuse among individuals under arrest

ABSTRACT Background: Between 1988 and 2013 the U.S. government conducted surveillance of national drug misuse use trends by collecting voluntary urine specimens from individuals under arrest in major counties. It was discontinued for financial reasons. The program was the only national survey that used a bioassay to measure drug use. Other national drug surveys continue to be based entirely on self-reports of drug use. Objective: Given the current opioid and incipient methamphetamine epidemics, this study aimed to demonstrate the feasibility of surveilling drugs subject to misuse among individuals under arrest using oral fluid collected anonymously by jail staff in one U.S. county. This method has never been previously employed with an offender population. Methods: The subjects were adults arrested for any reason and booked in one Midwest county jail in the U.S. between July 2019 – January 2020 (N = 196; 145 males). Oral fluid specimens were provided for research purposes voluntarily and anonymously. Results: 79% of individuals approached consented to participation. The most frequently detected drugs were cannabis (53%), methamphetamine (27%), cocaine (9%) and opioids (11%). Further, 74% tested positive for at least one drug; 36% tested positive for at least one illegal drug, 10% tested positive for at least one possibly illegal drug, and 54% tested positive for at least one legal drug (predominantly cannabis). (Tests for nicotine and ethanol were not included.) Conclusion: The feasibility of collecting oral fluid from individuals under arrest in a jail setting to measure the prevalence of drugs subject to misuse was demonstrated.

Mental Health Identification Practices of Jails: The Unmet Needs of the "Silent" Population: Special Issue: Criminal Justice and Community Psychology: Our Values and Our Work.

The overrepresentation of individuals with mental illness in the criminal/legal system is well documented. While professional associations urge diversion towards treatment, little is known about the practices these institutions use to identify this population. One understudied space in the criminal/legal continuum is jails. This exploratory study compares two types of mental health identification at jail booking to assess jail- and community-based service outcomes by identification type (N=2956): (a) staff observation and (b) a standardized screening instrument. Individuals identified through staff observation were significantly more likely to receive jail- and community-based services, even though current symptomology and substance misuse were both significantly higher for individuals identified only by the screening instrument. These findings point to the importance of jails in providing stabilizing services during incarceration, but further, show the impact that identification practices have on individuals as they transition to the community. Community context showed varied rates of jail staff observations of mental illness, showing greater risks for individuals in rural communities. Implications include a need for system-level changes by instituting evidence-based identification practices in jails, and improving professional collaboration practices between mental health and criminal/legal practitioners as individuals enter and exit jails.

Factors associated with psychotic symptoms among a sample of male prisoners with substance use disorder: A cross-sectional study

BackgroundPrisoners have a higher prevalence of substance use disorder (SUD) than the nonincarcerated population. Many studies report that an SUD increases the likelihood of psychotic symptoms/disorders. Inmates, therefore, may be at higher risk for psychotic disorders. ObjectiveThe main objectives of this study were to (1) estimate the prevalence of psychotic symptoms in a sample of male inmates with high levels of SUD and (2) verify if type of abuse or other sociodemographic/clinical features are risk factors of psychotic symptoms. In light of the high prevalence of childhood trauma (CT) among inmates, a further objective was to 3) assess whether exposition to CT can predict psychotic symptoms. MethodWe included three hundred and nineteen male prisoners, admitted to Monza prison between January 2017 and March 2019. We interviewed participants to collect sociodemographic and clinical information. We administered the Brief Psychiatric Rating Scale (BPRS) and the Drug Abuse Screening Test (DAST) to assess the presence of psychotic symptoms and SUD, respectively. Inmates also completed the Childhood Trauma Questionnaire (CTQ). ResultsData were available for 141 inmates. Forty-five prisoners (31.9%) had psychotic symptoms. Multivariate logistic regression analysis showed that a history of previous incarceration (aOR = 2.98, p = 0.034), opioid abuse (aOR = 5.02, p = 0.008), suicide attempts (aOR = 5.55, p < 0.001), and childhood emotional abuse (aOR = 4.11, p = 0.027) significantly increased the likelihood of psychotic symptoms. ConclusionsPsychotic symptoms are widespread among inmates and are associated with specific risk factors. Prison and jail staff should screen for these factors at the start of an inmate's detention to identify subjects at risk of psychotic symptoms.

Identification, Referral, and Services for Individuals With Serious Mental Illness Across Multiple Jails.

Identification of serious mental illness (SMI) among those entering jail is the first step in diversion or appropriate services in jail. Although best practices guidelines for identifying SMI exist, many jails do not employ these standards. Researchers describe identification of SMI in the "practice as usual" and compare/contrast the results with a validated screening instrument for 2,961 individuals across eight jails. Overall, 20% scored positive on the screening instrument, and staff identification yielded an additional 16%. While the instrument was consistent in identifying the proportion of persons with SMI across each county (16% to 22%), the proportion identified by jail staff varied greatly (3% to 33%). Moreover, referral to-and receipt of-subsequent services for the staff-identified individuals varied greatly, leading to recommendations for improved processes.

Expert stakeholders’ perspectives on a Data-to-Care strategy for improving care among HIV-positive individuals incarcerated in jails

ABSTRACT Data-to-Care (D2C) uses surveillance data (e.g., laboratory, Medicaid billing) to identify out-of-care HIV-positive persons to re-link them to care. Most US states are implementing D2C, yet few studies have explored stakeholders’ perspectives on D2C, and none have addressed these perspectives in the context of D2C in jail. This article reports findings from qualitative, semi-structured interviews conducted with expert stakeholders regarding their perspectives on the ethical challenges of utilizing D2C to understand and improve continuity of care among individuals incarcerated in jails. Participants included 47 professionals with expertise in ethics and privacy, public health and HIV care, the criminal justice system, and community advocacy. While participants expressed a great deal of support for extending D2C to jails, they also identified many possible risks. Stakeholders discussed many issues specific to D2C in jails, such as heightened stigma in the jail setting, the need for training of jail staff and additional non-medical community-based resources, and the high priority of this vulnerable population. Many experts suggested that the actual likelihood of benefits and harms would depend on contextual details. Implementation of D2C in jails may require novel strategies to minimize risk of disclosing out-of-care patients’ HIV status.

Screening for Opioid Use Disorder in the Largest Jail in Arkansas: A Brief Report.

Individuals who have experienced incarceration have an increased risk of both fatal and nonfatal overdose. Given the increases in illicit opioid use in Arkansas and across the South, many individuals with opioid use disorder (OUD) are likely to encounter the criminal justice system, particularly county jails. However, there are currently no published data on OUD among entrants into county jails in the South. This study presents data from an OUD screening project initiated by the Pulaski County Regional Detention Facility, the largest county jail in the state of Arkansas. As part of the regular intake process, a jail staff person administered the Rapid Opioid Dependence Screen. De-identified data were provided to researchers at the University of Arkansas for Medical Sciences. The data clearly show an increased prevalence of OUD, justifying the need for evidence-based substance use programs such as MAT in jail settings in the South.

Expanding low-threshold buprenorphine to justice-involved individuals through mobile treatment: Addressing a critical care gap

BackgroundOpioid use disorder (OUD) is highly prevalent among justice-involved individuals. While risk for overdose and other adverse consequences of opioid use are heightened among this population, most justice-involved individuals and other high-risk groups experience multiple barriers to engagement in opioid agonist treatment. MethodsThis paper describes the development of Project Connections at Re-Entry (PCARE), a low-threshold buprenorphine treatment program that engages vulnerable patients in care through a mobile van parked directly outside the Baltimore City Jail. Patients are referred by jail staff or can walk in from the street. The clinical team includes an experienced primary care physician who prescribes buprenorphine, a nurse, and a peer recovery coach. The team initiates treatment for those with OUD and refers those with other needs to appropriate providers. Once stabilized, patients are transitioned to longer-term treatment programs or primary care for buprenorphine maintenance. This paper describes the process of developing this program, patient characteristics and initial outcomes for the first year of the program, and implications for public health practice. ResultsFrom November 15, 2017 through November 30, 2018, 220 people inquired about treatment services and completed an intake interview, and 190 began treatment with a buprenorphine/naloxone prescription. Those who initiated buprenorphine were primarily male (80.1%), African American (85.1%), had a mean age of 44.1 (SD = 12.2), and a mean of 24.0 (SD = 13.6) years of opioid use. The majority of patients (94.4%) had previous criminal justice involvement, were unemployed (72.9%) and were unstably housed (70.8%). Over a third (32.1%) of patients had previously overdosed. Of those who began treatment, 67.9% returned for a second visit or more, and 31.6% percent were still involved in treatment after 30 days. Of those who initiated care, 20.5% have been transferred to continue buprenorphine treatment at a partnering site. ConclusionsThe PCARE program illustrates the potential for low-threshold buprenorphine treatment to engage populations who are justice-involved and largely disconnected from care. While more work is needed to improve treatment retention among vulnerable patients and engaging persons in care directly after release from detention, offering on-demand, flexible and de-stigmatizing treatment may serve as a first point to connect high-risk populations with the healthcare system and interventions that reduce risk for overdose and related harms.

Exploring How Workplace Factors Are Associated With Role Strain Among Jail Staff: A Replication and Expansion Study

Role strain has many negative outcomes. While the majority of role strain research has focused on its effects, this study explored possible antecedents of role strain among staff at a large, urban Southern jail in the United States. Based on regression analysis of survey data, instrumental communication, views that policy is followed, input into decision-making, formalization, and supervisory support each had significant negative effects on role strain. Administrative support and positive relations with coworkers, however, had nonsignificant effects. Jail administrators should attempt to reduce role strain by creating clear structure of job duties and expectations (formalization), providing staff with a greater organizational voice (input into decision-making), explaining the importance of organizational policies being followed and how they benefit staff, improving the flow of critical information about job and organizational matters (instrumental communication), and training supervisors about how to provide support to their subordinates and reward them for doing so (supervisory support).

Exploring Healthcare Experiences for Incarcerated Individuals Who Identify as Transgender in a Southern Jail.

Purpose: To document the health-related experiences and needs of jail detainees who self-identified as transgender women.Methods: Semistructured interviews with 10 transgender women of color were conducted in a county jail in a mid-sized southern city between 2015 and 2016. Interviews were recorded and transcribed, and later analyzed using a general inductive approach.Results: Participants experienced high levels of abuse and harassment, solitary confinement, mental health issues, and lack of access to hormone treatment. Participants described discrimination (both by other inmates—particularly while in special housing units—and correctional officers); harsh correctional conditions, which exacerbated mental health issues; and a marked lack of access to healthcare, including hormone treatments.Conclusion: Policy changes are needed to address housing and placement issues, and to increase access to healthcare for transgender women jail detainees. Training is needed for jail staff and medical care professionals in correctional settings to better understand the unique needs and experiences of transgender people.

On the Death of Sandra Bland: A Case of Anger and Indifference

Trooper Brian Encinia conducted a traffic stop on Ms. Sandra Bland in Prairie View, Texas, on July 10, 2015. Ms. Bland was not cooperative. She swung her fist at him. Trooper Encinia verbally escalated the situation. He arrested her. She struggled with him outside of her vehicle. She was taken into custody and charged with a felony. She was taken to the Waller County Jail. The jail staff ignored both her history of depression and numerous cut marks on her arm. The jail staff did not place her on suicide watch. She could not raise her bail. Ms. Bland rolled a plastic trash can liner into a noose and hung herself in the cell. She was pronounced dead on July 13, 2015. Larger issues concerning de-escalation in police–citizen encounters and jail suicide are also examined.

The Effects of the Workplace on Jail Staff: The Issue of Perceptions of Pay Fairness

ABSTRACTDrawing from person–environment fit theory, the current study adds to recent empirical inquires that have considered how workplace factors affect jail staff. In doing so, the focus is on how perceptions of pay fairness effect the job stress, job involvement, and organizational commitment of jail personnel. Utilizing survey data from a large county correctional system in Orlando, Florida, the results of multivariate analyses reveal that staff that hold more favorable perceptions of pay fairness are more involved in their jobs and more committed to the overall organization. The implications of these findings for correctional research and practice are considered.

Continuum of Care for Inmates Taking Psychiatric Medications While Incarcerated in Minnesota County Jails.

Mental illness is more prevalent among adult inmates in Minnesota county jails than nationally. All 78 Minnesota county jails were surveyed about their continuum-of-care procedures to help ensure that inmates who have mental illness continue to receive psychiatric medications after release. Of the 28 county jails responding to the survey (36%), most estimated that greater than 40% of their inmates receive medication for mental illness during incarceration. But while 89% of respondents reported that inmates are frequently taking medication(s) to treat mental illness at release, prerelease planning for these inmates was rarely undertaken. Few Minnesota jails reported having continuum-of-care procedures in place for inmates who have mental illness when these inmates are released back into the community. Jail staff desire greater collaboration between jails, human services agencies, and community mental health providers to help support discharge planning and enhance the continuum of care for inmates who have mental illness.

Inmate Perceptions: The Impact of a Prison Animal Training Program

Objective: The purpose of this qualitative study was to explore the perceptions of jail inmates participating in the Paws and Stripes College program. The Paws and Stripes College program involves incarcerated inmates training local humane shelter canines’ obedience training techniques using the canine good citizen model as well as teaching the canines skills in which to participate as comfort/emotional support dogs. Using secondary data from self-report questionnaires completed by the inmates, this study sought to explore how the inmates felt before and after their exposure to the Paws and Stripes College program. Specifically, if the inmates felt that participation in the program was beneficial to them or not, and if so, how. Methods: The jail staff administered and collected the questionnaires via a self-report instrument completed by the inmates Each inmate in the Paws and Stripes College program were asked to complete a self-report questionnaire reflecting on the time they are serving in the jail and time they have participated in the Paws and Stripes College program regarding how they felt before joining the Paws and Stripes College program, how they feel being a part of the Paws and Stripes College program, and how if they believed they program made an impact on the dogs and the community and if so, how. Each self-reported questionnaire was collected, transcribed, and analyzed for common themes. Results: All participants experienced positive reactions while participating in the Paws and Stripes College program, feeling the program equipped them with perceived increased employment skills and communication skills. The Paws and Stripes College program improved their emotional state by offering them more self-confidence, patience and increased animal training skills. The inmates indicated the animal training they had learned helped them better address both the canine’s they were working with and their own emotions and conflicts, increased coping strategies for everyday situations, and improved their outlook during their incarceration, and each believed the training would help them with employment and their personal lives after their release. Inmates felt they had taken from society and by participating in the Paws and Stripes program they were able to give back to society. Conclusion: The Paws and Stripes College program has a positive impact on inmate increased knowledge and skills in animal training leading them to better communication, conflict resolution, and interpersonal behaviors which are believed to enhance future employability, self-confidence and self-esteem. Additionally, the inmates were impressed with the enhanced adoptability of the shelter canines that completed the training, and their service to the community. Correctional facilities may want to consider recommending an inmate and canine training program as a viable intervention for improving inmates’ behavior and emotional states during incarceration and improve chances for inmates’ successful functioning by assisting with finding meaningful employment once they are released. In addition, the homeless canines benefit by the Paws and Stripes College program by not being euthanized, finding valued homes to care for them, and the ability to provide useful service to both families and those with special needs.

Differences in the Predictors of Job Stress and Job Satisfaction for Black and White Jail Staff

ABSTRACTThe importation model holds that certain personal characteristics, such as race, may shape employees’ views and may also influence how workplace factors affect them. Most correctional staff job stress and job satisfaction studies treat race/ethnicity as a dichotomous variable (i.e., White/Non-White) to be controlled for in multivariate analysis but have not explored if the effects of variables differ by racial groups. Thus, the effects of workplace variables may differ between Black and White correctional staff. Using survey data from staff at a large southern jail system, this study examined how personal characteristics (i.e., age, gender, educational level, and position) and workplace factors (i.e., role strain, perceived dangerousness of the job, instrument communication, input into decision making, and administrative support) predicted job stress and job satisfaction between Black and White staff. Results indicate that there were no significant differences in the effects between the two groups for job stress. For job satisfaction, however, there was a difference, with gender, position, and perceived dangerousness of the job having larger effects on White staff, and role strain, input into decision making, and administrative support having larger effects on Black staff.